Protecting the weak and vulnerable

Sept. 25, 2018

I spoke with a dear friend of mine over the holiday weekend. She was calling from the Whiteley Center on San Juan Island, just off the coast of Washington state, a refuge for established scholars and artists to study, write, create, and interact in a peaceful and quiet environment. An MD with a Masters in Public Health, my friend currently serves as Associate Professor in the Department of Family Medicine and in the Department of Obstetrics and Gynecology Division of Family Planning at University of Washington.

She’s been a star in my book long before she went to medical school and before her professional fame escalated after she was featured on the cover of New York Times Magazine. I’ve confided in her over the years about many things, medical stuff in particular. I’d trust her with my life.

Alas, we spoke of what all old friends speak about when they haven’t spoken in a while: our jobs, our parents, our partners. Unfortunately, her partner had lost both his parents this year; his mother in March, his father just a few weeks ago in Pittsburgh. “How?” I exclaimed. “Perforated colon,” she responded. “Sepsis??” I cried. “Yes!!” She adamantly disclosed.

The remainder of the morose conversation revolved around sepsis. How she—at first—gently nudged her partner to become more aggressive with his father’s doctors. Asking questions daily about whether or not the father had fever, delirium, was someone watching his urine output, blood pressure. She reiterated that a patient’s mortality risk rises 7.6 percent with each hour that sepsis goes undiagnosed; that every minute and even every second, counted. And how she—at the end—was demanding to her partner that his father be moved to ICU.

Unfortunately, her partner’s father never made it to the ICU. He arrested the night before. The entire gruesome scenario lasted exactly two weeks; from emergency surgery to death. Ironically, she shared that just a few months prior, UW Medicine had a patient die of sepsis, which triggered a formal announcement from UW’s Medical Director for all staff, outlining early sepsis warnings and calls to action. I boldly asked if this was information she already knew. She confessed, “not all of it.”

I am both shocked and saddened that the medical community is still so behind in not only treating sepsis, but identifying it. I am often hesitant to cover “yet another” article on sepsis as MLO Editor, however, this heart-to-heart conversation rejected any qualms I may have had—or will have in the future—in regard to covering this life-threatening medical emergency, and educating both professionals and layman, alike.

Currently, there is no single test that can identify sepsis. Typically practioners order a combination of tests to help diagnose sepsis, to distinguish it from other conditions, to detect inflammation, and to evaluate and monitor the function of the affected person’s organs, blood oxygenation, and acid-base balance. Laboratory tests to detect sepsis and identify infection include procalcitonin, gram stains and cultures, blood culture, urinalysis and urine culture, cerebrospinal fluid analysis, sputum culture, as well as cultures of other body fluids that may be done as needed to detect the source and type of infection.

Worldwide, one-third of people who develop sepsis die. We are all susceptible. Every single one of us. Protect yourself and those you love by learning more about sepsis and how to identify it in its earliest stages.