As a staff pathologist at Mount Sinai Hospital, Dr. Richard Kirsch is accustomed to seeking answers to medical questions.

But in January 2007, Dr. Kirsch found himself as the patient. The next few weeks of his life were a harrowing descent from feeling “a bit ill” to being on life support.

Today, the 40-year-old South African-born specialist is the picture of good health and can calmly recount the story. He says he is alive thanks to the team in Mount Sinai’s Intensive Care Unit (ICU).

After feeling a little off one wintry Wednesday, Dr. Kirsch says he managed to make it through the weekend before suspecting he might have flu-related pneumonia.

Unfortunately, he was right.

He was in the full grip of influenza, a viral infection that attacks the respiratory system. A rising respiratory rate, pulse rate and the development of sharp chest pain alerted him to this possibility. He checked in to the emergency department at Mount Sinai on Monday morning.

By the end of the day, Dr. Kirsch had been transferred to the ICU where his condition progressively deteriorated. It became apparent that he had developed Acute Respiratory Distress Syndrome (ARDS), a life-threatening complication of pneumonia and sepsis (unchecked inflammation related to an overwhelming infection).

Within two days he was on a ventilator — what most of us refer to as life support. Due to the severity of his ARDS, Dr. Kirsch required a special and relatively new method of assisted breathing called High-Frequency Oscillating Ventilation, in which little tiny breaths are delivered extremely quickly.

This method improves oxygen delivery and carbon dioxide removal while reducing the chance of lung injury. Gentle support was key as it gave Dr. Kirsch’s body a chance to resolve injuries to the respiratory system and other organs which subsequently became involved. Members of the ICU have been pioneers in both research and clinical application of this technology.

Dr. Kirsch’s condition was further complicated when his kidneys began to fail, necessitating continuous renal dialysis for a period of time. The combination of ARDS and acute renal failure has a mortality rate that exceeds 60 per cent.

Dr. Kirsch’s parents flew 13,000 kilometres from their home in Cape Town to be by their son’s side and to support his wife, Tanya, who was five months pregnant at the time.

After two weeks of ventilation, a tracheostomy was performed. “I thought I might not make it,” says Dr. Kirsch, who sports a barely visible scar below his Adam’s apple from the tracheostomy. “When I woke up, I thought I was doing worse, but everyone in the unit was smiling. They knew I was improving, but I didn’t know because I was coming out of sedation required for ventilation. There was a gap in my memory of things.”

Dr. Kirsch says having a speaking valve placed in his tracheostomy was an important psychological milestone in his recovery.

“Once I could talk, I knew things would get better,” he says. “It was a huge turning point. I received incredible support from the whole ICU team. Everyone was pulling for me. It was definitely something special. The clinical care was superb, but the human side was remarkable. There was interaction with me and my family at every level.”

Dr. Kirsch says the work of the nursing team, respiratory therapists, physiotherapists and Drs. Tom Stewart, Stephen Lapinsky, Sangeeta Mehta and Randy Wax was a prime example of bringing research into action.

“I was told that when it comes to ARDS, there’s no better place to be than Mount Sinai ICU,” says Dr. Kirsch, who, along with his wife, now serves as a patient/family advisor in the ICU, helping clinical teams better understand the patient perspective in order to improve the delivery of Patient and Family-Centred care.

Dr. Kirsch’s father, himself a doctor, concurred in a June 2007 letter:

“The ICU team exploded the myth that science and humanity are mutually exclusive,” wrote Dr. Ralph Kirsch, Emeritus Professor of Medicine at the University of Cape Town. “Indeed, the skill of the staff was more than matched by the compassion, care, consideration and kindness which they consistently showed…We spent the better part of four weeks in the ICU visitors’ waiting room and were able to witness the ICU staff going out of their way to communicate with their patient’s relatives.”

Rehabilitation from ARDS is a slow process but Dr. Kirsch’s recovery was remarkably quick compared to most patients with this condition. He attributes this to the expert ventilatory support he received at Mount Sinai Hospital. Today, he’s back to full fitness and recently ran a 10-kilometre race.

“I almost didn’t get to see my daughter come into the world,” says Dr. Kirsch, whose daughter was born in June. “I am indebted to the ICU team for ensuring that I am here for my children and family! My experience as a patient at Mount Sinai Hospital has given me a great sense of pride to be part of this excellent institution.”