Tending the tiniest hearts

The human heart is about the size of a fist, even at birth. When she was born, Peggy Drummond's heart was the size of three baby fingers, and it worked so hard to pump blood through her little body that she suffered a stroke at 19 months old.

Later a doctor looked at her CT scan and muttered, "You've got to be kidding." He pronounced her brain "incompatible with life." But other doctors, including Doctor Carol Cottrill, thought differently, and they went to work to help Peggy beat the odds.

Thirty-seven years, five heart surgeries and a regimen of physical therapy later, Peggy Drummond bounds into Dr. Cottrill's clinic in Somerset, Ky., with her mother in tow.

A freckle-faced bundle of personality, she shows off her Dukes of Hazard purse and her prized autographs from its cast. She attends a sheltered workshop, where she does piecework two days a week, and says she's writing a book. A rebuilt heart, and a full life.

Dr. Cottrill has helped mend hundreds of hearts in the tiniest patients, pulling them through with her skills and her deep faith. It's for that reason that the 71-year-old pediatric cardiologist was selected to receive Catholic Extension's Lumen Christi Award, the na­tion's highest honor for home mission work.

Many fine Catholic doctors are practicing in the U.S., but not many could claim the title of "missionary." What qualifies Dr. Cottrill is her commitment to the health of the needy in eastern Kentucky, where she runs two monthly cardiac care clinics, and her unwavering respect for human life.

Holding on to ideals

Cardiovascular problems are the single largest contributor to infant mortality associated with birth defects.
In poor and rural areas, the odds are even steeper against babies born with these defects to have a fighting chance.
But the feisty lady doctor from Cincinnati is in their corner - because she's been there herself.

Young Carol Cottrill already had three healthy children when she gave birth to her daughter Crystal in 1961. The baby had a condition known as Tetralogy of Fallot, a constellation of heart abnormalities that today is generally correctable by surgery.

But this was long before laser surgery and heart stents for in­fants were even thought of.

Crystal's mother read all she could about the workings of a baby's heart and even en­rolled in night school at the Uni­versity of Cincinnati to learn more.

Science came easily to her, she found, so she entered medical school - one of five women in a class with 102 men.

Right after the first year of med school, however, Crystal's heart gave out at age 6. Her grieving mother went back to classes two months later. Perhaps she could save others, she told herself. "You don't change your ideals because something doesn't work out for you personally."

Surgery might be glamorous, but this budding doctor found more satisfaction in puzzling out a heart defect, making a referral, and then monitoring her patients' progress over months or even years.

A fellowship in pediatric cardiology offered by the University of Kentucky Medical Center firmed up her career choice - and also introduced her to the needs of nearby Appalachia.

The UK team conducted yearly medical clinics for families living around Pikeville, a tiny town of around 6,000 in eastern coal country. It was a firsthand look at the obstacles to serv- ing the rural poor: homes without phones, families without trans­portation, sub­standard nu­trition and little prenatal care.

"I would send nurses out to find patients I knew we had to see," recalls Dr. Cottrill. "Even if it took a couple of hours to find them, we would get them there."

When the fellowship ended, she decided to settle in Kentucky permanently, but she never forgot the medical needs in this mission region.

Floating a loan

Children with major heart problems need constant monitoring. So when Dr. Cottrill opened a practice in Lexington in 2000, Pikeville Methodist Hospital asked her to set up a cardiac clinic so parents wouldn't have to make the 112-mile drive to Lexington.

Dr. Cottrill and her office staff hauled in the EKG machine, blood pressure cuffs and medical records for the monthly clinic. It proved so popular that last fall they opened a second clinic in Somer­set, about two hours south of Lexington.
The doctor now sees as many as 30 patients a day at each, not even stopping for lunch. Nobody is turned away. The office staff has been known to quietly lend gas money to a family down on its luck to reach treatment out of state. "Even if we lose money, it's still the right thing to do," reasons Dr. Cottrill.

Taking children in

The doctor's care for children extends beyond the clinical setting. She and husband Tom have served as foster parents to more than two dozen children, most of whom were born with debilitating medical conditions.

There was Max - a pound and a half at birth - whose mother was a drug addict who walked out of the hospital soon after, never to be seen again. And Virginia, who only smiled once or twice in her brief life, but whom the family embraced nonetheless.

The family used to get calls from nurses: "There's a baby here. You've got to take him/her."

A few were from Appalachia, such as Carl, a cyanotic "blue baby" from the hollers whose mother gave him up because she couldn't care for him on her own.

Carl was fascinated by the fact that the doctor's home was warm in the winter and cool in the summer. His mother's home only had a potbelly stove, lit by a single bare bulb overhead.

Carl was with them for six years, and Carol and Tom saw to it that he was baptized and re­ceived Reconciliation and First Communion. He died at age 11, though he was wise beyond his years, the couple says. He taught everyone the grace and beauty of any life, even one as brief and as fragile as his.

Usually after a young cardiac patient dies there's a conference with the parents. Dr. Cottrill dutifully goes over the autopsy. She's a doctor first, but a mother, too, and she knows that a child's death leaves a hole in the heart that no doctor can fix.

Parents "don't want to talk about the report, they don't want to talk about the disease, or the defect," she says. "They want to make very sure that someone remembers their child."

Frog socks and Nikes

Outside of the stethoscope around her neck, Dr. Cottrill could easily pass as a suburban grandmother, comfortably dressed in a pastel jogging suit, frog socks peeking out of grey Nikes. How­ever, her days are far from restful, and she has no plans to retire.

Her day starts at 7:30 a.m. with rounds at Kentucky Children's Hospital in Lexington. Then she sees patients from 9:00 until no more patients are scheduled.

Her desk is piled with medical journals, records, and thank-you gifts from patients, like a coconut painted to resemble a heart.

There's a real heart, too - a plastinated specimen taken from a pony. She's studied horse hearts to investigate why equine hearts seem to escape some of the problems that human hearts develop.

The doctor also has had a full career in teaching other doctors - and is teaching still, as she pauses in the hallway to debrief two Guatemalan med students. "I try to tell them that there is more to practicing medicine than merely taking care of people. You're setting a Christian example as well. I have a Christian commitment to go the extra mile."
And Dr. Cottrill has demonstrated that commitment, despite a schedule that would wear out someone half her age. She's regularly taken part in medical missions to Central and South Ame­rica and Africa, and she's been an active and visible participant in civic and religious organizations in and around Lexington, including Birthright, the Newman Foundation and the Diocese of Lexington Mission Board.

Talents, challenges

For the past 2-1/2 years Dr. Cottrill has worked from a wheelchair because of rheumatoid ar­thri­tis. "It's frustrating," she ad­mits. "Sometimes I wonder why the Lord gives you talents and then challenges you to use them."

Why indeed? It's a question as complicated as the workings of the human heart, but she learned long ago to trust in God and to never give up on any of His creatures.

When she's not poring over medical journals or patient re­cords, her reading tastes run toward religious writers: St. Aug­us­tine, John of the Cross, and Thomas Merton. Her faith infuses her practice. "To walk away from God is to walk into nothing," she quotes C.S. Lewis.

Despite Appalachia's crushing medical needs, she keeps an upbeat attitude, and does what she can. It was a lesson learned on one of her trips to Guatemala, where she saw a daily procession of patients, each with a more devastating problem than the last.

That trip, she vowed, would be her last - until she stepped outside and saw one of the nurses tenderly bathing a patient's feet.

"Isn't that what the Lord told us to do?" she says with a smile. "All we can do is wash feet. The rest is up to Him."