The Death-Defying Case of the Secret South Pole Patient

How a UTMB surgeon, via telemedicine and in person, helped save a gravely ill man

In early September 2003, local and national news programs were abuzz with a tale about a medical crisis set in the frigid Antarctic terrain, where blizzards abounded and temperatures plunged to ninety degrees below zero. The drama focused on the ordeal of one of the fifty-eight scientists and support staff members at the United States’research facility at the South Pole who had a potentially life-threatening but as of then undisclosed illness—gallstones and a dangerously infected gallbladder.

Because of the harsh Antarctic climate, the news stories said, the sick man’s departure was delayed for nearly a week. The reports hinted that there might be no way to rescue him in time from the Amundsen-Scott South Pole Station and bring him back to the developed world for emergency treatment. In fact, it wasn’t clear to doctors whether the patient would survive until late October or the first week in November, when flying conditions were expected to improve. His only hope lay in a break in the notoriously treacherous Antarctic wind and blowing snow. Luckily, the weather turned cooperative, and it ultimately permitted a deHavilland Twin Otter turboprop airplane fitted with skis to land on open snow and ice on a runway that had been painstakingly groomed for four days by snow machines and illuminated by improvised smudge pots to direct the plane toward the landing site.

Meanwhile, back in the United States, a bevy of reporters for CNN, MSN, ABC, and myriad other news outlets speculated, with studied vagueness, about the patient’s condition and where he might be taken for treatment should the evacuation succeed. All this discussion occurred in the midst of a virtual fact blackout: the man reportedly wished to remain anonymous and didn’t want the media to discuss the details of his case.

Finally, details began to leak out when reporters got a tip from the manager of an ambulance company in Punta Arenas, Chile’s southernmost city. A second Twin Otter had flown the patient to Punta Arenas from Rothera Air Station on the Antarctic coast, tag-teaming with the first Otter that for ten hours had ferried the patient from the South Pole to Rothera. In Punta Arenas, the man had been put on a Lear jet bound for Houston. The patient’s name was Barry McCue, and the world learned later that he was a fifty-one-year-old environmental health and safety coordinator for Denver-based Raytheon Polar Services Company, the logistics contractor for the U.S. Antarctic research program. Hearing the news about the Houston destination, some reporters speculated that one of the hospitals in the Texas Medical Center there was the patient’s ultimate destination.

What the media did not know was that, behind the scenes, Dr. William H. Nealon, the UTMB professor of surgery who had been consulting via telemedicine since August 26 with McCue and Dr. William Silva, the single physician in residence at the South Pole station, had discreetly begun preparing for McCue’s possible arrival in Galveston along with hospital staff working to ensure his privacy. Although Nealon had been treating the patient via telemedicine for nearly four weeks, other doctors elsewhere in the world could have handled McCue’s case competently. In fact, eight physicians—from Denver, Baltimore, and Boston as well as Galveston—had conferred early on via teleconference. They all agreed that gallstones were causing the intense pain that, when it first struck, made McCue feel like he’d been hit in the stomach with a two-by-four.

It was Nealon’s prior involvement via telemedicine with McCue’s case and his expertise in diseases of the pancreas, bile ducts, and gallbladder that prompted the patient, his primary care doctor at the South Pole, and officials at Raytheon to choose the Galveston physician. McCue (who dropped the request for anonymity after his treatment at UTMB and subsequently spoke widely to the media) felt comfortable with Nealon. “The patient had gotten to know me and Dr. Silva at the South Pole had gotten to know me,” Nealon later explained, “and there was essentially a doctor/patient relationship sustained over eight thousand miles that they wanted to honor.”

When McCue finally arrived at UTMB after forty-five hours in the air, Nealon and his team were ready for him. Almost four weeks after Nealon first dealt with the case, the situation was indeed potentially lethal—on that point, at least, the media was dead right.

After McCue got a brief rest, Nealon and his team performed a minimally invasive procedure called a laparoscopic cholecystectomy to remove the nearly destroyed, massively infected gallbladder. Complicating the procedure, however, was the fact that adjacent organs and tissues had enfolded themselves around the gallbladder to sequester poisonous tissue from the rest of the body. This resulted in distinct tissue planes and required extra care to separate these tissues from the gallbladder before it could be removed and to protect those tissues from injury in the process.

All this discussion occurred in the midst of a virtual fact blackout: the man reportedly wished to remain anonymous and didn’t want the media to discuss the details of his case.

“We performed the gallbladder operation without a problem,” Nealon said. He fulfilled a request of McCue’s, which was to take pictures of the procedure. “The picture of the dead gallbladder was very impressive to him,” Nealon said.

Next, Nealon performed a procedure known as an endoscopic retrograde cholangiopancreatography to remove stones from McCue’s bile duct, the presence of which had put his pancreas at risk. After that, McCue’s body began to heal. Just a few days later, he again was on a jet plane, this time headed to a daughter’s home in Chicago, where he would recuperate.

Throughout his hospitalization, reporters called UTMB asking if the institution knew where McCue was being treated. But the privacy request and federal regulations contained in the Health Insurance Portability and Accountability Act (HIPAA) precluded UTMB representatives from even confirming whether he was a patient, much less from releasing any details of his treatment.

When McCue was released and lifted the request for privacy, he granted interviews about his harrowing experience with the New York Times, the Chicago Tribune, “The Early Show” on CBS, CNN with a televised interview with Paula Zahn, and many other news outlets. When he spoke of UTMB, McCue remembered his stay there almost fondly. “If it wasn’t for getting surgery, stuff poked into me at all hours, and feeling really crummy after it was removed, I probably would have had fun,” he said. “You really do have a great facility and the best people.”