Homage to a Hero: Dr. Rick Harrison

From Rudy’s new room, I can look across the nurses’ station to his old one and it brings back memories of those first days when this whole place was so unfamiliar.  I remember being overwhelmed by mysterious pieces of equipment being wheeled around.  I remember trying to divine the purpose of many procedures I had never seen before.  I remember the parade of people coming in, introducing themselves, their specialty and then examining Rudy.  The raw intensity was such that most of the names escaped me well before their bearer even left the room.


A few repeated faces started to distinguish themselves amidst the blur of those first few days.  Rudy’s condition was very tenuous at that point and there was lots of attention being paid to him and all the foreign numbers up on the monitors.  The doctor with lively ties seemed to be in the room quite a bit, watching carefully.  Like everyone else, he watched the numbers tick by, but gave equal amounts of time to watching Rudy—noting his skin tone, the flare of his nostrils and the cadence with which his chest would rise and fall.  Even when he was dealing with other kids in the unit, most of his passes by the room included a quick scan and status check.


It was only the most disciplined restraint that kept us from constantly cornering every doctor for detailed explanations on what they were doing and seeing.  There was an instinctive sense that hovering over the staff would interrupt their work and divert the attention that needed to be paid to Rudy.  But even if he couldn’t give a running commentary, the doctor with the ties always seemed to stop at just the right time to give us an update on what was going on.


Dr. Henderson?  Dr. Haroldson?  Doctor Richardson?  For some reason it took me quite a few quiet checks with nurses to get straight on the name, but finally I got it that the Doctor with the ties was Rick Harrison.  Remembering his name at this point isn’t much of a challenge as Rick is the second intensivist who has done the bulk of the rotations during Rudy’s sojourn here in the ICU.


I’m not sure how one could navigate such a journey as the one we’ve been on without trust in the people we simply need in order for Rudy to have a chance.  As I’m continually impressed by the giftedness and knowledge of most every nurse, tech and therapist, I have nothing but awe left for the doctors.  In position, but more importantly in competency, Rick is at the top as he brings incredible expertise and clinical experience into the very emotional arena of very sick children and the fretful parents that accompany them.


As much as I’d love to cling to the notion that no one knows my child better than I do, I probably let go of it well before Rudy was born.  No one loves him more, but it only takes one visit in rounds to be reminded that there are levels of detail I’ll never understand and questions I wouldn’t even think to ask.  For Rudy’s sake, I’m grateful there is expertise that far surpasses our own.  I’ve come to see that his treatment rarely involves black-and-white decisions; but an involved sequence of judgment calls requiring knowledgeable coordination of disparate and often intricate steps.  We are grateful for the many weeks that Rick, with his measured and seasoned expertise, has played this central position.


A good doctor at this level is deeply knowledgeable, drawing on science and experiences with thousands of patients.  An exceptional one also recognizes that each patient is unique and at some point departs from the textbook conventions.  We have often heard Rick remind the doctors in rounds that Rudy has his own norms.  He is probably more intricately aware of the data than anyone else and would never flippantly dismiss it, but his overall assessment leaves room for common sense and basic observation.  As helpful as science is, a skilled clinician knows when it should be trumped by simply looking at whether the patient looks peaceful or distressed.


We never lose sight of the fact that Rudy’s condition has us in a place of dependence and we are so grateful that one of the key people we are leaning on is one we trust so deeply.  Trish and I have daily discussions about Rudy’s course of treatment, and more often than not they touch on Rick’s opinion.  Rick’s esteem among his colleagues seems to match ours as I can’t recall anyone being offended by the many times we’ve asked if he’s been consulted.  It was only in gathering my thoughts to write this that I discovered that Rick wears another hat—as Medical Director for the Mattel Children’s Hospital.  As far as we can see, they sure have the right guy in charge.


We place our trust in Rick not only because of his technical competency, but also because of his ability to appropriately straddle clinical distance.  This journey is about my kid and I’m a human being going through emotions that I’ve never experienced before as I try to comprehend realities I never dreamed I’d have to face.  So, I need guidance from human beings, who never lose sight of the seriousness of the situation or some form of necessary objectivity; but don’t engage without emotion.  They hurt with us; are frustrated with us; know the process well enough to identify milestones worth celebrating; and introduce well-timed humor amidst circumstances so intense it would never be expected.  In light of this, my most vivid memories of Rick do not center around medical details, but on human interactions:  celebrating when Rudy peed enough; overseeing Rudy’s first two extubations; losing more than a couple nights’ sleep at home pondering Rudy’s condition; feeling sad and frustrated with us when we had to go the route of the tracheostomy and feeding tube; and stopping in on an off day to see Rudy and Trish after hearing of the chylous fluid in Rudy’s stomach.


Rick describes himself as “the doctor no one wants to see”; because dealing with him means you have a very sick child.  Point taken, but given that I have no choice over the condition Rudy was born with, I can’t tell you how glad for the many times we have seen Rick.


Dr. Rick Harrison
Dr. Rick Harrison

It’s another Monday…

…but I’m starting out this Monday more encouraged than last.  You might recall my concern (or maybe just my weariness) last week at the weekly staff changes that seem to bring with them changes in Rudy’s care plan that leave us feeling like we’re in the middle of a ping pong match.  Well, maybe the changes aren’t THAT “back and forth” but even the subtle changes from week to week can get confusing after a while.  Anyway, I came back from breakfast to find Dr. Rick in charge this week and, although all of Rudy’s doctors are great and I shouldn’t have favorites, Dr. Rick is one of my favorites.  (I can post that because I don’t think he reads the blog! Ha)  Simply put, he is comforting to have around…I don’t know what it is about him but he is always so calm and measured, never in a rush, always stops in and conducts a physical exam on Rudy himself…so tender with him and, most of all, seems to appreciate our ever-growing menagerie of artwork and knick-knacks always taking the time to look around…next time he drops in I have to remember to show him the dancing Christmas tree!

Another Hero - Dr. Rick
Another Hero - Dr. Rick

I also got a chance to talk with our surgeon, Dr. Brian, and the cath-man, Dr. Dan, (also favorites) so I feel like I’ve had face-to-face updates from the men in charge and that is always reassuring.  So, where do we stand now?  Not a whole lot has changed in Rudy’s condition but when I got back to him last night after the long weekend, he seemed better to me…his color was good and he wasn’t as fussy.  He has battled a fever off and on all weekend so he has been on antibiotics, his fluid output is slowly decreasing but not yet enough,  his nutrition numbers are climbing so that, too, is slowly inching to where it needs to be.  All the indicators TO ME say we’re moving everso slowly forward and it is still a matter of time.  But as Dr. Rick put it this morning, “there’s no known reason why he shouldn’t be thriving and off the ventilator now”.  That said, Dr. Brian and Dr. Dan feel strongly that a heart catheter is the next step and they have scheduled that procedure for tomorrow (Tuesday).  The information they can get from the catheter is something they will need in preparation for Rudy’s second open heart surgery in about 4 months (called the Glenn) and doing it now might shed some light on why he’s not progressing.  Dr. Dan will conduct the procedure and he just finished drawing me a very nice picture of what he’s going to do on my whiteboard!  Although Rudy’s heart function looks great on all the echos (ultrasounds of the heart), there could be something they are missing.  I’m feeling okay with it especially since this is a procedure he’ll need in a couple of months anyway but I wish he didn’t have to make another trip downstairs as that trip is always so labor intensive.  I trust that the docs are covering all the bases in their search for just the right balance of everything but I can’t help but think over and over that God knows exactly where the hold-up lies in terms of Rudy’s progress and I’m praying fervently that God will intervene by giving Rudy’s system a gentle kick in the pants to jump start whatever needs to get movin’.  How do you like my technical analysis and action step?  I’m off to lunch but will update later if I get more detailed information on the plan or it somehow changes!

P.S. It’s December 1st…Happy Birthday Grandma Jo!!!