MY TOUGHEST CASE: Dr. Peter Fail

All doctors want everything to be just right for their patients. While some medical fields may have a forgiving margin of error if something goes wrong, that is not true for cardiologists. When the heart fails, people die. It’s a challenge welcomed by Dr. Peter Fail, director of the cardiac catheterization laboratories at the Cardiovascular Institute of the South.

Dr. Fail’s most challenging case came in April 2016. His patient was an extreme surgical risk. The man had already undergone one chest surgery, was severely diabetic and had lung issues. He probably would not survive having his chest cracked open. So, Dr. Fail needed to think creatively. He tried an aortic valve replacement using a valve that was in the early phase of a clinical trial.

At first, the insertion appeared to go well. Then it suddenly moved to a sideways position. It obstructed blood flow to the heart and leaked. If it failed, advanced surgery would be required and the patient would likely die. Dr. Fail inventively inserted a balloon into the valve. After inflating the balloon, he used it to pull the valve out into the aorta. Then, he inserted a second valve into position and it held. The patient was able to go home in two days.

While most valve insertions go fine, a good doctor always has to be prepared for issues and complications. He cannot shut his brain down and panic if the original plan goes awry. The job requires physical and mental dexterity.

“You have to think on your feet to get out of trouble,” said Dr. Fail.

To this day, Dr. Fail is not sure what exactly went wrong with the trial valve. It could have been a positioning or a size issue, but he recently saw the patient for his six-month check-up and was pleased to see him doing well. Solving problems for patients and seeing them healthy again is why Dr. Fail still loves his work after over 25 years.

“I enjoy my patients,” Dr. Fail said. “Most of the ones I treat are miserable when they come in (pain, difficulty breathing, among other problems caused by heart issues)…After you fix these people, it’s like a switch goes on and it’s so rewarding to see them get back to their lives.”

When asked what he does for fun outside of medicine, the 61-year-old Dr. Fail laughed and said that his nurse says that work is what he does for fun. He does have other interests, the main one being flying, he's also a skilled pilot with his own plane, a Cessna 182.

Dr. Peter Fail, a native of Titusville, Florida, earned his B.A. from the University of South Florida and his M.D. from the American University of the Caribbean. The latter college was in Montserrat when Dr. Fail attended, but is now on the island of St. Maarten after the catastrophic volcano eruption on Montserrat in 1996. He has been married for 30 years to his wife Jean and they have two children: Allison (age 20) and Nicholas (age 24).

 

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