By John Scheinman
Special to The Washington Post
Tuesday, October 17, 2006; E01
KENNETT SQUARE, Pa. -- In the middle of the night, when a rhythmic routine settles over the intensive care unit at the University of Pennsylvania's New Bolton Center, nurse Jamie DeFazio marvels at the patient in her care.
"Sometimes it's just the two of us sitting there," she said. "He's easy when he's sleeping. You can pet him, and he's not the macho guy, and you say, 'Horse, do you even know how many people care about you?' I think he knows he's special, sitting there one-on-one with him."
Five months after he shattered his leg moments into the Preakness Stakes, Barbaro no longer looks like the majestic animal whose quicksilver blend of speed and stamina won the Kentucky Derby and made him an overwhelming favorite to capture racing's Triple Crown.
Yet, Barbaro has overcome enormous odds thanks to some of the most advanced medical care ever given to a horse -- and to a small group of doctors and nurses who have fed, washed, walked and otherwise nurtured him.
When Barbaro arrived at New Bolton, he had massive injuries to his rear right leg -- a fractured cannon, sesamoid and long pastern bone. Most horses would have been euthanized. Instead, a complex, painstaking operation followed that included the insertion of a titanium plate and 27 screws in an effort to stabilize the leg and save his life.
The lower half of his leg remains encased in a large, heavily taped fiberglass cast. His left rear hoof, removed in surgery in July after the onset of a life-threatening case of laminitis, a debilitating inflammation, continues a creeping regeneration that will take at least six more months. A protective boot over the stump recently was replaced by heavy bandages.
Largely confined to a stall in the intensive care unit, the bay colt's battle for life has left visible marks. His muscular frame has atrophied. His left side is scarred from blistering during surgery and a bulbous sore from lying down when he couldn't stand. When he is led out for daily late-afternoon grazing, he lurches gingerly. Still, the staff at New Bolton is hopeful.
"He was a tremendous physical specimen," said Dean Richardson, the chief surgeon who performed the surgery the day after Barbaro broke down and has shepherded his recovery. "For all his problems, he's in excellent physical condition."
An Unforeseen BuzzDeFazio, who grew up in Kennett Square and went to camps at New Bolton as a child, was watching the Preakness on television the afternoon of May 20 when she saw Barbaro pull up at Pimlico Race Course. "I thought, 'Oh, my gosh, it's over, and it's going to be devastating for our community, especially since I live" near Barbaro's owners, Roy and Gretchen Jackson, she said.
DeFazio, 27, works the midnight to 5 a.m. shift at New Bolton every other week. She was scheduled to work that night. After the race ended, DeFazio took a nap -- missing further coverage of the tragedy on the evening newscasts -- then got ready for work. When she arrived at New Bolton at 10 p.m., she learned that the horse in her care would be Barbaro.
"When I got in and saw him, I was just awestruck," she said. "He looked like an athlete in his prime. I half wanted to cry and half was excited. You didn't know how to explain it: He's a horse -- one of our patients -- but he's Barbaro, and he won the Derby, and he's all over the news, and he's right in front of me, and I need to make sure he makes it through the night."
Much of the country also was fixated on Barbaro's plight. While many people just wanted to see the Derby winner survive, others debated whether he was only being saved for a chance to earn millions in stud fees. The Jacksons, who had never seen one of their horses suffer a serious injury, said they would have gone to the same great lengths for even the lowliest gelding.
The first few weeks of Barbaro's stay were extremely hectic at New Bolton, one of the two top equine clinics in the country, as television trucks filled the parking lot and reporters camped for days in the hospital lobby.
"It took some getting used to," said Kasey McCafferty, 27, a nurse in the neo-natal intensive care unit. "When you came in the driveway, you had to show your ID. We've had other big stories, but nothing that continued on for so long."
Even now, the hospital lobby remains crowded with giant get-well cards covered with children's signatures. Care packages arrive daily with cookies, chocolates and treats for the staff and carrots for their famous patient.
"It's kind of odd because we've gotten used to it now, but it's very surreal," said Liberty Getman, a third-year resident physician who fills in for Richardson when he is elsewhere. "You can't go anywhere wearing a New Bolton shirt. You can't go to the grocery store or anywhere without being stopped and asked how he is. When you leave here, it becomes more obvious."
The intensive care unit has eight stalls with wooden doors and cinderblock walls. Five are used for neo-natal care in the spring, when most thoroughbred foals are delivered, and Richardson said "it is totally jam-packed" at that time. Now, however, in the fall, it is cool and quiet. Barbaro has his own stall in a corner.
The building has a carefully monitored room temperature and people must wear designated scrubs and coveralls and dip their shoes in a disinfectant wash upon entering and exiting.
Richardson or, more often, Getman, checks on Barbaro each day at 6 a.m. to see how he got through the night and to change his bandages. Four times a day, nurses feed him alfalfa, grass, hay and grain enriched with supplements. They monitor vital signs twice daily and give him antibiotics for his left foot, which, though not infected, remains an open wound.
Barbaro is groomed every day and receives visitors, his extended human family. Gretchen Jackson brings freshly cut grass from her nearby farm in West Grove. Trainer Michael Matz visits regularly. Richardson occasionally allows Matz into the stall to groom Barbaro and apply front bandages. Matz wraps the legs just as he did when the horse was an undefeated 3-year-old with Triple Crown potential. Edgar Prado, his jockey, makes it down from New York from time to time.
The highlight of the horse's day comes when Richardson leads him outdoors to graze.
At night, the lights are dimmed and Barbaro and the other I.C.U. residents receive periodic checks. The Derby winner rarely stirs, Richardson said. "He's a good sleeper."
A Model Patient, MostlyLike many top-class racehorses, Barbaro is alert and inquisitive. On a recent afternoon, he flirted with a cow penned at the hospital. Barbaro only backed away when his new playmate attempted to administer a slobbering bovine lick to his face.
"He has a lot of personality," Richardson said. "Sometimes he's a firebrand, jumping up and down and trying to rip your head off, and sometimes he's very sweet. He's very complete."
Barbaro has gained respect at the hospital for his perseverance, though he has at times drawn the line. He loathed the masseuses brought in to work muscles that were knotted because of a lack of exercise. He fussed and bit and threatened until they decided to leave him alone.
"He's like a crotchety old man in a hospital," DeFazio said. "You come in with the medicines, and he says, 'What are you doing in here?' He makes faces at you. I wouldn't say he's cranky, but mouthy."
Richardson, who early on said the chances of Barbaro's survival were no better than 50-50, continues to be cautious about his recovery. "You've still got a long way to go to know whether he'll grow a foot that will allow him to be a stallion or live in a field," he said. "We're better than I thought we'd be in early July when he foundered, but it brings you back to earth when you think about it every day."
No figures have been released on the cost of his treatment the past five months, but it reportedly has run into the tens of thousands of dollars.
Although Barbaro's racing career is over and his ability to stand at stud is uncertain, he has been bringing in money -- for the hospital. Even before he had arrived, New Bolton administrators had begun to compile a wish list for its future.
The hospital, Executive Director Corrine Sweeney said, has been delivering "21st century medicine in a 20th century facility." Now there is the Barbaro Fund, which began with an anonymous donor pledging $500,000 and has raised approximately $1.2 million. The money will go toward the prevention and cure of laminitis, medicine and new equipment.
"It will immediately benefit the patients," Sweeney said. "No one wanted this tragedy to occur, but once it did occur an awful lot of good things happened."
And they continue to happen to Barbaro, the odds-defying patient who happens to be a star.
"I will be able to look back," McCafferty said, "and say to my children and grandchildren, 'I worked with Barbaro, the Kentucky Derby winner.' "
