In disaster, courage (and support) count

photo of kate nugent

When West’s body began failing from the virulent infection that seemingly came out of nowhere, it took a team, including ICU physician Kate Nugent, to keep him going.

Emory University Hospital

Brad West was tireless. He rushed home from his landscaping job to work in his own garden, play basketball with his son, volunteer at church. When he developed fever and chills, the 35-year-old assumed he would soon shake it off. But he had never before faced streptococcal bacteremia (and never found out where the uncommon infection came from). By the time he got to Emory University Hospital, the bacteria already had released chemicals in his bloodstream, setting off inflammatory responses throughout his body, lowering his blood pressure and reducing the heart’s ability to pump blood to vital organs.

Despite a course of increasingly stronger IV antibiotics and blood pressure support, West’s condition rapidly worsened. At one point, his heart spiraled into an abnormal rapid beat, requiring the ICU team to shock it back into a stable rhythm. Shortness of breath progressed to reliance on a mechanical ventilator. Dialysis was initiated to support his kidneys. Dry gangrene began spreading across his arms and legs as his skin and soft tissue died from lack of blood. Halting deadly spread of the infection would require amputation. Surgeons Thomas Dodson and Robert Fang were called in to save the young man’s life.

After two months of intensive care, the bacteremia was gone, and West’s heart, lungs, kidneys, and other organs had recovered. But he now had to learn to cope without his legs and arms. His bravery, determination, and unquenchable good nature and the support of his wife and extended family in the face of this disaster had an enormous impact on the team caring for him, including Dodson, ICU doctors Kate Nugent and Prem Kandiah, bedside nurses, ICU social worker Courtney Faulkner, physical therapist Primrose Mlilo, occupational therapist Rebekah Kirk, and speech therapist Stuart Schleuse. They encouraged West as he healed and prepared to get his prosthetic limbs. Since West had no insurance, Emory set in motion his application for Medicaid. In the meantime, the hospital wrote off more than $770,000 in bills.