How pediatric critical care and a physician anesthesiologist saved a teen’s life

It’s amazing when events that seem to be “miracles” happen, and even more magical to be a part of them, however peripherally.

My husband, David Merzel, MD, a physician anesthesiologist and pediatric intensive care specialist, and his patient, 17-year-old Chiann Wheeler, share the remarkable story of Chiann’s brush with death from sepsis, and how David’s quick diagnosis saved her life.

The story began one morning when then 15-year-old Chiann felt so sick that her father brought her to the emergency department at Bakersfield Memorial Hospital (BMH) in Bakersfield, a town of about 350,000 in central California. David was the physician on call for the pediatric intensive care unit (PICU). A report in the BMH newsletter described what happened next.

It began, her father Chris Wheeler recalls, when they both became ill after attending a birthday party. While he quickly recovered, Chiann’s condition deteriorated with each passing day.

“When she kept getting worse and had a temperature of 102, we took her to Memorial Hospital on Sunday morning, and they immediately wheeled her into the emergency department,” Chris remembered. “A nurse said something’s not right and made a phone call.”

That call brought Dr. David Merzel, a pediatric intensivist, and anesthesiologist, into the room where he immediately began going through a mental checklist to determine what was making Chiann so ill.

“I was told there was a young woman with possible food poisoning, but she also had hypotension, which is life-threatening low blood pressure, she was in shock, and they didn’t think she was going to stabilize,” he said. ‘As a pediatric intensivist with a critical patient, sometimes we need to stabilize first and play detective second. Walking in, I saw her eyes were red, and her tongue looked like a strawberry.”

Dr. Merzel noticed one more thing. “I asked, ‘How long have you had that rash?’ And her dad, the nurse, and the ER doctor all said, “What rash?” It was covering most of her body, a very distinctive rash that feels like sandpaper from toxins that germs release. I knew then Chiann had classic septic shock due to toxic shock syndrome (TSS), and we were able to start more aggressive treatment immediately.”

Chris Wheeler was awestruck. “Dr. Merzel walked in and was able to pinpoint that it was TSS within two minutes of being in the room. To me, Dr. Merzel, he saved my daughter’s life.” 

Chiann and David have become eloquent spokespersons about what the hospital and their personal relationship mean to each of them.

David credits Jon Van Boening, the hospital’s CEO, with the vision to bring advanced pediatric care to Bakersfield, establishing a new PICU and an acute-care pediatric floor. Most cities of Bakersfield’s size don’t offer such specialized care.

“It is difficult to build pediatric care in a community,” he says. “Pediatric care is not ‘sexy’; it doesn’t lend itself to media sound bites like a Trauma Unit, a Burn Center, a Heart Center, or some hi-tech surgical program.”

“Kids don’t vote, fund-raise, or hold sway with payers be they insurance or government,” he explains. “My colleagues and I cannot emphasize enough the hard work and the administrative leadership (and guts) it took to bring advanced pediatric care, with the PICU as the foundation for growth, to BMH.”

David believes that it was from a sense of community and from personal experience — some of it tragic — that families knew it was time for advanced pediatric care. Before, Bakersfield children who developed serious illnesses such as cancer, diabetes, respiratory failure, or those with traumatic injuries from serious accidents, were at risk of being “shipped out of town” for their care. Sometimes there were critical delays in getting the children the care they needed.

When advanced pediatric care isn’t available in a community, children are separated from families, David explains. Travel to and from the hospital strains families and interferes with work.

“It takes generosity and a sense of community to facilitate care for our children,” he says.

Without a doubt, Chiann Wheeler and her family are grateful for the presence of advanced pediatric care in their hometown. She and her father become emotional when they recall how important it was to them to stay near one another during Chiann’s critical illness.

Chiann says she feared that she might not have survived a transport to a remote hospital — the next closest PICU was over 100 miles away. If air transport is unavailable due to severe weather, the only other option is ground transport for several hours in an ambulance.

Today Chiann is a healthy high school senior.  Throughout 2015, she has served as a Children’s Miracle Network Hospitals ambassador for the state of California, telling her story and helping to raise awareness of the need for advanced pediatric critical care throughout the state.

Thanks to the vision of BMH in creating a pediatric program and opening a PICU, Chiann was able to get her critical care locally.  And thanks to the availability and advanced training of a pediatric anesthesiologist with intensive care expertise, Chiann is here today. It was my privilege to be a small part of that experience, and to hear how many lives have been touched by the care my husband and his partners deliver.

As Chiann’s and David’s story demonstrates — when seconds count, physician anesthesiologists, and pediatric critical care, save lives.

Linda Hertzberg is an anesthesiologist, and alternate director for California, American Society of Anesthesiologists.

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