Background of Father George Stuart Burchill

Having retired in 1992, Canadian-born Father George Stuart Burchill is a legend in the city for being the first headmaster of a scholarly school of classics for 38 years, known for its academic rigor. He has married many prominent families’ children and graduated or taught many future Gasparilla Krewe members of Tampa’s elite. Despite being a happy retired professor, he was often irritated by prank phone calls.

Emergency Room Encounter

Fast forward 20 years. I had just finished rounds on the 4th floor and bounded down the stairs with my student Rob in hot pursuit. Cardiologists always took the stairwell rather than elevators to set an example. We made our way to the Emergency Room, where action awaited.

“Hey Captain Cardiac, what’s up, man?” said Ray, the ER Director, without looking up from the chart on his desk.

“Not much, Boss. Just about ready to leave for the Cath Lab. This is Robb Griffin, my new MED student from Saba MED School by way of Ocala.”

“Hey Robb, you will learn a lot from this guy.”

“He has already taught me so much I never learned in Saba or any of my clinical rotations.”

“Well, Captain, I see from last night’s records Fr. Burchell was here. Pedal edema without DVT with treatment with IV furosemide and compression stockings, then to see Dr. Grizzard today.”

“I wondered how he’s been doing since retirement from St. John’s?”

“Said something about a recent trip to Athens, then back home yesterday with a new copy of Ancient Greek poetry to read in his library.”

“So, that’s how he got the pedal edema. Sitting in a window seat sleeping, reading, while flying back from Athens to Atlanta then Tampa,” I said. “See you, man!” Robb and I headed for the Cath Lab.

The Critical Moment

Later that same day, I received a stat call from the ER. Robb and I rushed over to find Fr. Burchell in extremis—cyanotic, unconscious, heart rate 40, BP 60 mm Hg systolic, and struggling to breathe. His legs were still swollen. The echo tech arrived, and we quickly saw the right ventricle was swollen and barely beating. The cause of death would be acute pulmonary emboli with hemodynamic instability.

I ran to the waiting room to inform Mrs. Burchell, “He’s in big trouble! His pulmonary circuit is blocked by blood clots from his swollen legs. There are only two ways to unblock this: open heart surgery with surgical clot removal or pulmonary artery cannulation with direct injection of blood thinners and declotting agents. Neither is available here and now. It will take a pocketful of miracles to save him.”

The Thrombolytic Cocktail

“TPA 75mgs stat! Lovenox 100 mgs IV push,” I ordered.

“Doctor, we’ve never given this drug IV. We always give it subcutaneously,” the nurse complained.

“Give it now!”

“What kind of combination is this, doctor?”

“Get me an Integrelin drip—180 mcg per kg IV over 2 mins.”

“Get me the Zoll, Robb!”

“Put the pads on the chest and turn it up to full current at a rate of 60!”

“Are you sure, doctor?” the nurse questioned.

“I’ll do it,” I said, grabbing the Zoll and flipping up the current. Fr’s chest muscles and diaphragm jerked like a washing machine loaded with a flipping rug, but suddenly a miracle happened. He turned from bluish to pink all over his body as his blood pressure and heart rhythm shot up. He looked like a pink cherub painted by Tiepolo.

Victory Over Death

“Get Stromy on the phone at TGH! Fr is going for a ride to Mecca!” I exclaimed. Stromy would receive the patient at TGH, where he would be stabilized and given the best care. Death had been beaten back once more.

I returned to the waiting room to Mrs. Burchell with a half-smile. “We had a pocketful of miracles, Mrs. Burchell. We will be moving him by ambulance to Tampa General Hospital as soon as Fire Rescue gets here. He is doing much better. I think he just might make it.”

Reflecting on the Miracle

Later, Robb and I were in my library, pulling together medical records to start writing our case report.

“I’ve thought of a catchy title for JACC! What do you think of ‘Thrombolytic Cocktail, Shaken But Not Stirred?’”

Editorial Points

• Innovation
• Spiritual Connection
• Science
• Diagnostic Probability Without Proof
• Aggressive Action
• The System Will Try to Prevent You
• Humanity
• Continuous Education
• See One, Do One, Teach One
• Not in the Guidelines