When finished, our McMurry West Tower and MRI building will have more than 3 miles of copper electrical wire laid within the walls. That’s enough to stretch from Wyoming Medical Center to the Casper Events Center.
The McMurry West Tower is set to open late this summer. It will provide 98,000 square feet for state-of-the-art medical care, 20 private surgical rooms and a new mother-baby unit with 12 private rooms.
As the weather turned colder this winter, workers for Haselden Caspar/ Pope JV moved inside to frame out the building’s interior with more than 11,000 steel studs. Crews have installed 5,000 batts of insulation and are now hanging the 4,300 sheets of drywall. Now, you can imagine the shape, layout and space the rooms will provide for patients and families. You can also see the outlines of our new main entrance, spacious dining area and the Cottage Gift Shop. The tower will also have space for a 7,000-square-foot Wellness Center.
Many more impressive numbers can be found inside the walls of our new tower, designed to create a better hospital experience for the thousands of Wyoming families who come to us each year. Here are a few:
2 air-handling units, each weighing 55,000 pounds, installed on the roof to ensure quick and efficient air ventilation
More than 100 windows framed and installed
15,000 cubic yards of soil removed for caissons and foundations
275 tons of rebar used
4,411 cubic yards of concrete poured
1,400 sheets of thermax sheathing installed
3,300 exterior steel studs installed
10,000 feet of 6-inch metal strap blocking used
240 sheets of ¾-inch fire treated plywood blocking used
More than 8,000 feet of ¾-inch metal electrical conduit laid
Emergencies, by nature, are chaotic affairs. Events seem to unfold faster than most of us can process them. We may wonder if we’d be any help at all if faced with a car crash or other disaster. Kaleigh Peil thinks we’d be surprised with what we could contribute.
She should know. On Dec. 23, she came upon a terrible car crash with multiple casualties. She encountered several bystanders who were eager to help but didn’t know how. All stepped up when given a specific task.
“They may have been teachers or secretaries or anybody. They were just driving by, too. No one there knew what Incident Command was. But that was OK. I could still use them ,” she said.
It happened about 6 p.m. as Peil was driving from Casper to her family’s home in Riverton. About 50 miles out on Highway 20/26, she saw hazard lights and thought someone had hit a deer. She soon realized it was something much bigger. She approached slowly and noticed two vehicles in the ditch – one to the left of the road, one to the right. She had to pick one, so she picked right.
“There was no reason why. It was just a split-second decision,” said Peil, administrative assistant for Wyoming Medical Center’s Disaster Department.
Peil first scanned the scene. The SUV in the right-hand ditch was crumbled in on the front driver side with debris scattered for 100 yards. Seven or so people who stopped at the crash stood by, unsure of how to help. Two of the three crash victims were still in the SUV while the driver stood outside. Peil asked the bystanders if law enforcement personnel were yet on scene. None were.
My name is Kaleigh and I’m going to be assuming command, Peil said. I’d like to use you all as volunteers if you think you can help.
A couple of things you should know about Peil before we continue: In person, she’s not what you’d call intimidating. She’s 22 but could pass for a few years younger. She stands 5 feet, 5 inches tall. But when she took control of that scene, the bystanders were happy to listen.
Peil has high-level training in the Incident Command System (ICS) – a standardized protocol for managing incidents of any type, scope or complexity. It is used by all levels of government agencies and by Wyoming Medical Center. For example, we employed the system the afternoon before October’s winter storm Atlas, checking on resources, assigning specific tasks and making contingency plans for possible power outages and road closures. We also sent representatives to Natrona County’s Central Command Center the day of the storm to serve the county-wide ICS response.
Peil recognized that her right-side crash scene should be managed through ICS.
“My whole goal was not to get tunnel vision,” Peil said. “It’s really easy in that situation to focus on one person or one aspect of the crash. The ICS was useful in reminding me to take a step back and to realize that there were a lot of things going that all need addressed. Knowing what to do in the first couple of minutes and not just focusing on one thing helped me to respond to the whole situation.”
Peil, who is trained as an EMT but is not currently certified, quickly triaged the three patients:
— In the back passenger seat was a woman in her 80s, obviously in pain. She suffered trauma to the head and was passing in and out of consciousness.
— In the front passenger seat was a woman in her 50s or 60s. She was shook up but not as badly hurt as the elderly woman.
— Outside was the driver, a woman in her 40s. She was responding to questions.
Next, Peil delegated the most important tasks. She charged one volunteer with gathering lights, either from flashlights in the stopped cars or from cell phones. She charged another to recall 911 and update them on the patients’ conditions. She assigned two more to monitor the two patients with the less serious injuries and to notify her of changes in breathing or circulation and if they developed signs of shock and hypothermia. Temperatures had dipped to about 15 degrees, and they were working on frozen snow and ice at the bottom of the ditch. When they were almost hit by oncoming traffic, Peil assigned two more volunteers to slow down approaching vehicles with lights and flags.
“They all wanted to help but weren’t sure how. When I gave them a task that they were able to do, they seemed relieved,” Peil said.
Peil took control of the elderly woman in the back of the SUV. Her head injury was bleeding and her coat was filled with blood. She floated in and out of consciousness, and she was scared and confused when she did come to. Peil explained that when the emergency responders showed up, there would be lights and sirens. It would seem chaotic and confusing, but it would be OK.
Law enforcement arrived between 20 and 30 minutes after Peil took command. Riverton’s Air Medical Flight Services came a few minutes later, responding to the crashed car in the left-hand ditch. The first fire truck also responded to the left-hand scene.
Between 40 to 50 minutes after the start, the remainder of fire and EMS were able to relieve Peil of incident command. She briefed the EMS personnel about patient conditions and the tasks she assigned out. She then volunteered herself, assisting in the extraction of the elderly woman via a backboard. She also helped to extract the front passenger using a Kendrick Extraction Device, designed to remove patients from vehicles in the sitting position, while holding the spine and neck stable.
She then asked if there was anything else she could do, and when there wasn’t, she finished her drive to Riverton.
“The first thing that came to my mind was how blessed Wyoming Medical Center is with so many amazing employees,” said Mike Magee, WMC’s emergency preparedness coordinator. “To me, it just says that Kaleigh is it. She is the kind of person who we need here.”
A week or so after the accident, a letter arrived at Kaleigh’s desk: “We want to thank you for your excellent assistance on 23 December, 2013 at the motor vehicle crash on highway 20/26,” wrote Dale T. Gibson on behalf of the Fremont County Fire Protection District. “We often find bystanders who are willing, but not trained, to help. It is rare to find a well-trained EMT-B, as yourself, providing good medical assistance at scenes … You made a difference in the outcome of those lives, and we want to thank you in this small way.”
Peil, who plans to stick with disaster and emergency management throughout her career, didn’t expect a thank you, but was touched by the sentiment.
“I felt honored that they saw me as good help to the situation and that they took the time to find me. For the first couple of days it was easy to wonder if I actually helped or not,” she said. “But after receiving the letter, it eased a few of my doubts.”
Written by Cornell Colbert, Director of Food and Nutrition Services at Wyoming Medical Center
Monday, I witnessed something truly special.
One of our room service associates, Teresita “Ching” De Guzman, became an American citizen. She was among 21 others from 11 different countries who pledged their allegiance to the American way of life.
Most of us reading this message were lucky enough to be born here. We didn’t have to travel great distances, take tests, or pass background tests to enjoy the benefits and privileges of being an American.
At the ceremony, I thought of the challenges before us and compared them to the challenges of those who worked so hard to join this community. What I realized was that, despite whatever hardships we may think we are enduring, those whom I witnessed Monday happily accepted the hardships just for the opportunity of being a part of what we are.
Let’s be thankful today and moving forward, because there are so many wishing that they had both our blessings and our difficulties.
Cornell Colbert has been Wyoming Medical Center’s director of Food and Nutrition Services since December 2012. He has a passion for seeing employees reach their fullest potential at work and in life. He has served on the Sodexo Cross Market Diversity Competency Council, as a leadership mentor and coach, on the board of the Colorado Springs Diversity Forum, and as an urban missionary to the Asian community in Philadelphia.
Scroll through for more photos from Teresita “Ching” De Guzman’s citizen ceremony.
Thank you to the El Dorado Hills (Calif.) Fire Department for taking the time to recognize several members of our ER team.
Fire Chief Dave Roberts sent a letter on Sept. 10 thanking Dr. Jonna Cubin for the excellent care Wyoming Medical Center gave to a colleague and friend who’d wrecked his motorcycle on his way to the Sturgis rally. He asked her to pass on his department’s gratitude to WMC Emergency Department Senior Nurse Manager Corrine Arross, ER nurse Nicole Beckstead,Sam Baker, Paramedic Riley Becksted, and Wyoming Life Flight nurse Chuck Bright. He also sent along six coins he developed to award his staff for “performance above expectations.”
“It is a tradition in the military, law enforcement and the fire service to ‘coin’ someone for going above and beyond in the performance of their normal duties. In my opinion, your team far surpassed all of our expectations,” Chief Roberts wrote. “Very few of these El Dorado Hills Fire Department coins have gone outside the walls of our organization. I would be honored if you would accept a coin yourself and present each of the members I have listed with one of our coins.”
Read the entire letter by clicking on the images below. Please accept our belated appreciation, Chief Roberts, and we wish your friend a quick recovery.
In 2008, Wyoming Medical Center got the state’s first da Vinci S™ HD Surgical System. Our doctors are the most experienced on the da Vinci and offer more procedures than any other hospital in Wyoming.
Dr. Todd Hansen, a urologist at Central Wyoming Urological Associates, has performed hundreds of surgeries with the robot, cutting his patients’ recovery times and improving their outcomes.
The Pulse recently sat down with Dr. Hansen to talk about the benefits of minimally invasive surgeries and how patients can determine the right treatment options for them.
Hansen: I grew up in a small rural town in Arizona called Joseph City. My grandfather was a big rancher, but my father went into dentistry. We lived right there with my uncles who took over the ranch and were highly involved. I liked ranching more than I did dentistry.
The Pulse: What interested you about medicine generally and urology specifically?
Hansen: I think it just kind of fascinated me. I was not certain at all when I got started with school that I was going to go into medicine, but it just kind of aligned with my interests and talents.
Urology is kind of a hidden specialty. It is not something a lot of people think of, and I was one of them. I never thought of it going into medical school, though I did feel myself getting pulled toward the surgical side of things.
I was working with a urologist when I began to realize that: One, they were a fun group to work with and, two, the procedures and the surgeries they were doing were very fascinating. I think most of us kind of think urology as old man’s health care. I realized that was anything but the truth. Really, we were on the cutting edge of a lot of surgical innovations, and we did extensive surgeries that I really enjoyed.
The Pulse: What do you mean cutting edge?
Hansen: For example, we do many laparoscopies, robotics and things like that. Quite frankly, urology has been the leader in robotics. Look at minimally invasive surgery, endourology with the ability to do things with scopes that we do. We do some really big, fascinating reconstructive surgeries as well. We do cystectomies and reconstruct a whole urinary system.
The Pulse: What are the advantages of minimally invasive procedures like those that can be done with the da Vinci S™ HD Surgical System?
Hansen: Before da Vinci, I had already done a tremendous amount of laparoscopy, where you are putting ports into the abdomen and doing surgery. The da Vinci is just an extension off of that, but you have a robot, so you have wristed instruments. It is kind of a natural step to be able to provide more care minimally invasive that you could not do with just a plain laparoscope.
With robotics, you do a complex surgery without making a big incision. An open surgery entails going through major muscles, even potentially taking a rib. There is much more pain and discomfort, a much higher chance of hernia and higher risk of infection; da Vinci makes smaller port sites, hernias are much less common. Infection rate drops a lot. Pain and discomfort drop immensely and there is a shorter hospital stay.
The advantages are fairly obvious. A large incision going through major muscle versus some small port sites is not a subtle difference.
Hansen: That just depends on how you term recovery. The patient will forever be more comfortable without open surgery, because once you go through those muscles, a lot of times you end up with nerve injuries and some muscle paralysis. The short of it is: You are going to be dramatically more comfortable after minimally invasive surgery. Your ability to get back to work and do things is going to be increased significantly in terms of weeks probably.
The Pulse: What can you offer with da Vinci that others can’t?
Hansen: There is a huge gap in the community and their understanding of what is really offered here that is not offered anywhere else in this state urologic-wise.
For example, if you have a tumor in your kidney, we have the ability to remove that tumor without removing the entire kidney – what we call a partial nephrectomy. That results in longer life expectancy and decreased chance of renal failure. There are huge advantages to the patient to do a partial versus a total nephrectomy.
We not only have the ability to do that, and to do that well, but to do it without an open incision. That is not being done anywhere else. The ability to re-implant ureters and do it without an open incision is not being done anywhere else. We can do sacrocolpopexy, or female reconstructive surgery, without making an open incision.
If you want to know the truth, I suspect there are a ton of patients out there that are getting total nephrectomies with the entire kidney removed when they should just be getting a partial nephrectomy. I can tell you that no one else is doing that minimally invasively. To be frank, I do not think the community has any idea how much further ahead we are than the rest of the urologic community in this area.
The Pulse:Is this something that patients should ask for? If their urologist doesn’t offer minimally invasive or laparoscopic surgeries, what should they do?
Hansen: It is a patient issue. Patients should ask for second opinions on the best treatment options, and that doesn’t mean going to Denver or Salt Lake City. A lot of people just don’t realize that we offer it in Casper.
I get some urologists who do refer to me, but there are a lot that do not. They either just remove the entire kidney, or they do an open surgery. You cannot say that is substandard care, but I do not think even our own hospital recognizes how much further apart we have set ourselves than the vast majority of the care that is getting performed.
I think it is appropriate for any patient in any situation to ask for a second opinion if they feel that it would benefit them. It is okay for a patient to ask for a second opinion. I have patients who do that. We all have patients who do it.
It’s OK to ask your doctor: “Is this something that can be done in a less invasive way?”
The Pulse: How many different procedures are you able to do on the da Vinci?
Hansen: The question anymore is, “What don’t we do on the da Vinci?” There are not very many abdominal surgeries that we are not doing with da Vinci and/or robotically.
Take a prostatectomy: You end up being able to do a better dissection because you can see better. You end up doing a better anastomosis because you can see better. You can actually perform the surgery better robotically than you can open.
Some people would debate that. This is not a hard and fast thing, but in my experience, I think you can actually get better outcomes doing it robotically. There is a fair amount of literature that suggests you can. Definitely, you can do it with a better recovery. If your surgeon said “Let’s take out your gallbladder laparoscopically versus doing an open gallbladder,” every person would choose a laparoscopic gallbladder.
The Pulse: What are the advantages of having these procedures in Casper as opposed to traveling out of state?
Hansen: One of the huge advantages is follow-up. You have a physician who is committed to taking care of you long term. Many of my patients have found it frustrating that they have gone elsewhere and then realized that there is really not much follow-up. These physicians are kind of like, “just go back and see whomever.” That is probably one of the biggest advantages as there is much better follow-up care long term, not just immediately.
I still respect the fact that the patients need to do what they are comfortable with. I do not believe I lose very many to outside facilities. Most of them are very comfortable with the care we are providing. I know the hospital is very focused on that. I think I have more in-migration than out-migration. I get many more patients referred into me than I have leaving, by a huge number.
I do think there are patients who we never see to begin with because they do not know what we can do here. The biggest area that is true in is pediatric urology. That is probably education that needs to go on at the level of the pediatricians.
The Pulse: What trends do you see coming in urological medicine?
Hansen: There have been so many advances, mainly related to the da Vinci robots. When I started here, for example, we were doing all kinds of open procedures. Now, the number of open procedures has been cut down to just a trickle.
The biggest advancements are going to continue to be learning to do things minimally invasive with better outcomes. That will still be the trend. Cystoprostatectomies are getting done robotically. That is probably something that we would bring in.
The other thing is that I think that there is going to become better screening for cancer. Two big areas in urology, other than minimally invasive, would be better cancer screening and detection so that we can differentiate who to treat and not to treat. New organs at some point, they are already in the process of developing things like bladders and that now. There will come a point when we use tissue that is grown in the lab to implant surgically.
There are some phrases you don’t want to hear over a plane’s intercom while suspended thousands of feet in the air. On Dec. 30, Amy Sorensen heard two of them: Are there any medical professionals on board? Then, a little later: Does anyone have flight experience?
Sorensen, 24, was watching “We are the Millers” when the first announcement sounded. She was returning from a family Christmas, flying United Airlines from Des Moines, Iowa, to Denver with 154 other passengers. Call lights started flashing almost immediately. She figured, there must be several doctors on board with more experience than me. She’d earned her Bachelor of Nursing degree from the University of Wyoming just a couple of weeks earlier and, while she had worked at Wyoming Medical Center since September 2012, she’d only worked the last six months in the Emergency Department.
But none of the call lights came from doctors. Responding flight attendants told worried passengers that they couldn’t give any more information and then moved to the next call light just to say the same thing. Only one other medical professional – ICU nurse Linda Alweis of California – had responded. When a second call came over the intercom, Sorensen flipped her switch.
We need you up front right now, the flight attendant told her. It’s the captain.
“I think I was just still shocked,” Sorensen said. “I didn’t know what to expect. But, by the look on the flight attendant’s face, I knew it was something serious. She looked frantic. She looked scared.”
Sweat had soaked through the pilot’s jacket by the time Sorensen got to the cockpit. His face was white and his lips were blue. He was covered in vomit. The copilot blocked his hands as he grabbed at the controls, obviously disoriented. He knew his name and nothing else. Heart attack, Sorensen thought, or something just as serious.
Are we diverting? Sorensen asked. We need to land as soon as possible.
Yes, the copilot answered. They were turning around to Omaha, Neb., the closest city with a medical center.
Sorensen, Alweis and another passenger unbuckled the captain and pulled him out of his chair. They lay him in the attendants’ galley, the small compartment between the cockpit and first class where attendants prep their carts. It had slightly more floor room than the aisle. Sorensen knelt next to his head, taking charge of interventions. Alweis took charge of medications and supplies.
Sorensen told Alweis to cut off his clothes and asked an attendant to gather all the medical supplies, including the Automated External Defibrillator – AED. The pilot had a heart rate of 200 beats per minute, suffering ventricular tachycardia with a pulse. In other words, his ventricles were beating way too fast to adequately pump blood through the body. He needed a short burst of electricity to shock the heart into a more stable rhythm, but the plane’s AED had just two buttons: on/off and a full-force defibrillate shock.
Sorensen gave him a nitroglycerin tablet, but without an equipped emergency room or a team of doctors and nurses, she went back to the ABCs – Airway, Breathing, Circulation.
“You are totally out of your element. You don’t know what you have to work with. I was just talking loudly to the nurse saying, man if I had this or if I had that, and they’d go find it. I said, ‘You know we need to get vitals on him’ and out of nowhere a blood pressure cuff comes flying at me,” Sorensen said. “At one point, I looked up and saw all these heads just leaning in the aisle looking down at us.”
The pilot’s blood pressure was 70-over-40, about half of what it should have been. His condition deteriorated as the flight continued. They put him on oxygen. Sorensen set up an IV and taught an attendant how to push the fluids through more quickly. When his breathing slowed and he started to lose consciousness, Sorensen administered a chest rub – a trick to arouse a patient with pain. She and Alweis worked on him for 25 to 30 minutes before Sorensen got scared.
I think we’re going to have to start CPR, she told Alweis. She knew that a patient’s chance for recovery decreased significantly once it got to that point.
Just about then, a flight attendant told them to brace for a rough landing. Sorenson grabbed onto the oxygen tank and her patient, trying to keep both from jostling around in the galley. The attendant asked if they could taxi to the gate.
There isn’t time, Sorensen answered.
The plane came to a stop and the doors flung open. Firefighters and medics removed the pilot while the plane was still on the runway.
Alweis and Sorensen stayed in the galley to help clean up and to collect their own composure. “It looked like a yard sale with medications and supplies strewn everywhere, just like you see in an ER when you get a critical patient. They were all traumatized,” Sorensen said. Passengers cheered as she walked back to her seat, but Sorensen could only think about what else she might have done.
Passengers stayed overnight in Omaha. Sorensen went for a glass of wine in the hotel bar and several passengers offered to buy her a drink. They all flew to Denver together the next day. The pilot had made it to the Cath Lab in time and was in stable condition, an attendant told her. Sorensen felt good.
“I’ve been an ER nurse for six months. I don’t know how I would have reacted if that had happened before my time in critical care,” she said. “My experience here (at WMC) and what I’ve learned from my coworkers has definitely taught me stuff to take out in the real world.”
Corrine Arross, Emergency Department senior nurse manager, agreed: “I do have the say that the girl is cool under fire. I’ve seen her in action and she’s got a good head on her shoulders.”
United assigned Sorensen a seat at the back of the plane for the flight into Denver where she faced a seven-hour layover. She was content to sit back, relax and maybe finish an entire movie that go around. One passenger wouldn’t hear of it. He offered Sorensen his seat in first class and didn’t let her refuse it.
As for that second phrase nobody wants to hear on an airplane — Does anyone have flight experience? — Sorensen isn’t exactly sure when she heard it in all the commotion. Sometime after she and her help pulled the captain from his pilot’s seat. Sorensen remembers hearing the copilot say that while she’d done it before, landing was more the captain’s duty. It wasn’t part of her routine and, if at all possible, she’d like someone in the cockpit with her.
“Fortunately, we had a retired Air Force pilot on board,” Sorensen said.
Today, Ninja Dorian checked off an item on his bucket list.
Air Methods, which operates Wyoming Life Flight and transports patients to and from Wyoming Medical Center, took Dorian Layton for a short helicopter ride around Casper. Dorian’s big brother, Julien, and mother, Krishelle, rode with him.
Welcome, Adelia Houser, to Casper, Wyoming and 2014.
Adelia, the daughter of Genneca and Eric Houser, was the first baby of the year born at Wyoming Medical Center. She came at 8:49 a.m. Wednesday, one week shy of her Jan. 9 due date. She weighed 4 pounds, 13.9 ounces.
Mom had contractions all day New Year’s Eve. They started getting worse about 1 a.m. New Year’s Day and she and dad, Eric Houser, arrived at the hospital about 4:30 a.m. At about 7:45 a.m., Adelia decided she wouldn’t budge, no matter how hard Mom pushed. There was no amniotic fluid and Adelia’s heart rate started dropping. Doctors decided they needed to deliver her by Caesarean section.
Adelia is Genneca’s first baby. Like many new mothers, she worried this morning that she wasn’t producing enough milk and that Adelia wasn’t getting enough to eat.
That will come, pediatric hospitalist Dr. Robert Benowicz told her. “She’s looking good, her vitals look good. She’s acting hungry, but babies do that.”
Adelia is the third child for dad Eric Houser who has an 8-year-old girl and a 4-year-old boy. The family will likely stay through tomorrow to make sure Adelia is eating and gaining weight and to give mother time to recover.
“I just know you’re adorable,” mother whispered to baby. How does it feel to have Casper’s first baby born in 2014?
“I’m just happy to have a baby. I’m pretty stoked about that,” Genneca said. “One little miracle is enough. It was a labor of love.
Wyoming Medical Center welcomed three new babies on New Year’s Day, but Adelia was the first. Welcome little Adelia, and congratulations to Genneca and Eric!
My name is Dorian Layton, but my family and friends call me Ninja Dorian. I am a Make-A-Wish kid and I am also a cancer kid. I have a brain tumor, but I am not afraid. Ninjas are BRAVE! One day, I will go to sleep and not wake up, but people shouldn’t be sad about that because Heaven is an alright place. I know the reason I am here. I am supposed to help people be happy and tell them that they shouldn’t be scared.
Dorian Layton, 5, knows how it feels to be a kid in a hospital. He’s stayed at several. He’s been poked, prodded, cut open and put under general anesthesia 14 times. It can be boring and the waits can be long. He doesn’t like to think of other kids sitting there with nothing to do.
This weekend, Dorian had an idea: What if he used his Christmas money to buy toys and games for kids at the Wyoming Medical Center? He arrived on Tuesday wearing his red ninja suit and bearing gift bags for boys and girls unfortunate enough to come to the ER over the holidays. Why a ninja suit? Because ninjas save the city, Dorian said.
Sometimes, ninjas also have brain tumors.
“This is my little brother. I don’t want him to go to heaven yet,” said Julien Layton, 9. “I want him to live until he’s 100 years old.”
Dorian once told his brother not to be sad. He knows why he’s here: to help people and tell them that heaven is a good place. He’s not scared to go, he said. Ninjas aren’t afraid.
At 15 months old, Dorian fell out of his high chair and hit his head. The emergency room CT scan showed he didn’t have a concussion nor a fractured skull. But doctors spotted a strange shadow, and they admitted him for an MRI the next morning at Texas Children’s Hospital.
A neurosurgeon walked in and showed his mother, Krishelle Layton, the results. Dorian had a tumor, partially on his brain stem, he said. Inoperable. He couldn’t explain why Dorian was functioning so highly, ahead of all the milestones for his age group.
For months, years even, the family learned to adapt to each new symptom. Brothers played cars in the house, wrestled in the dirt and climbed on the tree outside their trailer. “We’d use our imagination and we’d do anything,” Julien said.
This last year, though, the tumor advanced more quickly. Doctors removed a thyroglossal duct cyst from his neck and he suffered a grand mal seizure which triggered a tick episode that wouldn’t stop. His long-term memory seems to be slipping. His mother and grandmother, Carolyn Hackworth, have to reintroduce him to relatives he’s known for years.
Dorian always went under general anesthesia for his MRI scans because he couldn’t keep still and the machine made him feel claustrophobic. In October, he went in for yet another appointment. He had a bad reaction to the anesthesia and had a short grand mal, this one lasting about 30 seconds. It triggered the biggest tick episode he ever had.
I don’t want to be put to sleep anymore, he told his cancer doctors later. It’s scary. If I ever have to have another MRI, I promise I’ll be still.
Krishelle and her mother, Carolyn, started talking about moving back to Casper in March. Dorian was born in Casper. Krishelle and Carolyn were born in Casper. It’s home, where friends and family live. But as Dorian’s condition worsened, they stayed close to their doctors.
Then, Dorian’s cancer doctor had frank words for mother and grandmother after Dorian’s last MRI appointment: At this point, the doctor said, there’s no good reason to put him through it anymore.
“Not just the general anesthesia and the MRI , but all the things that are all entailed in cancer treatment that people don’t realize,” Krishelle said. “You have to go in the night before, or be up very early, and be poked and do labs and get IVs set, have an MRI. And, several hours later after you’ve woken up in recovery, then you can go see the doctor.”
No good reason. The tumor is still inoperable and untreatable, no matter what they put the boy through. Their doctor recommended that they take Dorian home. Keep him comfortable and happy. Be near family, friends and a good support network. Find a good neurologist and keep watch, but above all, let Dorain be a boy.
The family moved back to Casper on Dec. 15.
“It was bitter-sweet, that last visit. We felt kind of crushed, but it kind of felt like we had a weight lifted,” Krishelle said. “Ok. Now it’s time to start living a life and having fun.”
Dorian’s philanthropic streak started with Macy’s Believe campaign. For every Santa letter filled out and dropped in the big red mailboxes at Macy stores, the company will donate $1 to the Make-A-Wish Foundation. Dorian’s turned in 1,486.
The whole family pitches in. They set up a table outside Macy’s and Dorian tells people about his tumor and why Make-A-Wish is so important. Julien pushes around his 18-month-old sister, Vivien, because he’s discovered that her red hair and blue eyes are fantastic bait for potential signers.
Dorian got the idea from his Facebook friend Gabriella Miller and collected letters in her honor. Miller pledged to raise $1 million for Make-A-Wish through the letters and founded the Smashing Walnuts Foundation to fight pediatric cancer. She had a brain tumor, too, and posted fun riddles and jokes on her page. By dictating to his mother, Dorian started exchanging messages with Gabriella.
“They bonded because the feelings she wrote about were the same feelings he was feeling,” Carolyn said.
Gabriella died Oct. 26 at 10 years old. Dorian wasn’t sad, his mother said. He definitely wasn’t happy about it. He sat quietly and processed it. But then, out of nowhere, he said: Ok. She’s in heaven now and I’ll see her when I get there.
This weekend, Carolyn’s parents gave him a check for $200. It came from some family cousins who donated it to Dorian’s cancer fund with the stipulation that he spend it on anything he wanted for Christmas. Mother and grandmother expected Dorian to go on a shopping spree. If any kid deserved one, Dorian did.
Instead he asked about all the animals who don’t have homes. Wouldn’t they like treats and toys?
After delivering gift bags to Metro Animal Shelter, Dorian still had money left over. Mama, how many children are in the hospital who can’t come home from Christmas? he asked.
Now they call it Dorian’s bucket list. When Dorian thinks of a small community service project, a charity he wants to support, or something he wants to do like learning to ninja climb, they post it on his Facebook page, Karate Chop Cancer with Ninja Dorian. Anyone who wants to help in whatever way is welcome, and his family starts working to make it happen.
“I never did much community service or involvement. I was just raising them,” Krishelle said, nodding toward her children. “Dorian’s philanthropic gene is entirely his. He comes up with the ideas and we encourage him.”
For a long time, the family couldn’t say the word out loud. Not with Dorian’s name in the same sentence. He gave them a new way to think about it one day, out of the blue, on a drive across town.
I know why I’m here, Dorian said.
Yeah, you’re here to go to the store, Julien answered.
No, I’m here to tell people about heaven. To make them feel all right that their brothers, or their sisters or their mothers are going to heaven.
That’s how the family thinks of it now.
On Tuesday, Ninja Santa delivered his gift bags to the few boys and girls in the ER and left some for others who might come in. Then it was his turn to be surprised.
Seven Marines and Marine reservists from Toys for Tots gave him and his siblings sacks of presents after hearing about Dorian’s Christmas gesture. Lance Cpl. Ashton Buckingham, 22, dropped to one knee and presented Dorian with his Eagle, Globe and Anchor, the official emblem of the U.S. Marine Corps.
“This is never given, but always earned. If anyone has earned this, it is you,” Buckingham said to Dorian.
It’s tempting to say, after watching a U.S. Marine humbled by the strength of a 5-year-old boy, that he’s just too young. Too young for a bucket list. Too young for grand mal seizures. Too young for what might come next. But on Christmas Eve, in his red ninja suit, Dorian might have been the wisest person in the Emergency Department.
He doesn’t want you to be sad for him. He wants you to write a letter to Santa and drop it off at Macy’s. He wants you to give a cat or a dog a good home or deliver a present to a deserving kid. He doesn’t want you to be scared about what will happen when he goes to sleep and doesn’t wake up. Dorian’s not scared. Ninjas are brave.