Doc Gets New Heart, Loses Residency in 5 Weeks

Alin Gragossian, DO, MPH

Disclosures

December 17, 2019

I was midway through my third year of residency when I became critically ill and was hospitalized. I thought I was going to die. But in the end, I received a heart transplant, as I described earlier in a Medscape interview.

When I was discharged, I felt reborn, and I was ready to get back to work. Then I heard rumors that my hospital was about to close.

Hahnemann University Hospital was founded in 1885 in Philadelphia, and rumors of its demise had been floating around for years. As an emergency medicine resident, I was always particularly proud of being "Hahnemann-trained." We didn't always have the best equipment and the newest technology. Our scrubs didn't always match. But we were trained well. "We were always doing more with less," a nurse aptly commented.

If you could work at Hahnemann, you could work anywhere.

Then the public hospital was purchased by American Academic Health System (AAHS), who said they had no other option but to close it down.

And that was that.

The day I returned to work—July 1, 2019—everything became official. The 574 hospital residents, including me, were about to be orphaned.

Some of us had houses or families in Philadelphia. I needed to stay in the area to continue follow-up care with my doctors. I needed health insurance, too. And I had to make sure I found a place quickly so that I would get those much-needed benefits as soon as possible.

At first, I didn't worry. If I could get through a transplant, I could get through anything, I thought. But then, I became angry. Why did this have to happen to me? Why did this have to happen to any of us?

This wasn't just about the residents either. Thousands of hospital employees were about to become jobless. Our patients, mostly underserved and uninsured, were going to suffer miserably.

The stress in the air was obvious. Residents began interviewing at nearby residency programs, competing for the same slots we had competed for years ago, but now against each other. Local media outlets kept reassuring the public: The residents will be okay! Philadelphia hospitals will take all the residents!

But the residents were not okay. Philadelphia hospitals certainly did not take all the residents. We were helpless, confused.

Life isn't always beautiful… But being alive absolutely is.

At least with the heart transplant, I had a management plan. I had support. But there had been no plan for anything like this.

After my heart transplant, I used my voice as a physician to bring awareness to the importance of organ donation. I advocated for women with heart disease, young people with cardiomyopathy, and transplant patients in general.

After the Hahnemann closure, I used my voice again (that gained a little bit of attention through the heart transplant itself) to put the story out there. To show others that our system may be failing with for-profit hospitals, especially those that host residency programs. To raise awareness about how physicians are underrepresented in hospital administration policies.

Eventually, I found myself a new family at UPMC Pinnacle in Harrisburg, Pennsylvania. I still live in Philadelphia and keep up with my weekly heart appointments at the University of Pennsylvania, and I still make it to my shifts on time in mismatched scrubs. My program directors and the faculty have been more than welcoming (and respectful of my health needs). So far, everything has been going well.

I don't complain about much these days.

So, what's next? After I finish my residency, I will be starting a fellowship in critical care medicine in New York City in a few months. As promised, the program kept a spot for me without hesitation. (I had matched into that fellowship just weeks before my heart stopped last year.)

I continue to help with various nonprofit organizations, including Gift of Life, Advanced Cardiac Therapies Improving Outcomes Network (ACTION), and a few others. I recently became an ambassador for Safebeat Initiative, an organization aimed to help identify young patients who may be at risk for arrhythmias or cardiomyopathies.

I believe that a lot of lessons can be learned through my story. Most important, I hope that if people are ever struggling with catastrophic life events, they can take a moment to remember this:

Even during my darkest days, I quietly processed the most fascinating thought. I was lucky to be alive and feel even the worst of human emotions—loneliness, despair, anger—because life isn't always beautiful. But being alive absolutely is.

Dr Alin Gragossian's blog, A Change of Heart, provides a closer look into her terrifying ordeal as a patient and as a resident over the past year.

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