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College of Medicine Alumni Magazine - Winter 2022 When the Doctor Becomes the Patient

Sooner or later, all of us require medical treatment, and physicians are no exception. These three accomplished alumni faced extraordinary circumstances and beat the odds through their courage, savvy and determination to heal.

By Elisa Ludwig

SAVED BY INGENUITY

Three years ago, then-80-year-old Robert Ersek, MD, HU ’66, boarded a plane with his girlfriend, anticipating several days of vacation ahead. As they lugged their carry-ons up the aisle, Ersek suddenly collapsed. A woman who was a nurse emerged from the crowd and immediately started performing CPR on Ersek, who had turned blue. An aide arrived to administer a defibrillator. On the second zap, Ersek started to regain color. An ambulance whisked him to a nearby hospital where he was admitted to the cardiac unit.

“They ran some blood tests and did a cardiac catheterization,” he says. “They saw that I had an 80 percent blockage of my anterior descendant cardiac artery.”

The doctor gave Ersek a stent. Had Ersek been conscious, he would have told the medical team that he himself had invented and patented the first intravascular stent during his residency at University of Minnesota in 1968.

But Ersek was not conscious — he was intubated and closely monitored for three days while his family discussed his uncertain outlook and their next steps. Years earlier, following the death of his wife, Ersek had amended his living will to include a DNR order.

“Back then, I said, ‘I’ve had a wonderful life with 52 years of marriage, six grandchildren and travel all over the world, as well as many wonderful successes. I don’t want to spend my last days hooked up to a bunch of machines. If I’m not going to get to 90 percent recovery, just let me go.”

You could even say I saved my own life — 50 years earlier.
Robert Ersek, MD, HU ’66

Luckily, a cardiac enzyme study came back showing no damage to the heart whatsoever. When Ersek regained consciousness, he was sent home. He completed a month of cardiac rehabilitation and was given a compos mentis test to see if he had lost cognitive function during the incident.

“After giving me the third part of the test, the woman said, ‘You’re just fine, a highly functioning 80-year-old. So I have had a complete recovery. You could even say I saved my own life — 50 years earlier.”

In total, Ersek accrued 34 patents over the course of his career. And though he initially planned to become a cardiac surgeon, he changed tracks after serving as an Air Force general surgeon at Dover Base, and went on to become a highly successful plastic surgeon who also founded nine companies. He continues to see patients today.

Months after his heart attack, Ersek got his vacation, a trip to the Austrian Alps where he donned his skis and went down one of the toughest slopes. He has since changed his DNR order.

HEALING THROUGH GRATITUDE

In November 2020, 53-year-old pulmonologist Sean Devine, MD, MCPHU ’98, contracted COVID-19. Just a few months later, the vaccine would be made available to health care workers, but with no antibody protection, Devine was vulnerable to the novel virus that had impacted so many of his patients. After four or five days of low-grade illness, he woke on the morning of November 13 short of breath and unable to think clearly.

“I noticed that my skin was somewhat blue and when I checked them, my oxygen saturation levels were in the 70s,” Devine says. “I called my wife, who had left for work, and said, ‘You need to take me to the hospital.’” Devine understood the seriousness of his condition and made sure his affairs were in order when he left the house. He barely made it to the emergency room, where aides helped him into a bed.

Two days later, Devine was placed on a ventilator and subsequently treated with extracorporeal membrane oxygenation, but his condition didn’t improve. Unbeknownst to him at the time, his oldest daughter had also contracted COVID-19 and was hospitalized three floors below. She made a full recovery and was sent home, but Devine continued to decline. After three weeks in the hospital, Devine’s family was told that the staff would make comfort measures. Unwilling to accept this outcome, Devine’s wife frantically began making inquiries about lung transplants, a then-emerging treatment for COVID-related lung disease. In fact, until summer of 2020, double lung transplants were not an option for COVID-19 patients.

University of Florida was one of the few places in the country offering the experimental treatment, and specialists there agreed to see Devine.

“Two weeks before I got sick, I had said to my daughters that I wanted us to go to Florida during the winter for a week. Well, it wasn’t a week — it was six months, and I got a private plane, too. Of course, I don’t remember it!”

On December 14, Devine was flown to Gainesville. Paralyzed from deconditioning, he communicated through tongue movements, which demonstrated that he was neurologically intact — an important indication for the surgery. Ten days later, physical and occupational therapists started working with Devine to improve his ability to move. It was easy for him to comply with orders, but he says the most difficult part about being the patient was knowing what could go wrong, both during and in the weeks after surgery, and how critical it was to get the transplant as quickly as possible.

You really need someone there to make sure nothing falls through the cracks and to assimilate all the information.
Sean Devine, MD, MCPHU ’98

“After several weeks, I was able to get out of bed, with great assistance. But the transplant service would not list me for a transplant until I could demonstrate that I could walk a significant distance,” he says.

By January, Devine accomplished the task. After a few dry runs, a suitable set of lungs became available in early February. The 11-hour surgery went smoothly. More challenging, Devine says, was the rehab that followed, starting three days later. By the time he was taken off the ventilator and the tracheostomy was removed, he weighed 105 pounds, down from 145.

In April he was discharged, and he returned home to his wife and three high-school-aged daughters in Philadelphia in May. Devine continues to receive physical therapy for four hours a week. He went back to work full time in August 2021.

“It has certainly affected my lifestyle, and I have had to alter my career to an extent. I still practice medicine but my days of doing procedures are over. I have to be careful about contracting any illness, so I mostly work via telemedicine. I went into this profession to help take care of people, and I’m not going to get out of it because of the risks now. I just need to take the proper precautions.” Still, Devine remains remarkably optimistic, and his positive point of view has only been reinforced by all that he has endured. He feels more sympathy for his patients now, he says, and he has a deeper conviction about the need for patient advocacy.

“You really need someone there to make sure nothing falls through the cracks and to assimilate all the information.”

In the meantime, he has a renewed sense of purpose, in both his work life and his family life. “Six hours after my transplant, my daughter was sending me messages that she needed help with a school project, which I was very happy to do.”

A SELF-DIAGNOSIS AND CARE FROM HER OWN DEPARTMENT

In 1977, medical oncologist Mary Raab, MD, WMC ’68, and her late husband, Spencer Raab, MD, were recruited to Greenville, North Carolina, to help launch oncology services at the new East Carolina University School of Medicine.

“The two of us worked very diligently to establish oncology in Greenville. At the time, people had to travel at least 50 to 100 miles to get radiation or chemotherapy, and many did not have the resources to do so,” she says. “I was shocked at how many patients presented late in their illness. Then, because we saw how difficult it was for many patients to get here, we worked to expand outreach clinics around eastern North Carolina.”

Over the next four decades, Raab served as a full-time staff physician, teaching residents and medical students, and seeing patients in her own clinic. After Spencer’s death in 1993, she married radiologist William McConnell, MD. Together they continued to improve care for patients in North Carolina, establishing an American Cancer Society Hope Lodge in Greenville, providing lodging and support to patients and their caregivers. Then in 2002, at age 60, she discovered a lump in her own breast.

“I am a strong advocate for the breast self-exam. I had a mammogram in October, which was totally normal, and I did yearly mammograms. It’s important to get those screenings done. But they were normal. In February, I was doing my self-exam when I noticed the lump.”Raab had the mammogram redone and it still read as normal, but as a seasoned oncologist she was not content to accept the result.

“Now this was back before they did the new 3-D mammograms, and they didn’t do breast MRIs at that point. But they did do an ultrasound and they saw that it was suspicious.”

I always tried to be empathetic as a physician, but being a patient yourself teaches you to approach your own patients with greater humanity.
Mary Raab, MD, WMC ’68

Raab visited a breast surgeon in her department, who conducted a biopsy. It was inconclusive, so she opted for a lumpectomy, which finally gave her a diagnosis: invasive lobular cancer. Because it was a small tumor, she was placed on hormonal therapy and underwent six weeks of radiation treatment, continuing to work every day, as she was lucky to tolerate both well.

That she even had the option of world-class treatment in her hometown was largely due to Raab’s own work with her husband, laying the foundation for the Leo Jenkins Cancer Center.

“The area continues to be pretty rural, but it has changed significantly over the years, and we now have a tremendous hospital and radiation therapy, all the things that we did not have back in the day: a full complement of specialists, an excellent oncology surgeon.”

While she did have some cumulative side effects that include osteoporosis worsened by the hormonal treatment and heart damage from the radiation, Raab has been cancer free for 20 years. Now retired, she says that the experience taught her to relate differently to her patients in the last years of her practice.

“I always tried to be empathetic as a physician, but being a patient yourself teaches you to approach your own patients with greater humanity,” Raab says. “Having had breast cancer and having to go through the scans and uncertainty gave me a greater awareness for the emotional journey. There’s a difference between care and caring, and I wanted my patients to know they were more than just a diagnosis.”

 
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