Lawrence Engel, 47, has been an assistant nurse manager in the cardio-thoracic department at Southside Hospital (SSH) for the past five years. Mr. Engel has attended to hundreds of patients at the hospital’s cardiac intensive care unit (ICU).
This past June, Mr. Engel found himself admitted as a patient at the very hospital he has treated so many others. His life took an unexpected turn when Mr. Engel was working in the ICU and suddenly couldn’t speak. This is commonly known as aphasia, where a person has an inability to comprehend and formulate language because of a dysfunction in the brain.
Mr. Engel’s colleague, Heather Kennedy, RN, thought he may have been showing signs of a stroke and performed a neurological exam. As with any patient who is suspected of having a stroke, SSH’s Gary Plotkin, NP, called for “Code Stroke.”
“When there is a Code Stroke alert, it notifies the stroke team which consists of residents from the department of medicine and the neurologist on-call,” said Andrew Rogove, MD, the hospital’s medical director of stroke and Mr. Engel’s neurologist.
Mr. Engel was also evaluated by a stroke-certified neurologist, Anand Patel, MBBS, via the health system’s telestroke program where a neurological exam was performed by remote from North Shore University Hospital (NSUH) in Manhasset, NY, a member of Northwell Health.
Since Mr. Engel’s speech was impaired at the time of the exam, Dr. Patel recommended that the SSH emergency department physician administer the clot-busting drug, tissue plasminogen activator, or tPA. If given intravenously in the first three hours after the start of stroke symptoms, tPA has been shown to significantly reduce the effects of stroke and lessen the chance of permanent disability. The good news for Mr. Engel was that a magnetic resonance imaging (MRI) scan did not show any damage to the brain.
However, shortly afterwards, Mr. Engel experienced seizures, which worsened over time. He was transferred to NSUH’s Epilepsy Monitoring Unit where an electroencephalogram (EEG) was performed, which monitors brain activity and pinpoints areas of the brain causing the seizures.
In addition, a computed tomography (CT) scan was performed which revealed a small lesion in the temporal lobe of the brain. It was determined that the lesion was a glioma brain tumor located in the area of the brain that controls language. This helped to explain that Mr. Engel’s inability to talk coherently was actually not from a stroke, but from the lesion on his brain, which will require surgical removal.
Mr. Engel is grateful to the staff at SSH for recognizing that something wasn’t quite right when he couldn’t talk that day in June and that the staff followed proper stroke protocol.
“The care and compassion I received from my colleagues to treat one of their own, was truly amazing,” said Mr. Engel. “I also know that the stellar treatment I received was the same that we do every day for all of our patients.”
About Northwell Health
Northwell Health is New York State’s largest health care provider and private employer, with 21 hospitals and over 500 outpatient practices. We care for more than 1.8 million people annually in the metro New York area and beyond, thanks to philanthropic support from our communities. Our 61,000 employees – including 15,000+ nurses and 2,500+ doctors within Northwell Health Physician Partners – are working to change health care for the better. We’re making breakthroughs in medicine at the Feinstein Institute. We're training the next generation of medical professionals at the visionary Hofstra Northwell School of Medicine and the School of Graduate Nursing and Physician Assistant Studies. And we offer health insurance through CareConnect. For information on our more than 100 medical specialties, visit Northwell.edu.
About Southside Hospital’s Department of Neurosciences
Southside Hospital’s Department of Neurosciences, which partnered with Northwell Health’s Neurosciences program in 2007, includes all aspects of neurological and neurosurgical disease treatment, including a level III epilepsy center that is certified by the National Association of Epilepsy Centers, a New York State Designated Stroke Center which received the Gold Plus Award for outstanding stroke care from the American Heart Association/American Stroke Association, a comprehensive pain management program and sleep center. For more information about Southside Hospital’s Department of Neurosciences, click here.