Skip Navigation
Book Now! Find care near you Find care near you Find care near you
wellstar-logo
Wellstar Go Back
Go to MyChart

Questions? We can help!

Call (770) 956-STAR (7827)

Monday - Friday, 7 AM - 4:30 PM

Contact Us
For Patients & Families For the Community For Providers About Us Careers
  • Start Your Care

  • Find a Doctor
  • Find a Location
  • Our Services
  • Virtual Visits
  • Planning

  • Accepted Insurance
  • Financial Assistance
  • Pricing Information
  • Before Your Visit

  • Sign Up for MyChart
  • Visitation Guidelines
  • Know Where to Go
  • While You're Here

  • Support & Entertainment
  • Join an Event
  • After Your Visit

  • Pay Your Bill
  • Get Medical Records
  • Contact us
  • COVID-19 Support

  • COVID-19 Information
  • Vaccines
  • Testing Information
  • Visitation Updates
  • Foundation Relief
  • Community Health

  • In the Community
  • Health Highlights
  • Community Health Needs Assessment
  • Latest News
  • Center for Health Equity
  • Events & Programs

  • Events Calendar
  • On-Demand Classes
  • Support Groups
  • Give

  • Wellstar Foundation
  • Donate
  • Ways to Give
  • Thank a Caregiver
  • West Georgia
    Health Foundation
  • Volunteer

  • For Adults
  • Care

  • Transfer a Patient
  • Cures Act
  • Refer a Patient
  • Lab Test Directory
  • Request to Conduct Research
  • Connect

  • Physician Relations
  • Request Imaging Services
  • Wellstar Clinical Partners
  • Wellstar Medical Group
  • Mayo Clinic Care Network
  • Medical Staff Services Credentialing
  • Provider Recruitment
  • Log In

  • EpicCare Link
  • Lawson Connect
  • MyID Password Reset
  • Citrix Access
  • Leadership

  • Authority Board
  • Board Of Trustees
  • Foundation Board
  • Regional Health Boards
  • Executive Leadership
  • Awards, Recognition & Safety

  • Accreditation & Certifications
  • Awards & Recognition
  • Safety First Program
  • Nursing
  • Careers at Wellstar

  • Apply now
  • Upcoming virtual events
  • Why Wellstar?
  • Nursing Careers

  • Nursing (Direct Care)
  • Nursing Leadership
  • Nursing (Non-bedside)
  • Nursing Support
  • Physician, APP & Clinical Careers

  • Advanced Practice Providers (APPs)
  • Allied Health Professionals
  • Homecare & Hospice
  • Physicians
  • Support Team Careers

  • Administrative & Clerical
  • Coding, Compliance & HIM Systems
  • Facility, Environmental & Nutrition/Food Services
  • Information Technology & Systems
  • For Patients & Families
  • For the Community
  • For Providers
  • About Us
  • Careers
  • Search Search Search
  • MyChart MyChart MyChart

Start Your Care

Find a DoctorFind a LocationOur ServicesVirtual Visits

Planning

Accepted InsuranceFinancial AssistancePricing Information

Before Your Visit

Sign Up for MyChartVisitation GuidelinesKnow Where to Go

While You're Here

Support & EntertainmentJoin an Event

After Your Visit

Pay Your BillGet Medical RecordsContact us

COVID-19 Support

COVID-19 InformationVaccinesTesting InformationVisitation UpdatesFoundation Relief

Community Health

In the CommunityHealth HighlightsCommunity Health Needs AssessmentLatest NewsCenter for Health Equity

Events & Programs

Events CalendarOn-Demand ClassesSupport Groups

Give

Wellstar FoundationDonateWays to GiveThank a CaregiverWest Georgia
Health Foundation

Volunteer

For Adults

Care

Transfer a PatientCures ActRefer a PatientLab Test DirectoryRequest to Conduct Research

Connect

Physician RelationsRequest Imaging ServicesWellstar Clinical PartnersWellstar Medical GroupMayo Clinic Care NetworkMedical Staff Services CredentialingProvider Recruitment

Log In

EpicCare LinkLawson ConnectMyID Password ResetCitrix Access
About Wellstar

Our patients are the center of everything we do. We're nationally ranked and locally recognized for our high-quality care, inclusive culture, exceptional doctors and caregivers, and one of the largest and most integrated healthcare systems in Georgia.

About Us

Leadership

Authority BoardBoard Of TrusteesFoundation BoardRegional Health BoardsExecutive Leadership

Awards, Recognition & Safety

Accreditation & CertificationsAwards & RecognitionSafety First ProgramNursing

Careers at Wellstar

Apply nowUpcoming virtual eventsWhy Wellstar?

Nursing Careers

Nursing (Direct Care)Nursing LeadershipNursing (Non-bedside)Nursing Support

Physician, APP & Clinical Careers

Advanced Practice Providers (APPs)Allied Health ProfessionalsHomecare & HospicePhysicians

Support Team Careers

Administrative & ClericalCoding, Compliance & HIM SystemsFacility, Environmental & Nutrition/Food ServicesInformation Technology & Systems
Questions? We can help!

Call (770) 956-STAR (7827)

Monday - Friday, 7 AM - 4:30 PM

Contact Us
Close
  • Urgent Care
  • Primary Care
  • Virtual Care
  • Emergency Care
Close Close Close Book Now Menu
  • Urgent Care
  • Primary Care
  • Virtual Care
  • Emergency Care

Introducing

Wellstar Virtual Care

Access Wellstar healthcare providers
wherever you are.

Get started

Warning Warning Our "Book Now" feature should not be used for life threatening conditions such as heart attack, severe injury, poisoning, chest pain, or stroke. If you are experiencing such conditions, STOP and CALL 911 IMMEDIATELY or visit your nearest Emergency Department.

I Understand
  • Home
  • Articles
  • ZacCare
Article Category: PeopleCare

ZacCare

Published on August 16, 2020

Last updated 04:35 PM August 21, 2020

Zac standing outside the front of his home

Zac standing in front of his parents' home.

Looking at Zac DiGiorgio today, you wouldn't know he almost lost his life — twice.

Like any typical guy in his early 20’s, Zac was always on the move. He liked to keep himself busy and lead an active lifestyle.

So naturally, when his parents needed their shutters replaced, Zac was the first to volunteer. With a drill in hand, he climbed up the ladder to replace the old hardware and change out the shutters.

Moments later, everything changed in the blink of an eye.

A terrifying crash sounded from outside the home. Zac’s father, Chris DiGiorgio, rushed out the front door to see a parent’s worst nightmare: his 23-year-old son face down in the driveway, having a seizure.

After shouting to his wife to call 911, Chris was at his son’s side. He cradled Zac on the concrete driveway, trying to steady his body from the convulsions.

“I really didn't know what was happening,” Chris recalled. “I knew he was having a seizure, but I didn't know if he had any other injuries or anything else going on.”

But one thing was clear: Zac had plummeted to the ground from the top of the ladder, smacking the right side of his head hard on the concrete.

The severity of the fall triggered a seizure, often characterized by body spasms or unconsciousness. However, these episodes can also have cognitive and emotional effects, such as fear or anxiety.

In Zac’s case, he became extremely agitated. After waking from the initial seizure, he argued with his dad and fought against his hold. Even when the first responders arrived, he refused to get on the stretcher and instead walked himself to the ambulance.

With lights flashing and sirens blaring, the ambulance raced towards Wellstar Kennestone Hospital. On the way, Zac complained of pain in his shoulder from a broken collar bone. But after experiencing another seizure on the short eight-minute drive, it was clear much more was going on inside his body.

After being admitted, it would be weeks before Zac awoke again in the hospital — with no memory of the accident.

Performing brain operations on people like Zac is very humbling. Each patient is part of someone’s family, whether they’re a father or mother, son or daughter. At Wellstar, we never lose sight of what really matters.

- Dr. William Benedict

Wellstar Neurosurgeon

Listen to Zac's Story

Brainpower at work

Upon arrival at Wellstar Kennestone Hospital, the DiGiorgios were escorted to a private room, waiting for word on their son’s condition. A short time later, the couple got news, but it wasn’t what they were expecting at all: although Zac had survived the fall, he had suffered a traumatic brain injury (TBI) as a result.

The DiGiorgios were blown away. “Since Zac had gotten into the ambulance himself, we thought he would just be treated for a concussion and released in no time,” Chris explained, recalling how he almost vomited when he heard about the extent of his son’s injuries.

Despite their unrest, the DiGiorgios jumped into action. Zac’s mother, Betsy DiGiorgio, started rallying a support team around her son. She made several calls to out-of-state friends and family with medical backgrounds, and they assured her that Zac was in good hands at Kennestone.

“They all said, ‘He’s in a great place. Don’t move him,’” Betsy remembers.

But despite their initial hopes, getting Zac back to better health wasn’t going to be easy due to the severity of his head injury.

Behind the scenes in the emergency room, the Wellstar team performed a CT scan, which revealed life-threatening bleeding in Zac’s brain. It quickly became clear that he was suffering from a severe TBI. With a network of experts seamlessly working together, Zac was swiftly transferred to the Wellstar Kennestone Neuro ICU for specialized brain care.

Once Zac was transferred to the Neuro ICU, Dr. Christopher Horn — a Wellstar neurologist who specializes in neurocritical care — inspected Zac’s injuries.

“When I first evaluated Zac, his imaging, labs and brain testing were not uncommon for a young trauma patient,” Dr. Horn explained. “However, he had sustained a severe lung injury likely during his seizure and it was throwing us a curveball.”

“Due to the injury, Zac was having trouble oxygenating his body. Unfortunately, that only made his intracranial pressures worse and could cause more harm to the traumatic brain injury,” Dr. Horn said, remembering the grave situation.

To control the pressures in his brain and aid in his lung function, Zac was placed in a medically-induced coma. According to Dr. Horn, the team then closely monitored Zac’s body and brain while treating him with broad-spectrum antibiotics.

“Even with treatment, his intracranial pressure would briefly respond, but still showed a worrying trend,” the neurologist recalled. “To relieve the pressure, we needed to make some space for his brain to swell.”

That’s when Wellstar Neurosurgeon Dr. William Benedict joined the team. He remembered the struggle to control Zac’s building brain pressure.

“When Zac came into the Neuro ICU, he had seizures almost immediately. We monitored his brain pressure and it kept going up,” Dr. Benedict recalled. “Ultimately, it became unresponsive to medication.”

At that point, Dr. Horn, Dr. Benedict and the Neuro ICU team knew Zac would require surgery to save his life. Together, they decided to perform an emergency craniectomy, a surgical removal of part of the skull to expose the brain and allow it to swell.

With Zac’s condition worsening, Dr. Benedict raced to the DiGiorgios to get their permission to perform the surgery. With their son in a comatose state, his parents had to call the shots when it came to his care.

“At that point, I had my game face on,” Betsy said about staying strong throughout the process and signing the surgical consent form. “I thought, ‘Let’s go. We've got to do it.’”

Zac was rushed into emergency surgery to save his life.

With great precision, Dr. Benedict removed part of Zac’s skull to help relieve pressure in his brain. This procedure allowed his brain to swell as needed.

The piece of skull, called a skull flap, was taken off and implanted in his abdomen between the muscle and fat. By storing it in his own body, the skull flap remains viable for reattachment in the future.

The surgery was a success. Through it all, the gravity of the situation was not lost on Dr. Benedict. He and the entire Neuro ICU team take their responsibility for patients seriously.

“Performing brain operations on people like Zac is very humbling,” Dr. Benedict said. “Each patient is part of someone’s family, whether they’re a father or mother, son or daughter. At Wellstar, we never lose sight of what really matters.”

With the help of Wellstar’s Neuro ICU team, Zac narrowly avoided death. But his path to wellness would be a long road, with many ups and downs along the way.


Continued care

Even after the craniectomy, Zac’s long road to recovery was just beginning.

Throughout the aftermath of the accident, Chris and Betsy were at the hospital day in and day out, yet throughout the process, Wellstar made the DiGiorgios feel at home.

“We really felt like we were part of the team,” Betsy said about the Wellstar physicians and nurses in charge of her son’s care.

“One of us was there 24-hours a day and they always welcomed us,” Chris added. “We could be there for him all the time.”

The Neuro ICU team kept close watch on Zac all day and all night. Leading the charge, Dr. Horn became a fixture in Zac’s room. He often would evaluate Zac, studying the beeps, whirs and readings coming from the six or seven machines keeping him alive.

After surveying the room and assessing Zac’s condition, Dr. Horn would come up with the day’s game plan, briefing with the DiGiorgios and the nurses on their next course of action.

“It was incredible to watch Dr. Horn’s mind work,” Chris remembered. “You could see the gears turning.”

“I do whatever I can to help my patients,” Dr. Horn said, sharing his philosophy on patient care. “My patients typically have a tragic or life-altering illness, and I know their life and wishes are now in my hands. The person lying in the hospital bed is counting on me to help them survive.”

Dr. Benedict also visited Zac daily to check progress, monitoring his brain closely.

“There’s a whole other world behind those closed doors,” Betsy added about the Neuro ICU and their team. “We got to experience it on a daily basis. It’s amazing what they do every day.”

Since their son was still in an induced coma, the DiGiorgios were making all the care decisions for him. Quickly, the parents learned to rely on the Wellstar care team for advice along the way.

“It’s scary at first because you don’t know what’s going on with your son,” Chris said. “But once I met with Zac’s doctors and nurses, I trusted them to do what they needed to do and if they recommended a treatment, we did it.”

“We knew we were in good hands at Wellstar,” Chris continued. “We asked a lot of questions about our son’s condition, but we never questioned what they were doing. I felt like Kennestone was the place my son could receive the best care for his injuries.”

A little over a week after his craniectomy, Zac’s brain was slowly getting better. But his respiratory system began to deteriorate. His lungs were failing because of heavy medication and relying on a ventilator to breathe.


50/50

“All the pressure from Zac’s brain had been released after the surgery, but his lungs were failing,” Betsy said, recounting the scary situation. “He was on the ventilator 100% of the time which made his lungs like plastic.”

Zac had developed Acute Respiratory Distress Syndrome (ARDS), a life-threatening condition that causes dangerously low oxygen levels in the bloodstream. Because of ARDS, the tiny sacs in his lungs — called alveoli — filled with fluid, making it more difficult for his lungs to remove carbon dioxide from his bloodstream.

That’s when Wellstar Pulmonologist Dr. Asif Saberi approached the parents about an intense treatment called extracorporeal membrane oxygenation (ECMO).

“ECMO is a way to provide air to the body when the lungs fail completely,” Dr. Saberi explained.

If the lungs are in peril, ECMO can help remove carbon dioxide from the bloodstream using a machine. Once a patient is on ECMO, blood is diverted out of the body using tubes and cleaned of carbon dioxide. It is then re-oxygenated and recirculated through the system again.

Since Zac had just had brain surgery, he was considered a high-risk patient for the treatment, but his odds weren’t looking good either way.

“Dr. Saberi told us our son had about a 50/50 shot of surviving ECMO,” Chris recounted the terrifying moment. “But if we didn’t do anything, I felt like he would die. When it’s your son, you just move forward with whatever might save him.”

“We didn’t have much time. We had to take a shot to save his life,” Betsy added.

But before moving forward, Dr. Saberi met with Dr. Horn and Dr. Benedict — the care team from the Neuro ICU — to make sure it was the right treatment for him.

“At Wellstar, ECMO is a multidisciplinary decision,” Wellstar Neurosurgeon Dr. Benedict said about his involvement in the decision. “We all came together and decided ECMO was the best option, despite the risks.”

During the procedure, a special catheter, called a cannula, was inserted in Zac’s major blood vessels to divert the blood out of his body. The cannula had dual channels: one to move blood out of the body and one to bring the reoxygenated blood back into the system.

“It really hit me after I saw the blood moving in and out of his body through the tubes,” Chris remembered seeing his son after he was placed on ECMO. “The machine was doing the work of his lungs for him.”

“At Wellstar, the medical staff is constantly growing together,” Dr. Benedict said. “With state-of-the-art programs like ECMO coming in, we all learn from each other and push each other to provide next-level care.”

Zac was placed on ECMO for over two weeks to allow his body to rest. His stiff, inflamed lungs began to recover slowly.

Finally, his family could breathe a sigh of relief.


Moving forward

After what seemed like an eternity, Zac opened his eyes.

“I felt anxious at first,” Zac remembered waking up in a hospital bed, hooked up to machines with tubes coming out of his body. “Because of all the tubes, I felt tied down and it was overwhelming. I didn’t know where I was or what had happened.”

He immediately wanted to ask his parents rapid-fire questions about the situation, but he couldn’t even say a word because of a tracheotomy.

“I couldn’t speak. I couldn’t even remember anything from the accident,” he explained. “I honestly thought I had gotten in a car crash or something.”

Pieces started coming back to Zac. It happened in flashes: the beep of a ventilator or the distant memories of visitors.

“The whole time I was in a coma, it almost felt like I was dreaming,” he recalled. “Being in the hospital, hooked up to machines and being wheeled from room to room… I thought it was a dream, but it was real life.”

From physicians to family to friends, Zac had a constant stream of visitors checking in on him after he woke up. It was a lot to take in at once. While learning about the accident, Zac had to keep all of the doctors and their specialties straight, too.

“As time passed and I got to know the doctors and nurses, I felt more comfortable,” he said. “Getting to know everyone by name and learning the hospital routines helped me feel at ease.”

The entire care team — including Dr. Horn, Dr. Benedict and Dr. Saberi — made regular visits to his room. Even after regaining consciousness and working on his rehabilitation, Zac had a lot of work to do to get back to his life.

“One of the first things that crossed my mind was my weight,” Zac said. “I dropped almost 80 pounds when I was in the hospital. One of my biggest goals was just to go back to normalcy and do everything I could do before the accident.”

That’s been one of the toughest lessons he and his family have learned throughout his recovery: it’s not always a fairy tale ending. Recovery looks different for everyone.

“In the movies, people who are given a second lease on life always go off and save the world,” Chris explained. “Zac just wanted to go back to his normal life and routine. In real life, the best part of recovering is getting your life back.”

Three months after the accident, Zac hit a big milestone in his recovery when he went into surgery to have his partially-removed skull reattached by Dr. Benedict.

“It was like a jigsaw puzzle. It went back on perfectly,” Dr. Benedict recalled how the cranioplasty procedure went smoothly without a hitch.

Zac also began rehabilitation to rebuild his strength after the accident. At first, his body was so weak that he couldn’t even walk. But he quickly met the challenges before him with strength and determination.

From taking his first few steps to running a half-marathon just months later, Zac has been making steady progress towards his goals since his hospital release. After a year and a half, he is getting behind the wheel of his car after being seizure-free for several months.

All in all, his journey to recovery has been remarkable.

“When I meet people, they don’t know that I’ve ever been hurt. They don’t know I had a life-threatening brain injury unless I tell them,” Zac said.

“Actually, there is one person who can tell what happened,” he added with a smile, “My barber — he can see the scar whenever I get a fresh haircut.”

Zac’s family is overjoyed by his recovery. They can now cheer him on as he keeps moving forward in everyday life.

“It was divine intervention. We ended up in the right place at Wellstar and it couldn’t have turned out any better,” Chris beamed.

Zac has a lot to look forward to today and in the future. From the first responders to nurses to physicians, he credits his entire care team at Wellstar Kennestone Hospital for saving his life.

“Wellstar is the reason I’m still here today.”

Tags

Kennestone Hospital William John Benedict Jr Christopher M Horn
Asif Ali Saberi Neuro Care
Read related articles
Headshot photo of Mary Chatman, Wellstar and Georgia Hospital Association logos

Newsroom

Mary Chatman, Executive Vice President of Acute Care Operations for Wellstar Health System, Elected Chair of the Georgia Hospital Association Board of Trustees

ATLANTA – Mary Chatman, PhD, RN, executive vice president (EVP) of Acute Care Operations for Wellstar Health System, was elected chair of the Board of Trustees of the Georgia Hospital Association (GHA) earlier this month. Chatman, who has served on the GHA Board since February 2020, will lead the Board in developing strategies for GHA hospital members, advocating for the highest quality care for patients, and supporting adequate reimbursement for hospitals.

“Mary Chatman’s extensive leadership experience and skills make her well-equipped to lead our Board,” said GHA President and CEO Caylee Noggle. “She is a strong patient advocate, and her experience will serve our members well.”

Serving as a Wellstar EVP, Chatman oversees the operations of Wellstar’s 11 hospitals, post-acute services, and emergency departments. In 2020, she led the opening of Wellstar Kennestone Regional Medical Center’s new emergency department, the largest in the Southeast.

Prior to serving in her current role, Chatman was the chief operating officer and chief nursing officer at Memorial Health University Medical Center in Savannah, where she was responsible for managing the 654-bed hospital and its nursing operations. She also served as interim chief information officer for Memorial and completed the electronic health record conversion to EPIC.

In 2021, Gov. Brian Kemp appointed Chatman to the state’s Healthcare Workforce Commission, where she has helped address challenges in the hiring and retention of health care workers.

Chatman has been recognized locally and nationally as a prominent leader and strong patient advocate in health care. Atlanta Daily World recognized her among the 2018 Women of Excellence. Diversity MBA Magazine named her among the 2018 Top 100 Under 50 Executive & Emerging Leaders and 2020 Top 100 Women of Influence. Profiles in Diversity Journal named her a 2020 Women Worth Watching® in STEM award winner. Chatman was recognized by Atlanta Magazine among the 2021 Women Making A Mark honorees and by Becker’s as one of the 75 Black Healthcare Leaders to Know 2022. She was also named the 2020 West Cobb Citizen of the Year for serving on the frontlines for Cobb County, fighting COVID-19, and collaborating with local leaders.

Chatman is deeply involved in the community, serving as board member for United Community Bank and active in the fight to find a cure for type 1 diabetes. She is a member of the American Nurses Association and the American College of Healthcare Executives. She earned her Bachelor of Science, Master of Science, and Doctor of Philosophy degrees from East Carolina University in Greenville, North Carolina.

About GHA Founded in 1929, GHA serves nearly 150 hospitals in Georgia and promotes the health and welfare of the public through the development of better hospital care for all Georgia’s citizens. The mission of GHA is to advance the health of individuals and communities by serving as the leading advocate for all Georgia hospitals and health care systems. GHA represents its members before the General Assembly and Congress, as well as state and federal regulatory agencies, and is an allied member of the American Hospital Association. For more information, please call 770-249-4500 or visit gha.org.

Keep reading
Illustration of physicians reviewing lung cancer image on a screen

Highlights

How research and faster time to treatment are progressing cancer care

This article was originally published on Atlanta Business Chronicle on November 3, 2023.

As cancer research advances, doctors know more about the keys to reducing cancer cases and driving better outcomes, like long-term survival. Prevention, early detection and treatment—an area that has drastically improved through scientific discovery—are the big three keys today. While preventative measures reduce the risk, screening for cancer before someone has symptoms can be a lifesaver when it is identified earlier and in more treatable stages. Newer, more advanced treatments and starting treatment faster are also making a sizeable impact on survival. For a closer look at how healthcare experts apply these keys in the fight against cancer, Atlanta Business Chronicle’s Market President and Publisher David Rubinger sat down with Wellstar leaders and patients for a sponsored panel discussion on the state of cancer care.

Panelists & moderator


Images and titles of lung cancer panelists and moderator

  • Dr. Bill Mayfield, MD, medical director, lung screening program, medical director, incidental pulmonary nodule program, medical director, STAT Clinics, Wellstar
  • Dr. John French, MD, medical oncologist, Wellstar and Northwest Georgia Oncology Centers*
  • Kathy DeJoseph, lung cancer survivor
  • David Rubinger, market president and publisher, Atlanta Business Chronicle

*Wellstar partners with Northwest Georgia Oncology Centers to provide world class cancer care close to home.

Keys to better outcomes

David Rubinger: Cancer is one of the top causes of death in the U.S., second only to heart disease, with 1.9 million new cancer diagnoses expected this year. The whole idea of trying to beat cancer is the common language of treatment now. We’ve really changed the conversation in many ways. Dr. Mayfield, what have been the keys to getting these better survival rates across all types of cancers?

Dr. Bill Mayfield: There are three basic components to improving outcomes and reducing cancer. Number one is prevention. How can you prevent cancer? Smoking cessation is a major way to reduce the risk for cancer, especially lung cancer. The second key is early detection screening for cancer such as colonoscopies, skin exams and low dose lung cancer CT scans.

Finally, we have treatment as the third key. We have dramatically improved treatments, especially in the last 10 years, with targeted therapies, immune therapies and precisely targeted radiation therapy. For some cancers, reducing the time it takes to start treatment can be as impactful as some of the newer cancer therapies. At Wellstar, we speed up time to treatment through our STAT Clinics.

Rubinger: Dr. French, from the medical oncology standpoint, what has specifically gone on in your world since you started practicing medicine that you think has improved these outcomes?

Dr. John French: There’s no bigger story than immunotherapy in the last 10 years. It was 2017 when Jim Allison out of the University of Texas MD Anderson Cancer Center and Tasuku Honjo in Japan won the Nobel Prize for cancer immunotherapy—the first time the Nobel in Medicine recognized a cancer therapy in decades. Wellstar and our patients participated in clinical trial development of immunotherapy for various cancers.

In medical oncology, there are also targeted therapies. In improving the survival and outcomes of patients, we do a lot of what we call next generation sequencing—tumor genomics and tumor DNA. The way I explain this is, “We’re not testing Kathy’s DNA. We’re testing the tumor itself. We are trying to find a lock and key mechanism, where if we can find what’s driving the cancer, maybe there’s a pill or a target that we can go after to take it out.”

Rubinger: Let’s move on to lung cancer in particular. Lung cancer has traditionally been known as a smoker’s disease—at least that’s how many people view it. It appears as though in the United States we’ve seen an improvement in terms of the number of lung cancer cases. Dr. Mayfield, where is the lung cancer discussion right now? I feel it was maybe one of these small victories that are going on in the cancer movement.

Dr. Mayfield: We do actually have some large victories. The surgeon general came out with a report in the 1960s that said smoking caused premature death and lung cancer. Men in Georgia started reducing their smoking about 35 years ago. As a result, we have 50% fewer male smokers and 35 years later, we’re now seeing a 50% reduction in primary lung cancers from tobacco.

Rubinger: As far as I understand it, early lung cancer is one of those cancers that has no outward physical markers that tell you you’ve got something going wrong. So as lung cancer specialists, what do you advise people to do when they’re getting their checkup? What is the process by which they should be screening for lung cancer?

Dr. French: The biggest thing you can do is if you’re smoking, stop smoking and get screened if you’re eligible. Dr. Mayfield discussed that already, but I’ll add some numbers and perspective.

Number two, if you were a smoker, understand the guidelines and recommendations to undergo screening. They updated the guidelines in 2021 that if your age is 50 to 80 and you have a 20 or more pack per year history of smoking, and currently smoke or quit within the past 15 years, then you’re eligible for screening.

By having a CT scan, you can reduce the risk of lung cancer death by up to 20% by identifying and treating cancer earlier.

Rubinger: Let’s talk to a lung cancer patient about this. Kathy, thank you for joining us. Take us briefly through your journey. What is your background with cancer?

Kathy DeJoseph: This year, I’m a 12-year survivor. Before I was diagnosed, I was a career person and I was on my computer one day and up popped information about this early lung cancer screening study that Wellstar was a part of. I had no symptoms. I had a long history of smoking, grew up with parents who smoked, grandparents who smoked, lived near a factory that was belching out junk into the air.

I was a workaholic and a mom and I saw this study and for whatever reason, I called and talked to the nurse navigator. I was like, “I don’t know whether I want to do this or not. You know, this sounds like I’m going to end up paranoid about it.” She encouraged me to participate.

Dr. Mayfield: Kathy was enrolled in the study and had three or four normal CT scans before she developed a mass. And sure enough, we jumped right on it through Lung Cancer STAT Clinic and got her treatment plan together quickly. That was the point of her being in the annual screening study.

What is a STAT Clinic?

Rubinger: Kathy, before we dive further into your treatment, will Dr. Mayfield help define the STAT Clinic? It’s not a simple thing to do. You all are very busy people and you all have individual schedules. To turn you all into this sort of troop, if you will, moving in sync, that’s a logistical nightmare for a bunch of doctors.

Dr. Mayfield: STAT stands for Specialty Teams and Treatments and it’s about bringing multiple cancer experts together to collaborate about a patient’s care and meet with them the same day so they can get treatment started quickly. We created STAT because we saw a need to do things better and to put the patient at the center of everything we do.

About 17 years ago, we opened a general Thoracic Surgery practice at Wellstar Kennestone Regional Medical Center. And we did everything like everybody else did. We had a navigator—someone who connects a person who has cancer with the help and support they need. We had tumor boards—a group of physicians and scientists who meet to discuss treatment options for individual cancer patients.

But when we looked carefully, we saw that by the time the patient’s case was presented in a tumor board, it was 58 days on average from the time the patient had their original CT scan. They had gone from a primary care doctor to a pulmonologist to an oncologist back to the pulmonologist, then had a biopsy, a PET scan and then maybe saw a radiation oncologist. It was 58 days by the time they got to the tumor board and were able to get a treatment plan started. That’s a problem. But that is the standard of care in the United States today—60 to 90 days in this workup period.

We said, “There’s got to be another way.” I knew of a clinic run by a pretty notable oncologist in another state, who brought the thoracic surgeons, pulmonologists and the oncologist to his clinic to see the patient at the same time. An oncologist and I drove up there, spent the day, asked a bunch of questions and said, “You know what, we need to do this.”

So we came back and getting those specialists—the thoracic surgeon, pulmonologist, medical oncologist, radiation oncologist and navigator—in the same place at the same time was hard.

What we decided to do is start with one hour on Wednesday afternoon. So we saw two patients one week, then 2 to 3 the next week and then 3 to 4 the next week. Then a primary care doctor heard about it and the pulmonologists heard about it and suddenly we were seeing 12, 15, 20 patients.

A few years ago we surpassed more than 10,000 patient visits in the Lung Cancer STAT Clinic. And during that time, we started the lung screening program and the incidental nodule program.

The culmination of our initiatives to identify lung cancer earlier and hasten the time to treatment has reduced our time from abnormal image to starting treatment to somewhere between 14 and 20 days, rather than 60 to 90 days. The early detection program has made it such that 40% of the cancers diagnosed at Wellstar are stage 1 and 2, when cancer is more treatable and patients have better outcomes. On a national average, just 15 to 20% of lung cancer diagnoses are stage 1 or 2. We’ve dramatically improved the ability of our lung cancer patients in our community to survive their disease.

Rubinger: It sounds like early detection and shorter time to start treatment make a real impact for patients. Kathy, let’s talk a little bit about what those things meant for you as a patient. Let’s start with when you were diagnosed. Did you have any symptoms? What happened next?

DeJoseph: I didn’t have any symptoms. Everything was fine, except for my history with smoking. The year I was diagnosed, I was going to quit the study but the nurse navigator took me out to lunch to convince me to come back—and thank goodness she did. I was diagnosed the very next day.

The biggest benefit for me with the way the STAT Clinic works is that I didn’t have to worry about whether the doctors had actually talked to each other. I didn’t have to worry about whether maybe they didn’t actually agree. All those things that I would have been worried about went away because I talked to all of them on the same day in the same place.

It gives you a lot of confidence. I thought, “Well, you know, they’d have to all be wrong on the same day at the same time to screw this up.” I ended up becoming a volunteer and would meet with newly diagnosed patients for several years. One of the biggest things that I would talk to new patients about is how STAT Clinic kept things from dragging out for months, going from doctor to doctor.

Rubinger: It sounds like STAT Clinic is meaningful to patients, not just medically, but emotionally. Is the STAT Clinic exclusively for people with lung cancer or are patients with other conditions benefitting from this model now?

Dr. Mayfield: That’s a good question. We added Lung Cancer STAT Clinics at Wellstar Cobb, Douglas and North Fulton Medical Centers. Outside of lung cancer, my neurosurgery buddy got curious. He’s saying, “Wait a minute. You know, we have this patient with brain cancer and they have to go see the radiation oncologist but your patient gets to meet the radiation oncologist at the same time as you. We want that.”

So the next STAT Clinic that cranked up was for neurological tumors. It was awesome to see that we could inspire other folks to do the same thing.

Dr. French: To add to that, we also have STAT clinics for breast cancer and head and neck cancer. All of these cancers require multidisciplinary care with doctors from different specialties who collaborate on patient care because otherwise, you have to go see different cancer subspecialists and that may take a longer period of time.

Dr. Mayfield: Here’s the dark secret about cancer care in the U.S. Dr. Alok Khorana at the Cleveland Clinic published a paper about three years ago. He studied 1.2 million cases in the national cancer database and 340,000 of those were lung cancer patients. He clearly showed that for every seven days’ delay in therapy in stage 1 or stage 2 disease, you lose 2% five-year survival. Delay in time to initial cancer treatment in the U.S. is an important risk factor for survival over time.

A first-hand account

Rubinger: Kathy, let’s come back to you for a second. So you go into this STAT Clinic. Obviously, this whole process must have been terrifying on so many different fronts.

DeJoseph: I wasn’t as terrified for as long as most people are because I had answers within a short period of time.

Rubinger: How short?

DeJoseph: I had my biopsy the next morning after the first STAT Clinic appointment. About a week and a half after that, I started chemo. That was really fast. I had surgery after chemo.

In the STAT Clinic, every doctor comes in and talks to you. You learn what their role is going to be and what the timing will be with other treatments. It all happens at the same time. I took a lot of confidence in questioning everybody on the same day and knowing they had also talked together. I knew for sure that they had, where I would have really wondered about that if had I done it the normal way—visiting multiple specialists over a several-month period.

Rubinger: I’ll be the contrarian for a second. What if I walk into the STAT Clinic and say, “Well, I’d like to choose my surgeon. I’d like to choose my oncologist. I’d like to choose the radiation oncologist I want to use for my radiation treatment.” How much flexibility do I have within the STAT Clinic to select the doctor I want to work with? Or do I have to take the ones that are assigned to me regardless?

Dr. Mayfield: That is an excellent question. You can come to us for a consolidated opinion and get your care wherever you choose. You have four experts looking at you physically and reviewing all your imaging and all your tests together, coming to a consensus. For treatment, you can use any oncologist, any thoracic surgeon, anybody you want, even if it’s within our own institution.

Dr. French: Whether we’re providing the care or simply an opinion, STAT Clinic puts the patient first. We have patients from Alabama, Tennessee, North Georgia who can’t travel here for ongoing care. I’ve even had patients who live near the Carolina border. Part of the STAT Clinic is also handling the logistics where one of these patients may need treatment closer to home. For example, someone may need chemotherapy and I say, “OK, I’ll coordinate that with the medical oncologist in your area.” When we’re done seeing STAT Clinic patients, we agree, “You call the local radiation oncologist, I’ll call the local medical oncologist and let’s get them plugged in and connected with treatment recommendations.” Again, STAT Clinic expedites and coordinates all that care. Getting the foot in the door and getting that ball rolling is half the battle.

The state of screening and future goals

Dr. French: In talking about screening earlier, we didn’t address non-smokers. If I don’t smoke, I don’t need to be screened if I’m doing my well check-up and I’m not having a cough or chest pain. There’s really no screening for lung cancer outside of those recommendations.

That being said, the other thing that you need to understand is that in the state of Georgia, we are horrible at screening people. We rank toward the bottom quartile of the entire country in screening patients when it comes to the proportion of eligible patients. The American Lung Association data ranks Georgia 35th in the nation. We screen 5% of eligible people, so we’re not capturing 95% of people who could be screened.

We know the data to support screening is there. Kathy is a living example of this. Talk to your primary care doctor about your history with smoking and the need for screening.

Dr. Mayfield has ramped up the effort to capture more at-risk people through screening, but we still need to get the message out.

Dr. Mayfield: We started our screening program 15 years ago as part of I-ELCAP—the International Early Lung Cancer Action Project—and then we broke off of the study because the results were so positive. We decided we’re just going to do this as a standalone program in our community.

As a result, over the last 15 years, we become one of the three largest lung cancer screening programs in the U.S. We have about 15,000 people in our program currently.

The problem is, we serve a community of 1.7 million in 15 counties. Knowing that 40% of those are smokers or former smokers, we should be scanning a million people a year.

Why aren’t we screening more people? We’re a part of the Georgia Lung Cancer Roundtable and the National Lung Cancer Roundtable trying to solve that problem. I think it’s going to take a national awareness campaign.

When that happens, we need to prepare our screening centers for high volumes. That will drive us from discovering more stage 3 and 4 lung cancers when people are dying, to finding more stage 1 and 2 lung cancers. Those earlier-stage cancers are much less expensive to treat from a policy and population health level and are easier to treat, giving more patients good long-term outcomes.

Rubinger: But we wouldn’t be screening non-smokers at this point.

Dr. Mayfield: There’s not enough data yet to guide us to any other risk factor than tobacco use.

What employers should know about cancer

Rubinger: Let’s talk about the business community for a second.

When it comes to the employee, when you see patients who are in full-time jobs, what role do you see the employer playing when you’re caring for cancer patients? What can employers do to help them in their battles?

Dr. Mayfield: I have a pretty strong opinion on two items. One is that employers should promote age-appropriate screenings for all cancers among their employees. Give them that half a day off if they need to go somewhere for a doctor’s appointment to get that screening exam. And as callous as it may seem, that half a day off to find cancer in earlier stages is much less expensive than treating an advanced cancer years later, from extended time off to the insurance costs associated with advanced cancer.

The CEO of the corporation, the vice president, the chief medical officer, the chief operating officer—they assume that if they or any of their employees get cancer care, they’re going to get the best care available. But unfortunately, the best care available today in most places is going to take them 60 to 90 days to get through the initial doctors’ visits and tests that at the STAT Clinic, we manage in 14 days.

My challenge to the business community is to ask their insurers and their healthcare providers a very difficult question, “How long will it take to get our employee from an abnormal finding to starting treatment?” When insurers and healthcare providers have to start answering hard questions, then we’ll move the ball.

Dr. French: I would add, when a corporation buys health insurance, it needs to make sure institutions that perform research and clinical trials are covered.

I had a patient who had stage 4 prostate cancer and there is a clinical trial using novel bispecific immunotherapeutics. The guy is young; he’s eligible for the trial. The patient signed the trial consent only to find out that his insurance doesn’t cover the medical facility that’s offering it, so therefore he’s not eligible for the clinical trial. Now he’s going to have to get the standard of care, which is good. But he could have gotten something new on a trial if it was covered by his company’s health plan.

So, companies should first make sure that employees are covered for good quality healthcare and at top facilities that perform research.

Number two is, if you’re an executive, consider supporting on-site screening. I’ve seen a lot of patients in the STAT Clinic who get executive physicals, they get a day off and they do this comprehensive testing. Lo and behold it shows something. That early detection gets them to treatment at an earlier stage when the cancer is less advanced and they have a higher chance for better outcomes.

So consider offering a half-day, a health fair or on-site health screenings as part of your company’s health offerings.

I think a healthy employee, one that feels valued and respected, will be a hard worker. If I feel that my business cares about me, my health, my life and my family, that sounds like a company I’d want to work for.

Learn more about cancer care at Wellstar. 

Keep reading
A photo of Wellstar Kennestone Regional Medical Center, the 3 Star Rating, Joint Commission C4 certification and Wellstar logo

Newsroom

Top Marks for Heart Care at Wellstar Kennestone Regional Medical Center

Wellstar Kennestone Regional Medical Center recently received two major commendations highlighting the high level of heart care continuously provided to patients—putting Wellstar Kennstone among the top hospitals in the nation. The Marietta-based heart care program received:

  • A distinguished three-star rating from The Society of Thoracic Surgeons (STS) for its patient care and outcomes in isolated coronary artery bypass grafting (CABG). This is the highest category of quality, placing Wellstar Kennestone among the best programs for heart bypass surgery in the U.S. and Canada. 
  • The Joint Commission’s Gold Seal of Approval and the American Heart Association’s Heart-Check mark for Comprehensive Cardiac Center Certification, which means Wellstar Kennestone is the only hospital in Georgia to raise its total cardiac program to the elite level. 

“This community is where we live, and when we care for our patients, we’re caring for our neighbors and friends—that’s why pursuing excellence is such a high priority,” said Steve Cermak, executive director of Wellstar Center for Cardiovascular Care & Hospital Operations at Wellstar Kennestone Regional Medical Center. “We feel it’s our duty to provide the highest level of care possible.”

Keep reading
Back to Top
Branding illustration
Wellstar Logo
More than healthcare. PeopleCare.
Branding illustration
For Job Seekers & Team
Careers Diversity Equity Inclusion and Belonging Onboarding
For Students
Students Portal
Graduate Medical Education
Medical Residency Pharmacy Residency
For Business
Corporate Purchasing
For the Media
Media Room Community Health Needs Assessment
Help
Contact Us Pay Your Bill Policy & Privacy Information Hospital Transparency Information
For Job Seekers & Team
Careers Diversity Equity Inclusion and Belonging Onboarding
For Students
Students Portal

Graduate Medical Education
Medical Residency Pharmacy Residency
For Business
Corporate Purchasing
For the Media
Media Room Community Health Needs Assessment
Help
Contact Us Pay Your Bill Policy & Privacy Information Hospital Transparency Information

Copyright © 2023 Wellstar Health System. All Rights Reserved.

Wellstar does not discriminate on, exclude people or treat them differently on the basis of race, color, national origin, age, disability, sex, gender identity or expression or any other type of discrimination prohibited by law.

Cookie Preferences

We use cookies for booking and general analytics. Learn more about or internet privacy policy.