Turning back the clock to meet a patient

HEART BEAT: When a young girl’s next appointment was her wedding day

HEART BEAT:When a young girl's next appointment was her wedding day

OUT OF the blue, Mr and Mrs David Doyle of Enniscorthy invited the HA and I to the wedding of their daughter Jeanne to Mr Aidan Kinane.

A long time ago I operated upon Jeanne in Our Lady’s Hospital for Sick Children in Crumlin. Following surgery and initial follow-up, I told her mother and grandmother that I would not need to see her again until her wedding day. Jeanne, who is now a teacher in Rockwell College, told me she was marrying a fine Tipperary man.

I want you Jeanne and your family to know that your invitation was very special to me and is deeply appreciated. I wish you and Aidan every happiness, in every way. To digress slightly I wish your charges in Rockwell and the college itself success in the future. I appreciate that you might have other things on your mind.

READ MORE

Jeanne was referred to me for surgery by Prof Conor Ward who held the chair of paediatrics at UCD and was a cardiologist of note on the world stage. Conor described, in the Journal of the Irish Medical Associationin 1964, a hitherto unobserved familial cardiac rhythm disorder in children. The following year, a Dr C Romano independently noted the same arrhythmia and published his findings in the Lancet. The complex is known as the Ward-Romano syndrome and is one of the causes of sudden death in childhood and adolescence. Now when noted, it can be treated. Conor was largely responsible for my appointment in Crumlin and became a great colleague and friend.

At the beginning of the unit in Crumlin, great strides were being made in this facet of heart surgery. This was largely due to a greater understanding of the anatomy of congenital heart disease, much of this facilitated by the retention and study of postmortem hearts. This showed the complexities of anatomical variation and was absolutely necessary to allow the surgeons devise operations to remedy them. This led to problems down the line, not foreseen in those pioneering days. The operations were only one aspect of the treatment. The anaesthesiology and the intensive care had to be of very high standard and they progressed very rapidly with skilled and enthusiastic staff to a stage where today they are second to none.

It is deeply distressing to hear of theatre and intensive care closures and staff shortages in this wonderful unit delivering world-class treatment. It is but another example of the havoc wreaked in our health service by this woeful regime. Let nobody tell me that our health service is improving.

In the earliest days when Conor and I and Dr Brian Denham provided the service, we needed to develop the nursing intensive care team. Sr Augustine (Gussie) from Crumlin and Conor’s wife Pauline uprooted themselves from Dublin to undertake the paediatric intensive care course in London’s Great Ormond Street Children’s Hospital. Thousands of children benefited from that little seed and more will benefit still if the little patients who need help are not blighted by the little people who exercise power without understanding or compassion.

On retirement Conor and Pauline went to live in London where some of their family were working. Conor immediately became involved in major voluntary work for children with Down syndrome. He is that kind of man and my life has been immeasurably richer for knowing himself and Pauline.

There is a bit of “white horse syndrome” about meeting former patients. They all remember you because their cardiac surgery was such a major event in their lives. For you it was your day’s work. You knew some through other fields and some you remembered vividly because they had helped your hair turn grey. Large numbers became involved in support groups and fundraising to ensure better facilities for those needing surgery in the future.

On another occasion, in a shop in the west the local fisheries inspector said: “Look after the surgeon Jim, he saved my son’s life.” “Well and if he did,” says your man, “my brother wasn’t so lucky.”

Well you can’t and didn’t win them all. You could only do your best. However, trying to function without adequate facilities poses ethical and moral questions that are unanswerable.