When the Doctor is on the Other Side of the Sheet

Kenneth F. Casey, MD

We doctors spend our days running around, seeing patients, looking things up (really, we do – all the time!) and filling out seemingly endless insurance forms, and patients and their families still have to fight the system with us. It has always been an eye-opener to “switch roles” for a bit, but not wishing for anyone to have to fight for their health or with the system.

Since finishing medical school, I have had the opportunity to be on the patient side of the sheet a few times for some pretty major reasons: a liver transplant, gunshot wound care, and kidney stone treatment. It is a sobering journey for anyone, but I have experienced a change over the years.

Here I was, a starting tackle on our college football team. We made it to a bowl game. Sadly, I cannot remember anything past the first quarter. The story, as related to me two days later, is that in the third quarter, while blocking an opposing player, I had my “clock cleaned” (to use the vernacular of the time). It took two weeks of recovery before my brain was feeling okay.

No one looks to get shot, but it happens. In my case, I thought I had a bruise under my vest. But no – it was a gunshot wound! This time around, the care was fragmented between an overseas healthcare system and the US healthcare system. Interestingly for that time (1973), the caring nature of the doctors overseas was more evident than in the US, where it seemed to me that our healthcare system was a bit stressed.

Fifty years later, in 2022, I developed liver failure from Hepatitis C. A side note here: very few people are screened for Hepatitis B or C, as routine blood testing does not look at either. With 17,000 new cases yearly, and over 75% with no symptoms in the early and middle stages, both are a risk. Well, I met that risk. After severe Covid-19, (at least I couldn’t taste my bad cooking), I just didn’t turn the corner. After a month or so, I had to cut down on my patient commitments, even starting to move some surgeries. Somewhere in that timeframe, my accurate account of the days and weeks was lost due to “liver brain,” better known as hepatic encephalopathy – I couldn’t spell that in my state, so don’t quail when terms are thrown at you. In my case, my wife-caregiver-friend, truly my savior, would force doctors to speak to her in layman’s terms. In fact, she related that on one ambulance run, she was telling the EMTs what I had and why.

In the following months, after sneaking onto the transplant list (again a blur), she tells me of several more hospitalizations, four in part with my status worsening, with no donor, dead or alive, on the horizon. At the four-month mark, she told me that an early morning call to our Detroit abode spoke of a possible donor, who was brain dead. We rushed to Pittsburgh, where I was admitted, underwent lab testing, and began to wait. At the twelve-hour mark, the transplant surgeon told my wife that the nearly deceased donor’s liver was not in condition to go ahead. A bit of a blow, more so for her, as she understood that my time was running out. After one more near death experience in the hospital, a miracle happened – a living donor match was found!

This hero gave me a piece of his liver, and gave me, my wife, and children a new outlook on life. I intend to make the best of it and keep in touch with all of you.

It has been a struggle at times, dealing with the hands I’ve been dealt by fate. But I have found that by surrounding myself with excellent healthcare providers, a strong care network, and information and support from the FPA and the facial pain community, it’s a little easier to endure the pitfalls of our healthcare system.

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