Scott Swanson
Dr.
Alan Blake sits in a comfortable armchair in his living room,
listening intently as family members chat with a visitor.
He
might be a little thinner than patients who’ve seen him at his
office at Sweet Home Family Medicine might remember.
His
left hand clutches his right arm. A cane lies on the floor by his
feet. Though he’s clearly following the conversation, he doesn’t
say much.
That’s
because he can’t – yet.
Blake,
58, has spent the last seven months recovering from a massive stroke
he suffered during a missions trip to Ukraine last June that left him
close to death and, more recently, paralyzed to various extents on
his right side.
It’s
really a miracle that he’s seated in his living room, family
members say.
“It’s
a nightmare story,” his wife Zsuzsa (pronounced “Zoo-sha”)
said, recalling the 15-day ordeal in which she navigated strange,
shockingly under-equipped Eastern European medical facilities with
largely uncooperative staffs in an attempt to get treatment for her
husband.
Their
tale began June 5, 2015 when Alan, Zsuzsa and their youngest son
Zach, then 20, who has Down syndrome, flew to Hungary to embark on a
four-week medical mission at a girls orphanage in western Ukraine,
just across the Hungarian border.
Zsuzsa
is Hungarian by birth and grew up speaking the language at home. The
Blakes lived in Budapest, Hungary’s capital, in 2007-08, so they
chose a destination where they could serve, Zsuzsa said.
“It’s
extremely poor and in need and speaks the language that we speak,”
she said of the area in which the orphanage is located.
After
visiting friends in Budapest, they crossed into a rural area of the
Ukraine – far, she noted, from the fighting with Russia in the
eastern portion of the country.
The
plan was that Alan, Sweet Home’s longest-practicing medical doctor
in recent years, would do medical care at the orphanage, located in
an area where “there’s not much else there,” she said.
The
depth of local need for quality medical care became apparent almost
immediately – on a very personal level.
Upon
arrival at the orphanage on June 10, they and some other visitors
from the Netherlands were welcomed with a “wonderful reception,”
a dinner prepared by the girls in the orphanage and a trip around the
compound to see the livestock – “it’s a self-sustaining, for
the most part, orphanage,” operated by the Hungarian Reformed
Church, she said.
“We
were just enjoying the evening.”
The
Stroke
Zsuzsa
and Zach retired to their room to unpack while Alan went to the
common area of the compound to try to send some e-mails.
He
didn’t return.
“We
were upstairs wondering why it was taking Alan so long,” Zsuzsa
said. “Finally, someone just came banging at our door and said Alan
had fallen.”
She
raced downstairs to find Alan sitting in a chair. A member of the
Dutch missions team was a nurse.
“He
and I just kind of looked at each other and it was pretty apparent
that it was a stroke. (Alan) was looking at us, he was awake, but he
couldn’t respond.”
Even
though the orphanage was well-organized, “everything happens very
slowly,” she said. They located the orphanage director, who got
hold of a physician in the region who spoke Hungarian and who came to
the site.
That
doctor “was a very kind man,” Zsuzsa said. “He did all he
could, which wasn’t much. They don’t have any kind of system at
all like we would recognize.”
An
ambulance was called.
“We
just kept waiting, and looking at each other, and waiting some more
and knowing that this is a stroke – time is of the essence. There
was nothing we could do but pray. Fortunately, we were in the right
place for that.”
During
the wait, they debated whether they should even go to the Ukrainian
hospital, which was about an hour away by ambulance over roads laden
with potholes, or risk a border crossing to get Alan back into
Hungary where there would likely be better medical care – and
communication.
“We’re
trying to make this decision with basically zero information,”
Zsuzsa said. “Where do we even go if we try to cross the border?”
Debrecen
was the nearest city in Hungary, but the quality of medicine would
likely be “well below” any American standard, though “way ahead
of Ukraine,” she said.
They
decided not to attempt a border crossing because of the risk of
delays.
“It’s
pretty strict. They don’t take into consideration that this is a
medical emergency or that we have American passports. None of that
would necessarily make any difference.”
Finally,
she said, an ambulance showed up “after I don’t know how many
hours.” It was a van with a table screwed to the floor and a light
on top. There was no lift apparatus, so “everybody had to help get
Alan onto a stretcher and lift him in. He’s not a small man.”
Zsusza
said that “should have been” a tip-off of what was to come.
A
Wild Ride
“I
can’t even believe they have tires on their vehicles, the potholes
were so unbelievable,” she said.
In
an attempt to cheer her up, the ambulance crew observed that “in
the U.S. you know somebody’s drunk when they’re swerving down the
road, but in Ukraine you know they’re drunk if they drive in a
straight line, because they hit all the potholes.
“The
IV pole was a little Ukrainian girl, who did not speak Hungarian,
holding up the IV that the local doctor had started. “She sat there
the whole time, holding up the IV.”
The
trip to the hospital took close to an hour. They pulled in to the
emergency room, which was about the size of a typical American living
room.
Three
attendants sat on benches along the walls, watching the ambulance
crew wheel Alan in.
“They
just watched, doing nothing. Literally, they sat and stared at us. At
that point I knew we were in trouble.
“It
was very dirty. Very, very dirty.”
In
a Ukrainian Hospital
As
Alan lay on a gurney in the middle of the ER, the orphanage director
arrived with the doctor who had seen Alan earlier.
“They
were such a blessing because they just took over. The people in the
hospital largely only spoke Ukrainian. I couldn’t communicate with
most of them.”
A
neurosurgeon arrived about 5 a.m., eight hours after the stroke
occurred.
They
had been told the surgeon was the best brain doctor in that part of
the country and, possibly, the whole of Ukraine, Zsusza said. He
confirmed, as best he could, the earlier diagnosis.
Since
visitors weren’t allowed into the ICU, the director took Zsusza and
Zach, whom she had brought along, back to the orphanage until
visiting hours later in the day.
“Zach
handled himself like a trooper from the beginning to the end,” she
said, adding that she wasn’t sure how much he really comprehended
about the situation. “He was amazing.”
She
returned to the hospital later in the morning, accompanied by
orphanage staffers who spoke Hungarian and Ukrainian “so we would
have all our bases covered.”
“God
sent them, because they were advocates – they knew the system. They
pushed where we needed pushing and backed off where they knew it
wouldn’t help.”
Conditions
were better in the ICU – barely.
“It
looked clean, but it looked like 1940,” Zsusza said. “Like
something you’d see in the movies, packed with people – probably
20 or 30 beds in a very small space. It was a scary sight from an
American’s eyes.”
The
neurosurgeon was “a very, very helpful, kind man” who spoke
broken English.
Using
Alan’s cellphone, which had an international connection, Zsusza
called her son Nicholas, a medical school graduate who is a resident
in family practice in Missoula, Mont. He talked directly with the
Ukrainian neurosurgeon, who said Alan needed immediate surgery or the
swelling in his brain would kill him.
“We
had a little window of time,” Zsusza said. A primitive CT scan had
been done on Alan’s arrival and it had confirmed that he had
suffered “a massive stroke.”
They
decided, because of the risk of infection at that hospital, which the
neurosurgeon had told them was his biggest concern, they decided to
transport him to Hungary.
“I
felt for that man,” she said. “I think he was really a good
surgeon. He was, at least, honest about everything. I told him that.
Through American eyes, the risk of infection was just too much. He
understood that.”
Fighting
for Life
After
another wait for an ambulance, during which the orphanage staff “made
a multitude of phone calls” to try to work out the details of
crossing the border, they made it to Hungary at 8 p.m., nearly 24
hours after the stroke occurred.
Passage
over the border was simplified by one of their party, who had a
diplomatic passport, though they had to switch ambulances when
crossing into Hungary. They even had their luggage along in the
ambulance, which the Dutch team had packed for them.
“God
was really working because it could have been a nightmare just to get
over the border,” she said.
They’d
decided that their best option was to go all the way to Budapest,
where the best medical care available would be, so she spent most of
the “long” ambulance trip “praying a lot” and updating
family, friends and Samaritan Health staff, who had been alerted to
the situation.
“Alan
would wake up and look at us, but it didn’t look good,” she said.
“We knew we had a window that was closing, with the brain swelling.
So there was a lot of anxiety involved.”
When
they finally pulled into the hospital, they were turned away.
“I’ve
never been so crushed in my life,” Zsusza said. “This one doctor
came out and chewed me out: ‘What do you think you’re doing? Why
do you just think you can come here?’ It was unbelievable.”
One
of her Hungarian friends, a pharmacist, met them there. She was
appalled and took the hospital staff to task over his treatment of
“a colleague,” but to no avail.
“They
never let us in,” Zsusza said. They located another hospital a
couple of hours later, now nearing midnight.
“The
ambulance drivers were very kind men,” who advocated for them, she
said.
The
hospital “very grudgingly took us.”
The
doctor asked, “Why did you come here?” and requested Alan’s
medical records from Ukraine, but when Zsusza produced them no one
could read them.
“She
looked at it and I said, ‘This is why we’re here. I can’t
understand anything of what’s going on.’
“She
just had this face, like, ‘Oh my goodness, I can’t make heads or
tails out of this other language.’”
The
doctor softened at that point, and started going to bat a bit for
Alan, Zsusza said.
“Hungarian
doctors will not talk to patients’ families,” she said. “They
are arrogant and very rude and give no information whatsoever. As an
American, we expect full disclosure as a spouse. They weren’t very
happy with me for wanting information, which I pursued anyway. ‘OK,
be mad at me, but just tell me what’s going on.’”
They
wheeled Alan away and told Zsusza to come back the next morning at
11, during visiting hours.
She
and Zach slept on the floor of her friend’s apartment.
The
next day, they affirmed what the Ukrainian doctor had told her: They
had to do surgery.
That
would have been it for communication, had Zsusza not gotten
aggressive.
After
the operation, “I literally had to pursue the doctors through the
hospital because unless you are standing there waiting at the door,
they will tell you nothing about how the surgery went,” she said.
“Because I could speak Hungarian, I could find out at least some
information. I happened to catch one of the doctors who had done the
surgery and she said he was ‘fine.’ That was essentially it.”
They
stayed in Budapest for about a week, during which Alan’s sister
Susan from Kentucky arrived to retrieve Zach, “who was getting
pretty weary of hospitals,” though “he’d been a trooper,”
Zsuzsa said.
Care
Concerns
The
Hungarian hospital, though cleaner than the one in Ukraine, was
lacking in patient care, she said.
“There
was nothing. The IV wasn’t running. They weren’t feeding him.
They just let him lie there. They did nothing. I thought he was going
to die.”
She
tried to “make as much fuss as possible” about the quality of
care Alan was getting: “Why does he not have an IV?”
Her
son Nicholas told her that they needed to feed Alan because he needed
strength and stimulate him so he could regain his movement.
“I’m
in there exercising him and Zach is in there, lifting his arm
passively. ‘OK, squeeze our hand, squeeze our hand.’
“When
he would squeeze Zach’s hand, Zach would give him a big thumbs-up.
Everybody around there thought we were nuts. When I would go in there
he’d be basically almost non-responsive. By the time we left, he’d
be saying ‘Yeah.’ It was so obvious that all we needed to do was
not neglect him.
“I
don’t know if it was because they didn’t care, which is what I
think it was, or because they thought we wouldn’t pay – I
have no idea. I kept trying to talk to them and they kept saying,
‘It’s fine, it’s fine.’”
Friends,
particularly a Hungarian pastor they knew, were praying about the
difficulties.
Meanwhile,
Samaritan staffers, led by Becky Pape, then-CEO of Samaritan Lebanon
Community Hospital, and Sweet Home Family Medicine medical assistant
Kristi Walker and manager Kristin Ashcraft, had launched efforts to
get their colleague to better medical care.
Walker,
in particular, was a “bulldog” in getting things done, she said.
“These
people at the office, all of them, they were ready to do anything
they needed to to get Alan back. And they did.”
She
said the idea of airlifting Alan out of Hungary, suggested by
Samaritan, had not even occurred to her. The Samaritan staff “got
right on it” and worked through the complications and insurance
paperwork.
“Because
it was a brain surgery, they needed to know his condition was stable
to airlift, which, of course, makes sense. But then they wanted a
western doctor’s opinion. So then it became complex.”
They
waited nearly a week in Hungary as they tried to find a hospital that
would take Alan.
“Nobody
wanted him. They didn’t want the liability in western hospitals.”
Rescue
Arrives
After
“a whole lot of drama,” an airborne medical team from Germany
arrived.
“It
was like something out of a movie,” Zsusza said.
As
they waited in the waiting area – a few chairs in a hallway
outside the ICU, wondering what was next, “the door bursts open and
these three big dudes come walking in. This one guy was literally
6-6. He was the ICU nurse. The doctor was like 6-2 and the ambulance
driver also.”
The
three were decked out in full flight gear and western equipment. The
Hungarians sitting in the hall were speechless, she said.
“It
was hilarious.”
They
got out the next day. They flew to Ingolstadt, in southern Germany.
The
Samaritan staff got Zsusza a hotel to stay in.
“We
were just thankful that he would get real care, with a real IV.”
“With
trained professionals,” her son Isaiah chimed in.
The
Hungarian surgeons had removed a section of Alan’s skull, which in
Western medical practice should have come with him. It didn’t, so
that caused “more adventures” with the insurance company, Zsusza
said.
But,
Alan was “getting the care he needed and I could stay all day. I
could go back to the hotel and sleep and make my phone calls and
e-mails and texts and try to get through to the insurance company so
we could get home.
They
were there a week.
“I
cannot say enough good things about what Samaritan did to get Alan
home. They bent over backwards to do that. They did wonderful.”
They
puddle-jumped across the Atlantic and North America in a Cessna,
making stops in Iceland and Greenland, getting clearance at each
stop, “showing our passports,” she said.
It
was a 19-hour trip from Frankfurt to Eugene, where Isaiah met them
and Alan was transported to Samaritan Regional Medical Center in
Corvallis, arriving June 25.
“I
knew we were OK then,” she said.
Exceeding
Expectations
Asked
if he had had more surgeries, Alan responded with a wry, drawn-out
“Ohhhhhhh.”
Samaritan
doctors put a fabricated patch in Alan’s skull in September “after
all kinds of adventures,” Zsusza said.
Alan’s
prognosis now is much better than when he arrived in the U.S., she
said.
“Looking
at where he was when we landed in Corvallis – he couldn’t
speak, he could hardly move, he couldn’t eat, he’s doing
amazingly well. He’s walking, standing up on his own, he is now
starting to speak in full sentences.”
The
latter didn’t happen when a reporter was present, though Alan
frequently assented to things his wife said with “yeah,” or “oh
yeah” – familiar responses to those who knew him before the
stroke.
Recently,
he suddenly said to a visitor: “I want to go on record to say that
I want to come through the test with flying colors.”
“For
someone who was in that state to be where he is now is an answer to
prayer and a lot of fortitude on his part,” Zsusza said.
His
right arm is not working, but occupational therapists say it’s
responding to stimulation – which is what happened with his
right leg.
“Now
he can lift it. He can do resistance. He can go up and down stairs,”
said Isaiah, who graduated in December from Northwest Christian
College, and has moved home, assisting “in every way possible,”
according to his mother.
Help
from the Community
“Everyone
has functioned in their area of gifting,” she said. “It’s been
incredible to see that: All four sons and their two wives, my
brother, other family members. The community has stepped up.”
Friends
and people the Blakes didn’t even know showed up to work on trees
in their yard, fix their well water system, and put carpet on a ramp
built by local contractor Jeff Parker, who also enlarged the interior
doorways to accommodate a wheelchair and installed grab bars for
Alan.
“I’m
leaving out half the stuff,” Szusza said, her voice quivering a
bit. “I just want to make sure to say thank you to the community.
We couldn’t have done it without all that help.”