Prince of Hearts
Three-year-old Xzavion Gonzales looks up at his mother in a preoperative room at Phoenix Children's Hospital.
"Am I gonna die, mama?" Xzavion asks Samantha Blier, moments before a doctor gives him a shot to make him sleepy.
Blier is taken aback. No, you're not going to die, she says, you're going to be much better after your operation.
Dr. Michael Teodori, who will be performing major heart surgery on Xzavion's aortic and pulmonary valves in an hour or so, steps into the room.
"I'm gonna make your heart better," the 47-year-old doctor says gently, evoking a smile from the child. He is a wiry, dark-complexioned man who emanates calmness and confidence, especially in such situations.
"You want your teddy bear with you?" Xzavion's father, Pete Gonzales, asks his son.
Xzavion nods that he does, but he's barely awake by now.
"He's seeing little green dudes," says his mother, a 21-year-old Phoenix woman who has Xzavion's name tattooed just above her right ankle, and is wearing a large necklace that also bears his name.
A few minutes before 8 a.m., the boy's parents carry Xzavion to the operating room door. They each kiss Xzavion on the forehead, then hand him to veteran pediatric heart nurse Rita Boese.
Boese takes the child and his teddy bear into the operating room, and sets him down carefully on the table.
The extraordinary world of pediatric heart care is populated by skilled and compassionate medical professionals, by overwhelmed but resolute families and, of course, by gritty little children battling for their lives.
New Times was given unbridled access to this world, as it exists at Phoenix Children's Hospital, and in the heart, mind and hands of Michael Teodori, who is acknowledged by peers as Arizona's finest pediatric cardiac surgeon.
It also is an arena in which the competition for millions of dollars in "business" is increasingly fierce. In Maricopa County, it's Phoenix Children's versus St. Joseph's Hospitals.
Phoenix Children's took an unexpected hit in mid-July, just two months after it had opened in its new location at State Route 51 and East Thomas Road. Water flooded into the main facility after the big thunderstorms of July 14, causing extensive damage on the ground floor, and forcing officials to shut down the operating rooms for six weeks.
The flood was a huge blow to the hospital, which had opened in May about $40 million over budget, but was gaining momentum in the public's consciousness as Arizona's only acute-care hospital devoted solely to kids.
Mike Teodori had been doing surgery almost exclusively at Phoenix Children's since September 1999, but as an independent doctor, not an employee. In May, he'd accepted an offer to be the hospital's chief of thoracic and cardiovascular surgery, a coup for Phoenix Children's.
Then, on the evening of July 27, Teodori and his 15-year-old daughter, Teresa, were driving to their Scottsdale home after attending a movie. Heading southbound on Hayden Road in a BMW sedan, the two were hit head-on by a Chandler woman driving a Toyota 4Runner in the wrong lane.
Teresa suffered only minor injuries, as did the driver of the Toyota. Scottsdale police reports suggest that the Toyota's driver was impaired by prescription drugs used to treat anxiety and other mental disorders.
But Dr. Teodori was knocked unconscious, and suffered a shattered left shoulder and right ankle, among other injuries. He spent two weeks in a Scottsdale hospital, and is still wheelchair-bound at his home.
The doctor says he doesn't know when or even if he'll be able to return to fixing kids' hearts, a task that requires physical endurance and agility in addition to profound expertise as a surgeon.
"I have to rework my entire life right now," Teodori said at his home last week, sounding pragmatic and even somewhat upbeat. "But my goal is to get back to what I love, which is pediatric heart surgery."
The ramifications of the accident also have been enormous for untold children on whom Teodori won't be able to operate. Soon after the accident, his longtime office manager, Maree Court, and her assistant, Lydia Orozco, broke the bad news to anxious parents whose children had been scheduled for surgery with the star doctor.
Dr. Mark Lupinetti, a respected surgeon in his mid-40s who moved here from Seattle in May to become Teodori's partner, has picked up some of the slack created in the accident's wake.
But other repercussions have yet to sort themselves out, including the question of which Valley hospital is going to be the leader in pediatric heart surgery.
Besides being an ace surgeon, Mike Teodori long has been a controversial figure in the politically charged landscape that marks the local pediatric heart scene. In a defining moment in late 1999, Teodori quit performing surgeries at St Joseph's, claiming that his young heart patients were getting far better aftercare at Phoenix Children's.
Teodori's departure from St. Joe's seemingly meant he wouldn't be operating on any of the 100-plus children approved annually for open-heart surgery by the state's Child Rehabilitative Services program. (CRS is a managed-care program for children with chronic and disabling conditions, but who may be cured or show significant improvement. A majority of CRS patients come from indigent families.)
But St. Joe's held -- and still holds, at least until the end of this year -- a $32 million contract with the state of Arizona to operate and manage the CRS program in Maricopa County. In September 2000, the hospital hired Dr. David Cleveland, formerly of Dallas, to fill the void left by Dr. Teodori's exit.
However, until Dr. Teodori's recent accident, several cardiologists had continued to refer the more complex CRS cases to him "out of network." For financial reasons, the state and St. Joseph's frown upon that practice, but it demonstrates the high regard in which other cardiologists hold Teodori.
This year alone, Teodori performed 12 heart surgeries on CRS patients at Phoenix Children's, including on Xzavion Gonzales, with several more scheduled before his car crash.
Since the accident, however, those same cardiologists have been referring many complex CRS heart cases to Dr. Cleveland of St. Joe's, not just to Teodori's new partner Dr. Lupinetti, who has just started to earn his stripes locally.
No one is yet sure how Teodori's injured status may affect the new CRS contract, which comes up for bid later this year. St. Joe's and Phoenix Children's are expected to compete for the lucrative contract.
The operating room at Phoenix Children's is cold enough to hang meat in. It's that way for two reasons: So Xzavion Gonzales will be kept cool during the operation, and because Dr. Teodori tends to perspire profusely while performing surgery.
Dr. Teodori downs a cup of hot chocolate in the cafeteria -- no caffeine before surgery -- as his team prepares for Xzavion's procedure. It includes anesthesiologist Dr. Casey Lenox and Dr. Tom Waitz, who will be first assistant to Teodori during surgery. Curtis King will be operating the crucial heart-lung bypass machinery, Amy Riccio will be the scrub nurse, and Rita Boese and Janet Moore will be the on-duty circulating nurses.
The music system Teodori bought for the operating room isn't hooked up yet. That means there will be none of the light jazz, classical or R&B music that the doctor favors while working.
Teodori enters the room at 9:17 a.m. He is wearing turquoise-blue surgical scrubs and cap. He attaches a coal-miner's-like light to his forehead, straps on his magnifying goggles, and gets to work.
Within minutes, he's cut through Xzavion's sternum with a high-powered electric saw. The nauseating smell of the boy's burning flesh wafts through the frigid room. He pulls Xzavion's ribs apart with a metal device, moves aside the thymus gland, and exposes the heart.
Shaped like an upside-down pear, it's beating like a drummer in a punk-rock band. Dr. Lenox soon thins Xzavion's blood before sending it to the bypass machine located a few feet from the operating tables.
The machine will keep the boy alive for much of the operation, as it circulates his blood through his body while his heart is stopped. But surgeons are keen to keep the time that a patient is on the bypass to a minimum, because it can mean potential damage to the brain, liver or kidneys.
"Bypass on," Curtis King says loudly at 10:07 a.m.
The doctors chill Xzavion's body to 63 degrees. Teodori then stops the boy's heart with a shot of potassium.
Teodori is about to start a Ross operation, a sophisticated procedure that only a few hundred heart surgeons have mastered worldwide. Named after the British doctor who developed the operation in the late 1960s, it calls for a surgeon to cut out the defective aortic valve, then move the patient's own healthy pulmonary valve to the aortic valve position. The surgeon then replaces the original pulmonary valve with a valve from a human donor. For various reasons, cadaver valves work far better as pulmonary valves than as aortic valves.
As recently as the 1980s, most doctors would have replaced Xzavion's bad aortic valve with one harvested from a pig, or may have installed a mechanical valve. But studies have shown that patients in Xzavion's shoes stand a far better chance at a normal life span after a successful Ross operation.
Two cadaver valves sit in a freezer in an adjacent room. The donor valves come from a 37-year-old woman who died of blunt-force trauma -- sounds like a homicide to the operating team -- and a 17-year-old girl who died in a car accident.
Within a few hours, Dr. Teodori will reinvent one of those valves as Xzavion Gonzales' new pulmonary valve. He and his team labor with quiet urgency, as nurse Rita Boese starts to thaw out the deceased 17-year-old's valve in hot water shortly before 11 a.m.
Dr. Teodori says he concluded in the late 1990s that the quality of St. Joe's pediatric intensive-care unit was far inferior to that of Phoenix Children's. To that end, he sent a remarkable letter in September 1999 to officials at Children's Rehabilitative Services, which had contracted with St. Joe's to run its program.
"It has become increasingly obvious that there is a large difference between the two institutions which provide care for children with congenital heart disease," Teodori wrote. "I cannot overstate the significance of this difference. More than any other child in the hospital, pediatric cardiac patients define the quality of the institution. These patients, more than any other, are most vulnerable, and exact the most demanding standards. Phoenix Children's now provides better care for these children and is more receptive to developing the best care possible."
The people who run St. Joseph's strongly disagreed with Teodori's remarks, but the doctor reiterated his concerns more specifically in a letter to the then-chief executive officer of St. Joe's. He wrote of the frustrations he felt at the deaths of two children on whom he had operated.
"Both of these deaths have been the results of unsuccessful intensive care management for patients who had an excellent operative result," Teodori wrote in part.
His decision to abandon St. Joe's stunned the state's medical community, which generally is unwilling to make waves so loudly.
"I'm not going to shy away from taking on any hospital or any other doctor who I don't think is doing the job," Teodori says.
Dr. Bill Peoples, a member of the Arizona Pediatric Cardiology Consultants group, says that "Mike is absolutely aboveboard and honest, and says just what he feels. What he says carries a lot of weight. One reason is that, as a surgeon, he gets the best results of anyone here, and he does the most complex of the most complex."
Soon after Teodori quit operating at St. Joe's, three intensive-care doctors also left St. Joe's for Phoenix Children's, as did 10 nurses whose specialty was pediatric hearts. Some took pay cuts to join the surgeon.
By then, Phoenix Children's already was securing funding for its proposed new facility on East Thomas. (Since it had first opened in 1983, the hospital had leased space inside of Good Samaritan Hospital, on East McDowell Road.)
Even without his CRS/St. Joseph's cases, Teodori by then already had as many patients as he could handle. Congenital heart disease still ranks first in the United States among the causes of infant mortality. According to the American Heart Association, about 35,000 babies, or one of about 150, are born with heart defects each year in the U.S.
In 2001, Teodori performed 247 cardiovascular surgeries at Phoenix Children's, a large percentage of which were considered highly complex.
But his increasing caseload hadn't solely been the result of the Valley's surge in population. Monumental advances in pediatric heart care have meant that children who surely would have been sent home to die as recently as a decade or so ago now fill about half of the nation's 3,000 pediatric intensive-care beds.
Pediatric cardiology is a relatively new field. Until the late 1980s, most doctors hesitated to operate on newborns with complex heart defects, choosing to wait until years had passed. But it seems that operating as soon as possible -- sometimes within hours after birth -- significantly lowers the mortality rate, and gives many more kids a fighting chance.
"I remember sending kids home to die," Dr. Teodori says of his early days as a surgeon. "Just didn't have the expertise yet -- few of us did. There were fascist doctors who'd suggest that a mom get an abortion when a heart defect showed up before birth. But things were moving forward in light-years as I gained experience and started to get better and better outcomes."
Teodori's growth as a surgeon paralleled that of the pediatric heart surgery world. Though there's no such thing as simple heart surgery, studies indicate that between 1984 and 1994, the rate of infant deaths from congenital heart defects dropped nationwide by 26 percent, even as the surgeries were getting more and more complex.
A comprehensive national study released last year indicates that the average surgical mortality rate for pediatric hearts is 6.2 percent. Statistics provided by Phoenix Children's Hospital indicate that the mortality rate there last year was 5 percent.
But Arizona Department of Health Services officials concede they currently have no mechanism to organize, evaluate or analyze diagnostic data, therapeutic data or outcomes data when it comes to treating pediatric heart patients -- CRS patients or otherwise.
Not surprisingly, treating those patients is extremely expensive. Says Chris Atherton, a Scottsdale mother of eight, including two born with major heart defects, "Hearts are about life and death, and fixing hearts costs a lot of money. It's a big, big business."
For example, one of the most treacherous operations Teodori does is the Norwood, named after the Delaware surgeon who developed it in the early 1980s.
The Norwood is the first in a series of three operations designed to treat a grave defect called hypoplastic left heart syndrome. It occurs when the left side of the heart, which supplies blood to the body, is grossly undeveloped.
Until the last decade or so, a hypoplastic left heart diagnosis was a guaranteed death sentence; about 95 percent of the afflicted infants died in their first four months of life. But these days, nationwide, more than half survive the third stage of the surgical series, which usually is completed before a child's fifth birthday.
Teodori says the average life expectancy of Norwood patients remains uncertain, because the procedure is still so new, but adds that some of Dr. Norwood's first patients from the early 1980s are still alive.
The total cost of a first-stage Norwood, including pre- and postoperative care, and the operation itself? About $150,000, approximately $50,000 more than an average Ross procedure -- the one Xzavion Gonzales underwent.
In late April, Samantha Blier and her son, Xzavion, met with Dr. Teodori for the first time. The boy's father, Pete Gonzales, and maternal grandfather Don Blier joined the meeting.
A dynamo with a winning smile, Xzavion seems the picture of health, if a bit small for his age. But the boy's heart is very sick, and if Dr. Teodori doesn't fix it properly, the 3-year-old's life will be tragically short.
Xzavion had shown signs of congestive heart failure immediately after his birth at Samaritan Regional Medical Center in July 1998. Tests revealed he'd been born with aortic valve stenosis (AVS), in which blood can't flow freely between the left ventricle and the aorta.
When Xzavion was a day old, a doctor inserted a kind of balloon to open the bad valve. The procedure is considered a stopgap measure to keep a child alive until surgeons may attempt a potentially more lasting operation, the Ross, some years later.
But Xzavion had to have a replacement balloon implanted when he was just four months old. It achieved far better results, and subsequent testing by a machine that examines the heart with powerful ultrasound equipment was positive.
Then, last Christmas Eve, Xzavion collapsed while playing outside with other kids. He was unconscious for a few seconds, then, his mother says, "He was back to himself in an hour or two."
In April, cardiologist Dudley Halpe told Samantha Blier that the bad aortic valve was 70 percent closed, compared with the 40 percent closure of just a few months earlier. That put the little boy in immediate peril.
Dr. Halpe recommended the Ross operation, and that the best surgeon to perform it was Mike Teodori. But Xzavion Gonzales is a CRS patient, and as such was supposed to be treated by doctors at St. Joseph's Hospital.
However, Dr. Bill Peoples says he, Halpe and other cardiologists had continued to refer their most complex patients to Teodori, whether the child was CRS-eligible.
"I have no trouble trying to work within a program," Peoples says, "but there are degrees of complexity. The ultimate result is my only concern, and if I think that Mike Teodori -- who is technically the best of any pediatric heart surgeon here -- is the guy to do the job, then I'll send a case to him."
Recalls Samantha Blier, who works as a cashier at a Phoenix Wal-Mart store, "I just asked Dr. Halpe who he would want to operate to perform heart surgery if one of his own children needed it," she says. "He said Dr. Teodori. I said, That's my guy, then, CRS or no CRS.'"
At the April meeting with Xzavion and his family, Mike Teodori explains that Xzavion has gotten as much mileage as possible out of his bad aortic valve. Samantha Blier replies that her son is tiring more and more easily, though he keeps trying to keep up with other kids.
"His adrenaline is working like he's walking fast all the time," the doctor continues. "Or like he has to jump over a hurdle every few steps when he's just walking."
Teodori lifts an oversize plastic heart from a shelf as a teaching tool. He describes how heart valves are thin leaflets of tissue which open and close like a one-way door during each heartbeat. Their main job, he says, is to keep the blood from flowing backward into the heart.
The pulmonary valve directs blood from the heart into the lungs, while the aortic valve pumps it into all parts of the body.
"For the first time in his life, he'll have a normal valve," Teodori tells Blier. "He'll have more energy than ever."
"Oh, no," she replies, kidding.
"This is a big operation, a lot of work," Teodori says, "but with an excellent chance of a good result for life. I've done over a hundred of these, and I've had beautiful results. There are surgeons at St. Joe's who could do this, too. But if you want me to go ahead, I'll be glad to."
"Yes, I would," Blier says. "But what's the risk?"
"About 3 percent," Teodori replies.
He warns Blier that the Ross surgery won't cure Xzavion's defect, and says the boy probably will need another pulmonary valve when he's an adult. But, the doctor adds, Xzavion's quality of life and his life expectancy should increase dramatically after the upcoming operation.
"The chances are excellent," he says, "that Xzavion goes home in about four days with his heart working like it's never worked before."
"He's gonna make your heart better," Blier tells her son, who is fiddling with the big plastic heart.
"It's going bye-bye -- my heart," Xzavion says.
Teodori asks Xzavion to sit by him.
"Make a muscle for me," he asks the boy.
Xzavion scrunches up his face, and gives it his best shot.
Teodori feels a bicep, then nods as if duly impressed.
"After I fix your heart, it's gonna be even stronger," Teodori says. "Are you scared?"
"You're a special little boy. I think you're just a borrowed angel. You're going to be special to people for a long, long time."
Seeing Mike Teodori perform surgery is akin to listening to a world-class jazz musician engaged in his craft. Teodori and his "bandmates" -- everyone in and out of the operating room -- tackle intricate tunes that only superior players can execute with any acuity.
The doctor and his crew also must be able to deal quickly and precisely with the unexpected note, or the missed syncopation on their "instrument" -- which in their case is a tiny, ailing heart.
Teodori has a reputation at Phoenix Children's as a demanding perfectionist in the operating room, and no wonder: He doesn't get to have a bad day. But he has gotten testy only a time or two during Xzavion Gonzales' procedure -- and then just for a moment.
Teodori has been operating on the boy for about three hours when Rita Boese hands him the thawed-out cadaver valve in a small, blue bowl. It looks like a chunk of raw calamari, and is about the size of a hollowed-out quarter.
"Hey guys, if I slip and fall, can I go home right now?" Teodori jokes, moments before taking the valve with forceps and starting to sew it in as Xzavion's new arterial valve. "I'm hungry. I'd even eat a Diamondbacks hot dog, and I know how bad those things are for you."
One reason for the doctor's levity is that Xzavion's operation has gone smoothly. By 12:30 p.m., Teodori has sewn the new arterial and pulmonary valves into place perfectly, and the boy's repaired heart and lungs again are working on their own.
Cardiologist Roy Jedeikin is informed that the operation is in the home stretch. Jedeikin soon comes by to perform an echocardiogram on Xzavion, which shows that the child's heart is in excellent shape.
Shortly before 1 p.m., a nurse tells the Blier and Gonzales clans in the waiting room that Xzavion is doing fine -- "His little heart is beating really, really good."
At 1:18 p.m., Teodori strips off his surgical gloves.
Good work, everyone," he says.
He soon heads over to the intensive-care unit to see how his other patients are faring, before grabbing a bite to eat at the cafeteria -- an unbuttered bagel and a piece of fruit, not a hot dog.
Mike Teodori was the fourth of eight children born to Pete and Philomena, of Pittsburgh, Pennsylvania. Pete Teodori owned a building-supply store, and Phil (as everyone calls her) took care of her kids.
"When Michael was 4, he announced that he was going to be a doctor, and that was that," Mrs. Teodori says. "And when Michael puts his mind to something, he can be very, very determined about it."
Teodori rolls his eyes when told of his mother's recollection. He says he went to undergraduate school -- Massachusetts Institute of Technology -- with expectations of becoming an engineer, not a doctor. But two years into his studies, he decided that medicine might be a more satisfying career path.
That road proved to be arduous and expensive. After he graduated from MIT, Teodori completed four years of medical school at the University of Pennsylvania, then a six-year general surgical residency at the University of Pittsburgh, and, finally, three years in a cardiothoracic residency.
Teodori was 35 when he became a pediatric heart surgeon, a specialty he embraced late, and only after a mentor, Dr. Ralph Siewers, suggested it.
"There's a lot more to pediatric heart surgery than just doing the operations, which in themselves are all about life and death," Teodori says. "You have stressed-out parents to deal with. And you have to connect with young kids -- I can catch the attention of a one-month-old.
"Some of my patients are just about the sickest patients that you can have, but they can get better. Compare that to the guy who goes to a cardiologist at age 50 after a life of bacon, butter and eggs. You can fix him, too -- for a while. That's a different gestalt for me."
Teodori and his wife, Janet, moved to Arizona in 1990 with their three small children. He'd met Janet Buonocore (it means "good heart" in Italian) at the University of Pennsylvania School of Medicine, and the couple married in 1980. She, too, is a doctor, specializing in child neurology, but hasn't practiced medicine since the Teodoris migrated here.
Teodori worked with Dr. Robert Fortune for less than a year, then struck out on his own in late 1991, performing surgeries both at St. Joe's and at Phoenix Children's. The intensive-care nurses at Phoenix Children's witnessed Teodori's growth as a doctor.
Then, as now, Teodori hardly lacked for confidence, and already had a healthy ego typical of those of his stature in any profession.
"He's always been compassionate," says nurse Arva Bynum. "But as he matured, he started teaching us more instead of arguing with us. It amazes us how he can switch strategies on a case in midstream, winging it, and saving a whole lot of kids. Nothing is really straightforward in what he does."
Adds Liv Lowry, who has worked inside Phoenix Children's pediatric intensive-care unit since the hospital opened in 1983: "To watch Teodori work is like watching an artist paint or sculpt. It's artistry. Our babies are so flippin' small. You watch him work. What stands out is how he anticipates things, and how kind he always is."
A day after performing surgery on Xzavion Gonzales, Mike Teodori visits the boy at the unit. Xzavion is very sore, and still has several plastic tubes attached to him, but he attempts a smile when he recognizes Teodori.
"You have a big strong heart now," Teodori tells him. "You're gonna be able to pee big, and run fast, and have a great time."
"I want to be strong," Xzavion says.
"You're gonna be strong -- and fast," the doctor replies.
Just three days after his surgery, Xzavion is allowed to go home.
Mike Teodori ran over to the pediatric intensive-care unit at Phoenix Children's Hospital on the afternoon of June 19.
A nurse had paged him just as he was about to start his second heart operation of the day: Thirteen-month-old Maya Angeline Robinson was "coding" -- hospital talk for not breathing -- and wasn't responding to resuscitation efforts.
Teodori had performed surgery on Maya the day before, repairing four major congenital defects called tetrology of Fallot. The highly complex five-hour operation went well, and Maya had remained stable for the critical first 24 hours.
Then, suddenly, she'd crashed.
"Nothing seemed to work," says Bynum, the pediatric nurse, her eyes misting at the recollection. "When Mike [Teodori] came into that baby's room, she really was dead."
Hospital personnel spirited Maya's parents, John and Anita Robinson of Surprise, to a nearby room. Teodori and intensive-care Dr. Robert Graham conferred about the extent of possible brain damage Maya might have suffered when her heart stopped.
"That was a heavy concern," Teodori says. "I don't ever want to let someone I operated on die without opening the chest. But even if we could bring her back, was she going to have a mind?"
He soon decided to reopen Maya's sternum and try to jump-start her tiny heart: "She just wasn't responding. I think she really was dead. But I still had this sense that I could do something for her."
He opened Maya up right there in Room Six, and reached into her chest cavity. He then began to massage her heart -- about the size of a small apricot -- with both hands. Teodori detected a scant heartbeat, but it disappeared soon after he stopped massaging her.
Maya's potassium levels continued to shoot skyward, another sign that she wasn't going to make it. Teodori continued to massage the baby's heart on and off, as he called for an ECMO machine.
The ECMO (it stands for Extracorporeal Membrane Oxygenation) works much like the heart-lung bypass machines used in operating rooms, taking over the work of those organs so they can rest and, hopefully, start to heal. Doctors consider the ECMO a last-ditch effort, to be used only in the most dire of situations.
As he worked on Maya, Teodori asked Dr. Graham to tell the Robinsons that the situation was grim.
"I have to have the parents trust me, good news or bad," Teodori explains. "When I tell them something, I always mean it."
Recalls Maya's mother, Anita Robinson, "After Dr. Graham told us what was happening, I started to think to myself about where we were going to bury her, here or Tucson. Then, I prayed for her."
Her prayer went something like this: "Lord, please take my baby's heart in Your hands and squeeze it. Please make her heart start beating so Dr. Teodori has a chance to work with something."
The ECMO team arrived about an hour after Teodori began to work on Maya. He hooked the machine up to the baby, inserting two plastic tubes, called catheters, into a vein and artery.
Somehow, Maya responded to the ECMO, and her vital signs took a significant -- some would say miraculous -- turn for the better. At 10:30 that night, the Robinsons were allowed to visit their daughter.
No one knew how long Maya would survive her ordeal, or the extent of any irreparable brain damage she'd suffered when her heart had stopped. She'd spend five days on the ECMO before doctors would let her try to breathe on her own, which she did.
On August 17, two months after the closest of calls, doctors allowed the Robinsons to take their baby home. Two days after that, about 20 parents of "heart kids" -- children with congenital cardiac problems -- gathered at Phoenix Children's for their monthly support group.
Anita Robinson arrived a few minutes late. She was toting Maya, who was breathing with the help of oxygen, but seemed alert, animated and a mite fussy.
After a Mexican food dinner, the parents took turns talking about how they and their children have been faring. But when it was Robinson's turn, she said only, "My baby almost died a few months ago, but now she's doing okay."
The room was silent for a moment. Then, Carrie McDevitt, a plucky woman whose 20-month-old daughter, Faith, died last December of heart problems, spoke up.
"That's real good, Anita," McDevitt said, smiling over at her friend. "Can you tell us just a little more?"
That evoked a group chuckle, and a tired smile from Robinson. Many in attendance had rushed to the Robinsons' side in June, when Dr. Teodori literally had taken Maya's life into his own hands.
"Okay, let's see," Robinson responded. "Dr. Teodori saved Maya, and here she is. I thought my world had come to an end when I heard about his car accident. He's our hero. It's just been a long summer. Oh, and I forgot about the flood."
Her last comment led Phoenix Children's social worker Tom Dusbabec to utter wryly, "We did miss the pestilence."
"At least we're here," Robinson concluded. "I just wish Dr. Teodori was here, too."
Last month, Phoenix Children's nurse Liv Lowry joined about 40 others at a prayer meeting for the injured Mike Teodori.
She was on duty at the intensive-care unit when the vigil began, but asked a colleague to cover for her so she could speak near the end of the get-together, which took place in a different part of the hospital.
"Thank you, Lord, for Dr. Teodori," Lowry said, weeping, "and all the miracles we have been part of here at the hospital, and he is one of the miracles that God has given us. The reason we feel so strongly about him is the personal love he has given totally to his patients and to us."
Lowry then practically ran back to the pediatric intensive-care unit, where she resumed her care for a two-month-old girl on whom Dr. Lupinetti had operated the day before. As she looked down at the tiny baby, the nurse decided to tell a very personal story:
"Two times in 20 years, I have felt something envelop me, wrap itself around me like a cocoon. It was right before I had to take care of two babies who were in bad shape and weren't supposed to make it. But they did. It may have been positive ions or it may have been something else, but it was real, and I didn't ask for it -- it just came.
"I think what happened to me is what it must be like to be Mike Teodori in the operating room. It's a beautiful thing."
Dr. Teodori is examining Xzavion Gonzales at his office in early July, a month after the boy's surgery. Xzavion is a bundle of pep, and is constantly irritating his mother by looking for mischief to get into.
"I know you," the boy tells the doctor during the postoperative exam. "You're the fix heart guy."
"Yup, that's me," Teodori replies. "You look great. I didn't slow you down. Your heart is working beautiful."
Xzavion proudly shows the doctor his long surgical scar, which has healed nicely.
"That's my man," Teodori says. He touches Xzavion lightly atop his head, then fetches the boy a lollipop before saying his goodbyes.
"Thank you, doctor," Samantha Blier tells him. "I don't know what else to say."
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