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Daughter Born To Widow Of Slain Boston Surgeon

Mikaela Jane Davidson (Courtesy of Brigham and Women's Hospital)

Mikaela Jane Davidson (Courtesy of Brigham and Women’s Hospital)

This poignant birth announcement is just in from Brigham and Women’s Hospital:

Davidson Family Welcomes Baby Girl

Boston, MA – On behalf of Dr. Terri Halperin and the Davidson family, Brigham and Women’s Hospital announces the arrival of Mikaela Jane Davidson, born Saturday, April 4, 2015. Mother and baby are doing well.

Mikaela’s father, Dr. Michael J. Davidson, was tragically shot and killed by a patient’s son at BWH on January 20, 2015, leaving behind his beloved wife Terri, daughters Kate (10) and Liv (8) and son Graham (2). Mikaela was named after her dad and shares his initials – MJD.

Terri said, “Michael was very much looking forward to the birth of this beautiful baby girl. At a time when my children and I are completely heartbroken over the loss of Michael, we are finding joy in Mikaela’s arrival. We have been humbled and touched by the tremendous outpouring of love and support coming from family, friends, patients and all those kind-hearted souls who have been moved by Michael’s senseless death.”

Brigham and Women’s Hospital established the Davidson Family Fund to provide support for the Davidson children.

The press release notes that Dr. Halperin is not otherwise interacting with the media right now.

A woman wears a button honoring Michael Davidson at his January funeral service. (Jesse Costa/WBUR)

A woman wears a button honoring Michael Davidson at his January funeral service. (Jesse Costa/WBUR)

Related:

Worcester Telegram: Alleged Brigham Shooter Had Complained About Past Medical Bills

Flowers are left outside the Brigham in honor of the slain Dr. Michael Davidson. (Robin Lubbock/WBUR)

Flowers are left outside the Brigham in honor of the slain Dr. Michael Davidson. (Robin Lubbock/WBUR)

Stephen Pasceri, the 55-year-old Millbury man who police say shot and killed Brigham and Women’s Hospital surgeon Michael Davidson and then himself, had complained in the past about medical bills, the Worcester Telegram & Gazette reports here.

It writes today:

Mr. Pasceri, in 2012, told Telegram & Gazette columnist Dianne Williamson that he was frustrated with an $8,100 bill that his mother received after his father died from a heart attack. He sent copies of the bills to then-Sen. John F. Kerry and U.S. Rep. James P. McGovern, he said, because he believed Medicare was being overcharged by hospitals. His mother, who said in 2012 that she was making payments to UMass Memorial Medical Center in Worcester, died in November.

The Boston Globe reports that Pasceri “‘had some issue’ with prior medical treatment of his mother at [Brigham and Women’s], said Superintendent Robert Merner, head of the Bureau of Investigative Services. Marguerite E. Pasceri died Nov. 15.”

The Globe also reports that Pasceri’s brother, Gregory, believes “something snapped” when Pasceri got new information recently about their mother’s death. She developed complications after surgery at the Brigham, he told the Globe.

That 2012 Telegram column by Dianne Williamson was headlined, “A Beloved Dad Passes, A Bill Lingers,” and includes this:

Some of the charges in the itemized bill from UMass include $1,928 for the emergency room; $645 for an echocardiogram; $1,462 for CPR; $454 for the doctor’s visit; and $2,149 for the ambulance ride up Belmont Street. As part of its Prompt Pay Discount Program, UMass offered to shave 20 percent from the bill if she paid it immediately, but Mrs. Pasceri lives off Social Security and was unable to take advantage of the offer. Continue reading

Related:

Doctor Shot At Brigham & Women’s Hospital Has Died

This post has been updated.

WBUR reports that the doctor shot at Brigham & Women’s Hospital yesterday has died:

A cardiac surgeon was shot inside Boston’s Brigham and Women’s Hospital Tuesday and later succumbed to his injuries, police said, and the suspected shooter was found dead in an examination room from an apparent self-inflicted gunshot wound.

Dr. Michael Davidson (Courtesy of Brigham and Women's Hospital)

“This evening, Dr. Michael J. Davidson, director of Endovascular Cardiac Surgery at Brigham and Women’s Hospital, has tragically died as a result of the gunshot wounds he sustained this morning during the shooting event at the Shapiro Cardiovascular Center,” the hospital said in a statement late Tuesday.

The 44-year-old from Wellesley was shot twice, Boston Police Commissioner William Evans said in a midday news conference, before Davidson died.

“Dr. Davidson was a wonderful and inspiring cardiac surgeon who devoted his career to saving lives and improving the quality of life of every patient he cared for,” the hospital statement added. “It is truly devastating that his own life was taken in this horrible manner.”

A former Brigham & Women’s cardiologist who worked with Davidson often called him “a dynamic and energetic thought leader in cardiovascular medicine.”

Police are seen outside the Brigham and Women’s Hospital in Boston Tuesday, where one person was shot. (Robin Lubbock/WBUR)

Police are seen outside the Brigham and Women’s Hospital in Boston Tuesday, where one person was shot. (Robin Lubbock/WBUR)

Hospital employees had been well-drilled for this disturbing eventuality.

In November 2013 we reported that about 1,200 Brigham doctors, nurses and other staff viewed the hospital’s new “Active Shooter Preparedness Training” video, which offers a step-by-step guide on how to handle a hospital shooter, which in some cases is called a “Code Silver.” Continue reading

Stick To That Book. Your Tablet-Reading May Hurt More Than You Think

(eef llc/Compfight)

(eef llc/Compfight)

If the holidays brought you a device or two, here’s something to consider.  That nighttime reading from your brand new iPad?  Maybe not such a good thing.

A new study from Brigham and Women’s hospital, published in the Proceedings of the National Academy of Sciencesfound that the use of light-emitting (LE) e-readers in the evening and even the early night may harm your sleep.

How?

The blue light produced by these specific electronic devices can actually shift your circadian rhythm by suppressing sleep hormones.  This means that that late night horror reading didn’t just give you nightmares, it actually makes you less alert in the morning. “We found the body’s natural circadian rhythms were interrupted by the short-wavelength enriched light, otherwise known as blue light, from these electronic devices,” said lead author Anne-Marie Chang, PhD,

Dr. Chang, associate neuroscientist in Brigham and Women’s Division of Sleep and Circadian Disorders and an assistant professor of behavioral health at Pennsylvania State University explains that twelve participants were monitored for two weeks in the hospital. Researchers compared their sleep patterns when reading text from an iPad and reading from a printed paper book.  (Images and puzzles were never included).  Volunteers were asked to read for four hours before bed for five nights in a row.  The same process was then repeated with a printed book. Participants who read from iPads took nearly 10 minutes longer to fall asleep and their sleep had less rapid eye movement (REM) compared with when they did late-night reading from a printed book.

The real eye-opener?

In a press release, Chang said she and her team were most surprised by the morning-after–iPad readers were less alert and more groggy after waking up.  Continue reading

The Art Of Surgery: Painting The Operating Room On Canvas

Coronary Bypass Operation at Brigham and Women's, Boston 2010 oil 40 x 70. A painting by Joel Babb. (Courtesy of Joel Babb)

Coronary Bypass Operation at Brigham and Women’s, Boston 2010 oil 40 x 70. A painting by Joel Babb. (Courtesy of Joel Babb)

When I walked into Joel Babb’s studio a few years ago, I was immediately drawn to a large painting in the middle of the room.  Propped on an easel and framed by the gaze of the sun, the painting transported me to an operating room.  Honestly, not a place I wanted to go.  But when I looked closely, I realized it was an open heart surgery — the life-saving procedure I had done when I was 10-months old. I looked closer and noticed the instruments, the placement of the patient’s head, the colors.

“I had that surgery,” I said to Joel.

“So did I.” he smiled.

That painting has stayed with me and it’s not the first medical painting Babb has finished.  I asked him to share some reflections on the art of medical painting — especially when the featured subject is so close to home. Here’s what he wrote:

In 1995-6, I painted a recreation of the first successful organ transplant which was done by Dr. Joe Murray at Peter Bent Brigham Hospital (now known as Brigham and Women’s Hospital) in 1954.  I love to paint landscapes but when I was asked me to do a painting of a famous surgical procedure I was immediately interested.

As part of the process of doing that painting Dr. Joe Murray, who received the Nobel Prize for the transplant surgery, took me around the operating rooms of the Brigham so I could observe and photograph operations while understanding the organization of the operating room. For this specific painting, I was working with the advice and cooperation of three doctors to recreate an event which happened 40 years before.

The operating room no longer existed, and there were only two black and white photographs taken from an observation gallery above on that day. So the doctors had to remember the configuration of the room, the people present, and I had to draw that room from a different perspective, and pose models in surgical gowns under both artificial and natural light. This required a whole series of drawings over several months to come to a final composition. This painting was conceived as complementing the Countway’s painting of the first use of anesthesia (ether) in surgery by Hinckley.

First Successful Organ Transplantation in Man 1996 oil 70 x 88. A painting by Joel Babb (Courtesy of Joel Babb)

First Successful Organ Transplantation in Man 1996 oil 70 x 88. A painting by Joel Babb (Courtesy of Joel Babb)

The painting of the first use of anesthesia by Hinckley hangs in the Countway Library of Medicine at Harvard Medical School.  The doctors told me that anesthesia was the greatest surgical innovation of the 19th century, and they regarded transplantation as the greatest innovation of the 20th century. 

I envisioned my painting as a pendant to the Hinckley — the figures are the same size as those in the Hinckley, but my painting is somewhat smaller because the rooms depicted are smaller. I tried to make the style contemporary, but subdued and historical.  To me there is a feeling of transition as Dr. Moore carries the kidney from the donor operation to the recipient just as one moves from awareness through unconsciousness to awareness when you undergo surgery experience anesthesia.  To Dr. Moore the transplant operation suggests the dawning of a new day of surgery.

After completing the transplant painting, I asked Dr. Moore if he could arrange for me to observe and photograph further surgeries with the intention of doing a contemporary surgical painting without the constraints of doing a commission. He agreed.

I remember photographing a mastectomy, a breast reduction, a complicated breast reconstruction, removal of a formerly transplanted kidney, and a lung cancer operation. But what I really wanted was to observe a heart operation — I had open heart surgery myself as a boy of 13 in 1960. The idea of a saving surgical intervention has been part of my development ever since.

I was able to observe Dr. John Collins and his team do a bypass operation. During the procedure the anesthesiologist let me stand in her place near the head of the patient, on a little foot stool which enabled me to see over the “ether screen,” giving me an incredible view of what the surgeons were doing. Continue reading

The Psychological Aftermath Of The Sydney Siege

A hostage runs to armed tactical response police officers for safety after she escaped from a cafe under siege at Martin Place in Sydney, Australia, on Monday. (Rob Griffith/AP)

A hostage runs to armed tactical response police officers for safety after she escaped from a cafe under siege at Martin Place in Sydney, Australia, on Monday. (Rob Griffith/AP)

By Jessica Alpert

The images of five hostages escaping from the Lindt Chocolate Cafe in Sydney are striking. A woman runs into the arms of law enforcement, her trauma and fear palpable.

This story is still developing, but one thing is for sure: “It really doesn’t take much to instill fear,” says Max Abrahms, a professor of political science at Northeastern University and an expert on terrorism. “This one guy managed to shut down an entire city, divert many planes away from Sydney, and transfix the world in real time following this story.”

As of press time, police were reporting that the hostage taker and two people were killed. For those who survived, what lies ahead psychologically?

Dr. David Gitlin, Brigham and Women’s Hospital vice chair of clinical programs and chief of medical psychiatric services, says recent research suggests reliving or “debriefing” survivors is counterproductive and “actually may precipitate the development of PTSD.”

Instead, health professionals are encouraged to use a resilience model in the immediate aftermath of an event like this one, “helping people think about the things they need to do to feel safe and secure…to deal with things on their timetable,” says Gitlin. Of course, this may come into conflict with the needs of law enforcement, who are looking for further control of an event or preparing evidence for prosecution. As this siege has ended and it’s believed that the assailant acted alone, Gitlin hopes that those now released will not be interrogated at this time.

Gitlin, who led the Brigham’s psychiatric team after the Boston Marathon Bombings, explains that “people need to be surrounded by their loved ones, put into a safe environment, and only process this when they are ready to do so.”

Acute Stress Reaction and PTSD

There are two types of trauma, says Gitlin. Continue reading

Related:

Quadruple Amputee Gains New Arms, From Donor Who ‘Gave Best Hugs’

Will Lautzenheiser looked down at his rosy, fleshy new arm at a Brigham and Women’s Hospital news conference this week and exclaimed, “It’s the most beautiful arm!”

For three years, Lautzenheiser — a quadruple amputee in the wake of a virulent bacterial infection in 2011 — had lived without arms. Now, he and his Brigham and Women’s Hospital transplant team have just revealed, he has two new ones, the gifts of an anonymous donor. A medical team of 35, including 13 surgeons, operated on him for nine hours last month to attach them.

Lautzenheiser, 40, spoke with us last year in the video above about his “sit-down” comedy career: “Did You Hear The One About The Comedian With No Arms And Legs?” That armless footage is now outdated.

It will take months for the new arms and hands to gain sensation and function, but Lautzenheiser, a former film professor at Boston University, says he’s already putting them to good use, hugging his partner, Angel Gonzalez. “To be able to hold my love in my arms again is really the best,” he said.

Arm transplant recipient Will Lautzenheiser uses his new arms to hug his partner, Angel Gonzalez, at a Brigham and Women's Hospital press conference. (Photo courtesy BWH)

Arm transplant recipient Will Lautzenheiser uses his new arms to hug his partner, Angel Gonzalez, at a Brigham and Women’s Hospital press conference. (Photo courtesy BWH)

The late donor put those arms to similar use, as described in a message from his family that New England Organ Bank President Richard Luskin read aloud to Lautzenheiser: “Our son gave the best hugs. We pray that you make a wonderful recovery and that your loved ones will be able to enjoy your warm embrace.”

Thus far, Lautzenheiser says, his new arms have little sensation, mainly just a bit of feeling in the skin right below where they’re joined to his own body. As for moving them, “If I really focus, I can occasionally move my thumb just a little bit, a few millimeters. It bends. I can pronate and supinate my wrist on my right arm. I have a little bit of wrist motion, a little bit of forearm motion.” Continue reading

What’s A ‘Natural Cesarean’ And How Natural Is It?

That was my reaction when I read a recent post by my friend Ananda Lowe who writes a blog, thedoulaguide, about childbirth issues of all sorts. (Disclosure: she is also my co-author on a book we wrote on how to have a fulfilling and fully-informed birth experience.)

Ananda explains that a new “natural cesarean technique” is being developed here in Boston at Brigham and Women’s Hospital:

While talking with my friend Dr. William Camann, director of obstetric anesthesiology at Brigham and Women’s hospital in Boston, I was surprised and excited to learn that he recently helped the hospital adopt components of what is being called “the natural cesarean” technique. Bill is co-author of the book “Easy Labor: Every Woman’s Guide to Choosing Less Pain and More Joy During Childbirth,” and the Brigham is Boston’s largest maternity hospital, so its adoption of these methods is good news. In the past, some mothers reported feeling “a disconnection from their cesarean baby because they did not actually see or feel the baby born,” according to the International Cesarean Awareness Network (ICAN). The natural cesarean technique offers parents the option of viewing the emergence of the baby if they wish. (For years, ICAN has been a pioneer in proposing guidelines for family-centered cesareans, as well as advocating for other reforms related to the use of cesarean sections—I encourage everyone to support their work!)

I spoke with Camann today and he said the preferred term for the new technique is “family-centered Cesarean,” or “gentle Cesarean.” The concept has been evolving for several years, he said, with some elements of it — like early skin-to-skin contact between mom and baby in the operating room — becoming more standard. The newest element — a clear surgical drape that allows the mom to actually see the birth — just started a few months ago. “To my knowledge, the Brigham is the only hospital doing that,” Camann says. “It was my idea; the patients love it.”

A "natural" or "family-centered" Cesarean section. (Photo courtesy Dr. Bill Camann)

A “natural” or “family-centered” Cesarean section. (Photo courtesy Dr. Bill Camann)

But a bird’s eye view of a surgical birth isn’t for everyone, he added, and some new moms don’t want to see anything. “You pick up cues from the patients and other providers,” Camann says. “It’s very much a judgement call.”

Here, Camann offers more details on the technique:

A growing movement is attempting to make the cesarean delivery a more natural, or family-centered, event.

Modifications of the standard technique include:
· Early skin-to-skin contact in the operating room (with either mom or dad)
· A slow delivery (with intent to mimic the “vaginal squeeze”) Continue reading

How Being Obese May Hinder Pregnancy: Eggs Gone Awry

Human egg

A human egg being injected with sperm (Eugene Ermolovich on Wikimedia Commons)

The more obese you are, the harder it is to get pregnant, and a study just out in the journal Human Reproduction offers some new insight into why. For the 1/3 of American women of childbearing age who are obese, its concrete images of eggs gone awry may also offer a bit of added incentive to lose weight before trying to get pregnant.

The study, led by Dr. Catherine Racowsky of Brigham and Women’s Hospital, found that in severely obese women who underwent fertility treatments, the eggs that failed to fertilize were more likely to have abnormal structures and disorganized chromsomes than the eggs in normal-weight women.

In particular, the eggs in the obese women were roughly twice as likely to have double “spindles.” The spindle is something like the axis around which the gene-bearing chromosomes organize themselves; for an egg to fertilize normally, it must have a single spindle. (See the image below.)

spindles

Normal and abnormal spindles in human eggs (Courtesy of BWH)

How, I asked Dr. Racowsky, might all this work? How might obesity lead to double spindles and other egg malformations?

‘The egg, of course, develops in the ovary,” she replied, ” and the immediate environment in which the egg develops is called the follicle. And we know from other studies that there are various abnormalities in the follicles of women who are obese. A lot more work needs to be done to understand how these abnormalities in the follicles relate to abnormalities in the eggs, but we do know that the relationship between the health of the follicle and the health of the egg is of paramount importance.”

In the paper, I said, I caught hints of a couple of familiar elements that may go wrong in the follicles of obese women. There were mentions of leptin, an obesity-related hormone involved in appetite and metabolism, and of inflammation, which has also been found to increase in obesity. Continue reading

First Total Artificial Heart Implant In New England: The Video

http://vimeo.com/44387011

Brigham and Women’s Hospital announced this morning that surgeons implanted the first total artificial heart in New England.

The Boston Globe reports:

The first total artificial heart implant in New England was performed last February on a 66-year-old retired high school teacher and track and field coach from the South Shore, who was diagnosed last year with a rapidly deteriorating condition that would have caused total heart failure.

The artificial heart that James Carelli received at Brigham and Women’s Hospital is intended as a bridge to a human heart transplant. Doctors diagnosed Carelli with cardiac senile amyloidosis, and they determined that his only option for survival was to receive the artificial heart while he awaits the transplant, according to an e-mail the hospital’s president, Betsy Nabel, sent Thursday morning to staff. He is on the waiting list for a heart transplant, as well as a kidney transplant.