At Cooper story slam, doctors tell of healing patients and themselves

Anthony Mazzarelli's story started with a scene in an obstetrics triage area.

The emergency physician  was watching as a nurse and resident examined a woman — nine months pregnant — who hadn't felt her baby move in a few hours.

As good stories often do, this one soon took a twist that led straight to the heart.

Mazzarelli was one of seven medical workers — six doctors and a nurse — from Cooper University Health Care and Cooper Medical School of Rowan University brave enough to tell five-minute stories before a crowd of about 200 medical students and coworkers in the organizations' first story slam. The event, presented by the Cooper Foundation, took the place of a more traditional lecture during this year's Berkowitz Family Foundation Lecture on Ethics and Humanism in Medicine.

Susan Bass Levin, president and CEO of the foundation, said the slam was meant to be a "different way of learning" and a reminder for everyone that the human element of medicine "should be part of every medical decision every single day."

It was modeled after an experimental story slam the Annals of Internal Medicine tried last year. Christine Laine, editor-in-chief of the Philadelphia-based medical journal, said its "On Being a Doctor" essays are an extremely popular feature. The journal recently has also published graphic medicine stories, told in a comic format. Laine wanted to try oral storytelling as an outlet for physicians who are more comfortable with talking than writing.

The first slam was a hit, and there have since been two others, at the University of Pennsylvania and Thomas Jefferson University.

The Cooper audience, primed with hors d'oeuvres and drinks, was enthusiastic as speakers told of connections made before death and ethical choices that put doctors at odds with their peers.

Mark Angelo, a palliative medicine doctor, told about how a hated Dallas Cowboys hat came to sit in his office. It was a bequest from a practical joker who was grateful that Angelo eased his cancer pain and drove him home from the hospital so that he could spend his last Thanksgiving with his family.

Brian Roberts, an emergency medicine physician, illustrated how one small oversight can have big consequences. He told of a man who fell off a ladder in the middle of the night as he tried to climb in a window to his house. The man, who had partied exuberantly at a wedding earlier that evening, couldn't find his keys.

They were in a pants pocket.

Lisa Laphan-Morad, associate chief nursing officer for Cooper Health Care, told about a schizophrenic quadriplegic patient whose spirit touched her when she was a new nurse.

Katherine Mayer, a fellow in the department of critical care, remembered a man who could not die in peace unless a home was found for Cheeky, a cat he had inherited from his mother. The staff brought Cheeky to the ICU for visits and made sure he was adopted. The man died — at peace — during Cheeky's last visit.

Pathologist William Kocher told of discovering — at a hospital that was not Cooper — that a dying man had been treated for the wrong cancer. Worse, his treatment had made the cancer grow more quickly. The man's oncologist suggested that Kocher delay his report, as the patient would be dead in days: "No one will know."

Kocher put his report in on time. The man chose to try another round of treatment — for the cancer he had. He lived another year.

"You don't want to take the easy way out," Kocher told the students. "You want to do what's right."

John Porter's story was in the same vein.  Porter, who is now head of the division of trauma and surgical critical care at Cooper, later explained that it happened about 10 years ago at a hospital in Pennsylvania that sometimes got help from surgeons in nearby Ohio.

One of the Ohio doctors called him one evening in a frenzy. He had been removing a gallbladder laparoscopically when he made a mistake. His patient, a 17-year-old girl, was bleeding profusely, and he didn't know what to do. Afraid they'd be sued, the surgeons at his hospital refused to help.

"She's going to die, and everybody else has turned me down," he told Porter.

Porter was not licensed in Ohio. But he jumped in his BMW M3 and topped out at about 145 mph during the 20-mile trip, a detail he revealed after the slam. He talked his way past a risk-averse administrator and repaired the girl's damaged hepatic artery and liver. Not long after, she sent him a picture from her vacation at the Grand Canyon.

The lesson: "When you know it's right, there is no decision."

Then it was Mazzarelli's turn, and it soon became clear why he was chosen to go last. He knew it was not unusual for the OB triage nurse to have trouble finding a heartbeat. He was impressed by her calm, her attempt to stay upbeat for the mother. She called for a resident, who brought an ultrasound machine.

"It took only a few seconds before the worst-case scenario was obvious even to me. There was no heartbeat in that fully formed baby," Mazzarelli said.

"I will never forget the absolute sorrow at that moment."

The mother was Mazzarelli's wife, a Cooper cardiologist. The dead child was his baby.

He told the story not to convey how it feels to lose a child, but to emphasize the power of small, human gestures on that horrible day, Jan. 26, 2013, which he has relived, in memory, "hundreds, if not thousands, of times."

He tries to keep that in mind during his own interactions with patients.

"The littlest things matter in those situations, I now realize, not only for that moment, but for all the times that the memories of those moments are replayed," said Mazzarelli, who also is an executive with Cooper Health.

"The patients and families may not remember your name or your face, but they absolutely will not forget even the smallest things you did in those moments because they will not forget the memory of what they were feeling."