Counting Minutes, Not Money (2008)

Doctor working with a patient

Scott Nichols was directing a dozen workmen on his construction crew, as confidently as a conductor in front of his orchestra, when his entire left side stopped functioning and he collapsed, unable to speak. 

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Counting Minutes, Not Money

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Nichols' son, a Georgia state trooper, heard the 911 alert on his radio and recognized the site where his father, a successful contractor, was working. He was there as quickly as the ambulance, which he escorted, sirens wailing, to Grady's emergency room, more than 60 miles away, passing other hospitals along the way. Grady has the care this stroke patient needs, insisted the paramedics. 

Neurologist Michael Frankel (pictured) and other members of the stroke team were waiting. Every minute counts following a stroke, but the contractor had made it within the short window of time for treatment with tPA, a clot-dissolving drug pioneered by groundbreaking work at Grady that led to FDA approval of the first brain-saving therapy for patients with the most common form of stroke. Within minutes the clot-buster was moving through an IV drip toward the clot that had felled Nichols, and his symptoms began to abate.

About the time Nichols was being rushed to Grady, LaVon Washington collapsed in his Atlanta living room. When his daughter stopped by with a bag of groceries, she found her father on the floor, unable to speak, see clearly, or move his arms and legs. He too was rushed to Grady, where the stroke team, under Frankel’s guidance, quickly began IV tPA. 

Although the outcome of their treatment was equally favorable, these two patients were different in key ways. Nichols had been in great health before his stroke, and he had private insurance, which would pay most of the costs of the hospital and physician services provided, as well as the $2,000 for each tPA treatment. 

Washington, on the other hand, was diabetic, with high blood pressure. He generally took his medicines, but without insurance he couldn’t always afford them.

For Frankel, the director of Grady’s stroke center, insurance was not the issue. For him, it was providing the right care within the time frame to allow brain tissue to be saved.