The Surgeon

The Surgeon

A memory of William Dayton Shelly, 2/17/43 to 4/13/08

Recently hurricane Matthew came through North Carolina. It caused widespread flooding and destruction. Many roads and bridges were destroyed. Homes were flooded and there were widespread power outages. Several lives were also lost. I was lucky. I lost power for only three hours, and was not personally affected. I however saw the devastating effects of this hurricane around me. This led me to remember another hurricane many years ago and a remarkable physician.

It was September 1999. I was working as an Internal Medicine physician in a small hospital in Eastern North Carolina. Hurricane Dennis had just passed through, causing a lot of rain, but no significant damage. The ground was however waterlogged, and we heard of another hurricane forming in the Atlantic. This was named Hurricane Floyd. I was not too worried. It was categorized as a category 2 and that did not seem too bad.

On September 16th, 1999, Hurricane Floyd made landfall in North Carolina. I lost power in my home that night as the winds howled around me. A large pine tree in my yard fell, but it fell away from the house. In the morning my home was intact and I still had running water. My neighbors came by and helped me clear the fallen tree. The power came back on later that afternoon and I thought the worst was over. I was wrong.

The ground was waterlogged from Hurricane Dennis when Floyd came onshore. The rains caused widespread flooding and nearly every river basin in the eastern part of the state exceeded 500-year flood levels. In total, Floyd was responsible for 57 fatalities and $6.9 billion dollars ($9.8 billion in today's dollars) in damages. Due to the destruction, the World Meteorological Association retired the name Floyd.

My office was closed because of the storm, but the next day was a Friday and I was on call for the weekend. I got a call mid-morning about a patient that had been brought in and needed to be admitted.

It was a sunny day as I drove to the hospital. I knew from the news that many surrounding areas had flooded. Waters had continued to rise as many streams and rivers overflowed their banks. I also knew that the National Guard had been called in. I was however unprepared for the scene that greeted me as I got to the hospital.

A large and very loud Chinook helicopter was landing in front of the hospital. It was bringing people evacuated from the floods. They were supposed to be taken to shelters from there, but many dazed people were walking aimlessly around. There were also many National guardsmen in their Army uniforms. It felt surreal, almost like a scene from a war.

I went in to see my patient. She was an elderly lady in congestive heart failure. Her heart rate was 30, which is very low. She was in a medical condition called a heart block. She needed a pacemaker. We put pacer pads on her chest and started to electronically pace her heart. Unfortunately, this was only a temporary measure. I had to get her to a Cardiologist so that a more proper pacemaker could be placed. This meant getting her transferred to our local teaching hospital.

I called our nearby teaching hospital and explained the problem. The operator told me they were on diversion and transferred my call to the chief of staff. I knew the chief of staff, and he told me that he would love to help, but they had lost power and running water. Their generators were running, but the flood waters were rising and those generators were about to be flooded. He said he would be happy to try to get her transferred once things got more stable.

With dismay, I realized that I was probably on my own for now. Luckily our patient was stable. I was however worried as I walked out of the hospital. Sitting outside the hospital was our surgeon. He had moved a few years ago from a practice in Pennsylvania to our small hospital. His motto was "love what you do so much that you never have to work a day in your life". He was sitting outside because he was smoking. He used to smoke fancy brown ‘More’ cigarettes. What is the matter, he asked?

I told him about the situation with my patient. He said, oh I can put trans-venous pacer wires in. This involves putting wires through a central line into the heart. I would have to go into the operating room with him and use the cardiac monitors to assess if the leads were placed in the right place and working properly. This is only done by Cardiologists today, but our surgeon said he had done this many times before. 

So for the first (and last) time since 1993, I put on scrubs and went into an operating room. He put the leads in through a central line into the heart, and I used the cardiac monitor to guide him. The pacer started working immediately and the patient’s heart rate improved. Her symptoms also improved later that evening. The next day, we were able to transfer her to another teaching hospital in a stable condition. That day my respect for our surgeon increased significantly

As hurricane Matthew came through, I thought about hurricane Floyd so many years ago and our remarkable surgeon. He has since passed on, but I will never forget his skills on that day, and I try to follow his motto of loving what you do so much, you never have to work a day in your life.

                                                   Effects of Hurricane Matthew