Pediatrician Ted Abernathy is advocating a more collaborative model of care. Photo by Adam Ewing
The abdominal pain didn't double him over, but it was prolonged and debilitating. What's worse, nobody knew why Dr. Ted Abernathy was hurting so badly.
Soft-spoken and mild-mannered, Abernathy, a physician with Pediatric and Adolescent Health Partners, is not given to making a lot of noise on his own behalf. But the pain came at the worst possible time — in mid-2011, right when his push for a proposed independent children's hospital in Richmond had begun gaining steam.
"All of a sudden, I began to have this abdominal pain," says Abernathy, a founder of PACKids (Pediatricians Associated to Care for Kids). "It was a miserable feeling."
But looking back, the experience also proved instructive to his advocacy work. The troubles he faced as a sufferer of chronic pain — unable to communicate his problem properly to an array of doctors and specialists who treated him, and stuck in the middle because those doctors and specialists had no system to directly communicate about his symptoms — were not unlike those of a chronically ill child caught up in a fragmented system.
"This really is the story of pediatrics — it's the story of what we all face," he says. "This is Richmond health care."
Abernathy showers praise on the doctors who treated him, blaming instead a communications breakdown that allowed one seemingly insignificant symptom to go nearly unnoticed. His doctors even started considering "scary stuff" like pancreatic cancer. "It just didn't get better," he says.
In frustration, Abernathy's doctors sent him to a surgeon, who found two very small hernias, but nothing that appeared worth operating on, and certainly nothing that would cause the sort of perpetual pain he suffered. After several months, he says, he became resigned and depressed, resolving that he would just have to live with the pain.
Then his inner pediatrician kicked in. He would never throw up his hands and allow a child's suffering to continue. There must be an answer. He also donned his imaginary deerstalker hat and took Sherlock Holmes' motto to heart: "When you have eliminated the impossible, whatever remains, however improbable, must be the truth."
Abernathy returned to the surgeon in November 2011 to eliminate two possibilities: the hernias. "I woke up from the surgery still sedated, and my daughter was there and I said, ‘The pain is gone,' " he says, still surprised.
"I guess the story in this is that everything was done right, it was all cost-effective and it was the way health care was supposed to be practiced," Abernathy says.
Medically and logically, those hernias couldn't have caused his nine months of pain. The surgeon noted them, but other physicians had no reason to notice them on his chart. Abernathy himself paid them no mind. But had his doctors worked in a system that put them in the same room to discuss his pain and treatment — those two insignificant details most certainly would have been given more notice.
Bringing a new model of care and collaboration for children "will translate to adults in Richmond as well," he suggests. "Right now, that doesn't exist in our system."