Responding To Relman: ‘Spaulding Gave Charlie His Recovery’

Yesterday we linked to Dr. Arnold Relman’s gripping near-death story of breaking his neck last summer, and the medical odyssey that followed. In it, Relman, the former editor of The New England Journal of Medicine, lavished superlatively high praise on Massachusetts General Hospital, where he was initially treated, but was much more critical of Spaulding Rehabilitation Hospital in Cambridge, where he spent about a month recovering.

That critique left some Spaulding patients (and their families) feeling perplexed and a bit slighted. Jeanette Atkinson, the wife of former Spaulding patient Charlie Atkinson, asked for space to offer another perspective.

Charlie Atkinson, 78, at home, is still recovering from West Nile Virus. (Courtesy)

Charlie Atkinson, 78, at home, is still recovering from West Nile Virus. (Courtesy)

Charlie was the subject of a recent CommonHealth post: West Nile Story: 400 Days In Hospital, A New View Of Health Care (And Life)

Jeanette submitted this “rebuttal” after reading Relman’s piece:

My husband, Charlie Atkinson, and I are in a particularly good position to respond to Dr. Arnold Relman’s article, “On Breaking One’s Neck,” since Charlie recently spent five weeks at Massachusetts General Hospital and thirteen months at Spaulding Long Term Acute Care Hospital in Cambridge and received spectacular care at both.

MGH saved his life. As Charlie (age 76 at the time) fell into a deep coma in August, 2012, doctors there inserted a breathing tube, started a ventilator, administered oxygen and drugs, inserted catheters, ordered tests, and worked around the clock to diagnosis his illness – which turned out to be West Nile virus of the most devastating kind.

After three weeks in Mass General’s intensive care unit and two in the respiratory acute care unit, he was stable enough to be discharged – but to where? He was tethered to respiratory machinery; he was almost completely paralyzed; he knew his name, but not where he was; and he would never have been able to maintain the rigorous physical therapy schedule at a place such as Spaulding Rehabilitation in Boston. He was still far too sick to be admitted to a regular nursing home/rehabilitation facility.

Spaulding Hospital, Cambridge, gave him his recovery. We’d never even known of the existence of “LTAC’s,” or Long Term Acute Care hospitals. Their range of services is much more limited (and far less expensive) than those of full service hospitals such as MGH, and much more focused on helping patients achieve a maximum quality of life while treating their on-going medical problems. Spaulding, Cambridge does that superbly.

During his thirteen-month stay on the third floor, Charlie stopped breathing twice, and emergency interventions saved his life. He was seen daily by the doctor who had oversight of his case, by a pulmonologist, and by consulting specialists, including an excellent neurologist. All were willing to talk at length, to explain their thinking and recommendations. The pulmonologist stepped in at a critical juncture, mid-way though Charlie’s stay, to advocate for his remaining at Spaulding when his lack of progress with physical therapy seemed to indicate discharge to a nursing home.

The physical and occupational therapies Charlie received at Spaulding, Cambridge were superb. Thanks to an observant junior physical therapist who saw the small advances Charlie was making, he was given the opportunity to work with the top physical therapist at the hospital.

Thanks to a caring (and no-nonsense) nursing assistant, Charlie was not allowed to give up on this rigorous “boot camp.” After eight months at Spaulding, Charlie stood up for the first time since he became ill. After nine months, he took his first steps with the aid of three therapists and a set of parallel bars. All the nurses, therapists and aides in the gym at the time applauded this amazing achievement and many confided that they had tears in their eyes at his courage and progress.

Yes, Charlie had a bedsore (which originally formed at MGH), and yes, it was very difficult to clear up – but it was carefully tended to by the nursing assistant and eventually disappeared.

Charlie has been home now for three months. His progress continues. He is walking easily with a walker and will soon graduate to a cane. He went off the night-time home ventilator a month ago and will finally have his tracheostomy tube removed in a few days.

Without Mass General, Charlie would have died. Without Spaulding, Cambridge, Charlie would not have his life back.

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