News for the Empowered Among Us
BRAIN INJURY MAKES DOCTOR LONG-TERM PATIENT
SACRAMENTO -- In the thin light of early morning, her running shoes pound a familiar route.
Suddenly, a sickening thump. The smashing of glass. The screeching of brakes.
She lies silent and bleeding, crumpled near a dark Saturn with a shattered windshield.
She is in her 20s, slightly built, her long, dark hair tied in a ponytail. An orange and white Sony Walkman is attached to her left arm. Her shiny right shoe is marked with a scuff and a small hole.
The driver of the Saturn leaps from his car, and other people spill into the street. The owner of Taylor's Market, who has just arrived to take fish and vegetable deliveries, rushes inside and calls 911. Someone from a neighborhood dry cleaner runs out with a blanket and covers the injured jogger.
She opens her eyes for a moment, struggles to stand, but slumps down again. Strangers crouch beside her, talking softly.
Minutes pass and sirens slice through the din of traffic. Paramedics swarm.
It is Friday, July 6, 6:34 a.m.
In the back of an ambulance, an "unidentified Asian female" is on her way to the UC Davis Medical Center.
Surely, someone will be looking for her soon.
Where is she?
Brian Gallucci is texting Cathy -- again. And getting no answer -- again.
They are planning to celebrate his birthday tonight with dinner at a downtown restaurant, and she is supposed to get off work early.
But it's past 5, and he's been trying to reach her for more than two hours. She's not responding.
She has a new job. Maybe her schedule changed, he thinks. Maybe she got busy or distracted. But still ...
Brian, a soft-spoken civil engineer, knows Cathy better than perhaps anyone other than her relatives. They went to high school in Chico together, started dating their senior year and have stayed close beyond college and into their middle 20s.
About 8:30, Brian decides to go to dinner with a friend and wait for Cathy to call.
I'm getting worried, he says, talking into her cell phone. Are you all right?
By 10, he and his friend decide to head over to her apartment on 21st Street.
The building, painted white with green trim, is quiet. Cathy's gold Toyota is parked outside. Brian knocks on her front door, then uses his key to unlock it.
Her car keys are on the table, along with her cell phone. Her pager and identification badge are lying on a chair. Her wallet is in the kitchen.
Brian notices only one thing missing: her running shoes.
His first thought is that someone has snatched her while she was out on her daily jog. He picks up the phone and, with all the calmness he can muster, talks into an answering machine at the home of Cathy's parents in Chico.
It is about midnight when Jen Liu hears the message. He and his wife, Pam, phone Brian back, and Brian calls the Sacramento police.
Within 20 minutes, a patrol car pulls up to Cathy's apartment. The officer scribbles down information about her and tells Brian he will check the local jail and hospitals. In the meantime, Brian starts calling Cathy's friends, but reaches only voice mail greetings.
At just past 1 in the morning, a second officer arrives at the apartment.
A young Asian woman was hit by a car while jogging the previous morning, he tells Brian.
The officer asks Brian if his girlfriend has a mole on her forehead. She does. Brian reaches for the phone again.
"It's got to be Cathy," he tells her parents back in Chico.
Within minutes, all three of them are on their way to UC Davis Medical Center, where a young woman known only as Jane Doe lies in the intensive care unit.
Dr. Kia Shahlaie's patient is spiraling downward.
She is lying on a gurney in the CT scan room, eyes closed, a breathing tube in her throat, an angry incision scissoring across the back of her head and curling around her left ear.
Shahlaie stares at the colorful images of his patient's head that have just appeared on the computer. To the young neurosurgeon, they look ominous. The bright splotches on the left side of her brain show that she is bleeding again.
It's yet another disheartening development for a woman who, after dodging death this morning, endured two major brain surgeries.
Can she survive a third one? Shahlaie wonders.
Shahlaie, the senior neurosurgery resident at the medical center, knows little about his patient beyond her injuries.
Her first head scan, taken minutes after her arrival, showed a large bruise over the left side of her skull. This subdural hematoma was creating pressure so intense that it was pushing the patient's brain to the right. She needed surgery right away or she had no chance.
And so, about 7:20 a.m., a pager went off in the ICU, where Shahlaie was making his early morning rounds.
In less than half an hour, the patient was in the second-floor operating room.
Hovering above his patient along with five other specialists, Shahlaie cut out a small portion of the patient's skull to expose the left side of her brain. It looked swollen and dark, nothing like the beautiful, shimmery surface of a healthy one. Shahlaie suctioned out the clot, temporarily covered the opening in her head with a sterile film and skin from her scalp, and sent her to the recovery room.
About two hours later, he was called into action again. Tests showed that the pressure inside the injured jogger's head was shooting up again. This time, the problem was on the right side. So the surgical team cut into her skull again and suctioned out another clot.
Now it is late afternoon, less than an hour after the second operation was completed, and the patient is in trouble again. Shahlaie is torn. What would be riskier, he asks himself -- taking her back into surgery for the third time in 10 hours, or trying to manage the situation with medication and careful monitoring?
Shahlaie pages James Boggan, a senior doctor on the neurosurgery staff. Together, after much discussion, they decide that they cannot afford to watch and wait. So once again, Shahlaie calls for an operating room.
Surgery No. 3 is particularly tricky. The woman's brain is grossly swollen. Shahlaie decides that he must remove a small portion of the severely damaged left frontal lobe.
It's a risky move that may save her but could affect her life forever. He must carefully avoid certain areas of the brain or she could lose her vision or her ability to speak or walk.
It's 6:43 p.m.
Shahlaie suctions the clots on the left side and carves out a damaged, golf ball-sized section of her brain. His marathon day of surgery ends at about 8:30, and he leaves the operating room exhausted.
The next morning, he learns that the patient is one of the hospital's own.
According to her parents, who arrived in the wee hours after her third surgery, her name is Cathy Liu. She is 25 years old, a first-year internal medicine resident at UC Davis, a woman who since the age of 8 has talked about being a doctor.
Cathy, the daughter of Taiwanese immigrants, was a high school valedic- torian and a star undergraduate microbiology student at UC Davis. Her medical degree is from Emory University in Atlanta, and she's already had two research papers published in a prestigious scientific journal. She has run a marathon and traveled all over the world. She is witty and kind, a clotheshorse and shoe aficionado who throws back her head dramatically when she laughs.
Cathy Liu, M.D., has just begun her medical career, and now the doctor is a patient.
Her physicians and nurses have worked hard to save her, but Shahlaie knows well the unpredictability of head injuries.
Will Cathy Liu ever wake up, he wonders?
Will she be able to use the right side of her body again?
Will she be able to speak and read and think clearly?
What about her budding medical career?
Pam Liu is standing beside her daughter's hospital bed one August day.
"Mom," Cathy whispers. It is the first clear word she has spoken in weeks.
Jen Liu, who is massaging his daughter's right foot, looks up.
"Mom," Cathy says again, and she reaches out with her left hand.
Cathy's parents have been keeping vigil at the medical center since the accident a month earlier that sent their older daughter's head crashing through a car windshield.
They believe that her survival is something of a miracle. After three surgeries on her brain, doctors were cautious in their predictions about her recovery. But on her seventh day in the hospital, Cathy turned a corner, thanks to the perseverance of her neurosurgeons and the innovative use of technology.
Right after her first major operation, Shahlaie had inserted a probe into the interior of Cathy's brain to monitor whether it was getting enough oxygen.
On Day 7, Shahlaie checked the oxygen monitor and became alarmed. Suddenly, it was dangerously low.
Shahlaie had a hunch that the blood vessels in her brain might be in spasm, choking off the oxygen supply. He ordered a test that confirmed it. After consulting with the UC Davis neurosurgery chairman, Dr. J. Paul Muizelaar, Shahlaie decided to try giving intravenous medications that would put Cathy in a deep coma. The idea was to essentially shut down her body and quiet her brain, reducing its demand for oxygen.
It was an aggressive and unusual approach to the problem, but it worked. After the vessels relaxed and the brain's oxygen level was restored, Cathy's prospects were much better. The doctors slowly brought her out of her induced coma, and she began blinking her eyes.
Since then, Cathy has hit a few milestones.
Toward the end of July, after doctors removed her breathing tube, she mumbled something. No one understood her, but it was clear Cathy was trying to speak. A few days later, one of her doctors asked Cathy to hold up two fingers on her left hand. She did it.
On another occasion, Cathy seemed to pore over the words on a greeting card sent by a friend. Was it possible, her mother wondered, that she was reading? Was it possible that she understood everything that had happened to her?
No one knew.
But for a while now, Cathy has been making eye contact. She clearly recognizes her mother and father, her boyfriend and other familiar faces, and she manages a crooked smile now and then. Her right side, which before the accident was the dominant side of her body, is weak but showing some movement.
And now, Cathy has spoken.
"Mom."
It is just one word. But it has given Jen and Pam Liu great joy, and one other thing that has been so elusive during this difficult saga.
Hope.
FORMER ST. JOHN'S STAR USING SOCCER TO FIGHT AIDS IN SOUTH AFRICA
Published: December 23, 2007 11:14 pm
By Bill Kipouras, Staff writer
The Salem News
Anthony Regis’ world these days is a bit different from when he was a student and star soccer player at St. John’s Prep and Bowdoin College in Brunswick, Maine.
The 23-year-old from Topsfield, an aspiring doctor, is currently in Bloemfontein, South Africa, using soccer as a means to educate African youths ages 10-18, both male and female, about AIDS and the HIV virus.
Regis is an advocate for GrassrootSoccer, a nonprofit volunteer organization that delegates soccer coaches and players to places such as Africa to lecture at clinics and schools and broaden the knowledge of young people on the issues of prevention and treatment of AIDS.
Regis took off for Bloemfontein in September and is currently back home for the holidays, but plans to return in late January and stay through June.
Before travelling to South Africa for a one-year stay, Regis prepared himself for the poverty he has encountered and the culture shock that would await him. He also was well immunized prior to flying to South Africa. Regis is not in a malaria-infected area, but if he were to travel he would need malaria shots.
“Bloemfontein is a city of 600,000, and the crime rate in South Africa in general is one of the highest in the world. It’s off the charts,” Regis said.
“It certainly is a whole different culture to see how people live on the other side of the world. When you get out into the townships — which could be identified as ghettos, for the most part — you run across what look like shanty towns, with people living in shacks. Not all these shacks or homes have electricity or drinking water.”
Even worse, said Regis, is that there is a very high unemployment rate, and that up to 20 percent of the population are HIV positive.
Regis was unaware of the GrassrootSoccer opportunity until his Bowdoin coach, Fran Leary, told him about it in the winter of his senior year. It held an immediate appeal to Regis.
The program’s motto is to use the power of soccer in the fight against AIDS. Officially, his title is African field intern, delivering the curriculum activity in association with soccer.
“There are children in these games, and the games have key messages in which kids can learn about AIDS,” he said. “Soccer has an interesting connection.”
The life expectancy in this part of the world is only about 50 years, Regis said. Nearly all the Africans he’s met have someone who has been affected by the HIV virus.
A New England Small College Athletic Conference (NESCAC) All-Academic scholar while at Bowdoin, Regis said the living conditions in parts of Bloemfontein make him thoroughly appreciate lifestyles back home.
He’s currently taking a short break for the holidays at home while interviewing at several medical schools: Boston University, Vermont, Tufts, UMass. Medical in Worcester, Dartmouth, Albany School of Medicine and New York Medical College. He is hoping to complete his interviews and return to South Africa in late January.
Naturally, Regis’ journey to South Africa with GrassRootSoccer is related to his chosen vocation.
“I wanted to take a year off before starting med school, and this was an ideal manner to familiarize myself with primary things of worldwide importance,” Regis said.
His background already includes three years as an EMT with Lyons Ambulance in Danvers, where he’s still employed. He was a call (volunteer) firefighter in Brunswick for four years during college, and an emergency room volunteer at Midcoast Hospital in Brunswick for two years. He’s unsure yet whether he’d like to go into emergency medicine or sports medicine.
He’s visited some clinics in Bloemfontein and seen long lines waiting to see doctors and nurses. The clinics are often overcrowded.
He’s also joined the Bloemfontein Young Tigers, a local professional soccer team, and said it’s been a great experience and given him the opportunity to make 25 friends.
“It’s the National First Division team of South Africa, and all the players are really talented. They’re all Africans,” Regis said. “It’s a totally different style of play; a lot of quickness and ball control. The field here is uneven dirt, bumpy, has glass, and is littered with garbage that we have to clear.”
The city is not rural with animals everywhere; it’s a fairly modern in the downtown area, known as the “City of Roses”. Regis has a fairly new apartment in a gated community, but the windows have metal bars and the residents are cautioned not to wander far away at night because of the crime rate. The chances of being mugged near the townships is pretty high.
Yes, Bloemfontein has a McDonald’s and a Kentucky Fried Chicken, as well as office buildings, traffic lights and malls. Regis hasn’t seen any wildlife, but said there are national parks and game reserves all over the area, and wild animals are evident in other townships (i.e., in the countryside), he’s been told.
It’s going to cost Regis about $8,000 for his entire year abroad. St. John’s Prep made a financial gift to him. For those willing to assist him, Regis can be reached through the program’s website at www.grassrootsoccer.org
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From St. John’s Prep to South Africa
Anthony Regis of Topsfield is spending a year in Bloemfontein, South Africa with the GrassrootSoccer.org program, teaching soccer while also helping Africans learn about the dangers of AIDS and the HIV virus. A few facts of his trip:
Length of his trip: September to June
Estimated cost of entire trip: $8,000
Plane ride to Johannesburg: 15 hours from Washington, D.C.
Cost of flight: $3,000
Bus ride from Johannesburg to Bloemfontein: 6 hours
South Africa’s monetary unit: The rand
Comparison to U.S. dollars: 61/2 rands to $1 U.S. dollar
Primary language in the area: Sesotho
CHINA TO ENACT LAW TIGHTENING SUPERVISION OF SOCIAL SECURITY FUND
BEIJING, Dec. 23 (Xinhua) -- China's top legislature on Sunday began reading the draft law on social security with an emphasis on strict supervision over the social security fund.
The draft law was submitted to the weeklong 31st session of the Standing Committee of the National People's Congress (NPC), China's top legislature, for first reading.
It states the social security fund is composed of five categories: pension insurance, medical insurance, work injury insurance, unemployment insurance and maternity insurance.
It stipulates all funds should be used for specified purposes only, and no institutions or persons had the right to occupy or embezzle from the fund.
To make management of the fund more transparent, the draft law asks institutions in charge of social security cases to disclose revenue, expenditure, balance and earnings on a regular basis.
"Only after the safety of the social security fund can be guaranteed, can the fund be used for investment operation to maintain and increase the fund value," the draft bill says.
In June, Shanghai courts started hearing cases against officials involved in the social security fund scandal that involved 3.7 billion yuan (502.3 million U.S. dollars).
Investigators found the money had been illegally loaned by a company of the municipal labor and social security bureau to Shanghai Feidian Investment Development Co. Ltd. The company was controlled by tycoon Zhang Rongkun, ranked 16th on the Forbes China rich list in 2005, who was arrested during the investigation into the misuse of pension funds.
The draft law says all governments above the county level should establish supervision systems to safeguard the secure and efficient operation of the fund.
Any embezzlement activities would be punished or investigated under the law, the draft says.
It also states finance departments and audit offices should administrate the security fund at corresponding levels according to their responsibility.
Company representatives, trade unions together with law experts and actuaries could also organize a supervision committee to supervise revenues, expenditures, the investment operation of the social security fund and put forward their proposals.
If the security fund was embezzled, the social security administration departments, financial departments and audit offices should recover the embezzled fund. Illegal income earned from embezzled social security funds should be confiscated and personnel involved would be punished according to the law.
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