View Full Version : Battlefield doctor’s efforts may save life of Iraqi child

01-30-08, 06:23 AM
Battlefield doctor’s efforts may save life of Iraqi child

By Alexa Hinton, ahinton@nashvillecitypaper.com

A Nashville doctor is hoping to send a powerful message to the people of war-torn Iraq by fixing the heart of young Iraqi girl.

Dr. John Nadeau is a top hypertension specialist at Vanderbilt on his second tour of duty as a battlefield surgeon with the U.S. Marine Corps in Haditha, Iraq. Nadeau’s soldiers discovered 2-year-old Amenah (her last name is being withheld by Vanderbilt for her family’s safety) on a patrol through the streets, and he recognized signs that pointed toward a rare birth defect called tetralogy of Fallot, where the heart is plagued by holes and obstructions.

Without surgery, the youngster would die.

“He e-mailed me back in October that he’d identified this child and wanted to know if he and the Marines could get the child to Vanderbilt, would we take care of her,” said Dr. Karla Christian, a pediatric cardiac surgeon at Monroe Carell Jr. Children’s Hospital at Vanderbilt. “He said that she was blue and that she had clubbing, which means misshaped fingers. You have abnormal fingertips when they don’t get enough oxygen and it implies a heart defect.

“He talked about how important it would be to fix this child and send a powerful message to the Iraqi people if we could get this done,” she said.

In this country, the defect would have been detected at the baby’s birth, but her village lacked the personnel and devices to make such a diagnosis.

Amenah’s mother said she did not know the outlook for her daughter was so grave. She took Amenah to a local doctor daily to be hooked up to an oxygen machine, but that was the only treatment the child had ever had.

Dr. Nadeau set into action a plan to save the girl’s life.

Once he had Dr. Christian on board to perform the surgery, he got a Children’s Hospital commitment to host the surgery. Then, he and other Marines including Maj. Kevin Jarrard set out to secure travel plans for Amenah and her mother [her name also is being withheld for security reasons], which meant raising funds and obtaining necessary clearance and paperwork.

Marines back in this country, aided by Jarrard’s friends and family as well as a church organization, collected more than $30,000 to cover the expense of plane tickets, medicine and documentation.

“[Dr. Nadeau] said he actually had to go grease palms — give bribe money — in Baghdad to get passports for [Amenah and her mother],” said Stephanie Nadeau, the doctor’s wife. “This has been in the works for a while.”

Amenah arrived in Nashville a week ago, and Christian said she had hoped to operate the next day, but found the girl in bad shape. Not only did she have a fever and three infections in her ear, bladder and lungs requiring a blood transfusion, intravenous antibiotics and the aid of an oxygen tube, but the doctors determined her heart defect was worse than first predicted, Christian said.

“We realized her heart is on the wrong side of her chest, her pumping chambers are backward, she has obstruction to her lungs and a big hole,” Christian said.

Doctors will perform more tests today that will help give even better definition to the anatomy of Amenah’s heart and the exact type of surgery needed to fix her defects. Regardless, the child will need open-heart surgery, which under the best conditions with nothing going wrong, will take at least five hours.

Christian said they plan to operate in two weeks, once the girl is recovered enough from her infections. The surgery is risky and carries the chance Amenah might not survive it, yet Christian said she is hopeful.

One of only a few women in the field of pediatric cardiac surgery, Christian said she knows a lot of eyes are on her with fingers crossed for success.

“I just hope everyone will pray for the child and pray for [her operating] team,” she said.

Amenah is the delight of her hospital floor. In the week since she was first admitted to the children’s hospital she is no longer the weak, blue-tinted child doctors first glimpsed. Instead she is all smiles, with a deep dimple that pops up in her right cheek when she giggles. She has learned to wave and greets every new visitor with vigorous hand wiggles, grinning and saying “bye” or “habebi,” which means “sweetheart” in Arabic. Her hair is parted into braided pigtails held with bright barrettes and she’s perpetually clutching close a stuffed animal raccoon and munching on its tail.

The youngster is perhaps happiest riding the halls in her red and yellow Little Tikes Cozy Coupe. Her mother scoops her up from her hospital bed, arranges her IV in the back of the plastic children’s car and places Amenah gently inside and closes the door. Since she can’t walk because of the IV taped to a board and attached to her foot, the coupe is the next best thing. The yellow sock on one foot and the white bandages on the other foot have a brownish hue from her incessant scurrying along the hospital floor.

The medical receptionist on her floor, Tara Godwin, knows the faster you push Amenah, the louder she laughs.

“We might have to send her back to Iraq in it because we won’t be able to get her out of it,” Godwin said.

While there is the danger of retaliation from Iraqi insurgents for Amenah’s family accepting help from Americans, her mother said she feels fortunate to be in Nashville working with specialized doctors to save her daughter.

“When I get back to Iraq, I’ll tell my family and friends and everyone what good people Americans are and how everyone treated me well and surrounded me with love and support and how helpful Americans were to me and my child,” Amenah’s mother said through a translator.