"The art of critical care is being prepared for those crises at any given moment," says Margie Haas. "You get an adrenaline rush. When you can help save someone, it's about the most gratifying thing you can do."
But before the intensivist can jump into action, he has to be alerted that there's a problem. It's not enough for a hospital to have intensivists, Malone says.
Critical-care technology has made amazing advancements over the past two decades; now it's time to look at the people-driven part of the system, she insists. One study shows that the intensivist-led team approach can boost patient survival rates by 17 percent. Malone thinks her father could have been one of the fortunate ones--if only an intensivist had been brought in early.
"I could just go on and on about how great Dr. Weiss was when he came to the scene," says Malone. "He knew immediately what was going on. There was no second-guessing."
Which makes it all the more tragic that no one alerted Weiss that crucial night when an intern and a floater nurse guarded Shipman's tenuous grip on life. At Presbyterian/St. Luke's, it is up to the attending physician to pull an intensivist in on a case, but Weiss was never contacted. In this well-equipped ICU, Shipman was "in the right spot, at the right time, with the wrong outcome," says Malone.
The changes that Malone is pushing for "are not going to benefit me," she says. Nor can they bring back Karl Shipman, whose ashes rest in the cemetery near his beloved Vermont farmhouse, in the shade of those maple trees.
Malone still doesn't understand how nurses taking his pulse could have missed the pronounced swelling above his left hand, or why doctors didn't open up his wrist and immediately put him on a strong course of antibiotics. If Shipman had been properly treated before he "crashed," she says, "he still would have been a very sick man, but his chances of survival would have been much greater."
Of course, his chances would have been better yet had Shipman's infection been caught weeks earlier. In the treatment of Dr. Karl Shipman, almost anything that could have gone wrong did. Rung by rung, the medical hierachy failed him.
If only the ICU had automatically assigned an intensivist to Shipman's case.
If only a more experienced doctor had checked on the intern.
If only the intern had asked for more qualified help.
If only the nurse had had more ICU experience.
If only the admitting physician--Shipman's longtime partner--had examined him further before admitting him to the hospital.
If only the Denver orthopedists had diagnosed Shipman's real ailment.
If only Shipman's family members, several of them medical professionals, had recognized the source of his problems.
If only Shipman had never climbed that ladder.
If only the physician could have healed himself.
No one recognized the complexity of medicine more than Karl Shipman--or realized just how long it would take would-be doctors to learn what they were doing.
In a 1975 letter published in the Annals of Internal Medicine, Shipman warned against the trend to squeeze medical residencies into fewer years. "After the year of rotating internship, a physician [begins] to emerge," he wrote. "And, after three years of residency, a solidly based general internist [is] developed...Four years of medical school does not produce a physician."
Visit www.westword.com to read related Westword stories.
