Neil Thornbury, CEO (Host): Welcome to Pulse and Perspectives, the show that brings you the heartbeat of healthcare innovation and the live experience behind it. I'm your host, Neil Thornbury, CEO of TJ Regional Health. Today's episode is deeply personal to me. My guest, is my older brother and colleague, Dr. William Thornbury, a primary care physician and leader in our health system.

On April 24th, only 11 days ago, Dr. Thornbury suffered a major health event and was rushed to our emergency room. Thanks to the rapid response of our ER team, the physician leadership, immediate imaging, efficient team coordination, he's made a remarkable recovery that he will share with us today. Uh, he also shares the gratitude for a health system designed to deliver world-class care close to home, and most of all, we'll talk about the second chance at life that this experience has given him and the lessons it offers every patient, provider, and healthcare in our area. So Doc, if you will, and for the audience, I will refer to Doc as we are very close as you could imagine. So, I'm going to keep this very casual and then we'll just walk into a lot of the questions and back and forth.

But Doc, I'll turn it over to you and let you share a little bit about what occurred 11 days ago and all the details around that.

William Thornbury, MD: Well, I had had a routine day. Earlier that week I had a pretty nasty stomach virus that was going around with my children. It's been a long, long, long time since I've had a stomach virus. In my field, we wash our hands and we wash them a lot, so it's very uncommon. Maybe, five or 6, 7, 8 years before I've had a stomach virus before and I caught one from my children. And, I had worked clinic that day. I came home, I was eating lunch, and had a meeting that afternoon I was getting ready for, and I started kind of noticing that I had a little trouble getting the lunch back in the refrigerator.

I'm thinking, why am I having trouble getting this food to fit back in the fridge? And then my housekeeper, fortunately, was here and she says, well, Doc, are you feeling okay? And I said, well, I think I'm okay. She goes, well, is your, is your face drooping? And I looked in the mirror and I could see my face, but I couldn't see it drooping.

But one of the things that happens with the kind of stroke that I was having was you get an inattention on the left side of your body, where I was having the only symptom I was really having, there was some slurred speech and my left facial droop. And I didn't notice that. And I came in looking for my phone and, and I started asking about it, and I could hear myself slurring.

And my housekeeper called my wife, who immediately came to get me, and fortunately she took me directly from my home here, 5, 6, 7, 8 minutes down to the emergency room where I was immediately met by a stroke team.

Host: So Doc, you know, you come into the emergency room, obviously, and I can speak from my end. I got a phone call, in the midst of all of those things transpiring, from your spouse as well as from a couple of people that had been notified at that point and I can tell you from my perspective, it's a phone call no brother ever wants to get and certainly no family member ever wants to get.

But I can also tell you that I know exactly the protocol that goes into place when someone presents at our emergency room. And I also know all the team members and I know the physicians. And, that gave me a lot of real comfort in knowing that that's where you were going and that's where you were headed.

So tell me a little bit about kind of your process of going through, once you're here and, and all the things that you kind of recall during that time in the emergency room.

William Thornbury, MD: Well, I was having symptoms here about 1:40 or 1:45 and I would say we got to the emergency department by the time my wife got here and back, right about two o'clock. I was immediately met with a little gurney to take me from the car seat. And I was taken back immediately to the CAT scan. They imaged me immediately. In the emergency room, were seven of my colleagues, seven other physicians were actually in the emergency room waiting on me and, they immediately read my CAT scan. They said they didn't see anything on it. The team leader who is our attending physician, Dr. Carter, requested an MRI. They took me directly from the CAT scan to the MRI and imaged me immediately. And there they saw an early change. And while I was in the MRI, they actually had the medication.

We use a thrombolytic called TNKase, and that was already mixed up and was delivered to me in the MRI. And so from the time I had all of my imaging, it was read, diagnosed, and from the time I hit the door, it was about an hour and 17 minutes, which really, if you understand the way the health system works, it really could not have been accomplished any faster. By the time actually I got from there, they took me from there directly to the air ambulance. By the time I actually left the building and spoke with Dr. Carter again, my NIH score had already improved. And by the time I actually made that trip down to our partner hospital, down in Nashville Skyline, my NIH score was, I think I was probably 50 to 75% improved.

And by that night, I think I was probably about 85 to 90% improved by, and by the next morning and next day, I was 95 to 98% improved. I left, 36 hours later on Saturday morning early about 8:30. And by that time I was 99 to a hundred percent improved. I'm fortunate because I had, the two things that matter for stroke are the time to treatment.

And my wife took me there and I really owe a lot of my life to her and the time to therapy, which is thrombolytic. And so those two things were taken care of immediately here. And because of that, I not only had no motor weakness on my face, which was my problem, I never had any cognitive illness. And I've had a complete recovery within about 24 to 36 hours.

I had no residual difficulties. And actually today I was back in the clinic working the way I always have been working.

Host: Yeah, so you mentioned what in healthcare we refer as is commonly referred to as the golden three hours. And that's why it's so important to really respond anytime someone feels like they're having some form of a stroke or stroke-like conditions, is that first three hours, once you start the first onset of symptoms, it's just very important to get as many of the imaging complete, walking through the whole protocol and making sure that we get the clot buster on board in that three hour window. Not that you can't have it outside that three hour window, but that golden three hour window, the results can be remarkable. And in your situation, it really was absolutely remarkable and I was going through it not only from the healthcare, perspective as working in this health system, but as a complete family member.

And I can tell you in both cases it was very stressful, very worrisome, but at the same time, I'm comforted in, in knowing all those things efficiently took place, which give you the best chance for the best outcomes, which is what we've got.

William Thornbury, MD: I think the thing that I would want to try to communicate to the listeners was that I got an exceptional outcome and I got the exceptional outcome because we were there quickly, on time. We got the medication immediately, but I didn't get that kind of care because I was the doctor. I really got that kind of care because I was the patient and I just happened to be the patient that day.

But our health system has a stroke team that was already instituted. It was refined, it was in place and ready to function for me today, but not only for me, for the other people that are going to be behind me. All those people are going to benefit because our health system has, in my opinion, and I have a bias with this, but I think our stroke team is on par with the best health systems in the country.

I mean, having worked in some of these systems and worked around these systems, the imaging, the decision, remember, these things have to be imaged. They are read by a radiologist, over read again, by our ER physicians. We had a neurologist in place to come to a conclusion. And again, my presentation was a little atypical than most strokes, and that's what made it a little bit, uh, unusual.

But the point is, is our system is in place. And because that system's in place, I was the beneficiary of that. And so I just hope that people can understand that should this happen to you or a loved one, the immediate thing we want them to do is contact 911 or if it's necessary, put the family member into the car, transport them immediately, and let the emergency room understand that you're coming so that we can have that stroke team in place for them too.

Host: Yeah, it really is one of those situations where I wish and in this case, have an opportunity to just show the community, show the public, how important we take every single service line. And when you talk about stroke and stroke protocols, coincidentally that morning the stroke team met, they meet every quarter.

They review every case with the previous quarter, and they try to work on improvement every time we get together. And that's a probably a room of 30 to 40 people, inclusive of all our providers, physicians, team members, all kinds of disciplines. And again, our goal is to make sure that when someone presents in our hospital that we move right into motion and everything takes priority to get the best outcomes.

And we're fortunate because we are stroke accredited and we've got great partners throughout the state, and in great health systems that also support us. So it really is a complete network of people to make sure we get wonderful outcomes. So let me ask you, just taking a step back Doc on all this and having some reflection, because of an event like this in your life, will certainly provide plenty of reflection. Tell me where you're at today.

William Thornbury, MD: Well, I would say a couple things. The first thing I would say is I'm not the person I was last week. I feel like I'm kind of a mix between the character that Tom Hanks played in Castaway, the guy that was on the island. You know, he found his way back home, but he was never really the same person.

And I think there's part of that when you just look at life differently. The things that I used to think about sometimes inhibited the joy that I got out of life. Things like, you know, petty disagreements or misunderstandings or problems that were beyond me or, or weren't my problems to solve; those things don't bother me anymore.

I just don't look at the world the same way. I'm grateful for the time that I have. I think the other thing I would say is I have a part of me that is more of the Charles Dickens Ebenezer Scrooge part, which is, you know, when you finally get insight into that, how grateful you are for the life that you have and how grateful you are to do things that help others and help other people fulfill their dreams, help families get help, help our health system help our community; that ought to be the business of your life. And if you're not doing that business, then you're wasting your time.

And I just decided to double down on that, to decide that I'm going to do things that are more directed again, toward helping people and try to be more meaningful toward that. Try to be more meaningful toward the fact that, if I'm going to get a second swing at the pitch, which most people don't get, that I'm going to make sure that my life every day has the right meaning, that I have the right frame of mind, that I can help our community and our health system get better.

Because that's really why I came here, was to devote my life to improving the health system.

Host: Yeah. And I can tell you from my perspective, it's very similar. Within our family, we've had an incident like this happen with our mother, and her grandmother for that matter. So it's something we take very seriously. And, kind of leads me to the next piece of this, of, from a physician standpoint, what would you recommend just from a preventative side for folks?

What are some things that people can do to go out there and be proactive in trying to, and again, all the things we try to do, and sometimes we do everything right and it still happens, but what are some preventative things and proactive things that the listener can do, as it relates to their health and family genetics, if you will.

William Thornbury, MD: I think about my case and what it illustrated to me, and I think that there's some important lessons that our community can learn. The first thing is I think that every one of us needs to be engaged with primary care. Primary care is the crux of our health system that helps you navigate well, what part of the health system do I need? Do I need a neurosurgeon or a neurologist? Do I need a nephrologist or a urologist? It helps you understand what we need. It does the preventative work, it takes care of the minor, and then even more complex disease systems. So all of us as families should be engaged with primary care, so that we're trying to prevent those things that this miraculous health system that we have in 2025, that we can take advantage of that wonderful science because there's so much of an opportunity there that we all have that I think we need to take advantage of.

The second thing that I would want to make sure is, again, to reemphasize it for a third time that people understand is should they develop symptoms like a stroke or a heart attack, that they engage the health system immediately. That they not ignore these symptoms and say, this is not right. I need to get help and I need to get help now. And I think the last thing that, I would say, is I'm very, very grateful that we have such an excellent health system here. And what I mean by that is, having worked with the Harvard Health System and other health systems across the country, having been in and around these health systems; I can tell you that our health system is excellent. But I guess no matter where you are, there's always the mirage of the next system. Where if you're here, a lot of people say, well, I need to go over there, it'll be better. And if you're over there, it needs to, you need to go somewhere else and that'll be better, and then that'll be better and that'll be better.

And the truth of it is, it's a mirage. It's not true. That sometimes our brains try to tell us that. But, this stroke system here that we have in our hospital, is on par with the very best systems in the country. And we have it right here in our backyard. If you try to drive 30 minutes or an hour, hour and a half, you know, that time that you took to drive there could cost you your livelihood.

I'm here today because don't have any deficit. I have no deficit whatsoever, and I'm a guy with little or no risk factors. I mean, my LDL is 52. My blood pressure is 116 over 60. You know, I exercise an hour every day of my life, and I'm saying if I can have a stroke, then anybody can have a stroke.

And what we need to appreciate is, I guess sometimes you don't appreciate the gold mine in your backyard until somebody starts digging in it. And you know, we have an exceptional health system and people forget just 10, 15 years ago that we were named the rural place of the year and we were named the rural place of the year, not because we're nice or have wonderful scenery; they told us all this. So we have a lot of people that have that. He goes, no one has that health system that you all have. And to appreciate the wonderful things that our health system has delivered for us over decades, and this is decades of many, many people, spending a career, with a shared vision to accomplish these things.

And just one of the most recent ones is our stroke team, but we have a cardiovascular team that is on par and some of the best cardiologists in the country live in our community. And I'll just implore people to please take advantage of that. Because these things will not only happen to me, they'll happen to all of us sooner or later, and they'll all be challenged.

But I would encourage you to make yourself available of primary care and what our health system can do for you, and to please make access of it and get to the emergency room that we have here as soon as you possibly can.

Host: It is an exceptional point. And again, like yourself, I'm biased, but I'm also part of a group and work with a group that is dedicated to making sure that we provide exceptional care to people and take care of the communities that we feel very privileged to be able to take care of. You brought up one very important thing, and I want to make sure that as a listener, this is exceptionally important.

And I know we see these commercials, but they are, and response time is everything. And when you go out there and you see those commercials for stroke, what you see is FAST. You gotta have it. I mean, again, see if you have face drooping and you talked about that earlier. Do you have arm weakness? Are you having speech difficulty? And if you have any of those signs or symptoms, you've gotta call 9-1-1 because the time for us to be able to get within that golden three hours is important. You even just talked about heart care. It's the same thing again, if the response time is exceptional and every minute you wait that muscle, that heart muscle declines and erodes. So you want to get quick action to all of those things.

So I would agree. I think that we're very fortunate. We have an exceptional group of physicians that lead our health system and it is on par with some of the best out there because of all the programs and the time we put to making sure that we get great quality.

I'm going to give you one minute and kind of a last thought Doc. Anything else you want to share before we wrap up?

William Thornbury, MD: Well, I'm grateful to the health system that I've helped work with over my 30 year career. It saved my life today, but it's going to be saving my neighbors' lives and our friends' lives tomorrow. And I'd hope that you can take the lesson that I learned the hard way and learn a lesson from me instead of having to live it yourself.

But, you know, try to be grateful for the opportunity that you have to live every day for the things that you can do every day. To make sure you're trying to make somebody's life better every day. People that don't have it as fortunate as you might have it or that we have it.

I would try to do something productive to help someone every day and try to be grateful for the wonderful health system and the many, many hundreds and thousands of people that have worked in our community throughout three, four decades here to make this system what it is. I'm grateful to my colleagues. I would reemphasize lastly that I've been here 30 years and I've never seen a better assembly of physicians as we have now.

We have cardiologists on par with anyone. We have exceptional surgeons here. We have neurology, ear, nose, and throat, gastroenterology, I mean these, pulmonology, these, are on par with any of the best teams that we have in Kentucky and we have some of the best equipment here. And all that's because of what our community has done to build our health system. And I'm only grateful for that.

Host: Well, and I appreciate all of your time today and sharing with everyone and I can tell you from my perspective and a very personal perspective, I'm also grateful for those things. I was able to spend a little more time with somebody that is dear to me. So, in that, I just want to thank everybody for joining us today on Pulse and Perspectives.

I'm beyond grateful to you, Dr. Thornbury, for courageously sharing your story, reminding us why every second and every well-rehearsed protocol matters in stroke. If today's conversation resonated with you, subscribe on your favorite podcast platform. Share this episode on your social media.

Together we can spread this message. Know the signs of stroke, act fast and trust in a team that's ready to go. And that's what we are. I'm Neil Thornbury, urging you to keep your pulse on the future and your perspectives open and your appreciation high for the healthcare heroes who save lives every day.

Thank you and be very well.