‘Angels on this Earth’: How MGH teams came together to address an unexpected diagnosis – and provide swift, life-saving care

When Ummema and her husband, Abdul, arrived in Michael Garron Hospital’s (MGH) Margaret Chambers Diagnostic Imaging (DI) Department on a Tuesday morning earlier this year, she was hoping to get answers for the “unbearable” stomach pain she was feeling – something she says she had never experienced before. 

After being seen by teams in both the Stavro Emergency Department (ED) and DI, Ummema received a diagnosis that was completely unexpected – one that caused her care team at MGH to spring into action and provide her swift, life-saving care in the span of just a few hours. 

“I felt very, very appreciative and very lucky,” Ummema says. 

Ummema’s experience at MGH is one example of the collaborative and emergency care that the interdisciplinary teams provide every day. 

In this case, their quick thinking and teamwork allowed for a timely, coordinated effort that identified and addressed a potentially life-threatening condition in a patient – and resulted in a positive outcome for everyone involved. 

Providing proactive care 

Ummema started feeling stomach pain during the evening on January 22. When the pain got progressively worse, she and Abdul decided to visit the ED at MGH, their community hospital. 

The pain Ummema was feeling began affecting her ability to speak and breathe at some points, so Abdul was there to provide support and facilitate communication with the care team. After being seen by an emergency physician, they were sent to the DI Department for further care. 

There, they met Kelli Jackson, Sonographer at MGH, for an ultrasound. “She was caring and compassionate,” Abdul recalls. “She knew my wife was in a lot of pain, so she never rushed us. She said, ‘If anything is uncomfortable, let me know.’” 

When Kelli scanned Ummema’s upper abdomen, she noticed abnormalities but nothing that explained her pain. Because of this, Kelli then took the initiative to scan Ummema’s pelvis even though she was not originally instructed to do so. There, she saw evidence that Ummema may be experiencing a ruptured ectopic pregnancy, a potentially life-threatening condition that may include severe bleeding.  

While ectopic pregnancies are not uncommon, this situation was unusual in that Ummema did not know she was pregnant at the time. Kelli was able to confirm the pregnancy when she noted in Ummema’s patient chart that she had a positive level of Human Chorionic Gonadotropin (HCG), a pregnancy hormone.

Kelli immediately called Dr. Noah Ditkofsky, Chief of Radiology at MGH. They decided that Ummema should return to the ED with the diagnosis of a ruptured ectopic pregnancy until proven otherwise. 

“In that moment, I felt I had a clear picture of Ummema’s history and explanation of what was causing her pain and I advocated for her,” Kelli says. “She wasn’t able to verbally describe her pain in detail, but I could see in her eyes, the colour of her face and her body language that she was not well and that this was an urgent situation.” 

From ultrasound to surgery 

At the DI Team’s request, a porter quickly arrived to move Ummema back to the ED. Dr. Ditkofsky walked alongside the bed with Abdul. “Given that she looked unwell, I did not want her to be without a physician,” Dr. Ditkofsky says. 

The emergency physician who initially saw Ummema met the group in the hallway as they headed toward the ED. Dr. Ilana Clark, Resident OB/GYN at MGH, was the first OB/GYN to see Ummema in the ED. 

“Dr. Clark continuously gave my wife comfort and checked in repeatedly,” Abdul recalls. “She was very compassionate and calming – exactly what was needed in such an overwhelming situation.” 

Dr. Clark then promptly notified Dr. Jennifer Cram, Chief of Obstetrics and Gynaecology at MGH. “She was very astute and knew exactly how to convey to me the urgency of the situation,” Dr. Cram says. “From there, everything happened very quickly.” 

The care team further assessed and treated Ummema. They also explained to her and Abdul what they suspected was happening and that Ummema would be transferred to the Operating Room to receive emergency surgery from Dr. Cram. 

“It was really nerve-wracking, but we appreciated the clarity we got in that situation. I know my wife was going through a lot,” Abdul says. “The surgery was successful, and we stayed at the hospital for three nights while Ummema recovered.” 

‘No hierarchy’ in emergencies 

Dr. Ditkofsky says Kelli’s critical thinking and the quick communication and action among the ED, DI, Portering, OB/GYN and Surgery Teams was key to the success of Ummema’s care.

“The patient’s care was essentially continuous from the moment Kelli noticed something was amiss to their time in the Operating Room,” Dr. Ditkofsky says.  

Kelli says, as a sonographer, her decision to scan beyond what was instructed of her did not feel like “going beyond” her scope of work. Rather, it is part of her job to “answer a clinical question – in this case, what was causing the patient pain – and document any findings through ultrasound images while providing care for my patients. 

“Patients look to healthcare providers to help them find answers, improve their well-being and live healthy lives,” Kelli adds. “Not all patients and situations are the same, so analyzing and considering all relevant information is crucial to be able to make any conclusions. I’m filled with gratitude to know that Ummema is alive and well, and I feel proud to have been part of the MGH team.” 

Dr. Cram says the experience demonstrates that “in an emergency, there is no hierarchy”. “Everyone on the care team did what needed to be done,” she says. 

Ummema and Abdul are thankful to those who were involved in Ummema’s care at MGH. “We want to express our gratitude to the entire team that helped,” they say. “It’s these people who are heroes and our angels on this Earth.”