The Tribune

By DR KENNETH D KEMP

IN January 2020, while getting ready for church, my patient sat in his living room chair to put on his shoes. Leaning forward his chest felt tight and his breathing became so laborious that he began to sweat. He attempted to stand but fell back down. Within seconds he was wheezing deeply and struggled to breathe. At age 71, he slowly and carefully walked over to the bedroom to find his wife and began to vomit blood so violently his throat burned. He didn’t have enough oxygen to yell for assistance so, clutching his chest, he slowly signaled to his wife. As she screamed running to support him before he collapsed, he felt in that moment that these would be the last moments of his life.

Known to his closest friends as Smiley, my patient was born in 1949 in Nassau and grew up in abject poverty. His neighbourhood barely had running water and electricity and he attended free public school barefoot for many years until he was gifted a pair of shoes by Catholic nuns. At 15, he left school, needing to find work to support his family. What he lacked in formal education for advancement, he more than made up for by his work ethic. After a stint as a food store clerk, he went to work at a hardware store where that work ethic paid off. Smiley was promoted to manager.

With an extraordinary gift for selling and interacting with people, he took those skills to several other jobs until he ultimately answered an ad in the newspaper and landed at an insurance company working as a messenger clerk. Before long, he was promoted to the role of underwriter when the position suddenly became available. In this new role, he reviewed insurance applications, evaluating and analysing the risks involved with approving them. A job as such typically requires a college degree but Smiley’s strong interpersonal skills were obvious to all who met him and that coupled with an exceptional mathematical and analytical prowess made him an ideal candidate for the job.

As he rose further in rank from senior underwriter to office manager then treasurer, he travelled to New York and Puerto Rico before ultimately being awarded the position of general manager at the age of 24, less than ten years after he started. Seven years later, Smiley had expanded the company by developing a subsidiary in St Maarten making it a multinational success but his external triumphs did little to mitigate his personal family struggle.

At five years old, his son began having epileptic fits. Watching his little body become tight and contorted without warning and then jerk and shake violently was devastating for Smiley and his wife. Before coming to join Smiley in St. Maarten, his wife took their son to a hospital in Miami and their worst fears were realised when he was diagnosed with a high grade, malignant brain tumor. His chances of survival were slim the first time he had brain surgery in the US and even slimmer two years later when his cancer returned and he had to undergo a second brain operation. Fortunately, Smiley’s son survived and today, against all odds, he is thriving.

During his son’s health crisis, Smiley left his job to be with his son and wife and help her take care of their daughter. But now that things felt stable at home, he set his sights back on his career and started his own insurance company. Trading on skills that he’d learned readily over the past decade, the process came naturally and in no time, he was up and running. But the pride and price of ownership are incontrovertibly fastened to the stress its success demands. The tensity took its toll one day while Smiley was driving to work. His chest constricted, he became light-headed and pulled over. Almost as quickly as it started, his symptoms resolved but with a deep appreciation for following up immediately on health issues, Smiley travelled to the US for a routine check-up.

He was diagnosed with an irregular (arrhythmic) heartbeat and was given electric cardioversion treatment where his heart was shocked everyday with quick, low energy electrical impulses. The treatment worked for a while, but not long after he was diagnosed with a blockage and Smiley had to have the aorta (main artery) in his heart replaced. Seventeen years later when he began experiencing heart palpitations and shortness of breath once again, he underwent a second cardiac procedure, this time to replace his malfunctioning mitral valve.

Unfortunately, Smiley’s health complications didn’t end there. Shortly after his valve replacement he began experiencing severe headaches lasting days at a time. A local physician ordered a CAT scan of his brain and diagnosed him with a sinus blockage but one night his headache was crushingly severe and he couldn’t stop vomiting. Afraid and concerned, Smiley and his wife travelled back to the US where in a Florida emergency room they were informed that a vein had burst in his brain and so much blood had pooled in the area that his surgeons were shocked that he was still able to walk and speak.

Because of the blood thinner medication Smiley took for his heart, his surgeon couldn’t operate that night and waited till the following morning. The operation lasted seven hours, pure agony for his loved ones. Twenty-four hours later, Smiley regained consciousness. Several weeks passed before he was cleared to travel back home but his celebration was short-lived. The incision site, a visual reminder of where his surgeon used a sharp blade to cut into his skull to enter his brain and remove a deadly mass, was critically infected.

The bacteria colonizing his brain were spreading quickly and time was not on Smiley’s side. Nearly 50% of Smiley’s skull was removed and couldn’t be salvaged. Weeks later, following an aggressive course of intravenous antibiotics, Smiley was supposed to have a metal skull implanted but the risks of a third brain surgery following two major heart surgeries were as high as it gets. So, he refused and since then has lived with a sunken depression on the right side of his head where his skull once existed.

For over a decade, Smiley enjoyed normal health until January 18, 2020, when he was getting ready for church and could no longer breathe. Smiley’s wife ran to help and got their daughter to take him to the hospital. On the way, his situation worsened. His skin turned a faint blue and the pain to his chest was so intense that he began to tell his family goodbye. His daughter, swerving between cars with fortunately light traffic screamed for him to pray and to keep fighting. Her attention painfully divided between him and the road, she punched his chest then wiped away her own tears. Smiley says the blow helped ease some of his pain.

At the hospital, attendants helped Smiley as his wife and daughter ran behind, their minds confused and their hearts racing. Smiley was immediately placed on life support and transported to the intensive care unit. He was in a coma for three days after which he was airlifted to the US at his family’s request. Smiley’s doctors there had seen him through unimaginable medical crises and for the fifth time, he would need them once again. Smiley was diagnosed with a severe form of pneumonia. One week later, he was released from the hospital and given the okay to travel home.

Smiley’s take home message is to always be an advocate for your health because no one will understand and care about your own body better than you. Having an internal locus of control will ensure that you remain in the driver’s seat of your wellness. Although doctors saved his life more than once, he says do not wait for a doctor’s analysis. If you feel something is not right, take charge and seek immediate attention. Listen to the message your body is trying to send you. Stop being the brave guy, be the smart one. Smiley thanks his family immensely for their unconditional love and support and as a true walking miracle, he emphasized that he wants to continuously live a life in the status of his Christian faith.

Nicknamed Smiley as a child because he always had a smile on his face, now at 73 he is still living up to his nickname. Eternally grateful for his loving and beautiful wife, healthy children, a successful business and for surviving so many health crises, he has even more reasons to smile today than ever before but particularly on his birthday, when his smile is about as big as it gets, every 29th day of September.

This is the KDK Report.

• Nicknamed ‘The Prince of Podiatry’, Dr Kenneth D Kemp is the founder and medical director of Baha-mas Foot and Ankle located in Caves Village, Western New Providence. He served as the deputy chairman for the Health Council for five years and he currently sits on the board of directors for the Princess Margaret Hospital Foundation in his role as co-vice-chairman.