Dr. Mounzer Kassab is an associate professor at Michigan State University’s Department of Neurology and a physician at Sparrow Hospital whose specialty is stroke. Last year, he got an emergency call at home about a four year-old boy named Gavin Ramirez who had “zero movement” in his left part of his body — his left arm and leg were paralyzed, the left-side of his face was drooped, and his speech was slurred plus he couldn’t see anything from his left side.
Dr. Kassab recounts for StoryBank what happened next:
“Stroke is exceedingly rare in children. The emergency clot lysing medicine available is approved only for adults. I was called at home, and gave an opinion over the phone along the lines that we can not do much and better not take a risk that may make things worse (giving that without knowing the proper dosing in children, the drug may cause brain hemorrhage and death). In order for the medicine to work, it needed to be given intravenously within three hours from the onset of symptoms.
I quickly drove to the hospital, thinking about my own four-year old child. When I arrived, I took one look at this innocent child who was paralyzed to one side, tremendously scared and wanting to go home, and knew I had to do something.
Discussing the dire options with the parents, including medicine which would cause hemorrhage and even death, they started crying and asked me what I would do if this was my child. Picturing my son in a wheel chair for the rest of his life (which was the likelihood if nothing was done), I knew I could never forgive myself if I did not offer the child a chance.
Despite knowing how litigious our society is, I decided to go ahead and use a lower dose of the lysing medicine. The nurses and pharmacist fought the clock to arrange the dose ordered and infuse it according to the strict criteria while I rushed them along as we were quickly approaching the three hour cut-off.
The bolus was administered 2 hours and 58 minutes after the symptoms onset.
As the infusion started after the bolus, I started to thank the nursing staff and pharmacist when a resident physician ran up to us exclaiming: “Dr. Kassab, come inside the boy’s room! He wants to give you a high five using his left arm and hand!”
People started to cry. The emergency staff started giving high fives. It was a great feeling. And the child ended up recovering completely.”
