Out of the 'box': Doc's extra test saves life

On the morning of August 13, freelance graphic artist John Wade had a pain in his abdomen. Since he was pretty sure it was a fairly simple problem– he'd had a kidney stone about 15 years before– he went to First Med on Pantops instead of a hospital emergency room.

And while such places are sometimes derided as "doc in a box," what Wade got was some out-of-the-box thinking.

"A less experienced doctor might have assumed it was a kidney stone, which is what I thought it was," says Wade, 57.

When a quick in-house x-ray didn't offer a clear diagnosis, the doctor, William G. "Gaines" Talbot– an 18-year veteran of emergency room medicine– decided to order further tests at Martha Jefferson Hospital. Docs there agreed to rush a CT scan that afternoon.

Turns out Wade was in the opening moments of a "triple A," an abdominal aortic aneurysm. If not immediately treated, the aneurysm can rupture, causing massive internal bleeding– and usually death. This is what killed television star John "Three's Company" Ritter a year and a half ago and what threatened to do the same to Wade.

"Six minutes after the start of the scan," says Talbot, "[the radiologist] called me and said, 'This guy's got an aneurysm.' It was a rapid cascade after that. Four minutes later, I'm talking to his wife saying, 'This guy's gotta have surgery.' Then I called the emergency room to tell them he was coming."

But Talbot won't take the credit for saving Wade from the 8.3-centimeter aneurysm.

"The beauty of Charlottesville is you have excellent health care– you have two systems," he says. "I have the advantage of having worked in both. If I can't get a scan done at Martha Jefferson, I'll try to get it done at UVA. In Canada, it might have been a month later."

Although he served the ERs of both local hospitals, Talbot is happier since going independent. "If you grow the emergency room, you're growing it for the hospital," he says. "If you grow your practice, you're growing it for your family and for God."

Both are integral parts of First Med. Talbot's wife works at the clinic, and all involved enthusiastically refer to it as a "Christ-based medical practice."

"We're not afraid to pray with a patient," says Talbot. "We don't push that, but if they want to, we do.

While his Pantops-based practice began as an offshoot of UVA's sprawling hospital network, that came to an end in 1999 when UVA decided to pack up and leave. Now it's called First Med.

"We started with zero patients," says Talbot. "UVA took all the records and everything they had– and we started over. Now, we have 22,000 charts."

In the Wade case, tragedy was averted, and Talbot is relieved at the outcome. "A 57-year-old with an aneurysm is pretty rare," he says.

So is a 54-year-old with two entirely separate medical armies at his fingertips. Fortunately, the combination spelled rescue for John Wade.

Gaines Talbot