By Susan I. Finkelstein and Gail Luciani
"Everybody on a championship team doesn't get publicity,but everyone can say he's a champion."Earvin "Magic" Johnson
They had always been a team
Each department, each person had an integral part in the workings of New Bolton Center, the University of Pennsylvania's 700 acres in rural Pennsylvania where some of the finest veterinary services available can be found. Doctors and nurses, admissions and housekeeping staff, telephone operators and mail clerks-all were part of an elegant, complex synergy of healing animals and helping people. Yes, they had always been a team, but they may not have realized it until Saturday, May 20-when a champion horse faltered before the eyes of millions of people. The horse was Kentucky Derby winner Barbaro, and his larger-than-life presence at the George D. Widener Hospital for Large Animals since then has connected all New Bolton's players in not only caring for this horse loved round the world, but in keeping the Hospital at the top of its game.
Saturday Afternoon and Night
Soon after his shocking injury barely out of the gate at the Preakness Stakes, Barbaro was stabilized by track veterinarians (which included Dr. Scott Palmer, V'76, and Dr. Dan Dreyfuss, former surgical resident at New Bolton), and then rushed from the Pimlico Race Course in Baltimore to Widener's Intensive Care Unit. Well-wishers had begun to gather at the Hospital, displaying signs-"Barbaro, we love you" and "Good luck, wonder horse"-hoping to catch a glimpse of their fallen hero. Reporters and broadcast vans came in droves in anticipation of the horse's arrival.Chief of Surgery Dr. Dean Richardson saw the misstep that ended Barbaro's career at the Preakness on television, just after finishing a difficult surgery in Florida. Not only was he immediately in touch with Barbaro's trainer and veterinarians, radiographs of the right hind leg were e-mailed to him within minutes. "I knew we weren't going into surgery right away; we've learned that it's best to give supportive care for 18–24 hours instead of immediately performing surgery," said Dr. Richardson. "But after seeing those radiographs, I didn't get a whole lot of sleep. I knew exactly what the fracture looked like and what was ahead of me."By 9:00 p.m., Barbaro's ambulance, accompanied by a caravan of cars, including a police escort, pulled into New Bolton Center. Dr. Barbara Dallap, V'94, assistant professor of emergency medicine and critical care, was waiting to examine the colt. "The vets at the track did a wonderful job of stabilizing him," she said. "He was able to walk into his stall in Intensive Care, where he remained for the night."
Sunday Morning
Dr. Carinne Sweeney visits a young horse.News vans, microphones, cameras, satellite dishes, mobile broadcast towers-not exactly the type of equipment you would expect to see at a hospital for large animals, but just as familiar a sight outside Widener during those early days as horse vans, trailers and cattle trucks. Journalists from around the world had been at the Preakness on May 20, but immediately after the accident, many began the 82-mile journey to New Bolton Center to report on Barbaro's condition and the doctors' plans. Saturday night into Sunday-and for days afterward-scores of reporters camped in their cars or vans on the Hospital grounds, waiting for news, emailing stories back to big-city or hometown newspapers, or broadcasting updates to television and radio stations. The previous evening at Pimlico, the scene had been "chaotic and borderline unruly," according to Tim Layden, who writes the "Inside Horse Racing" column for SI.com. But Dr. Corinne Sweeney, Widener Hospital executive director and associate dean for New Bolton Center, handled everything with a "quiet calm," admired Layden, which was "transferred to very overtired journalists." (The donuts and pizza, compliments of the Hospital, also may have helped fend off the fatigue.)Dr. Richardson arrived at the Hospital by noon, having taken the earliest flight from Palm Beach, Fla. Initially, no plans were made to talk to the media before the surgery. But because the room had already filled to almost capacity, Drs. Richardson and Dallap spoke to the group for about 10 minutes to let them know their strategy for the day. "When will you begin the surgery?" asked one reporter. "As soon as you stop asking me questions," retorted Dr. Richardson. He left to see his famous patient, and the long wait began.
Waiting for News
Farrier Robert Sigafoos and Dr. Emma Adam with Barbaro.The complex surgery to repair the three fractures in Barbaro's right hind leg took five hours and required 27 pins and a stainless steel plate. "Barbaro presented with a case that was about as difficult as such an operation could be," said Dr. Richardson. He had performed many similar surgeries, but this case was more complicated; Barbaro had suffered fractures to his cannon bone, sesamoids and long pastern, and he also suffered a dislocation of the fetlock joint. The long pastern was broken into more than 20 pieces. Assisting in the complex procedure were Dr. Bernd Driessen, associate professor of anesthesia, and residents Drs. Liberty Getman, Steve Zedler and David Levine. The operating room at the George D. Widener Hospital is equipped with a monorail that runs to the recovery pool. The pool-recovery system allows a disoriented animal to waken suspended in a specially engineered harness and rubber raft, allowing him to gallop or flail in the warm water until fully conscious, significantly reducing the risk of re-injuring the damaged limb. Once awake, he is hoisted from the raft and moved to the recovery stall where he can stand at once. When Barbaro's surgery was completed, he had the first of several successful recoveries in this specially designed pool-a photo of the event taken that evening appeared on the front page of every major U.S. newspaper the next day, and was featured as a two-page spread in Sports Illustrated the following week.The colt "practically jogged back to his stall" in the ICU with the new cast on his hind leg, according to Dr. Richardson. Once the patient was safely in his stall, Dr. Richardson, joined by trainer Michael Matz, met with a standing-room-only crowd of journalists in the Woerner Amphitheatre to discuss the surgery and answer questions. (For progressive updates on Barbaro's condition, please see http://www.vet.upenn.edu)
Slow and Steady Healing
In the following days, Barbaro's right hind leg slowly healed. He had special visitors-his owners Gretchen, CW'59, and Roy, C'61, Jackson came almost daily, as would his trainer, Michael Matz. Jockey Edgar Prado came, followed by Penn president Amy Gutmann and Pennsylvania governor Ed Rendell. Press conferences practically became the norm-but life at New Bolton carried on."At the Widener Hospital on the day of one of our press conferences, beyond the buzz of activity and media trucks in the parking lot, I saw barn workers cleaning, nurses and students caring for patients, and a surprised-looking sheep in a wheelbarrow being returned to its stall," said Dr.Joan Hendricks, the Gilbert S. Kahn Dean of Veterinary Medicine. "If one scene spoke most about the professionalism of NBC's staff, faculty, students and administration, it was this one: in the face of sudden and unprecedented media attention and all the attendant disruptions and stress, patient care was the main focus. This is exactly how it should be, and I hope everyone realizes how much their work is appreciated."
Other Patients
Dr. Nadine Salamon, V'06, with an alpaca, part of New Bolton's huge caseloadduring Barbaro's stay.Barbaro was not alone in the ICU. "We have a lot of other patients here too, and they get the same level of care that Barbaro gets-without the media attention. Everybody here is working hard," said Dr. Richardson. For the nursing staff, the pressure was just as intense, as they cared for patients that included a lame alpaca, a foal stepped on by its mother, and mares with difficult deliveries. "Our ICU nurses and nursing assistants have been challenged by the attention that comes along with having a 'celebrity' patient," said Rosemarie Richardson, New Bolton's director of nursing. "But they have also enjoyed seeing a focus on the important work we do here every day. A lot of people can better understand our role now."
A Generous Donor and a Message Board of His Own
At this time, an anonymous donor gave a very generous gift to launch the Barbaro Fund, donations of which go directly to support the work of New Bolton Center, not for Barbaro's care. "It's wonderful that we can create something so very good out of Barbaro's tragedy and help celebrate animal athletes," said Gretchen Jackson, Barbaro's owner and a member of the School's Board of Overseers. "This fund in Barbaro's name will honor him and provide a lasting resource to help care for other animals treated at New Bolton Center." (Donors can find out how to offer monetary gifts at www.vet.upenn.edu/giving/giving_ways.html.)Barbaro also has a message board set up in his name for the thousands-more than 50,000 as of early August-of well-wishes sent to him electronically. The School's Web site (http://www.vet.upenn.edu/) had a fourfold increase in hits-some days, especially those with press conferences, reaching as high as 177,000, compared to daily pre-Barbaro numbers of 500 to 1,000. Visitors can check updates on Barbaro's condition and photos posted for the media, as well as explore other sections of the site to learn more about the School providing Barbaro's treatment.
Laminitis Strikes
While hopes were high that the three-year-old colt would heal from the massive injury to his right hind leg, one of the biggest threats to his survival was laminitis; at an emotional news conference on July 13, Dr. Richardson announced that Barbaro had indeed succumbed to the little-understood inflammation in his left hind foot. Laminitis is a painful condition in horses that can have any of a number of causes, including excessive weight bearing in one limb. It occurs when laminae, the strong connecting tissues that attach the pedal bone and the inner hoof wall, are inflamed. "While his condition is stable, it remains extremely serious," said Dr. Richardson, as he explained the implications of the condition at the press conference. Barbaro was being monitored very closely because signs can change quickly. Dr. Richardson later added, "It's important to remember that Barbaro's treatment could easily continue for many weeks, and if all goes well, several months. Our goal is to keep him as comfortable as possible, and clearly that comfort level will be a major indicator for our treatment decisions." Doctors commented on Barbaro's intelligence; his quick understanding of what was required of him in the healing process, from relaxing in his sling so as to reduce weight on his feet, to cooperating in the recovery pool after cast changes. "He has a very positive attitude," said Dr. Richardson. "If you look at this horse, it would be very hard to put him down."And so the work and the waiting continue.
The Gift Horse
In the months that have passed, thousands of fans from around the world have sent cards and posters, baskets of carrots and apples and sweets, bouquets of roses, letters and e-mail messages to Barbaro and to those who have been caring for him. And Barbaro is not greedy; of the thousands of treats sent to him, he enjoys what he can, and shares the rest with other equine patients. Among the people signing for the profusion of gifts has been Kathy Freeborn, in Patient Admissions. Each day, florists' trucks bring literally dozens of packages to the Hospital's front-desk area, where Kathy works. "Barbaro has touched the hearts of people all over the world. It's good to know there is so much love in the world, and that people take the time to show they care," Kathy said. Neither Rain nor SnowAnd then there are well-wishers who choose to mail their presents, letters and cards; whether via the U.S. Post Office or express mail services, the New Bolton mailroom has seen more activity than ever before. Mail clerk Nick Raimato has been kept busy receiving, sorting and delivering the influx to the proper places-namely to Barbaro and his caretakers. Since Barbaro's arrival in May, the steady wave of packages and paper has hardly subsided at all. "I've been amazed at the public's continuing interest in Barbaro and his well-being," Nick admitted. "Many of the cards and parcels from the Post Office have been sent as certified return receipt, insured and registered-I'm waiting to see if we will get one 'restricted delivery,' requiring Barbaro's signature for release."Hospital director Dr. Sweeney also has been touched by many of the letters and cards that have come into the Center, some addressed to Barbaro, some to New Bolton staff. "The letters sent to Barbaro-some, of course, are 'Get Well,' 'Go Barbaro,' 'We love you'-but some people have shared their own personal tragedies and successes," she recalled. "'Dear Barbaro, I too have had major injuries or multiple fractures, but you can persevere, you can endure.' These are the messages that America wants to share with us; very few of them have been anything but inspiring." Perhaps the most poignant messages to Barbaro are from children, and Dr. Sweeney has a pile of kids' homemade cards, words and horses colored in crayon, many bedecked with glitter. "With some of the children's cards, you can see that the teacher has prompted them to think of a topic relating to Barbaro. I smile because you can see the teacher was using this as a writing exercise and suggests they write a salutation, and they all do," Dr. Sweeney laughed. "One little boy wrote, 'Dear Barbaro, Well, I guess you're not reading this since you're a horse.' And then, 'Dear Barbaro, I'm not even sure if you speak English.' That was a pretty good one."
"The World Was Calling"
In the hours and days after Barbaro's accident, countless well-wishers and media types from all over the globe were part of the unprecedented number of information-seekers, especially remarkable for those working and living in the usually bucolic Kennett Square. The main method of early contact was by telephone, and the sound of ringing in the Hospital offices was constant. "The phones ring an awful lot anyway; they were ringing almost nonstop before Barbaro," Dr. Sweeney recalled. "But then if you can imagine that night, and those next days, the world was calling. We had one number, and they called. They weren't here, they weren't sending emails, they weren't sending get-well cards-they were calling. The switchboard was inundated.""It's human nature to want things to go well. For Barbaro, it's upsetting to everybody that he didn't have the chance to live up to his potential. He's very personable and he has a lot of charisma," Dr. Richardson explained. "Goodwill from people around the world has been tremendous; I haven't been able to answer my office phone in three months. This is real, genuine goodwill. A lot of people are caught up in the story of this horse, and that adds a lot of pressure."
Diane Combs was one of the operators fielding calls at New Bolton. "After the last press conference, two voice-mail boxes were set up just for calls concerning Barbaro, since the switchboard and the surgery secretaries were unable to keep up with the volume of calls. Many concerned callers simply want to know how he's doing or send their well-wishes or prayers, while others have advice to offer and some have products they feel might be beneficial to Barbaro's recovery. Some callers are quite emotional. It is truly amazing the love and concern shown for Barbaro."The added stress and inconvenience of almost constant media attention since May 20 has only strengthened the spirit of teamwork at New Bolton Center. Doctors and nurses, admissions and housekeeping staff, telephone operators and mail clerks-all will continue to do their jobs, as a team, healing animals and helping people.
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