Combining faith and science, Portland hospital system finds a way to serve Jehovah's Witnesses

[Musky]

Combining faith and science, Portland hospital system finds a way to serve Jehovah's Witnesses

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By Tom Hallman Jr., The Oregonian

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Celina Ortiz (left) watches as her daughter, 13-year-old Tania, examines a model of a spine with metal supports similar to the type she received recently during a 'bloodless surgery' at Legacy Emanuel Medical Center in North Portland. The type of surgery was important to the Ortiz family because they are Jehovah's Witnesses.

Severe scoliosis created such curvature in 13-year-old Tania Ortiz's spine that she hunched over, putting pressure on her heart and lungs. Although the problem could be corrected by implanting two metal rods along her spine, surgeons throughout Kansas refused because of her family's religious beliefs.

Devout Jehovah's Witnesses, such as the Ortiz family, interpret a Bible passage as a commandment to abstain from blood transfusions, or even storing the patient's own blood in advance so it could later be used.

Knowing those restrictions -- and believing that transfusions would likely be needed during the long and complicated surgery -- doctors would not operate. So in late 2010, the family reached out to Witness elders in their hometown of Olathe, a city about 20 miles southwest of Kansas City.

"We asked God for help," said her father, Santiago Ortiz. "We prayed for good hands."

The answer came when officials at the Jehovah's Witness headquarters in New York City told them to go to Portland's Legacy Health, which 20 years ago started the nation's first large-scale, hospitalwide bloodless surgery program.

Hospitals in other cities around the country have started similar programs. But Legacy's Bloodless Surgery and Medicine Program is so well known and established that thousands of Witnesses come to Portland each year from across the country as well as from overseas.

What the program does is manage blood loss -- before and during an operation. The techniques and procedures are covered by the patient's insurance. And because of lower costs, infection rates and shorter hospital stays, the hospital and patient save money.

The process begins weeks before surgery when doctors and nurses work with the patient, devising medical treatments to reduce blood loss during surgery. During the operation a series of machines recover the blood from the surgical wound, filter it and reclaim blood cells. The blood is then returned to the patient's body in a closed-circuit system, a process that does not violate Witnesses' beliefs.

Even in trauma, the doctors and nurses who are part of the program honor those beliefs

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"I'm not a Witness," said Dr. David Farris, an anesthesiologist and co-director of the Legacy program. "I'm a recovering Catholic. But when I applied for this position, I promised I would do anything for a patient's right to self-determination. I stood by the bedside of a Witness who was slowly dying from trauma injuries. His adult son, who was not a Witness, wanted me to give him blood. I didn't and the man died. Sadly, we have had patients die."

Because of this commitment -- both for adults and children -- the Legacy program has attracted the support of the nation's Witness community.

In 2008 and 2009 the system treated 4,000 Witnesses annually, said Mary Ann Knauss, the program's co-coordinator. Last year, she said, the number of Witnesses jumped to 8,000.

"We were the nation's first hospital to cover all surgical specialties with bloodless surgery," she said. "We do everything from open-heart to neurosurgery." Dr. Adam Barmada, pediatric orthopedic surgeon, shows before and after surgery X-rays of Tania Ortiz's body. Barmada recently operated on 13-year-old Tania Ortiz from Kansas to treat her scoliosis, whose family could not get any doctors to do surgery without transfusion. Earlier this year, Tania Ortiz underwent a successful nine-hour surgery at The Children's Hospital at Legacy Emanuel and soon rejoined her seventh-grade class. Not only was she able to straighten up – gaining 2 inches in height -- but the pressure on her heart and lungs was relieved.

"My daughter could not run or play before this surgery," her father said. "The doctors changed her life. They also understood our beliefs and knew that we wanted the best for our child."

Doug Menner, associate director of hospital information services at the Jehovah's Witnesses national office, said his office receives monthly calls from community members

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"For the medical staff, it's more than just employing techniques," he said. "It's about a mindset."

Farris said doctors devised ways to use existing medical equipment to create a system that would work for the Witness community.

"None of the pieces are special unto themselves," he said. "But by pulling them together, we created something that adapts to their beliefs. It's about being respectful of those beliefs."

Knauss said the 40 surgeons who participate in the program are committed to practicing first-rate medicine while supporting Witness beliefs.

Patients, doctors and hospitals around the world are becoming increasingly drawn to using bloodless surgery because of health benefits.

"The cost of one unit of blood, including the overhead, is about $1,000," said Melissa Smith, a co-coordinator of the program, a registered nurse and a Witness. " Medicare will not pay for the first two units, nor will most insurance companies. So the hospital eats those costs.

"If a person has open heart surgery, the length of stay in the hospital is seven to 10 days," she said. "A Jehovah's Witness having the exact same surgery with bloodless surgery will stay in the hospital five to seven days. The minimal cost for day in the hospital is $2,000."

Other area hospitals employ people who work with the Witness community, but Legacy says it has the only system-wide dedicated program. And it grew out of an early 1990s lunch between program founder and co-director Dr. David Rosencrantz, who is Jewish, and John Hanna, a friend of his who is a Witness.

"He told me that he wished there was a place in Portland where their people could be treated," said Rosencrantz, a urologist. "It made sense. Why not?"Rosencrantz heard about a Chicago hospital experimenting with bloodless surgery on a small scale. He visited, talked with doctors and was convinced he could make it happen in Portland.

"I thought it would be a slam dunk," he said. Instead, "It took me two years. To do this right I needed to get doctors in all specialties to commit to it. They not only had to have medical expertise as a surgeon, but they needed an inner courage and confidence in themselves."

After getting 40 surgeons signed on, the program was launched and the Witness community was notified. He said that the doctors and nurses participating in the program come from all faiths. Some, he said, are atheists.

"We're not here to judge what someone believes," he said. "This program succeeds because of the hearts and souls of the nurses and doctors involved." The first case came one Friday evening when Legacy officials were called by a Witness elder who said a patient in a Washington hospital needed help. She was pregnant and her placenta had torn away.

"She was bleeding out," said Knauss. "Doctors thought if she continued to bleed, her husband would consent to a transfusion. He wouldn't. She came to us bleeding. Her red blood cell count was 2.9. It should have been 15. She was almost gone. The baby had died, and her husband was told that his wife had a 99 percent chance of dying."

Surgeons and nurses in the bloodless program got to work. The woman was discharged, alive and well, eight days later.

Hanna said that the program shows that people of all faiths and beliefs share a common bond -- concern about their fellow man.

"The Witness community is also gratified that there's been so much additional research into bloodless surgery," he said. "Ultimately, all patients benefit."

Smith, the program's co-coordinator who is also a registered nurse and a Witness, straddles both worlds.

"The trust between the Witness community and the people involved in this program is amazing," she said. "The Witness community knows the nurses and doctors will go to the wall to respect and honor Witness beliefs. The program works because of that trust."

Article Source: Oregon Live

[miro]

this is great. only wished that we had something like this in portugal.

the only thing that i didnt liked was the coments that we can see in the link

[BlaqueCalalilly]

Why do I torture myself by reading comments to articles..........

I like the article itself......

[trottigy]

Thanks for the warning - I didn't click the link.

What a great article. I bet that they don't have near the financial troubles that other hospital have either - as God's people pay their bills!

We have a bloodless surgery center here in Las Vegas also. Jehovah through his organization is really take good care of us.

[esme_m]

this is a lovely article, thanks for posting it chuck. Its nice to see how the whole program is really well thought out, and the lengths that not only the brothers have gone to, but also the medical staff in doing there best to understand our beliefs and then create a system that allows them to treat us bloodlessly.

I also wish we had similar co-operation here in ireland......

[Lady Tee]

This is a goodnews. I wish this could go round so that we all can benefit worldwide.