Saving a lifesaver
Longtime pediatric trauma surgeon receives double lung transplant
By Tiffany Wilson
Joseph Tepas, M.D., thought the 17-year-old looked like his own daughter, also named Katie, who was only four years older. Both were cross-country runners and honor students. But Katie Caples had been in a car crash that left her severely brain damaged. Although Tepas, a pediatric surgeon, would do everything possible to save her life,
it soon become clear she would never recover.
Although Katie’s brain damage was severe, many of her organs were strong and healthy. The time came for her parents, David and Susan Caples, to make a difficult decision, except they didn’t have to. Katie had made the decision for them already by signing up to be an organ donor when she got her driver’s license.
The Caples lost their little girl that day in 1998, but her brave decision saved the lives of five other people. That was just the beginning of the impact Katie would have on organ donations. Her parents started the Katie Caples Foundation, which has educated thousands of high school students and community groups about the importance of organ donation. Every year, they support their cause by hosting the Katie Ride for Life, one of the nation’s most anticipated bike-riding events.
Tepas, chief of pediatric surgery and chief medical information officer at UF Health Jacksonville and associate dean for clinical informatics at the College of Medicine – Jacksonville, remained close with the Caples family. He, his wife and his son ride their bikes in the Katie Ride for Life every year.
But they had no idea another rider would one day save Tepas’ life when he needed an organ donation himself.
A dedicated athlete, Tepas, 68, did not notice his lungs were deteriorating last summer. His fitness level masked a condition called idiopathic pulmonary fibrosis, which causes lung tissue to scar until the lungs ultimately stop working. On June 16, 2014, he felt the first signs of shortness of breath and was prescribed medication to help. A week later when the problem hadn’t gone away, he knew something was wrong. Fortunately, he also knew whom to ask for help.
His physician at UF Health Jacksonville, Jeffrey House, D.O., began a thorough search for the cause of the sudden health crisis. He consulted Martin Zenni, M.D., director of nuclear cardiology, and ordered an echocardiogram to determine whether Tepas had experienced a pulmonary embolism, a blocked artery in the lungs. The sonogram showed that the left side of Tepas’ heart was strong, but something was wrong with the right. It was dilated, which happens when blood flow from the lungs stalls. Pulmonologist Abubakr Bajwa, M.D., the hospital’s chief of pulmonary and critical care medicine and sleep medicine, ordered a CT scan of Tepas’ lungs. All three doctors were alarmed when they saw the results.
“Holy mackerel! There were no lungs at all,” Tepas recalled. Instead of an embolism, he had a spreading condition that was aggressively claiming his lungs.
A transplant was his only hope of surviving. While UF Health Jacksonville is a national leader in organ procurement, it does not offer organ transplantation. Bajwa called the Mayo Clinic in Jacksonville. Although Tepas was over the age limit for a transplant, he qualified because of his excellent health.
Tepas stopped working at the hospital and went home, unsure if he’d ever be back.
Connected to an oxygen machine and unable to walk across a room without losing his breath, Tepas began to accept that it was his time to die.
“I felt like I’d been put in a cage with a disease that was going to slowly strangle me. I made a pact with myself to bear it with grace and dignity, and was OK with dying,” he said. “But someone else told me she wanted me to stick around.”
His wife of almost 44 years, Jeanie, was at his side when he was admitted to the hospital. It had only been a month since Tepas started wheezing. Now he required a battery of equipment just to walk down the hospital’s hallway. Two days later, an organ match was found. Tepas was prepped for surgery and introduced to his transplant coordinator.
“I remember you,” the man said. “You operated on my son.”
Now his own life was in the hands of Cesar Keller, M.D., director of Mayo Clinic’s lung transplant program. Like Tepas, Keller had ridden in the Katie Ride for Life almost every year for the past decade, but the two had never met. They agreed to someday ride in the race together.
After saying goodbye to her husband, Jeanie Tepas kept vigil in the waiting room for the next agonizing 12 hours. At last, the word came that Tepas’ surgery had been a success.
The staff removed her husband’s endotracheal tube and asked if they could get him anything, expecting his throat to be dry after the long surgery.
“I’ll never forget what he said,” Jeanie Tepas recalled, fighting tears. “He could barely talk at all, and the first word he said was, ‘Wife.’”
Today, Tepas is recovering from his surgery, but recovering may not be the right word for it. He comes to work every day. He goes bike riding with his wife. And, on April 18, he led his own team — nicknamed “J.J.’s Brigade” — in the Katie Ride for Life.
This year, a cause that was always dear to him, organ donation, means even more.