thumbnail of Mission from the Heart; Target New Jersey
Hide -
<v Speaker>Major funding for a mission from the heart is made possible by U.S. <v Speaker>health care, dedicated to providing over one million members with quality <v Speaker>care. U.S. <v Speaker>health care. The health plan for living. <v Speaker>Additional funding provided by Siemens, a diversified leader in medical electronics, <v Speaker>providing technology and caring hands nationwide, worldwide <v Speaker>for more than 100 years. <v Speaker>And the Medical Society of New Jersey, the oldest state medical society in <v Speaker>the nation, serving New Jersey with 10000 dedicated physicians. <v Speaker>The Medical Society of New Jersey caring for your health. <v Speaker>Since 1766.
<v Speaker>You're a part of a very, very special team going to Tbilisi in Soviet Georgia. <v Speaker>Gotta work harder than you ever worked your entire life. <v Speaker>But it's going to be very, very, very satisfying to you when you've finished it. <v Speaker>We've gotten records of the number of children from Armenia. <v Speaker>Ukraine and from soviet Georgia. <v Speaker>We've reviewed those medical records. <v Speaker>And from those we've picked the patients that we think are reasonable to operate on. <v Speaker>I think we should put this on a list of potential cases. <v Speaker>This is an undertaking that has never been tried before.
<v Speaker>It rested on our ability to bring essentially <v Speaker>a full operating room team. <v Speaker>I see your team post-operative recovery room team to a foreign <v Speaker>country with different electrical supplies, different water, different <v Speaker>philosophies of life, and try in that environment to <v Speaker>pull off somewhere between fifteen and 30 open heart operations. <v Speaker>Deborah Heart and Lung Center in Browns Mills, New Jersey, had a plan, <v Speaker>a mission from the heart to do pediatric open heart surgery <v Speaker>in a Soviet republic where medicine is 25 years behind American <v Speaker>standards. The idea was to help free small Soviet republics,
<v Speaker>Georgia, Armenia and the Ukraine to help their children. <v Speaker>To provide some modern equipment and to train their doctors. <v Speaker>Tbilisi, the capital of Soviet Georgia, is located in the eastern part <v Speaker>of the Georgian Republic, just north of Turkey and between the Caspian <v Speaker>and the Black Sea. It was chosen as the site for the mission because of its <v Speaker>location near Armenia and the Ukraine and chosen <v Speaker>because it was the smallest republic, thus had potentially the least bureocracy <v Speaker>to overcome. <v Speaker>[singing]. <v Speaker>Tbilisi, a Georgian for Warm Springs, warm, aptly <v Speaker>described the city not only because of its mild climate, but also <v Speaker>because of its people the most hospitable of places.
<v Speaker>City with old world charm, a place where locals <v Speaker>strive to keep traditions alive. <v Speaker>Tbilisi, like many other parts of the Soviet Union, is economically <v Speaker>hard pressed, government store shelves are bare. <v Speaker>Gasoline hard to come by and lines for cigarets are long. <v Speaker>The ruble is looked at as practically worthless. <v Speaker>There's no money for modern medical equipment and much of the equipment there breaks <v Speaker>down and either can't be or isn't being fixed.
<v Speaker>With such economic problems, routine medical care is <v Speaker>lacking. But we found out that 80 percent of the patients who are coming into the clinic <v Speaker>for evaluation of their congenital heart disease had never had any immunizations, <v Speaker>for example. So the pillars upon which all of your health care stand <v Speaker>are absent. <v Speaker>Cardiac surgery is one of the most expensive fields in medicine. <v Speaker>And the whole problem is very much linked up with economic problems, with the whole <v Speaker>republic. Pediatric open heart surgery is performed in Moscow, <v Speaker>Leningrad and Kiev. <v Speaker>The waiting line in Moscow and Leningrad is long and the mortality rate in Kiev, <v Speaker>capital of the Ukrainian republic high. <v Speaker>Deborah does heart surgery free of charge. <v Speaker>Since 1973. <v Speaker>Children from all over the world come to Deborah to be operated on. <v Speaker>In 1988, Deborah did open heart surgery on its first child
<v Speaker>from the Soviet Union. <v Speaker>Her name was Maya Sragow. <v Speaker>She was destined to die. <v Speaker>And that's what it was. she never walked in their life. She had to be carried by her <v Speaker>mother all the time. If she'd walk, she'd make two steps and go into <v Speaker>a crouch so she could breathe, because that's that's a physical part of this particular <v Speaker>sickness. Her lips were blue. <v Speaker>Her fingernails were blue. <v Speaker>And when she returned to Odessa in the Ukraine, the Soviet Ukraine, <v Speaker>it hit her all the newspapers throughout the entire country. <v Speaker>And we were flooded with requests by parents asking us to help them because they could <v Speaker>not get any help in Russia. Who would bring the children to Deborah? <v Speaker>Those case could run. The cost of those cases could run anywhere between 25000 <v Speaker>to 40000 or even sixty thousand dollars per child. <v Speaker>And there is a number of associated costs, the use of the bed, equipment, On-Call <v Speaker>time staff and so forth. <v Speaker>What we were able to do this time, of course, was to get all of the equipment donated, <v Speaker>put absolutely no pressure on Deborah's equipment.
<v Speaker>Number of foundations and corporations donated supplies and loaned equipment <v Speaker>to make the trip possible. <v Speaker>A mean, medical outreach arranged for a cargo plane to bring it all to <v Speaker>Tbilisi. <v Speaker>So instead of bringing the children to Deborah, Deborah came to the children. <v Speaker>Deborah asked the health ministries in Georgia, Armenia <v Speaker>and the Ukraine to send the medical records of children needing open heart <v Speaker>surgery. <v Lynn B. McGrath, M.D.>To carry out complex congenital heart surgery. <v Lynn B. McGrath, M.D.>Risk is involved to do that. And when you're going into it in a situation where there are <v Lynn B. McGrath, M.D.>a lot of unknowns, a lot of imponderables about which you're not confident. <v Lynn B. McGrath, M.D.>Then to try to reproduce what we do here. <v Lynn B. McGrath, M.D.>Make we may not be 100 percent successful in doing that. <v Lynn B. McGrath, M.D.>So I'm I'm a little reticent to go ahead and do too many complex operations for that <v Lynn B. McGrath, M.D.>reason. And also because taking care of those patients after the operation
<v Lynn B. McGrath, M.D.>is also an important part of their success, especially in complex forms of congenital <v Lynn B. McGrath, M.D.>heart disease. We'll be going over there for seven or 10 days and then we'll all be <v Lynn B. McGrath, M.D.>leaving. So I don't want to leave a whole bunch of patients who survive their operation <v Lynn B. McGrath, M.D.>of com- complex congenital heart disease and just leave them there isolated. <v Lynn B. McGrath, M.D.>And the people who are left behind to take care of them not really know how to manage <v Lynn B. McGrath, M.D.>that. <v Edward Rourke>When they start studying kids with more complex congenital defects. <v Edward Rourke>They're not going to get them on that system. <v Edward Rourke>They'll have to be redone elsewhere. So there's no sense kidding ourselves. <v Speaker>At least give us an idea whether or not this kid is even operable or not. <v Speaker>Give us some idea- some idea. <v Speaker>Medical records were slow in coming from Armenia. <v Speaker>And once staffers looked at sophisticated x rays of the heart. <v Speaker>They realized they needed to be redone. <v Speaker>Diagnostically, they were useless. <v Speaker>Yes. So a team of four left Deborah and went to Armenia <v Speaker>to get the medical information necessary for surgery.
<v Speaker>John Ludwig, chief technician in Deborah's pediatric cardiac catheterization <v Speaker>lab, was in Armenia. <v John Ludwig>The workup that they did with the children, the x ray and any kind of history physical <v John Ludwig>was not adequate for our physician to risk this, these children's <v John Ludwig>lives in order to correct their heart disease. <v John Ludwig>We had two days in which to prepare an entire cath lab and three days in which to study <v John Ludwig>fifteen children. And so we roughly worked, I guess, a good 12, <v John Ludwig>15 hours a day to get that done. <v Speaker>When the Deborah team reached Tbilisi, they found the Georgian cath lab also <v Speaker>troubling. <v Speaker>I need a part. I would usually get that part within the day or certainly the <v Speaker>next day. It takes them the better part of six months to a year to get that same <v Speaker>part. <v Speaker>What I saw was fifteen hundred boxes piled up in the same room, <v Speaker>which had to be moved out before we could do anything.
<v Speaker> <v Speaker>We start now, I want to store all this stuff somewhere else. <v Speaker>My be to set up two over there and two over here. <v Speaker>Wow. OK. <v Speaker>Lucy Palmer is intensive care unit charge nurse who speaks fluent Russian. <v Speaker>She was sent ahead to set up the ICU on the sixth floor of Children's <v Speaker>Hospital. My first impression when I arrived here was shock, <v Speaker>absolute shock to the amount of work that had to be done to set up the unit. <v Speaker>The room was bare. So we realize now that we had to negotiate for <v Speaker>curtains, beds, mattresses, tables for our monitors,. <v Speaker>And getting the operating room up to American sterilization standards was even
<v Speaker>tougher. <v Chizuko Williams, R.N.>I don't know how those people do cleaning, but <v Chizuko Williams, R.N.>I have to scrub down all the wall and not once. <v Chizuko Williams, R.N.>We have to do it every day. Three or four times. <v Chizuko Williams, R.N.>We have to demonstrate. How to do cleaning. <v Chizuko Williams, R.N.>Used to clean. Yes. <v Chizuko Williams, R.N.>How can I explain to her? <v Chizuko Williams, R.N.>We showed them how we do it because they don't even have a mop, <v Chizuko Williams, R.N.>don't even have the cleaning right. <v Chizuko Williams, R.N.>So we go through one step at a time. <v Chizuko Williams, R.N.>We cannot speak Georgia. <v Chizuko Williams, R.N.>And they cannot speak English but the body language, <v Chizuko Williams, R.N.>we communicate. <v Speaker>Communicate well enough that in a week's time, the sixth floor of Children's <v Speaker>Hospital was transformed into a working pediatric, cardiac, medical <v Speaker>and surgical unit. <v Speaker>I have tunnel vision when I'm operating. So what I'm saying is what I see in the
<v Speaker>operating room is what I see when I'm operating at the Deborah, doesn't change much. <v Speaker>My responsibility is is really not much different than it is <v Speaker>back home. The difficulty in doing it, however, is <v Speaker>all of the other people, all of the other backup systems that we need to have in place <v Speaker>are perfect. <v Lucy Palmer, M.S.N.>When I hear all the noise, the familiar sounds, the beats, the bubbling. <v Lucy Palmer, M.S.N.>You can close your eyes and feel you're back at home. <v Lucy Palmer, M.S.N.>But when you open 'em, you realize you're not. <v Maria Colombi, M.D.>As soon as the people of Tbilisi heard that there was <v Maria Colombi, M.D.>an American team coming down. <v Maria Colombi, M.D.>There have been many requests to be seen by us. <v Maria Colombi, M.D.>And since the first day that I was here. <v Maria Colombi, M.D.>I saw many patients, about 10, 12 a day and they continued to come <v Maria Colombi, M.D.>to be seen. <v Maria Colombi, M.D.>They are hoping, all of them, they are hoping to that we offer to come
<v Maria Colombi, M.D.>to the United States. <v Maria Colombi, M.D.>Unfortunately, we cannot do this because we have already many children. <v Maria Colombi, M.D.>Their children had relatively complex heart disease, but stable, <v Maria Colombi, M.D.>and they can wait for one or two years. <v Maria Colombi, M.D.>So these are the children that I select and I <v Maria Colombi, M.D.>offer to come to United States. I would say so far six or seven <v Maria Colombi, M.D.>out of seventy or 80 that I saw. <v Maria Colombi, M.D.>So we'll see. <v Speaker>And then there are the others. <v Maria Colombi, M.D.>It is very sad, especially for the very sick children. <v Maria Colombi, M.D.>But I quite agree with what they told you in Moscow. <v Maria Colombi, M.D.>That there is a hole. But the main problem is a very <v Maria Colombi, M.D.>high pressure in the lungs that at this point that will do only <v Maria Colombi, M.D.>harm to close the hole and much better to leave alone and not doing <v Maria Colombi, M.D.>anything. They probably think, yes, it's too risky and
<v Maria Colombi, M.D.>the heart will not work well. <v translator> is there any chance that if she gets well? <v Maria Colombi, M.D.>Is very difficult in generally, these is a progressive disease of the lungs. <v Maria Colombi, M.D.>The only possible treatment will be to consider heart and lung transplant, <v Maria Colombi, M.D.>which is done very rarely even in the United States. <v Maria Colombi, M.D.>So let's just say theoretical question then than anything <v Maria Colombi, M.D.>else. I do not know if they are doing it in Russia. <v Maria Colombi, M.D.>I review in the last six months about 150 medical records <v Maria Colombi, M.D.>of children from Russia and wind up to pick about 19 <v Maria Colombi, M.D.>20. They find it formularies, the noses and later symptoms <v Maria Colombi, M.D.>defects. <v Maria Colombi, M.D.>This is Chichinade, this is the challenge now, a six year old <v Maria Colombi, M.D.>and the current catheterisation was then two years ago in Moscow.
<v Lynn B. McGrath, M.D.>I'm just not so sure if the study is two years old that we should proceed <v Lynn B. McGrath, M.D.>because, you know, we wouldn't proceed with that if we were back home. <v Lynn B. McGrath, M.D.>I know we would restudy that our hands. <v Lynn B. McGrath, M.D.>So I think we have to reconsider that. <v Maria Colombi, M.D.>OK, I see you being protected. <v Maria Colombi, M.D.>If you speak to the mother of these children because they have a high <v Maria Colombi, M.D.>expectation for surgery. So you better you explain. <v Maria Colombi, M.D.>I have always been telling them that you were the guy making the final decision. <v Maria Colombi, M.D.>That was clear with me. But-. <v Lynn B. McGrath, M.D.>Never. Please. I'm Dr. McGrath. I'm a surgeon. <v Lynn B. McGrath, M.D.>I want to discuss her son's case with her. <v Lynn B. McGrath, M.D.>Her son has the trology of fillow which means there are two problems inside the heart. <v Lynn B. McGrath, M.D.>There's a hole inside the heart and also a narrowing in the lung artery. <v Lynn B. McGrath, M.D.>This needs to be repaired. <v Lynn B. McGrath, M.D.>However, the catheterization of the heart, the X-ray of the heart that the child had
<v Lynn B. McGrath, M.D.>was too old, two years ago and needs to be repeated before he can have an operation. <v Lynn B. McGrath, M.D.>So what we'd like to do is bring him up to the United States and catheterize him there <v Lynn B. McGrath, M.D.>and operate on him over there and tell her that we don't know now when <v Lynn B. McGrath, M.D.>he's going to come, but we will let her know when that will bring him over. <v narrator>Dr. McGrath also met with the parents of children scheduled for surgery. <v Lynn B. McGrath, M.D.>I'm Dr. McGrath. I'm the surgeon who will be operating on your child tomorrow. <v Lynn B. McGrath, M.D.>She has a problem. It's just outside the heart called the patent ductus arteriosus, <v Lynn B. McGrath, M.D.>its a big word means that there's an abnormal artery present. <v Lynn B. McGrath, M.D.>All children have this at birth, but it closes after about one or two <v Lynn B. McGrath, M.D.>weeks, normally in her case, this has stayed open <v Lynn B. McGrath, M.D.>and it's causing too much blood flow into her lungs, although she's <v Lynn B. McGrath, M.D.>getting along well at this time. <v Lynn B. McGrath, M.D.>Eventually, this will cause damage to her lung arteries, significantly reduced life <v Lynn B. McGrath, M.D.>expectancy. And this is why we're recommending that this be closed at this time.
<v Lynn B. McGrath, M.D.>There's risk involved to her life to have this done, but the risk is low. <v Lynn B. McGrath, M.D.>Like one percent means ninety nine percent chance. <v Lynn B. McGrath, M.D.>If she wants- [mother: one percent?] one percent risk, means ninety nine percent chance <v Lynn B. McGrath, M.D.>that she would survive and be well after. <v Lynn B. McGrath, M.D.>So I really believe it's the right thing to do for her at this time. <v Lynn B. McGrath, M.D.>You understand? [mother: Yeah.] Do you have any questions? <v Lynn B. McGrath, M.D.>Everybody's frightened to have their child to have surgery. <v Lynn B. McGrath, M.D.>But it's it's in her best interest to have this one. <v Lynn B. McGrath, M.D.>OK? <v narrator>Although the risk was small, Viollette Maisuradze was scared, mostly <v narrator>because her child, Mariem, didn't appear sick. <v narrator> <v narrator>Mariem would have undergone surgery even without the Deborah team. <v narrator>But the question was when.
<v Lynn B. McGrath, M.D.>The amount of surgery that takes place in this institution when we're not here is very <v Lynn B. McGrath, M.D.>limited. And so just because you have a patent ductus arteriosus that they <v Lynn B. McGrath, M.D.>have the ability to close here does not mean that it's going to get done. <v Lynn B. McGrath, M.D.>So we think that we'll do some of those too while we're here and maybe that will <v Lynn B. McGrath, M.D.>stimulate them to in the future, do more of those cases. <v Violette Maisuradze>So this operation isn't connected to his heart. <v Violette Maisuradze>And those advantages. It is operational? <v Lynn B. McGrath, M.D.>Yes. Because you have to get to the heart. <v Violette Maisuradze>Don't stop the heart? <v Lynn B. McGrath, M.D.>Very quick. It's a procedure that's been done tens of thousands <v Lynn B. McGrath, M.D.>of times, don't worry. <v Lynn B. McGrath, M.D.>I know. Don't worry is easy for me to say, although I worry too.
<v Speaker>[Mariam singing]. <v Speaker>All is good and everything went fine. <v Speaker>Mariam is back in the surgical intensive care unit and seems to be doing OK.
<v Speaker>[chatter] You want your mom. Ok. <v nurse>Everything went very well. <v nurse>[chatter] Hi, are you ok? <v nurse>yes. You want to go to this side? Come on over here. <v nurse>She's fine! <v nurse>She's awake too she's doing fine. <v Violette Maisuradze>She's well? <v nurse>She's fine. <v nurse>She's sleepy but she's awake. <v Violette Maisuradze> Now, I'm very happy
<v Violette Maisuradze>because my child is better I think. <v narrator>The majority of the 19 surgical procedures scheduled were open heart <v narrator>surgeries, procedures that Georgian and Armenian doctors perform <v narrator>on adults, but not on children. <v narrator>He has a problem with a hole inside the heart. <v narrator>The hole is between the two filling chambers of the heart. <v narrator>This problem causes there to be increased blood flowing into his lungs arteries. <v narrator>And although he's getting along well now, this problem will significantly reduce <v narrator>his life expectancy. <v narrator>Many children who have this problem will die in their 30s or 40s <v narrator>because of that. And this is why we're recommending that the hole be closed at this time. <v Speaker>Nine year old Dakia Vepkhvadze, an avid soccer player, came <v Speaker>to Tbilisi from an outlying village.
<v Liana Vepkhvadze>From my eyes my son is pretty healthy. <v Liana Vepkhvadze>I don't see anything. I'm afraid Doctor could cut him and it may be worse for <v Liana Vepkhvadze>him. I don't know. <v Liana Vepkhvadze>He doesn't worry about the operation. <v Liana Vepkhvadze>He tells me, don't worry, I'm happy. <v Liana Vepkhvadze>Don't worry. I'm not afraid.
<v Speaker>Tell your momma goodbye. <v Speaker>There's an endless stream of children with congenital heart disease in this country who <v Speaker>are going to die if they're surgically untreated. <v Speaker>And many of them are going to die soon. That we've seen in the clinic even this week that <v Speaker>we just can't help. At this time. <v Speaker>Colleagues of mine, for example, have set up congenital cardiac surgical units <v Speaker>in Arkansas. <v Speaker>And he took six month period of time setting up his congenital cardiac surgical unit
<v Speaker>before he was willing to proceed into his first case. <v Speaker>So we were going into a situation in a foreign country, in a hospital that had never <v Speaker>done any kind of congenital cardiac surgery. <v Speaker>And we were planning to do this in six days. <v Speaker>We did four cases today. We were done by 1:30. <v Speaker>If we were back at the Deborah. Probably we would have done one or 1:30. <v Speaker>So we're able to accomplish that very efficiently, just like we would have if we'd been <v Speaker>back home. <v Speaker>All right. <v Speaker>All right. How about four fifty? <v Speaker>Right at Fifty. Hundred percent of people charity. <v Speaker>This one's got a leak so you're gonna lose some of your title volume.
<v Speaker>Can you ask him to move, move. <v Speaker>Twenty nine. <v Speaker>Twenty nine point thirty, no twenty nine. <v Speaker>[speaks Georgian]. <v Speaker>Ask him to move his hand. <v Speaker>There's risk involved in his life to have this done, the risk is about two percent means <v Speaker>98 percent chance that he could survive and be well after. <v Speaker> I trust you completely. <v Speaker>Does she have any questions? <v Speaker>Seven year old Behance Sarkisian came to Tbilisi from Yerevan, <v Speaker>the capital of Armenia.
<v Speaker> I'm pretty calm before the operation. <v Speaker>Because my older son had an operation in the United States and everything went <v Speaker>well. So I'm pretty confident. <v Speaker>Yea he remember me too. <v Speaker>Lucy, can you talk to him. He's waking up. <v Speaker> Here's mama. <v Speaker>. <v Speaker>The children were all extremely stoic. <v Speaker>There is only of the 19 children we did, perhaps only two that had <v Speaker>major periods of crying and trying to get out
<v Speaker>from the situation. <v Speaker>Most of them just simply allowed what had to be done to be done <v Speaker>to them. And and because of that, sailed right through the operations <v Speaker>or sailed right through the intensive care unit. <v Speaker>My daughter's name is Salome. <v Speaker>She's two years old. She could not play for our loved time, play <v Speaker>got her tired. And she often had the cold or flu. <v Speaker>How would you feel if the child feels well? <v Speaker>Mother feels well too. <v Speaker> That's fine. <v Speaker>All together. Together.
<v narrator>This nine year old boy, Niaz Tsindiliani came to Tbilisi <v narrator>from a nearby village. <v Nunu Tsindiliani>He's extremely weak. <v Nunu Tsindiliani>He doesn't grow. He hardly eats. <v Nunu Tsindiliani>And I'm hoping this will give him a new view on life. <v Nunu Tsindiliani>Everything is in your hands to let him play like the other kids <v Nunu Tsindiliani>to grow and run. He cannot run. <v Nunu Tsindiliani>He walks slowly. <v narrator>There was an electrical problem and perfusionist. <v narrator>Jeff Luckenbach had to hand crank the heart lung machine, something <v narrator>that normally doesn't happen. <v Jeff Luckenbach>I've been in this racket 14 years and I've hand cranked twice previous. <v Jeff Luckenbach>I was concerned at first because I didn't know the nature of the product if it had been <v Jeff Luckenbach>what had been a similar the problems we had last week, we <v Jeff Luckenbach>could have been out of power for an hour. An hour and a half.
<v Jeff Luckenbach>Was the first case we've had electrical problems the previous week. <v Jeff Luckenbach>Power failures. <v Jeff Luckenbach>Electricians in the hospital have been turning power out without telling us. <v Jeff Luckenbach>So we went in expecting to have problems, as it turned <v Jeff Luckenbach>out. We've blew a circuit breaker in one of our power lines. <v Jeff Luckenbach>So we switched to the alternate power source. <v Jeff Luckenbach>As You saw we had hand cranked, for about 30 to 40 seconds. <v Jeff Luckenbach>The alternate power source provided us with electricity and we went back on bypass.
<v narrator>When they open Neaz's chest, doctors found his case was more complicated <v narrator>than they anticipated. <v Speaker>The diagnoses on this patient is not as clear as it would be from back home. <v Speaker>These children are not worked up diagnostically as thoroughly as we <v Speaker>would probably do back home. <v Speaker>We thought the problem was a simple hole inside the heart. <v Speaker>Between the two filling chambers in the heart. <v Speaker>And in fact, the child had a more complicated problem in that all of the veins that were <v Speaker>draining the blood from the right lung back into the heart were connected to the wrong <v Speaker>chamber. So what requiring more complicated repair with what we call a patch <v Speaker>or a baffle in order to redirect those anomalously connected veins <v Speaker>back into the left side of the chamber, which is where they should be. <v Speaker>If a child with a simple hole inside the heart were to develop damage to the lung <v Speaker>arteries, that might reduce the life expectancy for 30s or 40s. <v Speaker>But if you compound that by adding an increased amount of flow to the lungs, by having <v Speaker>all the veins connected to the wrong place, that development of damage to the lung
<v Speaker>arteries might occur more rapidly in the 20s. <v narrator>But despite these complications, Neaz did fine and was moved to the <v narrator>intensive care unit. <v Speaker>We'll talk to you about... Needs off in P1. <v Speaker>Tell me, can you believe it? <v Speaker>you want to go up? <v narrator>After the operation dr. Douglas Joyce went to find Neaz's mother to let <v narrator>her know how the surgery progressed. <v narrator>First he looked on the second floor. <v Douglas H. Joyce, D.O>She's upstairs. <v Douglas H. Joyce, D.O>We're done. And one of the surgeons we didn't find her, no. <v Douglas H. Joyce, D.O>Tell her that we're all done with the operation and everything is fine.
<v Douglas H. Joyce, D.O> We closed, we closed this hole <v Douglas H. Joyce, D.O>that was between the two filling chambers in the heart. <v Douglas H. Joyce, D.O> And her child is in the intensive care unit. <v Douglas H. Joyce, D.O>Her child is in the intensive care unit now.
<v Nunu Tsindiliani> How is the result of the operation? <v Nunu Tsindiliani>I would like to see my child. <v Douglas H. Joyce, D.O>They were under the impression, I think, that there was going to be no risk from the <v Douglas H. Joyce, D.O>surgery. And it's our practice to produce a low risk for certain procedures. <v Douglas H. Joyce, D.O>We convinced her that the risk was low and that she should let the child have the chance <v Douglas H. Joyce, D.O>to have surgery. And after the case, when I went to speak with her, I think that she was <v Douglas H. Joyce, D.O>concentrating on the fact that there was a possible mortality because of the low risk <v Douglas H. Joyce, D.O>that we put it, which to her was much higher than she respected. <v Douglas H. Joyce, D.O>So as soon as I spoke with her. She passed out right to the floor and it took several of <v Douglas H. Joyce, D.O>the cases to be done successfully before the parents got the feeling <v Douglas H. Joyce, D.O>that we actually were going to come out with good news rather than bad news.
<v Nunu Tsindiliani>Thank you. Thank you. <v Nunu Tsindiliani>I was afraid yesterday before the operation. <v Nunu Tsindiliani>Nobody gave me a 100 percent warranty that the child is going to <v Nunu Tsindiliani>do well. <v Nunu Tsindiliani>We are from pillory a little town, <v Nunu Tsindiliani>Nietselise. We are not Georgians. We are as elby jangling My <v Nunu Tsindiliani>son Gangaji Pirif is a six years old. <v Nunu Tsindiliani>He's a nervous boy. His heart gets him very tired. <v narrator>
<v narrator>This type of outpouring of emotion from Georgian and Armenian parents <v narrator>was the rule rather than the exception. <v Speaker>We have 300, 400, 1 3, 400 is fine. <v Speaker>415, fifteen was fine, 20. <v Speaker>Half-. <v Speaker>Did in the operation, we just closed the hole in the heart. <v Speaker>And your son is doing very well. <v Speaker>To be like.
<v Speaker>Go, go watch. I'll be here all day. <v Speaker>Watch them then. <v Speaker>[chatter]. <v Valerie Siegeldorf>I'm sure the parents in the United States are just as relieved when their children come <v Valerie Siegeldorf>out of surgery. But I've never seen anything like it here that fathers were <v Valerie Siegeldorf>crying. The mothers were kissing the surgeon's hands. <v Valerie Siegeldorf>You know, it's grabs your heart. <v Valerie Siegeldorf>It was very emotional for everyone here, I think, to see it. <v David Meier-Levi, D.O.>Did surgery on their son. And he has done very. <v David Meier-Levi, D.O.>You will be able to see him every two hours and you will <v David Meier-Levi, D.O.>be able to talk to him and also lay down during the day we'll be able to bring him some <v David Meier-Levi, D.O.>food. <v David Meier-Levi, D.O.>It was nice to see the appreciation of what we've what we did <v David Meier-Levi, D.O.>for them. But it embarrassed me a little bit because I did not <v David Meier-Levi, D.O.>really feel that we deserved such an adoration.
<v David Meier-Levi, D.O.>I think that was their way of showing their appreciation for that. <v David Meier-Levi, D.O.>And it may be their custom of doing that in this particular way. <v David Meier-Levi, D.O.>But I felt a little bit embarrassed about that because, first of all, I'm not used to <v David Meier-Levi, D.O.>that. Number two, I just-. <v David Meier-Levi, D.O.>I just felt I was doing my job and I was just very happy that the children were doing <v David Meier-Levi, D.O.>well. So that was my biggest. <v David Meier-Levi, D.O.>Thanks for me. <v narrator>Valerie Siegeldorf is a perfusionist someone who works at the heart lung <v narrator>machine, which keeps the rest of the body alive. <v narrator>As the surgeon stopped the heart to work on it. <v narrator>Two months before the trip, she gave birth to her first child. <v narrator>While she couldn't pass up the Deborah trip, she found her own heart torn <v narrator>between job and family. <v Valerie Siegeldorf>It was hard, very hard leaving. But it's quite an opportunity just to come here <v Valerie Siegeldorf>and to visit the Soviet Union is an opportunity in itself and to help take
<v Valerie Siegeldorf>care of these children who obviously wouldn't have gotten any help at all. <v Valerie Siegeldorf>I heard her cry yesterday. <v Valerie Siegeldorf>It's hard. I miss her a lot, but getting <v Valerie Siegeldorf>over it. And I think it gets worse every day. <v Valerie Siegeldorf>But there's a lot of nice people here and there's all kinds of babies <v Valerie Siegeldorf>downstairs. I can go down and visit home. <v Valerie Siegeldorf>It helps. <v Lynn B. McGrath, M.D.>It's <v Lynn B. McGrath, M.D.>extremely important in cardiac surgery in order to have success, to do a very <v Lynn B. McGrath, M.D.>efficient operation. <v Lynn B. McGrath, M.D.>And so you have to have people with you who are very familiar with your technique. <v Lynn B. McGrath, M.D.>So there's not a lot of talking back and forth and discussing the perfect <v Lynn B. McGrath, M.D.>cardiac surgical operation from the point of view of the surgeon is one where there's no
<v Lynn B. McGrath, M.D.>talking. The operation is just done. <v Lynn B. McGrath, M.D.>Everybody knows their place. It's like playing chess in the library. <v Lynn B. McGrath, M.D.>You have to be able to think and concentrate and have everybody working <v Lynn B. McGrath, M.D.>like a clock. <v narrator>But it isn't always easy for doctors to admit they need help from their peers <v narrator>or to admit that doctors from another country can do things they themselves <v narrator>are unable to do. <v Speaker>Unfortunately, the level of frustration of the physicians significantly increased <v Speaker>as a result of our visit because they saw that we came in and in the 10 day <v Speaker>period came in and set up an ICU, an operating room, <v Speaker>cart the heart lung machine, and carried out con, you know, congenital heart surgery and <v Speaker>that it's possible to do that. And so I think their level of frustration is is even <v Speaker>more enhanced. <v Dr. Teimuraz Chachanashvili>Now, let's see that your surgery. <v Dr. Teimuraz Chachanashvili>Not every problem can be decided or made <v Dr. Teimuraz Chachanashvili>by surgeons hands. <v Dr. Teimuraz Chachanashvili>The one of the point is the equipments and medication
<v Dr. Teimuraz Chachanashvili>won't surgeon have, and what team he have, or training <v Dr. Teimuraz Chachanashvili>the team he have. <v narrator>The mission gave the Deborah team a different kind of training. <v Valerie Siegeldorf>We sent blood to the lab, you know, one sample and got three results back <v Valerie Siegeldorf>and things like that. <v Valerie Siegeldorf>My patient had the wrong blood type on his chart. <v Valerie Siegeldorf>Luckily, we didn't need to give blood for that patient. <v Valerie Siegeldorf>If blood were needed and the wrong blood transfused, that patient might have <v Valerie Siegeldorf>become seriously ill or even die. <v Roger Moore, M.D.>Their laboratory would take an hour to an hour and a half to get a blood gas back to us <v Roger Moore, M.D.>when things are happening very quickly in an open heart operation, you can't wait <v Roger Moore, M.D.>that long. So many of us ended up relying on our clinical judgment, <v Roger Moore, M.D.>having done this type of surgery for 10 years or so before and <v Roger Moore, M.D.>treated in manners that we thought were appropriate for the clinical <v Roger Moore, M.D.>situations rather than basing it totally on laboratory data.
<v narrator>While doctors were often not satisfied with the quality of Georgeann lab work, <v narrator>they did find the Georgian people ready to help whenever they could. <v Speaker>We had chatted with four families. <v Speaker>We'd planned to go ahead on Monday with their operations. <v Speaker>And then we were told sort of offhandedly that there was no blood available for two of <v Speaker>those children. On further investigation, we found that of the 19 children that we <v Speaker>had planned to operate on. <v Speaker>There was no blood available on eight of them, which is really an incredible setback. <v Speaker>At that time. And so we spoke to the Ministry of Health about this, and <v Speaker>the health minister went on the television and made a plea for blood. <v Speaker>And by that evening, by Sunday evening, we had the place was inundated with donations <v Speaker>of blood. <v Speaker>Starting off with 450. <v Speaker>Although people worry about complications during surgery, the time children <v Speaker>spend in the intensive care unit is also critical.
<v Speaker> <v Speaker>Can you cough? <v narrator> doctors <v narrator>gave the children medication to reverse the anesthesia quickly after surgery.
<v narrator>Yet some took longer than others to come around. <v narrator>Have her mom come in. <v Speaker>[people talking to the child]. Look at your bear. <v Speaker>Every few minutes... <v Speaker>She's appropriate, but she just isn't responding to pain the way she should. <v Speaker>I think her pre med is just taking effect. <v narrator>They all were removed from ventilators and needed to practice breathing on their own.
<v John Hill>More and more and more after we remove the breathing tube. <v John Hill>We did a lot of post surgical care. <v John Hill>Deep breathing, exercise, chest percussion, breathing techniques were important to <v John Hill>prevent the patient from getting either pneumonia or collapse a segment of <v John Hill>their lungs. <v Nunu Tsindiliani>Four, five, six, seven. <v narrator>Mothers helped coach their children in proper breathing. <v narrator>They also prepared their food and took care of their clothing.
<v Speaker> <v Speaker>Leave me alone is what he's saying. Yes. <v Speaker>Usually they say Coca-Cola. <v Speaker>Who's this? <v Speaker>Real tough case. <v Speaker>We've been lucky. <v Speaker>No strokes, no reentry, no infection. <v Speaker>The bottom line has been all along the patients themselves, the children. <v Speaker>Our responsibility is really to those children who we shouldn't have taken it upon <v Speaker>ourselves unless we were confident we could do it. <v Speaker>The children spent one day in intensive care. <v Speaker>The next in the step down unit there, the children got stronger and <v Speaker>took their first steps. <v Speaker>You ready?
<v Pam Dey, R.N.>The first time that they get up, they are in a lot of pain. <v Pam Dey, R.N.>They're still weak from the surgery and everything that's happened to them. <v Pam Dey, R.N.>We take it easy. You know, we have them sit on the end of the bed first, make sure that <v Pam Dey, R.N.>they're not dizzy and they're not going to have any problems. <v Pam Dey, R.N.>And then mom and dad or whoever accompanies them or guardians them <v Pam Dey, R.N.>and the nurses help them take their first walk, once they get up, then <v Pam Dey, R.N.>they're not as stiff. And then they feel more comfortable. <v Speaker>The next day, they were moved to the floor, trying to be steadier on their feet. <v Speaker>Deborah's team did remarkably well with the 19 surgical procedures.
<v Speaker>Doctors and nurses found working with their Georgian counterparts a challenge. <v Diana Barker, R.N.>Yeah, I know that the systolic is good. <v Diana Barker, R.N.>Okay, let me do the pressure and then they can do the pressure. <v Diana Barker, R.N.>Who first? <v Diana Barker, R.N.>They knew how to do it. Unfortunately, here in the Soviet Union, <v Diana Barker, R.N.>they are not allowed to be autonomous and practice <v Diana Barker, R.N.>nursing. They work directly for the physician and not as a colleague, <v Diana Barker, R.N.>as we do in the States.
<v narrator>By the end of Deborah's time at Children's Hospital, the nurses were functioning much <v narrator>as American nurses do. <v narrator>Deborah attending anesthesiologist Konstantin Dateshidze is Georgian <v narrator>and went to medical school with the Georgian minister of health. <v narrator>Dateshidze grew up in Tbilisi, but left the Soviet Union in 1981. <v narrator>This mission allowed him to go back home. <v narrator>A bit of a hero. <v Konstantin Dateshidze, M.D.>I grew up in this town and everybody was waiting for for
<v Konstantin Dateshidze, M.D.>us. Everybody was waiting for me. And now, of course, everybody was proud. <v Konstantin Dateshidze, M.D.>And I was getting enormous amounts of phone calls. <v Konstantin Dateshidze, M.D.>My phone wouldn't stop ringing. <v Konstantin Dateshidze, M.D.>I was just incredible amount of <v Konstantin Dateshidze, M.D.>people who were wishing us luck, wishing me a lot personally <v Konstantin Dateshidze, M.D.>and proud. <v Erakle Menagarishvili> We all think this is the greatest event in Georgia, which cannot be over <v Erakle Menagarishvili>expressed. I want you to understand me correctly. <v Erakle Menagarishvili>We are not talking about the 19 lives only, although it is <v Erakle Menagarishvili>by itself very important. <v Erakle Menagarishvili>We are mostly talking about the big endeavor that Deborah center started <v Erakle Menagarishvili>along with the Georgian doctors. <v Speaker>So you have one, two, three, four boxes. <v Speaker>All right. So let's what do you want to label those? <v Speaker>Armenian Americans had raised money to buy much of the medical equipment and transported
<v Speaker>from Tbilisi to Armenia. <v Speaker>Without modern medical equipment. <v Speaker>Many questioned what Georgian doctors would be able to do once the Deborah <v Speaker>team left. <v Jeff Luckenbach>We left them with enough equipment for about eight open-Heart procedures. <v Jeff Luckenbach>Beyond that, the rubles aren't going to buy oxygen. <v Jeff Luckenbach>ADAS and the other about two thousand dollars worth of disposables per procedure. <v Jeff Luckenbach>Their hospital is being renovated and the people <v Jeff Luckenbach>that do the work we do haven't done a case in a year and a half. <v Jeff Luckenbach>Their surgeons who who rely on muscle memory, their <v Jeff Luckenbach>hands don't have that. <v Jeff Luckenbach>And I don't see how they can possibly perform open <v Jeff Luckenbach>heart surgery. I think we've given them maybe the initiative to try to use our equipment <v Jeff Luckenbach>and hopefully the children that they operate on will also benefit. <v Jeff Luckenbach>I keep my fingers crossed. <v Lynn B. McGrath, M.D.>If they're going to be successful, they can't continue with their usual mechanism, and <v Lynn B. McGrath, M.D.>that is everything, they reuse it because what happens after two or three uses,
<v Lynn B. McGrath, M.D.>it breaks down and you have a disaster on your hand. <v Lynn B. McGrath, M.D.>So they have to accept the fact that this would be a very costly program. <v Lynn B. McGrath, M.D.>It will all depend not on the interest of the medical personnel here who are extremely <v Lynn B. McGrath, M.D.>interested. All depend on their political will. <v Lynn B. McGrath, M.D.>And I'm sure of financial ability to support this kind of a program. <v Lynn B. McGrath, M.D.>We, of course, will do everything we can to try to support them, but they will ultimately <v Lynn B. McGrath, M.D.>will have to come up with a fair amount of money if they're going to support this type of <v Lynn B. McGrath, M.D.>ongoing endeavor. <v narrator>The Georgian minister of health wasn't really concerned. <v narrator>He felt that his republic would be able to find some hard currency to purchase <v narrator>equipment in the future. And he was happy that Georgian doctors would be the <v narrator>first to begin a three month study rotation at Deborah. <v Speaker>With this one visit, all the problems cannot be solved. <v Speaker>But once again, may I point out this was a very good, successful <v Speaker>beginning and I wish to continue like that in the future. <v narrator>But for now, 19 children benefited from an unusual cooperative
<v narrator>effort. A true mission from the heart. <v Speaker>Thank you very much for coming here and saving my daughter and the other children. <v Speaker>The memories will stay with us and the warmth in our hearts will stay forever. <v narrator>A few days after surgery, the children looked well. <v narrator>And only a week after surgery, Niaz Tsindiliani looked like <v narrator>he was well on his way to a full recovery.
Please note: This content is only available at GBH and the Library of Congress, either due to copyright restrictions or because this content has not yet been reviewed for copyright or privacy issues. For information about on location research, click here.
Mission from the Heart
Target New Jersey
Contributing Organization
New Jersey Network (Trenton, New Jersey)
The Walter J. Brown Media Archives & Peabody Awards Collection at the University of Georgia (Athens, Georgia)
If you have more information about this item than what is given here, or if you have concerns about this record, we want to know! Contact us, indicating the AAPB ID (cpb-aacip/259-qn5z9f3c).
No Description
Media type
Moving Image
AAPB Contributor Holdings
New Jersey Network
Identifier: BS-4660 (NJN ID)
Format: Betacam: SP
Duration: 1:00:00?
The Walter J. Brown Media Archives & Peabody Awards Collection at the University of Georgia
Identifier: 91028dct-arch (Peabody Object Identifier)
Format: U-matic
Duration: 00:58:00
If you have a copy of this asset and would like us to add it to our catalog, please contact us.
Chicago: “Mission from the Heart; Target New Jersey,” New Jersey Network, The Walter J. Brown Media Archives & Peabody Awards Collection at the University of Georgia, American Archive of Public Broadcasting (GBH and the Library of Congress), Boston, MA and Washington, DC, accessed June 26, 2022,
MLA: “Mission from the Heart; Target New Jersey.” New Jersey Network, The Walter J. Brown Media Archives & Peabody Awards Collection at the University of Georgia, American Archive of Public Broadcasting (GBH and the Library of Congress), Boston, MA and Washington, DC. Web. June 26, 2022. <>.
APA: Mission from the Heart; Target New Jersey. Boston, MA: New Jersey Network, The Walter J. Brown Media Archives & Peabody Awards Collection at the University of Georgia, American Archive of Public Broadcasting (GBH and the Library of Congress), Boston, MA and Washington, DC. Retrieved from