Cap, gown, defibrillator: A graduation miracle

June 07--A Flathead High School senior battling a life-threatening heart condition wanted more than anything to walk across the stage Friday night and claim his diploma.

Thanks to a kind-hearted cardiologist who alerted school officials, Scottie Smith got his diploma, though it happened in a hospital room Thursday instead of the high school gymnasium.

Just minutes before Scottie was flown to Spokane for further medical treatment, Flathead High Principal Peter Fusaro arrived at Kalispell Regional Medical Center on Thursday with a cap, gown and diploma to conduct an impromptu commencement ceremony.

"He's such a great kid," Fusaro said. "He's one of those kids who goes above and beyond to help others."

Fusaro said he got a call at noon on Thursday from Dr. Eve Gillespie, Scottie's cardiologist, asking if someone would be willing to present the senior with his diploma.

"We just ran up there," Fusaro said. Flathead guidance counselor Lisa Sears accompanied Fusaro. She has been working with Scottie over the past year to coordinate his class schedule around his illness and has seen firsthand how he has been a mentor to other students.

"He's beyond his years in maturity and work ethic, determination and his positive outlook," she said. "He's an amazing kid."

The abbreviated ceremony was a bright spot in what had been a very serious turn of events several hours earlier.

Scottie has viral myocarditis, a condition caused by a virus that settled in his heart a year ago. He spent a month last summer at Sacred Heart Medical Center, where doctors implanted a defibrillator in his damaged heart.

"That was his Hail Mary in case anything happened," his father, Scott Smith, said about the implanted device.

It was Smith who found his son unresponsive and barely breathing when he arrived home from his job in North Dakota on July 22, 2013. Scottie's mother, Sonja, was at work. First responders arrived within minutes and restarted his heart.

"He kept on coding blue," Smith recalled.

Scottie was airlifted to Spokane, where he was in a coma for a week as his organs began shutting down.

"They told us he wasn't going to make it," Smith said. Family members were called to his bedside, but Scottie somehow fought his way back to life and recovered.

The game plan after that was for Scottie to finish high school, enjoy the graduation ceremony and then prepare for a surgery his heart team had said he inevitably would need.

Scottie finished his last day of school on Wednesday, and just past midnight he knocked on his parents' bedroom door, saying something was terribly wrong.

"He believed he had been shocked by his implanted cardiac device, and there was a problem with the pump that provides his 24-hour IV infusion of heart medicine," Smith said. "His heart rate was off the charts and his breathing was very erratic."

After a couple of hours in the emergency room, Scottie's heart rate stabilized, but he remained at the hospital so his doctors could examine him the next morning.

The Smiths soon discovered how close Scottie had come to dying.

"As it got later in the morning a gentleman came into the room to do a device interrogation, which is fancy talk for saying that he used a computer to wirelessly connect to Scottie's [implanted defibrillator] ... a very concerned look came over his face and he explained what the interrogation revealed."

Scottie's heart had gone into ventricular fibrillation, a condition in which there is uncoordinated contraction of the heart muscle of the ventricles, causing them to quiver rather than contract properly. The data showed his heart rate had reached 300 beats per minute at one point.

"Now the real frightening thing is his defibrillator did what it was supposed to do and fired, not once but six times," Smith said.

The device can only fire six times, though, before it stops. In Scottie's case, his heart miraculously converted to a normal rhythm on that sixth shock.

"There wouldn't have been a seventh time," Smith said. "We hadn't realized the gravity of the situation."

It was clear to Scottie's medical team that he would need the prescribed surgery to implant a left ventricular assist device -- a titanium pump plumbed into his heart -- to take over the function of the heart's left side.

"This is a very serious, very complicated, very dangerous, long surgery that typically takes all day to complete," Smith said, adding on a positive note that the mechanical pump "will give him a great quality of life."

Once the device, known as an LVAD, is implanted, Scottie will be put on the list for a heart transplant. Because he has an uncommon blood type, O negative, it may take longer to match him with a heart.

Meanwhile, the Smiths are rebuilding their lives around their son's illness.

Smith works in the Bakken oil fields in North Dakota, commuting back and forth to Kalispell. Sonja had to step down from a job she loved at Mountain Meadow Herbs, working with "an amazing group of people" who went out of their way to accommodate her and her family.

She will be the caregiver for her son following the surgery.

There have been battles with the insurance company. The Smiths had put money down and were to close on a house near Spokane with the intention of relocating there as Scottie has his transplant. Then they were told their insurance won't cover the transplant, so they're figuring out their next move.

On the outside, Scottie looks like a normal 18-year-old.

"You wouldn't know anything is wrong with him," Smith said. "His amazing, inspiring attitude is so damn deceptive to what he is actually having to deal with. You've never seen anyone deal with such a garbage hand and just deal with it. He never loses his sense of humor."

There was pure joy and a little bit of a surprise on Scottie's face when Fusaro and Sears showed up for the expedited graduation ceremony.

Sears said Scottie wondered why she and Fusaro were there.

"Mr. Fusaro, what are you doing here?" he asked.

Smith said it was a proud moment when his son accepted his diploma. He and Scottie's Grandma Ruth, here from Michigan to celebrate his graduation, were the only family members to witness the event, though the flight crew and a couple of nurses were on hand, too. Sonja had gone home to gather what they needed to travel to Spokane.

"When they [Fusaro and Sears] walked in, his eyes lit up, and I had never seen a smile that big and beautiful," Smith said. "They all cheered when Scottie flipped his tassel to the other side, and we were able to get the absolute second-best thing to being able to participate in the full ceremony."

As Flathead's Class of 2014 graduated Friday night, there was at least one other graduate who had Scottie to thank for getting to the finish line.

Sears said when one of Scottie's good friends from elementary school was struggling this year, Scottie asked to have his schedule changed to be in the same class to help his friend.

"That student is also graduating this year and I'm confident Scott had a lot to do with it," Sears said. "He's such an inspiration."

Features editor Lynnette Hintze may be reached at 758-4421 or by email at [email protected].

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