“Mi pilim ai raun” (I’m feeling dizzy), J said as we loaded him on to the aircraft. That was the telltale sign that his heart was about to stop. Don’t stop yet, I thought as we were now so close to getting him to the lifesaving procedure he desperately needed.
J, an educated and athletic 25-year-old with lots of potential, came to Kudjip Hospital with chest pain after a rugby game. We diagnosed J with a massive heart attack. I was shocked when my colleague, Dr. Rebekah, and a volunteer ER resident, Dr. Candice, showed me his EKG and labs. These results should not belong to a 25-year-old, physically fit male… or so I thought.
We do many things at Kudjip very well—such as trauma care, obstetrics, and infectious disease—however specialized cardiac procedures are outside our scope of practice as they are rarely available in Papua New Guinea (PNG). In fact, the only place in PNG able to perform what J needed was a private hospital in the capital city (Port Moresby), which is completely inaccessible by road. Not only that, the private hospital’s fee for services (about 14,000 USD, which had to be paid up front) was well outside J’s meager budget. In comparison, our doctors’ fee is about 3 USD and our most expensive service (major surgery fee) is about 65 USD.
We gave J everything we had—donated blood thinners, medications for abnormal heart rhythms, and finally a medicine designed to break up the suspected clot in an artery around his heart. This medicine also has the potential for dangerous side effects, including an irreversible brain hemorrhage. We finally got J stabilized, but would it be too late? The family stepped into action, and literally hundreds of people donated to his cause.
Now we needed to find a way to get J to the capital. The private hospital offered an air medevac, but it would cost even more than the procedure itself (about 20,000 USD extra), more than doubling the bill. How were we going to get him there safely? Even though we were short staffed on physicians, Dr. Erin, our medical director, offered a physician and a nurse anesthetist to accompany J. But still, he couldn’t go on a commercial flight, and chartered planes weren’t even a possibility.
A Christian mission organization called Mission Aviation Fellowship (MAF) stepped in to save J’s life. After Dr. Erin explained the situation with their PNG director, Todd Aebischer, MAF agreed to cancel other flights so they could transport J to the capital. Our province’s health department also agreed to pay MAF’s more reasonable fee.
Unfortunately, with darkness descending in the Western Highlands, it was now too dark and dangerous to fly. We had to keep him alive until the morning. It was now up to Drs. Rebekah and Candice, who were on call overnight. Through constant monitoring and the help of our nursing staff, he survived until the morning with the aid of a lifesaving medication drip that kept his blood pressure up and his heart beating. Several times overnight the medicine ran out; his heart would quickly start to slow down at which point he would feel dizzy until more medicine was given.
In the morning, the baton passed to me and Mr. David (a nurse anesthetist). If J had any chance of survival, we would have to keep him alive in route to the capital. However, even the hour-long ride to the airport proved challenging. There was no way to monitor the amount of medicine he was receiving on our bumpy roads, but we managed to get him to the MAF hanger relatively stable.
Then, while loading him into the back of the airplane, J’s heart started to slow, causing him to feel dizzy. He had had an interruption in his medication drip for too long while moving him. We quickly gave him two medications and he stabilized!
The plane ride was difficult to monitor J with all of the noise, but we were able to get him to Port Moresby where an ambulance from the hospital picked him up. The cardiologist was on holiday, but fortunately he was nearby so he came in, placing a stent in J’s heart to alleviate the blockage that was causing the heart attack. He was discharged from the hospital two days later and is now resting with his family.
Miraculously, everything came together for J. From the fantastic team that monitored him all night, to the sacrifice of MAF’s team to fly him to the capital, to our hospital’s supply of the right medications to keep him alive, God’s hand was on his life. J must have a special purpose on this earth because there were so many times he was close to leaving it, but God intervened in so many small ways to give this promising young man a second chance.