Personal Narrative: The Drive To Cleveland

I was drafted into the patient safety movement by a phone call from my wife. My family had been visiting family in Cleveland. During that trip, our youngest son had been admitted to a Cleveland hospital when she called to tell me, “He has meningitis." Those three words changed my life.

My background as a logician, community organizer, and two decades as a malpractice lawyer, did not prepare me for the following week. During the drive to Cleveland, I consulted with a brilliant pediatric disease specialist (who dispensed journal citations with the medical articles he quoted). We arranged for my son to be transferred to one of the country's best pediatric hospitals. After arriving, I studied my son's chart and scanned the monitors attached to …show more content…
Experts had told me that cerebral edema could cause Cheyne-Stokes respirations. They explained that the respiratory center in the brainstem regulates our breathing patterns. If the respiratory center was not working, the patient's breathing pattern would be regulated by his oxygen saturation level. When the oxygen saturation level was high, the patient would stop breathing. The oxygen would be used up, and the oxygen saturation would drop. When the oxygen saturation levels were low, the patient would begin panting. Sufficient panting would increase the oxygen levels. The patient would stop breathing. Oxygen levels would fall. The patient would start panting. Oxygen levels would rise. The patient would stop breathing. Panting. Stop breathing. Panting. Stop breathing. This is the Cheyne-Stokes pattern. It is a warning sign of pressure on the brainstem. This pattern can be caused by cerebral edema.

The respiratory pattern heightened my concern for cerebral edema. I insisted that someone inform the attending. I was assured that the attending had been informed. ( Later, I learned that the attending was told that my son’s respirations were abnormal. My understanding is that the attending was not told of the Cheyne-Stokes respirations. Much later, I also learned that my son might have had an abnormal cardiac

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