Alumni Perspective: A Stroke of Luck
by Todd Kuiken, ’90 MD, PhD, ’91, ’95 GME
Having A Stroke Renewed My Pride in My Profession
I had a stroke last summer. In itself, this event is not particularly interesting to read about, as I am only one of almost 795,000 Americans who had a stroke last year, including undoubtedly several thousand physicians. But the one small silver lining to having had a stroke was that I was treated so well within a very complex medical system and had such an excellent outcome that the experience renewed my pride in being a physician.
I am a 57-year-old man in good health except for being overweight. I am a physiatrist (a doctor who specializes in rehabilitation medicine) and a scientist. My career has focused on research to improve the control and design of artificial limbs. I am proud of this work, its impacts on the lives of patients and its contribution to the fields of medicine and science. But after having a stroke, my perspective on medicine changed in unexpected ways.
My family and I live in Oak Park, Illinois. On July 15th, I woke up, showered, dressed for work and began packing in anticipation for a weekend away with my wife, Lisa. I woke Lisa up to take me to the train that morning, but when I spoke to her she looked at me like I was from the moon. “Sit down and raise your arms over your head,” she said. When only one of my arms went up, she called 911.
I argued with her that I was fine, as I did not realize I was having a stroke, but my words were incomprehensible. Lisa knew something was wrong and that she had to act immediately. Here are some of the points I took away from all that followed:
“THE PRACTICE OF MEDICINE seems to be under a lot of controversy these days. People complain that it’s too expensive, there are too many mistakes. And I read more about physician burnout than about what a wonderful and honorable job it is to be a physician. I had a stroke and was very successfully treated by a complicated system with a wide range of medical service providers. The whole system worked efficiently and well to save my brain.”
Public health education makes a difference
The National Stroke Association’s public education slogan to “Act FAST” helped my wife recognize the signs of stroke, as she had remembered the acronym when my speech troubled her (FAST = face, arms, speech, time). Even as I was arguing with her, she knew I was having a stroke and that treatment was time critical. The paramedics arrived at my house within 10 minutes and quickly carted me to a local hospital in Oak Park, where I was almost immediately seen by a neurologist via a telestroke service.
I received a CAT scan and tissue plasminogen activator, two appropriate first-line treatments for stroke. When these treatments were not effective, my team prepared to transfer me to a tertiary care hospital for further treatment. I asked if I could go to “my hospital,” Northwestern Memorial Hospital. The Oak Park physicians agreed, and in less than an hour I was on my way to meet my new care team.
The local EMS and hospital did well and were very fast with my care.
My trip downtown was much faster by ambulance than my usual commute. I arrived at Northwestern, where my neurologist Dr. Richard Bernstein and my interventional neuroradiologist Dr. Sameer Ansari were waiting. I had an exam and another quick CAT scan; then I was taken to the catheterization laboratory – probably within two hours of having had my stroke. There they performed a thrombectomy; they threaded a catheter through an artery in my groin all the way up to the top of my brain and pulled that nasty 3 cm blood clot out. It worked beautifully and the next day my hemiparesis was mostly resolved and I could talk understandably. I was told this amazing procedure was considered experimental only two years ago.
I am so grateful for the success of this remarkable advancement. While in the cath lab, my wife mistakenly thought I was having brain surgery and called the only surgeon she knew at Northwestern – my dear friend and research collaborator Dr. Gregory Dumanian, chief of the Division of Plastic Surgery. Greg could not find me in any OR so he tracked me to the cath lab, then found my wife and explained the procedure I was having to her. Greg continued to visit me every day and also played an appreciated role as medical interpreter for my wife.
Modern medicine can do amazing things.
I was in the hospital for a week so the doctors could carefully observe me and determine the exact cause of my stroke. The source turned out to be a dissection in my right internal carotid artery. We could not find a reason for the dissection; I had no known trauma or even slight injury. Sometimes things just happen and you have to move on. The nursing staff was great and cared for me with professionalism and compassion. We were also impressed by the house officers. Lisa liked the senior resident so much that she was disappointed when she found out that she was not an attending physician, and I would not have a follow-up appointment with her.
My recovery was going smoothly, but two days later at home I got lost on the way to my own bathroom. Lisa quickly took me back to Northwestern, where my team once again examined me and kept me overnight for observation. I went home again for good and have done very well. I started a day rehab program near my home about a week later and worked with a wonderful group of enthusiastic young therapists from the Rehabilitation Institute of Chicago (now known as the Shirley Ryan AbilityLab). I was probably not the best patient, as I was being a surly middle-aged rehab doctor with his own ideas about therapy, but the therapists were all patient and very responsive. My colleague Dr. Richard Harvey at the Shirley Ryan AbilityLab has had the challenge of being my physiatrist and has done a great job of balancing his role as both my colleague and physician.
Four months after having had my stroke, I returned to work part-time. Six months out, I was working full-time. I am now more than a year out and doing very well. The post-stroke headaches and fatigue were big challenges, but these were successfully treated with medication.
The practice of medicine seems to be under a lot of controversy these days. People complain that it’s too expensive, there are too many mistakes. And I read more about physician burnout than about what a wonderful and honorable job it is to be a physician. I had a stroke and was very successfully treated by a complicated system with a wide range of medical service providers. The whole system worked efficiently and well to save my brain.
Since my stroke, I have interacted with well over a 100 people in our medical system, and they were all very polite, professional and caring. Looking back, it gives me great pride to be a part of this medical system. I hope all healthcare workers reading this story take a minute to appreciate their profession and all the great people they work with and treat every day. I also hope it doesn’t take a medical catastrophe to appreciate the profound impact that the medical profession can have on patients who need their care, creativity and knowledge.
Todd Kuiken, ’90 MD, PhD, ’91, ’95 GME, is director of the Center for Bionic Medicine at the Shirley Ryan AbilityLab. He is also a professor of Physical Medicine and Rehabilitation, Surgery and Biomedical Engineering at Northwestern University. He has been a practicing physician for more than 20 years. Photograph courtesy of the Shirley Ryan AbilityLab.