Chapter-4
MacGyver
Gwen ended the call and tried to control her immediate dislike for the Ambassador.
Teplitz knows who I am, where I’m staying, and how to contact me.
She was instrumental in arranging my trip after her call to the Secretary Of State who made a personal call to Tom Mihaljevic, MD, the President and CEO of the Cleveland Clinic. Tom asked me to do this, that our diplomatic standing with Sri Lanka was at stake and it would be a personal favor to the US Secretary.
The Structural Heart Valve Team in Cleveland had a worldwide reputation for excellence. They are ranked #1 in cardiology by US NEWS and WORLD REPORT’ and are generally considered the place to be with a serious heart condition. Patients from around the world travel to Cleveland when faced with life-threatening heart disease.
We insist that patients come to Cleveland where we have state-of-the-art facilities, the latest technology, and, arguably, the best specialists in the world practicing cardiac surgery.
Receiving an urgent request for one of our surgeons to travel to the patient is highly unusual, I suspected politics but said nothing. Tom Mihaljevic is a respected administrator, a fine Doctor, and a colleague of long-standing, I couldn’t turn him down in spite of my apprehension.
Teplitz is in the political loop, she should have called me as soon as she knew something.
The PM was in the ICU of NHSL, the National Hospital Of Sri Lanka. I had done Google research on the NHSL and decided that while it was not the Cleveland Clinic it did have a respectable history since its founding in 1864.
“The National Hospital of Sri Lanka is a government hospital in Colombo, Sri Lanka. Founded in 1864 as the General Hospital, it is the leading hospital in Sri Lanka and is controlled by the central government. The hospital has 18 intensive care units and 21 operating theaters and 3,404 beds.”
I held my breath when we arrived, working in a government-run hospital was not compatible with my experience. Would there be layers of bureaucracy to contend with, would the attending physician be tethered to a committee before decisions are made?
I sucked it up and walked through those pneumatic double doors with all the confidence I could muster, I represented, after all, the finest cardiac hospital in the world, and the NHSL staff would be expecting a medical celebrity. I need to look the part and take control of my patient’s prognosis.
The PM had been moved from the ICU to the VIP Suite on the top floor, it was reached by a private elevator controlled by an armed security guard. It was spacious, with a view of the Indian Ocean behind heavy bullet-proof glass.
The suite consisted of 4 rooms, a bedroom with ICU equipment, a fully equipped office, a conference room, and a small galley kitchen. There was a nurses station staffed 24 hrs a day, a small anti room for Maxine Wang, and 2 restrooms, one private one public.
He was resting under an oxygen tent when I entered, my first impression was positive, the PM is resting calmly, his vitals are beeping quietly, and normally on the computer screen, resting PR 71 bpm, BP 123/76, EKG graph steady. The nurse standing next to me is a professional, her demeanor is calm and focused, if not a bit intimidated. I’m assuming she’s been briefed on the Cleveland Clinic and Gwendolyn MacGyver.
My tone is quiet and direct, “when did he arrive at the hospital, what tests had been performed, has his condition changed since he was admitted?” She handed me his chart, well-drafted, and succinct, with results of several tests reconfirming the diagnosis, severe aortic stenosis, an enlarged abominable aortic aneurysm, two small thoracic blockages, and a seriously damaged aortic valve. This man needed surgery, now.
Cleveland would evaluate this patient for two options:
Open heart surgery to fix the valve and the aneurysm and the blockages.
Or, two minimally invasive procedures, Cardiovascular Surgery to stint the Aortic Aneurysm and a TAVR (Transcatheter Aortic Valve Replacement) procedure to replace the diseased aortic valve. Both of these procedures require small incisions in the groin allowing a catheter to be threaded along the aortic artery to the affected areas. Once the catheter is in place, a wire would be inserted and threaded to the diseased location for correction.
This hospital isn’t equipped to manage these procedures, particularly the TAVR. This technique was developed 10 years ago in the US and has grown in popularity for patients diagnosed as unsuitable for the rigors of open-heart surgery, especially the extended anesthesia associated with stopping your heart and putting you on a heart-lung machine for an extended time.
I heard the cough behind my left shoulder, the nurse and I turned at the same time.
She was a tall, attractive, Asian woman probably in her early 30’s.
She interrupted my train of thought.
“ Doctor MacGyver I presume”
Her tone was clipped, more a statement, than a question.
My response is colloquial, “yes I am, I’m sorry, I didn’t get your name?”
I don’t know this woman or what she’s doing in the VIP Suite of the National Hospital while I’m getting ready to perform open-heart surgery on the Prime Minister of Sri Lanka.
The nurse quietly stepped aside, moving back to her station. Leaving two formidable women facing each other, unsure of their respective roles in this one-act play.
She responds with the self-confidence of a corporate CEO
“I’m Maxine Wang, the PM’s executive assistant and responsible for his care while he’s incapacitated. Decisions about his treatment must be approved by me before anything is done.”
I responded in kind,
“I’m Doctor Gwendolyn MacGyiver, Ph.D., MD based at the Cleveland Clinic in Cleveland, Ohio USA. Your Sri Lanka Ambassador to The US, our US Secretary of State, and our Ambassador To Sri Lanka have collectively made the decision to bring me here to treat your Prime Minister, that is what I will do to the best of my ability and the support of the NHSL. I’ll need the full cooperation of hospital staff and any other authority responsible for his survival. If you want the PM to leave here alive, we’ll need to avoid bureaucratic red-tape, which includes his Executive Assistant. I will make medical decisions as required. and won’t be checking with anyone, least of all an office assistant with no medical training. “
She’s stuttering, trying to interrupt, I brush past her to the conference room and close the door with finality.
Ms. Wang may be the PM’s Executive Assistant, but Dr. MacGyver is his lifesaver.
Chapter-5
Lipton