Saving One Of Our Own

Main Category: Cardiovascular / Cardiology
Article Date: 09 Jan 2009 - 0:00 PDT

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"I have to save him. I don't want his daughter to be left with those lasting images,'" Dr. Ali Denktas remembers thinking as his team worked feverishly to save a patient, a fellow physician, a fellow father.

Just two hours before, it had been an ordinary June day for Dr. William Daily, assistant professor of anesthesiology at The University of Texas Medical School at Houston. He was at a doctor's appointment for his 11-year-old daughter, Sophie, when he began to feel that something wasn't right.

"I can only go on what my family has told me," Daily says, who recalls nothing of the event. "I made a call to my wife and told her that I had chest pain. She wanted me to head to an emergency center. I told her I would wait until after my daughter's appointment was over."

Following the appointment, Daily, 51, drove to Memorial Hermann-Texas Medical Center. Walking hand-in-hand with his daughter on his way to the emergency center, he collapsed.

"Is there a doctor?" yelled a woman in the hallway. That shout caught the attention of Dr. David Robinson, vice-chairman of the Department of Emergency Medicine at the medical school who was the supervising physician in the Memorial Hermann- TMC emergency center that morning. "I was just returning to my shift after watching my wife, also a physician, receive an award. When I heard those words, my eyes dropped to the floor. I saw a man lying on the ground, bleeding and immediately went to work opening his airway and starting compressions."

While someone ran for a bed, Robinson quickly determined that "the man had collapsed from a stroke or heart attack and struck his head, which caused the bleeding."

Once inside the emergency center, a team led by Robinson worked tirelessly to stabilize Daily but his heart wasn't responding. Aggressive interventional therapy would be necessary to save Daily's life. Dr. James McCarthy, assistant professor of emergency medicine at the medical school and director of the emergency center, heard the commotion and joined the team.

"I looked down at the patient and thought, 'Yikes, I know him. This is Dr. Daily. He's one of us,'" remembers McCarthy.

"Looking back, I know I looked at Daily's daughter," Robinson adds. "She had that look on her face that said, 'I'm going to lose my Dad.'"

Out of time

Decisions had to be made. "I thought we could get his heart back--it just wasn't going to happen in the emergency center, so I placed a call to the cath lab," says McCarthy.

The "cath lab" is the nickname for catheterization laboratory where both diagnostic and treatment procedures occur using a coronary catheter. In most hospitals, patients are stabilized before being taken to the cath lab to correct the cause of the heart attack. UT and Memorial Hermann-TMC have one of the few cardiac interventional teams that will "cath" a patient while the team is performing ongoing CPR. Daily was not responding to treatment in the ER. "The cath lab was his only chance," McCarthy says. "Dr. Denktas said to bring him down."

With no steady heartbeat, an AutoPulse was placed on Daily's chest while in transport to the cath lab. The AutoPulse is a non-invasive cardiac support pump. It allows rescuers to provide compressions while performing other life-saving activities, or while transporting a victim down the stairs or in the back of a moving ambulance.

As the AutoPulse continued to keep Daily's heart beating, imaging showed Denktas that Daily's left anterior descending artery (LAD) was 100 percent blocked. A piece of plaque had opened up and clogged the vessel.

"We quickly opened up the LAD using stents. Once those were in place, his heart responded. We were able to get a steady rhythm and stop CPR," Denktas says. "To protect his brain, we used a cooling device to lower his internal temperature to 33 degrees Celsius and put him in a pharmacology-induced coma."

Living a dream

A little more than a week later, Daily remembers opening his eyes to family and friends. Ironically, he was in the intensive care unit just two doors down from a patient whose life he helped save a week before after 45 minutes of CPR.

"I have no memory of my heart attack, or even the few days leading up to it. I have many people to thank: the ones who saved my life, a co-worker who took care of my daughter while they worked on me and everyone who rallied behind me to roll their sick hours into a 'sick pool' for me," Daily says.

"If you add 30 minutes to this story, the outcome isn't the same. The entire UT medical team-- from the emergency center to the cath lab to the cardiac care unit-- made this happen. It was medical care at its best," says McCarthy.

"For years, our cardiologists and emergency medicine physicians have collaborated to reduce time between the emergency center and the cath labs. Dr. Denktas and his team showed extraordinary initiative when they took Dr. Daily to the lab knowing how unstable he was," adds Robinson.

'Daily' miracles

Six months later, imaging has revealed that Daily's heart and brain suffered no permanent damage. He continues his work as an anesthesiologist.

Carin A. Hagberg, MD, chair of the Department of Anesthesiology at the medical school says, "Dr. Daily is a constant reminder that medical miracles occur and that the collaboration of UT Physicians and Memorial Hermann-Texas Medical Center has the capability to provide such acute critical care of their patients. Without it, Dr. Daily would not be with us today."

Daily is doing his part to keep his heart healthy. "I have a family history of heart disease. I had borderline cholesterol levels when my attack happened, but I'm now taking medicine to control it. I have changed my diet and have added more exercise to my routine," Daily says and adds, "I have a lot to live for, my wife and our two young children."

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