Equum Medical’s Alin Gragossian, DO, brings a unique understanding to treating seriously ill patients. She spent more than a decade honing her skills in emergency and critical care medicine. Unlike her peers she also spent a lot of time in the ICU as a patient. She had a heart transplant, and as a result of the drugs she was administered she needed both hips replaced. All before turning 33.
In late December 2018 Gragossian thought she was wrapping up a residency in emergency medicine at Hahnemann University Hospital in Philadelphia. She hadn’t been feeling well for a couple of weeks and had a bad cough. Then she started experiencing shortness of breath. A friend who hadn't seen her for a while told her she looked ill. Thinking she had some kind of flu, she decided to go to the ER where she had worked a shift the previous day, this time to get medical attention for herself. She was exhausted. “I just wanted antibiotics and sleep,” she said. One of the attending physicians in the ER told her there were signs of something serious going on and she was going to stay until it could be diagnosed.
That night, Alin went into heart failure. She doesn’t remember much after the rapid response team arrived at her bedside. She awoke intubated and on a ventilator. And then she was put into a medically induced coma in an effort to stabilize her to buy time while doctors raced to figure out what was causing her symptoms. She was taken to the catheterization lab, her heart getting worse by the minute. She was put on medications just to keep her heart pumping.
Alin was ultimately diagnosed with dilated cardiomyopathy, a condition in which the heart chambers enlarge to the point of preventing normal blood flow. If it goes on long enough, it can lead to heart failure, as it did in her case. She was finally told that her heart muscles were so damaged that only a transplant could save her. She was transferred to the University of Pennsylvania system where on Jan. 15, 2019, 11 days after being placed on the heart transplant waiting list, she was, as she wrote in her Instagram blog, “reborn with a new heart, all thanks to a selfless organ donor.”
After a few months spent recuperating in her native Los Angeles, Alin returned to Philadelphia to complete her residency, and then landed a fellowship in critical care medicine at Mount Sinai Health System in New York. “I had the opportunity to take care of transplant patients.,” she says. “It has been especially rewarding to connect with patients and families on such a deep level in the different ICUs, especially since I have been through some of what some of my patients are going through.”
Amazingly, two more surgeries awaited her in New York. She was diagnosed with avascular necrosis, first in her left hip joint and then, months later, in her right, both a result of the steroids that she had taken for the heart transplant. “I had been in so much pain for months and had no idea where it was coming from,” she says. “I thought I was going crazy. It isn’t every day that a 32-year-old with a heart transplant needs new hips in the middle of a worldwide pandemic.”
Even though her immune system was compromised by the anti-rejection drugs she had to take, she was able to use protective equipment to complete her residency and fellowship.
She could do in-person care but relishes the opportunity to work with patients and providers at many types of hospitals. “Being immunocompromised, telehealth allows me to continue to work with patients and collaborate with colleagues while at a distance which I consider a better option for my health and situation. Telehealth supports my choice,” she says of her move to telehealth at Equum.
Her experiences have changed her outlook on work and life. She has worked with the American Heart Association and Donate Life America and serves as a member of the Transplant Community Advisory Council of the American Society of Transplantation, focusing on heart failure awareness and the importance of registered organ donation.
Her lived experience has taught her the importance of establishing a human connection between physicians and their patients. ‘’No matter who you are or what you know, being a patient is not easy,” she says. “I was always so appreciative of doctors and nurses who did the little things that made my patient experience so much better, every single day.”
