For 72 days, Stanley Wilks, a 44-year-old civilian mathematician for the Army, was kept in a state of suspended animation at George Washington University Hospital. He was conscious, but unable to move a single muscle or breather without the aid of a mechanical respirator.
Wilks' physicians intentionally paralyzed him with the drug curare, a substance used by some Brazilian Indian tribes on their blowgun darts. Wilks was totally paralyzed by the drug four times longer than any previous GW patient to slow his body down to the point where it had a chance to fight off pancreatitis and infections that were killing him.
Wilks is now a celebrated GW patient - not only because he is recovering when few thought he would live but also because his hospital bill is so astronomical: between $150,000 and $250,000.
Wilks will not have to pay the bill himself he belongs to GW's prepaide Health Maintenance Organization. Officials of the HMO said that Wilks's bills will cause part of a probable premium increase next year for all of the HMO's members.
Wilks' case also raises the moral question of how much of the nation's limited health dollars, manpower and resources should be expended on any individual.
"Were he a gentleman who didn't have the rehabilitation potential, I don't think I'd have favor his admission to the intensive care unit," said Gr. Glen Geelhoed, who heads the surgical teams caring for Wilks, "For every Stanley Wilks you have 150 cases where you have the investment made without the yield" of the patient recovering, said Geelhoed.
Geelhoed said that even some nurses and residents were questioning the expenditure of time and eff107 or 108 degrees.
"I was killing an Intern a month," said Geelhoed, referring to the fact that each month he would name a new "Stanley Wilks memorial intern" who would do nothing but care for Wilks. The surgeon said he told the staff Wilks was "completely rehabilitatable if we could get him over this. He's a vital entity with four children.
"I told them," Geelhoed added, "I'd take them all the restaurant of their choosing" when Wilks seemed on the way to recovery. So, on friday night, betwen 10 and 20 nurses and physicians will dine at the Rive Gauche in Georgetown at Geelhoed's expenses.
Neither Geelhoed nor the physicians treating Wilks know yet what caused the onset of his pancreatitis last November. All they know is "he was as sick as one could be . . . He had a peeudo cyst, which means that his pancreas was eating itself and everything around it." said Geelhoed.
The pancreas produces the enzymes that digest food, and if those back up it can begin to digest itself and the kidneys, and liver, and the aorta.
Geelhoed operated and drained the cyst and placed tubes in Wilke's abdomen to drain off fluids that were accumulating.
"We put him between two cooling blankets but we couldn't bring his temperature down. It was around 107 and 106, he said.
"He sarted expending so much of his energy breathing that he was consuming more oxygen breathing that he was taking in. We had to do something to slow down the healthy person takes about 10 breath per minute, Wilks was taking 40.
The physicians decided to use the curate, and discussed the proposed tratement with Wilks' wife, Jocelyn.
"It seemed like a resonable option at the time," said Mrs. Wilks, as she sat by her husband's bedside yesterday, just as she has through most of his hospitalization and paralysis.
"It was going to be between two and five days on lurare," she said. "If thought it was a blessing" for him to get some rest . . . But as time went on it didn't seem like a resonable thing to take him off curare," she said yesterday, as her husband lay, proped up in the bed, listening.
A photographer interrupted the conversation to ask the couple to hold hands.
"We held hands so many times when he was asleep," said MrWilks."I held his hands so many times when he was asleep that I told him he owes me 1,000 kisses at least."
The only things Stanley Wilks remembers about the days of paralysis between Jan. 8 and Mar. 20 is that "I was cold" at one point. Wilks' lacks of memory, Geelhoed said,, is "merciful."
"People (sometimes) go psychotic" on curare, the doctor said, when active minds are trapped inside totally unresponsive, bodies. Wilks "has suffered a merciful lapse of memory. We would talk to him as though he was a real entity. But he was just a black box, an appendendage of the machines to which he was attached.
Geelhoed said that some persons who have been under curare for shorter periods of time have spoke of being "blacks plastic boxes," attached by wires to other boxes and machines.
The surgeon said that when Wilks first came out of the paralysis he told of an incident in which he was acutely aware of being naked, except for a small towel across his groin, and feeling embarassed and helpless. Yesterday Wilks said he does not recall the incident.
While Wilks was paralyzed and his system had a chance to restore itself, doctors attempted to kill, oone infection at a time, the various bacteria that had filled his body. They don't know precisely what they did right, but they do feel no now that he will be going home in a month.
At the moment Stanley Wilks's biggest worry is that his sick leave and annual leave will run out on May 15. But at least he is able to worry about that.