Second,
Cappuccino instructed Lengel to drive to Millard Fillmore Gates Circle
Hospital. Normally a player injured in a Bills game would be taken to Buffalo
General, about a mile closer, but Cappuccino knew that Gates has magnetic
resonance imaging (MRI) technicians on duty 24 hours a day. This is rare, and
with Gates's in-house CT scanning capability it would enable swift diagnosis of
Everett's injury. The hospital also is the only one in Buffalo with a
neurosurgical intensive care unit, under the direction of Dr. Kevin Gibbons,
47.
Everett arrived
at the hospital about 35 minutes after the hit. X-rays and CT scans showed a
fracture dislocation of Everett's cervical vertebrae at the C3/C4 level,
meaning that one vertebra had slipped out of alignment and was compressing
against its adjacent vertebra and the spinal cord in the neck. An MRI showed
that Everett's spinal cord was 70% to 75% compromised, or pinched, by the
dislocation.
Cappuccino and
Gibbons, assisted by senior neurosurgical resident Ken Snyder, worked to reduce
the dislocation. A halo device was screwed into Everett's skull, and while he
remained awake, manual pressure and traction weights were used to realign the
vertebrae and remove pressure from the pinched spinal cord. Next would come 4
1/2 hours of surgery to stabilize Everett's vertebrae and further decompress
the spinal cord. Both the reduction and the stabilization surgery are common
practices in spinal cord injuries and clearly were vital elements of Everett's
care.
BEFORE EVERETT
had been put under anesthesia for the operation, Cappuccino had placed a call
to Everett's mother. Patricia had begun her day under the impression that she
could watch her son's game on cable television. When she found that the game
was not carried locally, she and her husband, Herchel Dugas, went to Mulligan's
sports bar in Humble. "We were late because I spent so much time trying to
get the game on TV at home," says Patricia. "When I walked in the door
at Mulligan's, it wasn't 15 seconds before I saw Kevin running down the field
and boom! And then Kevin wasn't getting up, and I was just standing there in
front of the TV. It was so noisy everywhere, but I couldn't hear a thing. I
felt like I was in a movie. And he wasn't getting up."
Patricia
remembered that she kept a number for a member of the team's training staff.
From the bar she punched it in, identified herself and left a message. Bills
director of player programs Paul Lancaster called back shortly and told her
Kevin had been taken to the hospital. It would be 90 minutes before Cappuccino
phoned Patricia from the surgical suite at Gates. She can't recall his exact
words, but snippets are burned into her soul: Your son is paralyzed right
now.... We're taking him into surgery.... Afterward I want to do something
called cold therapy. "She was upset," says Cappuccino. "She
cried."
It had been a
trying summer for Patricia. In August her youngest daughter, Davia, had fallen
into a diabetic coma and spent two weeks in intensive care in Galveston. Now
her oldest child was in a hospital, 1,500 miles away, paralyzed. Cappuccino
held a cellphone to Everett's ear so he could speak with the woman he calls his
Moms. Patricia heard a weak voice on the other end. "Don't worry about
me," Kevin told her. "I love you."
"That was my
baby," says Patricia, tears rolling down her cheeks as she retells the
story three months later. "He's always been so strong, and he sounded so
weak." The next morning Patricia would be on a plane to Buffalo with Moore,
at the Bills' expense. The surgery went smoothly and was finished at roughly
9:30 on Sunday night. Soon, however, another dilemma presented itself.
Last June the
hospital had purchased an Alsius CoolGard 3000 thermal regulation system, which
uses a catheter of cooled saline inserted through the patient's femoral vein
into the inferior vena cava, cooling the blood as it flows past the catheter
and regulating core body temperature. The machine, which has been helpful in
treating strokes and other brain injuries, had not yet been used at the
hospital on a spinal cord patient, but Cappuccino felt strongly that induced
hypothermia—at a significantly lower temperature and in a more controlled
environment than is possible with IV cold saline in the ambulance—could help
Everett.
There was
contentious debate at the hospital. At least two doctors, including Gibbons,
did not want to induce hypothermia, which can have dangerous side effects such
as heart arrhythmia, blood clotting problems, pneumonia and organ failure.
"Dr. Cappuccino was pushing the cooling, and it became a dynamic
issue," says Snyder, 35. "He had been saying all along, 'We should do
the cooling. We should do it.'"
Only when Everett
started developing a low fever did Gibbons and others assent. Still,
Cappuccino, who bore the ultimate responsibility because Everett was his
patient, took stock of his position. A native of New York City who counts two
other doctors among his six siblings and whose father was a research
biochemist, Cappuccino is married to a surgeon, Helen Hess Cappuccino, with
whom he has six children. His life's work and his life experience weighed into
the decisions he made that day.