Rusty Wagstaff doesnt remember anything between Dec. 18, when he first showed the symptoms of influenza, and Jan. 4, when he awoke in the hospital with no legs and was told his hands needed to be amputated.
In the hard weeks after the onset of a devastating infection, though unconscious and struggling to survive, Wagstaff inspired the scores of people who rallied to him during his toughest hours. Dozens of doctors and nurses who treated him at Rex Hospital in Raleigh were amazed by his resilience and his familys attitude .
All of them said they got more than they gave.
Every one of them was touched by Rusty and his family, said Dr. Sean Tehrani, the head of the Rex Hospital Hospitalist team. Every one of them became a better person.
Doctors believe Wagstaff, 54, had influenza and later picked up a bacterial infection in his blood, which led to sepsis, an overwhelming immune response to an infection that can result in inflammation and organ damage. About one-third of Americans who develop sepsis die, according to the National Institute of General Medical Sciences. The fatality rate is much higher for patients who develop septic shock, which leads to multiple organ failure.
Wagstaff was in septic shock when he arrived at the hospital. His ordeal would dramatically change his life and the lives of those who surrounded him.
He was this normal guy who got sick, fell asleep and woke up to find both legs are gone and that they are going to amputate his hands, said Kristen Parham, a nurse in the intensive care unit. I have never heard a word of complaint, not a single word. He smiles.
The Rex Hospital staff and the Wagstaff family developed an attachment so strong that doctors and nurses came to see Rusty on their days off. Tehrani, the Rex doctor who coordinated Wagstaffs care, once told the family that he envied his patient because of the familys strong bond. One hospital nurse, who never treated Wagstaff, came to visit because she wanted to meet the person and the family that she had heard so much about.
Wagstaff, a former East Wake High and UNC Wilmington baseball pitcher, worked as a wine wholesaler for almost 30 years, eventually becoming a sales manager for Empire Distributors.
He and his wife, Bonnie, were married almost 30 years ago. They live near Wendell. They have two daughters, Meghan, 27, a dentist married to major league baseball pitcher Tom Layne, and Mary Russell, 23, who is in pharmacy school.
If you write anything, make sure that I dont come across as some sort of hero or something, Wagstaff said during an interview in mid-January. All I did was lie around. The heroes are the folks that surrounded me.
You just dont recover
Kristen Parham was not excited to come to work as she drove to Rex to begin her 7 a.m. shift in the Intensive Care Unit on Dec. 25.
It was Christmas Day, Parham said. Nobody really wants to work on Christmas Day.
What Parham would witness during the next 12 hours continues to touch her.
Wagstaff had been admitted to the hospital on Dec. 22 with a fever of 105 degrees. He was in septic shock, and his major organs were failing. But on Christmas Eve, he seemed stable. Most of his family left the hospital around 11 p.m. Bonnie Wagstaff stayed, but the others went home or to a friends house nearby.
At 2:30 a.m., the family was summoned. Wagstaff had taken a turn for the worse and was in a coma. He already was attached to 12 IV lines; he was on dialysis and a ventilator; and three heart machines were working to stabilize his blood pressure.
Family members were told to prepare themselves to say goodbye.
Rustys circumstances were different from most of the people in ICU, Parham said. He didnt have an exacerbating condition from an underlying illness. He was a normal young healthy man who was living his life and he happened to get sick. You could see the love this family had for one another.
She checked the charts. Wagstaffs heart, liver, lungs, kidneys and bone marrow were all failing. The bacteria in his blood was attacking every organ.
You just dont recover from that, Parham said. Not from where he was. I thought my job that day would be to comfort this family as it said goodbye to a loved one.
But the family refused to let him go.
Im not saying goodbye, Bonnie Wagstaff said. Not now.
Brinkley Wagstaff, Rustys older brother, coached state high school championship baseball teams at Garner High and Broughton High in Raleigh. But he may have done his best work in the dark hours of Christmas morning.
He pleaded with Rusty, not knowing if his unconscious brother could hear him.
Mary Russell remembered her uncle talking to her father Come on Rusty, just 15 more minutes. Youve got to make it to 4 oclock. Dont quit on me now. You know you can make it to 4:30. Its almost 5, Rusty. You can do this. Just a little while longer, buddy.
Bonnie had crawled into bed with her husband and was holding him.
As the final moments seemed to be approaching, Layne, who pitched for the San Diego Padres last season and who had become a member of the family in November, slipped the wedding band off Rustys hand and gave it to his mother-in-law.
One last try
Dr. Vincent Hoellerich, chairman of Rexs Department of Anesthesia and Critical Care, reported for his shift at 7 on Christmas morning, too. He reported to ICU.
He studied Wagstaffs charts. Parham recalls him saying that he wasnt quite ready to give up on this fellow yet.
Hoellerich sent the family out and made changes to Wagstaffs treatment, trying one last adjustment of antibiotics and inserting a nutrition tube.
When I came in I saw a doting family, but I also saw a patient who was failing quickly, Hoellerich said. I think I arrived at a point where the family was coming to grips with the end being near.
But there were a few more things we could try. Many times, we do everything we can do in intensive care and it doesnt help. But sometimes something works and eventually a patient leaves the hospital.
Brinkley Wagstaff likened Hoellerich to a Christmas angel.
We never saw him before, he said. He was there for about an hour, performed his miracle and was gone.
Fighting for life
Paulette Langley, another ICU nurse, met Wagstaff at 7 the next morning, Dec. 26. He had survived the night but was still unconscious.
I dont know why we connected. How do you connect with someone who is unconscious? she said. But we connected somehow. It had a lot to do with his family. His family is so caring and godly and so appreciative. Ive never seen such a cohesive family. Theyve touched my heart.
The family arrived to see Langley stroking Rustys head, singing Christmas carols to him in her Jamaican accent.
I love music, but I am not a good singer, she said. Just thinking of the words helped me through the day. Sometimes words arent enough. I didnt know anyone could hear me. I just wanted to comfort Rusty.
Rusty became a part of Langleys life, so much so that she jokingly says she has been adopted. The family now calls her Paulette Langley Wagstaff.
More bad news
Wagstaff was in a coma, but his family talked to him about the future. Brinkley Wagstaff once had a radio program Katie Bs Beach Blast and he brought his old tapes to the hospital and played beach music, especially Rustys favorite Dont Let The Green Grass Fool You by Wilson Pickett.
They believed that one day he would dance again.
Sean Tehrani took over Wagstaffs case when he began his shift on Dec. 30. Tehranis first meeting with the family had to be held away from Wagstaff.
The family had a rule that nothing negative would ever be said in front of him, even while he was unconscious. They worried about what he might be able to hear.
Tehrani had difficult news to share.
Wagstaffs body, in an attempt to sustain life, had concentrated blood flow to his core. The lack of blood had harmed his feet irreparably. He had gangrene. He would lose at least part of each limb. In addition, every organ in his body was failing.
If he got better, we had no way of knowing if there had been neurological damage, said older daughter Meghan Wagstaff Layne.
Even with surgery, the odds were against survival.
I put the odds at 5 percent and that probably was too high, Tehrani later said. Regardless, Mr. Wagstaffs life would be altered significantly. Many people, and personally I am one of them, would prefer for nature to take its course at that point.
The family listened to the options during a meeting of 30 to 45 minutes and spoke with one voice.
Bonnie said there was no Plan B, Brinkley Wagstaff said. We wanted Rusty back, whatever parts we could get.
Meghan said the family believed that Rusty could live a normal life again some day.
No one knew what it would be like when he regained consciousness, she said. But he had a chance to live.
Wagstaffs legs were amputated on Jan. 2 and his medications became more effective. The process was slow, but gradually each of his organs regained normal function.
Mr. Wagstaff had been literally at deaths door, Tehrani said, but he turned back. If any one of his organs had not responded, he would not have made it.
Wagstaff regained consciousness gradually. The first thing he did when his head cleared was wish his family Merry Christmas, not knowing the holiday had been nine days before.
His legs had been amputated just below the knee. Doctors returned on Jan. 4 to explain why his legs were gone and why his hands had to be amputated.
He asked repeatedly if he had cancer. We dont know why, Meghan said. Maybe that is his greatest fear.
Family changed my life
Hospital staffs often see families at their worst times, stunned by circumstances and stricken with grief. Parham, the nurse who was with Wagstaff on Christmas Day, said his family amazed her.
Ive never seen a family so positive, Parham said. To see his family come together in the most dire circumstances without any dissension was incredible.
Parham believes that bond saved Rusty Wagstaff.
Rusty would not have made it without his family, Parham said. Ill always believe that. Being with him and his family reminded me of why I wanted to be a nurse. This family has changed my life.
Tehrani found himself drawn to Wagstaff and his family, too.
As doctors, we are trained to not get emotionally involved with our patients for a couple of reasons, Tehrani said. First, because it might impair our ability to make the right medical decisions. And second, you cant carry the emotions with you.
But I knew I was getting emotionally involved. I never tell my family about work, but I did tell them about this family without violating patient-physician privilege. I would come visit him on days when I wasnt working. It wasnt a burden. It was something I wanted to do. It was the same with everyone they touched.
Tehrani told Brinkley that he didnt know what the family had, but he was envious. He said he wished he had it, Brinkley Wagstaff said. I told him he could; wed adopt him, too.
On to Chicago
Wagstaff left the hospital on Jan. 28, rushing to beat a snowstorm. A local ambulance service carried him to the airport, where he was lifted onto a jet that had been donated for his flight to the Rehabilitation Institute of Chicago. Wagstaff will continue his rehab there and be fitted for his prostheses.
Doctors are hopeful Rusty will be able to walk this spring.
The dream, Wagstaff said, is to go to spring training and walk in. Ive always wanted to go to spring training, but never got around to it.
He plans to play golf with Bonnie, to teach his daughters to play golf, to have grandchildren someday and pull them around in a wagon. His old job, or at least a job, is waiting, but he could retire.
He said he is nothing special, but that he is surrounded by special people his family and his Rex friends.
It is a sad, happy day, Bonnie said, wiping away tears as they packed to leave Rex. No one would believe how good the people here have been to our family.
The large yellow-green poster board card filled with good wishes from the staff and quotations about the value of positive thinking was rolled up for the trip. Bonnie wiped tears from Rustys eyes as he left.
Everybody has been so good to me, he said.
Something bigger in store
Those who grew to care about the Wagstaff family say they gained more than they could give.
Everybody comes out of his room smiling, said nursing assistant Ruben Aluoch. You smile to other people and they smile, too. It is contagious. They just dont make people like these people.
Tehrani agreed. There has to be something bigger in store for him, he said. I want him to write a book. What did he do to have such daughters? Such a family.
Langley, the ICU nurse who sang to Wagstaff, remembers asking him how he felt about losing his legs.
He said he was glad that they were gone. They were heavy and kept him from moving fast. Now he was quick and could slap somebody, she said, laughing.
She says she asked him again: Honestly, how do you feel about everything that has happened to you?
He said, Im just happy to be alive, she said. Thats all I wanted to know. God has a plan. We just dont know it yet.