News

Quantity of care | A lost voice

February 10, 2017

By Mike Baker | The Seattle Times

After enduring years of painful headaches and injuries, Talia Goldenberg — a lively, uninhibited artist — was ready for surgery to help stabilize her flexible spine.

Talia Goldenberg emerged from the fog of anesthesia. The 23-year-old wiggled her toes. She wagged her feet. Good signs for a patient coming out of spinal surgery.

Emily M. Eng / The Seattle Times Illustration of a spinal fusion similar to the one performed on Talia Goldenberg.

The doctors at Swedish’s Cherry Hill hospital declared Talia’s surgery a success. Her surgeon noted there had been no complications and told her parents it had been “perfect.” The medical team talked about perhaps presenting the case so others could learn from the work.

It was just the news Talia and her parents had sought when they traveled from Oregon to Seattle for a promising elective surgery at the hands of one of the nation’s most prominent neurosurgeons, Dr. Johnny Delashaw. He was a star at Swedish, celebrated in ads for his workload of 350 spine procedures per year, along with many additional surgeries for aneurysms and tumors.

That volume of cases is meant to reassure prospective Swedish patients. After all, who wouldn’t want a surgeon who has seen everything?
But as the anesthesia faded in Talia’s system, she realized that not everything was perfect, despite the confident assurances of her surgical team.
Her lower jaw was ajar, jutting forward like a bulldog’s. Her face was swollen. Her delicate, singsong voice came out in a harsh rasp. She couldn’t open her mouth enough to squeeze in a finger. On her hospital bed, lying next to the stuffed rhino and stuffed zebra she’d brought along, Talia croaked to the nurse that she was having difficulty breathing.

She rolled onto her side and vomited in the bed. When the nurse covered up the spew with a towel, Talia vomited again right on top of it.

There’s an old mantra in medicine that reminds doctors not to grasp for exotic diagnoses: “When you hear hoofbeats, think of horses, not zebras.”
The saying comes from Dr. Theodore Woodward, a professor at the University of Maryland, who in the late 1940s used the line to guide medical interns. The advice has since morphed into a one-word warning in the medical community: zebra.

Read the full article

Case type: 2017, February

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