Expert, Supportive Team Helps Teen Heal
T T h i s i s a s t o r y a b o u t t h e v a l u e o f t e a m w o r k ; n o t s o m e l o o s e i d e a o f c o l l a b o r a t i o n o r a m a r k e t i n g s l o g a n , b u t r e a l , s e a m l e s s t e a m w o r k t h a t l e d t o t h e f i n e s t c a r e a n d b e s t p o s s i b l e o u t c o m e f o r a s e r i o u s - l y i n j u r e d 1 6 - y e a r - o l d . R u n n i n g a l i t t l e l a t e f o r r e h e a r s a l , M a x T i l l e r r a n t h r o u g h t h e h a l l s o f G l e n b r o o k S o u t h H i g h S c h o o l t o w a r d t h e a u d i t o r i u m a n d , u n f o r t u n a t e l y , r a n i n t o a s e t o f g l a s s d o o r s o n h i s w a y . S a f e t y g l a s s s h a t t e r e d a r o u n d h i m , T i l l e r l a y i n t h e h a l l w i t h o u t a c u t o r a s c r a t c h , b u t f a i r l y q u i c k l y s t a r t e d t o f e e l “ w e i r d , ” a n d sensed something was wrong. “Part of me was hoping it was only a cracked rib, hoping there was nothing really wrong,” he said.
Within minutes school officials called Tiller’s parents’ cell phones and minutes later Randy and Vicki Tiller arrived and immediately took their son to the Glenbrook Hospital Emergency Room.
“My husband and I crossed the threshold of shattered glass to find him tolerating first aid, but with that look in a 16-year-old’s eyes that says ‘I am not ok,’” said Vicki Tiller, in a letter following the incident.
A nurse for 30 years, Vicki Tiller watched her son with both a clinician and a mother’s eye. “At first his condition was not yet completely obvious to me or maybe I was just quieting that little voice of alarm,” she said.
The Glenbrook ER staff moved swiftly from the initial contact with triage nurse Martha Cronin, RN, to an evaluation with nurse Kris Dayrit, RN, and Emergency Physician Morris Kharasch, MD, who quickly determined that Max Tiller was in serious condition. All the while Nursing Supervisor Kathy Sammon, RN, was “professionally mothering the mother” helping Vicki Tiller through what was to be a long night.
What Max Tiller had hoped was a cracked rib, was actually a lacerated spleen caused by the impact of the metal bar in the center of the door. Thanks to Dr. Kharasch’s astute observation and quick call for a CAT Scan, they knew it was necessary to move him to the Level One Trauma Center at Evanston Hospital.
The Glenbrook ER team began the transfer process, informing the trauma surgeon at Evanston, securing an Intensive Care Unit (ICU) bed and maintaining Max Tiller’s stability until transport.
“But more than the phone calls and the consultations some- thing else happened in the ER that my husband and I will always remember and be grateful for, the staff carried us emotionally through this scary night,” Vicki Tiller wrote.
Everything was moving according to plan as Max Tiller was readied for transport, and then on the transport cart his blood pressure dropped and Dr. Kharasch was concerned that there could be increased internal bleeding.
After giving him some IV fluids and securing blood to go with him in transport just in case it was needed on the way, Dr. Kharasch got in the ambulance with his patient and took the ride to Evanston Hospital. Not standard procedure by any means, Dr. Kharasch said he felt more comfortable accompanying Max Tiller so he was there to give him blood if needed, and monitor his condition along the way.
Dr. Kharasch remembers making small talk with Max Tiller all the way to Evanston Hospital. Max Tiller remembers that Dr. Kharasch wasn’t laughing at his jokes quite as much as he had in the ER. “I knew I had internal bleeding, but I wasn’t panicking,” Max Tiller said. In fact all three of the Tillers remained calm
throughout the ordeal, confident in the treatment and compassion they were receiving. Trauma surgeon James Boffa, MD, was wait- ing for the Tillers when they arrived at Evanston. “It’s not what he said, but how he said it that gave us the sense that Max was in knowledgeable, empathetic and kind hands,” said Randy Tiller. Splenic lacerations are graded from one to five, with five being the worst and always requiring surgery—Max Tiller’s injury was a four, his spleen almost completely severed. Removing the spleen is considered a last resort as it leaves patients at greater risk for infection and other complications for the rest of their lives. Fortunately for Max Tiller he was able to heal under observa- tion in the ICU avoiding surgery.
“Treating somebody with a splenic injury, you don’t want to operate if you don’t have to. The only way you can watch a patient like this is if you have an operating team standing by 24/7, he could have started bleeding again at any time,” explained Dr. Boffa. “A case like this is the reason to have a Level One Trauma Center...it’s a great example of the benefits of the system.”
Dr. Kharasch agreed that Max Tiller’s case exemplifies the values of ENH connections. “The communication is smooth, we’re able to initiate all the resources of the institution…it is seamless because the institution is set up that way,” he said.
The connection between Max Tiller’s ENH physicians went one level deeper as his pediatrician Patrick Gries, MD, was also involved in this case, helping to keep the big picture in mind and serving as a resource for the family. This was unfortunately not the first emer- gency for Max Tiller who suffered a collapsed lung the year before. “Dr. Gries’ insight and ability to identify Max’s medical needs has been pivotal in obtaining good outcomes,” Vicki Tiller said. Those “good outcomes” mean that Max Tiller can continue to pursue his vast array of activities with his seemingly endless energy—a sure sign of the team’s success.
From left James Boffa, MD; Patrick Gries, MD; Max Tiller; and Morris Kharasch, MD.