There’s actually a major miracle here, but it starts like a normal story.
35 years ago, in the fall of 1985, I had a Fulbright Fellowship to teach at Addis Ababa University medical school. My office was on the 8th floor of Black Lion Hospital. I had completed my internal medicine residency in Baltimore, just months before. My specific job? Teaching cardiology to medical students and residents, and running the cardiology outpatient clinics, as well as attending on the medical wards.
I soon learned that Ethiopian heart disease was quite different from American cardiology, which is dominated by coronary artery disease such as heart attacks. In Ethiopia, there was still a lot of rheumatic heart disease, a consequence of strep throat, which can cause severe damage to heart valves. And plenty of uncorrected congenital heart disease, since many Ethiopians born with imperfect hearts could not get surgery. In a single clinic day, I’d see more rheumatic heart disease patients than I had seen in 3 years of training in Baltimore.
One week, I had 2 patients with the same name come to see me: Sebsebe. Both came directly to my office, ignoring the clinic for appointments. Sebsebe number 1 knocked on my door on a Monday, and had severe mitral stenosis. A gaunt 21 year old, he handed me a report showing that his mitral valve, one of the 4 heart valves (located between the left atrium and left ventricle) was far too narrow, scarred by rheumatic fever. Normal valve area is 4-6 cm2. Sebseb’s was 0.6 cm2. This is hardly compatible with life. Seb’s days were numbered. This was an emergency.
Professor Asrat, a fine Ethiopian surgeon, had the technical skill to operate, make a cut in the heart, and insert his finger into the mitral valve to crack it open. This procedure, called “blind valvotomy,” was invented by Boston surgeon Dwight Harken in 1948. I advised Sebsebe: “Right now, walk down to Professor Asrat’s office on the 5th floor and make an appointment. It’s your only hope.”
“Can’t you send me to America?” he asked. “I have no way of sending you to America, unless you have $25,000 for airfare and surgery. Listen to me – this is an emergency. You have one chance for years of life – it’s Professor Asrat.” He slowly walked out looking dejected. I never saw him again.
Three days later, I was sitting at my desk and heard another knock at my door. “My name is Sebsebe,” he said, “and I have a problem.” He explained: “I’m Ethiopia’s top light-flyweight boxer. I was on the Olympic team, but we did not go to the Los Angeles Olympics in 1984 because we are aligned with Russia. Every time I train hard, I cough up 1 cup of bright red blood.”
“Have you been to a doctor?” I asked.
“I know that coughing blood often indicates that you have TB,” he replied, “and I went to the TB center. They said it’s not TB. Nothing else.”
It’s known that rheumatic heart disease can frequently cause hemoptysis – coughing up blood. I was wondering about the state of his heart valves, though amazed he could still box. I had him take his shirt off and I listened carefully with both sides of my stethoscope – the bell and the diaphragm. Classically, it is taught that the low-pitched murmur of mitral stenosis is best heard with the bell. When I laid Seb down on his left side, a position to bring out mitral murmurs, I heard the low rumble of mitral stenosis. I sent him for a cardiac echo, which confirmed my diagnosis.
“Do you have $25,000 for airfare and heart surgery?” I asked. “Impossible,” he said. “Nothing.”
I explained that he would benefit from surgery soon, but my first patient was much worse. Just to be polite, I said “Write down your name and your phone number, in case I hear of anything that could help.” He tore off a scrap of paper, and wrote his name and phone number. I did not even look, I simply placed it into my top drawer. I asked myself: “What are the chances that I’ll get an offer of a free heart surgery? Zero.”
2 weeks later, my mail arrived from America. Inside was a letter, which the NIH in Washington had sent to every doctor in the US, asking for patients with mitral stenosis. They offered treatment with a new balloon procedure, in which a balloon goes up to the heart through the groin and is inflated, forcing the valve open. Without surgery! I wrote to the doctor at NIH and asked: “Would you accept Ethiopian patients?” “Sure,” she replied.
I went into my drawer and found the scrap with Seb’s name, dialed the number, and told him to come to my office. In the coming weeks, it all came together. Seb found a place to stay in Washington, and we got him a US visa and air ticket. He flew off to America.
Fast forward: About 2 years ago, I got an email from one Danny Simmons in Los Angeles. He was making a documentary film about a boxer – Seb Zewdie – and Seb had mentioned that I had saved his life. It took some time for them to find me – was my name Rhodes? Hodes? Horowitz? But they tracked me down. I flew to Los Angeles to be interviewed.
On December 8, 2020, Danny’s film SUFFER FOR GOOD is coming out:
Seb is now a boxing and fitness coach around Nashville, Tennessee. He is healthy. He is married, with a great family. Seb has a special interest in Parkinson’s Disease, and even during the COVID-19 lockdown, continued his Parkinson’s classes, which classify as physical therapy.
I simply marvel at these events – a patient needing a specific heart procedure, and the NIH contacting me to ask for mitral stenosis patients - virtually simultaneously. There’s no doubt that without care at the NIH, Seb would not be alive right now.
Seb is giving part of his proceeds to our work, sponsored by the JDC, to help other Ethiopians needing surgery.
Seb – we wish you great success with the film!
All the links you might need are right here: https://linktr.ee/brokendove