February 23, 2008

Positivity: Saving Monica

Filed under: Positivity — Tom @ 7:01 am

I saved this for the weekend, because it’s a two-parter (Part 2 at BizzyBlog, which is, like Part 1 below, is a small excerpt, will be here on Sunday morning), and each part is long — but worth every word.

Oh, and a warning — The story carries a triple-hankie alert, and if there isn’t a Pulitzer in this for Doug Most, there ought to be an investigation.

_____________________________________________

From various places in Greater Boston:

Saving Monica
February 10, 2008

She had just given birth and was full of joy. Then a deadly bacteria began ravaging her body, triggering a frantic race to keep her alive. But at what cost?

IT’S STILL DARK OUTSIDE as Monica Sprague and her fiance, Tony Jorge, drag themselves out of bed. It’s a muggy morning in August 2007. Their first-floor apartment in the yellow two-family with low ceilings and plush beige carpeting is quiet – Monica’s 9-year-old daughter from her first marriage is staying overnight with Tony’s mother. Monica and Tony are out the door by 5:30, driving down their narrow one-way street in Ayer, a rural town 35 miles northwest of Boston.

The journey for both of them to get to this day has been a bumpy one. Previous marriages failed. Families splintered. Cancer took all but one of their parents. Tony, short and stocky with a handsome, boyish face, jet-black hair, soothing voice, and a Bluetooth headset perpetually stuck in his ear, was born in Portugal, came to the States with his parents when he was 5, and grew up in Hudson. Monica, with shoulder-length brown hair and a bright, toothy smile that could light up a small town, was raised 10 miles away in Ashland, the youngest of six kids. Staying close to home, they got to know some of the same people, and first crossed each other’s paths at a Fourth of July party. Now, a little more than three years later, they are walking together through the front glass doors of Emerson Hospital in Concord to begin their next chapter together.

She’s 35. He’s 40. They’re not expecting any complications for her scheduled C-section, but Monica did have gestational diabetes during her first pregnancy and again for this one. That’s why, as a precaution, they had talked about what they should do if something went wrong.

“Save the baby,” Monica said.

“We can make another baby,” Tony answered. “We can’t make another you.”

Just after 6 a.m. on Thursday, August 9, Monica is admitted. She slips into her gown while Tony gets into scrubs. This will be her second delivery, but his first, and he doesn’t want to miss a thing. He’s so nervous that after getting himself changed and sterile, he steps outside for a cigarette, a sin that gets him yelled at by a nurse, who orders him into new scrubs and to wash up again.

By the time he’s ready, the doctors have started. They call him into the operating room, and he goes straight to the head of the bed. From behind his blue surgical mask, he sneaks a peek around the curtain just in time to watch his daughter be pulled out and unleash her first cry. The doctor hands the baby to a nurse, who gives her to a beaming Tony, who gives her to Monica, a final handoff that a nurse captures on Tony’s digital camera. Brown-haired, blue-eyed, 6-pound-14-ounce Sofia Maria is then taken for a few routine tests while surgeons stitch up Monica’s abdomen and Tony leaves to pick up Monica’s older daughter, Madalyn, and bring her back to the hospital. By noon, the whole family is together for the first time.

When Monica gets a fever later in the day, she passes it off as hormones, and nobody’s alarmed, least of all Tony, who goes home to rest. But the next two days her fever lingers, and she’s not having a bowel movement. Prune juice, suppositories, teas, nothing works. On Sunday morning, Emerson doctors, still puzzled, move her into the intensive care unit. She’s feeling bloated and experiencing sharp jabs in her abdomen, almost as if she’s giving birth again. She’s also wearing a mask to avoid passing on whatever she might have to her baby. With her pain still not subsiding, Monica finally calls Tony at home, crying in agony. He rushes to the hospital.

As soon as he arrives, doctors tell him they need to get her to Boston. They’ve run some cultures that show she has a strain of streptococcus, and while they don’t know how bad it is, it’s obvious she’s deteriorating rapidly. They have already called Massachusetts General Hospital and reached the senior surgical resident, Claudius Conrad. They mentioned the positive strep test and that she’s unstable; they’re fairly certain about what’s wrong with Monica and just want to get her emergency care immediately. The Emerson doctors ask him if they should put her in a helicopter for a five-minute ride or an ambulance for a 45-minute drive. Conrad doesn’t hesitate. He senses that the window of time to save her is closing. Fast.

Just before noon, Monica is rushed into the helicopter while Tony jumps into his car and races down Route 2 to Interstate 95 at close to 90 miles per hour. Getting on the Mass. Pike, he pays the toll with quarters, but when he comes to the Allston-Brighton exit, he just throws whatever change he has at the booth operator. “I have to get to the hospital!” he yells before speeding off.

He’s still driving when the MedFlight copter lands on the MGH helipad. It’s 12:12 p.m. when Monica is wheeled into the emergency room, where she’s pounced on by a team of residents, who poke and prod her body, searching for the source of her pain. They insert a catheter to pump some fluids into her, and they notice that her belly is as hard as a board, a strong sign of inflammation or infection. The on-call surgeon in the operating room hustles down and finds Monica hysterical and struggling to breathe. Her heart is racing at 160 beats per minute and her blood pressure is dangerously low at 70/30 – and dropping.

Tony arrives just before 1 p.m. and finds Conrad, who, in polite yet blunt language, tells him that Monica is in bad shape, that her body is going into septic shock, and that she has some kind of an infection and has to go to the operating room immediately.

“She has a high chance of dying,” Conrad tells Tony, “but we’ll do everything possible.”

Tony blurts back the only thing that comes into his head. “We just had a baby. She has a 9-year-old daughter. Do what you can.” …..

Go here for the rest of Part 1.

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