Getting hopes back on track

Hospitalist Jeffrey Mikell
Hospitalist Jeffrey Mikell coordinated a team of pulmonologists, neurologists, rehabilitation therapists, nurses, and social workers. The patient had to wake up, breathe on his own, then relearn how to swallow, eat, walk, talk, and think clearly.

 

sidebar

From the Executive VP

Charity care in Emory Healthcare Overview
• Emory University Hospital
• Emory University Hospital Midtown
• Emory Saint Joseph's Hospital
• Emory Johns Creek Hospital
• Winship Cancer Institute

Emory at Grady Hospital

Emory at the Atlanta VA Medical Center

Serving locally and globally

Education

Research

Economic impact

Woodruff Health Sciences Center

Aadi was the eldest son upon whom all hopes were pinned.

The family had moved from northern India two years earlier to give the 19-year-old computer whiz the best opportunities possible. He moved fast-track, taking classes, perfecting his English, working part-time, helping his parents and siblings navigate a strange and complex society. No wonder he was tired.

By the time he arrived at a local hospital, his undiagnosed, untreated tuberculosis had morphed into bacterial meningitis. A local neurosurgeon placed a shunt in his brain, but the injury and swelling already had caused major problems, and he did not respond well to treatment. Aadi was referred to Emory University Hospital, where doctors found a range of complications involving his brain and nervous system as well as liver failure related to medications he had been given. After those problems were addressed, Aadi was placed on a respirator and, as with so many difficult ventilator cases, transferred to Emory Wesley Woods Hospital (EWWH) for weaning and therapy.

There, hospitalist Jeffrey Mikell, medical director of the hospital’s LTAC (long-term acute care) unit, took over, coordinating a team of pulmonologists, neurologists, rehabilitation therapists, nurses, and social workers. Aadi had to wake up, breathe on his own, then relearn how to swallow, eat, walk, talk, and think clearly.

Drugs helped with his wakefulness, while preventing seizures. At first, Aadi resisted his therapists’ efforts, curling up in a ball, refusing to speak English, covering his head with a blanket, kicking, the full tantrum. Then, with incredibly strong family support (and much help from an occupational therapist who spoke Hindi), Aadi slowly turned back into the responsible (and clearly very charming) young man he had been before. “We knew we were making progress when he asked for his laptop and started flirting with the nurses,” says Mikell.

Aadi was discharged more than 200 days after surgery, with cognition, memory, and personality largely intact. At discharge, the unreimbursed cost to EWWH was $450,000, and he continues to require medical follow-up and half a dozen medications, two of which cost more than $1,200 each per month, provided by Emory’s pharmacy. It’s a lot of money, but it brought a young man back to his family and back to a bright future in his new country, says Mikell.


Founded as a facility for geriatric patients in 1987, Emory Wesley Woods Hospital (EWWH) completed its transition in July 2014 to an inpatient facility for adult psychiatric patients of all ages, with its long-term acute care (LTAC) unit now operated by Select Medical in a joint venture agreement. The LTAC patient story here pertains to the period prior to the joint venture.

The Emory Wesley Woods campus includes two additional facilities that focus on serving the elderly:

■    Budd Terrace, 250-bed skilled nursing care facility

■    Wesley Woods Towers, 201-unit residential retirement and personal care facility

Table of Contents




Community Benefits Report Cover 2014