Remembering Barbaro

Kennett Square, Pa.— Many patients leave caregivers with indelible memories, but none like this one.

Kentucky Derby winner Barbaro was one of a kind, and treating him for eight months after his catastrophic injury in last year's Preakness Stakes became a defining moment in the career of his surgeon, Dr. Dean Richardson.

Richardson says that in terms of the public and media attention he faced during "a weird confluence of events," Barbaro's case is easily the benchmark of his 28-plus years at the University of Pennsylvania's School of Veterinary Medicine. He is chief surgeon at the school's George D. Widener Hospital for Large Animals at New Bolton Center, 35 miles west of Philadelphia.

"I've worked on other horses, fancy horses, I've worked with even worse fractures, and one can get attached to any patient that's with you for a while. But nothing before even approximates this in terms of the spotlight that was on us. It was a unique experience, and I can't imagine that anything like it will occur again," Richardson says.

Barbaro left his mark on many others, too, including thousands who never knew him but were touched by his story.

Based on countless e-mails, letters and telephone calls the school received after Barbaro was put down the morning of Jan. 29, the horse might be considered a role model for courageously dealing with adversity.

And those who cared for him until the end say veterinarians can be grateful for the way he elevated public perception of the profession.

Hospital and school leaders, along with racing-industry officials, describe Barbaro's legacy as one of inspiration, hope and education that far outshines his racetrack accomplishments, even if he had gone on to win the Triple Crown as many of them believe he could have.

After his accident last May, Barbaro made good progress over several months, despite a few setbacks, but serious complications finally set in – particularly a flare-up of laminitis in his left rear hoof and new laminitis in both front hooves, leaving him in pain and unable to stand.

The distress was too much.

On Jan. 29, he was given a heavy tranquilizer and an anesthetic overdose to put him down.

At press time, there still was no official word on a burial site for Barbaro. Last month, Churchill Downs officials said they'd be "honored" to have him buried in a garden outside the Kentucky Derby Museum, not far from his greatest triumph, alongside four other Derby winners.

The fight for life

Today there is wide consensus that Barbaro's long struggle to bounce back from the gruesome fracture in his right hind leg and live out a normal life was heroic and will have long-lasting effects.

Dr. Dean Richardson: "My wife and I spent the entire Super Bowl just opening and reading letters."

"Maybe it (his fight to live) was bigger than the Triple Crown," his trainer, Michael Matz, was quoted as saying.

Few besides his owners are in better position to understand and assess Barbaro's impact on our culture than the staff at Widener hospital. They, like Richardson, have vivid memories of what it was like inside New Bolton during the 254 days Barbaro was a patient.

In interviews with DVM Newsmagazine, Richardson, DVM, Dipl. ACVS; the hospital's executive director, Dr. Corinne Sweeney, DVM, Dipl. ACVIM; and the dean of the veterinary school, Dr. Joan Hendricks, offered insight into the events surrounding Barbaro's passing and the story's far-reaching impact at their institution and beyond.

Richardson doesn't second-guess the decision to euthanize the patient, saying "that would serve no useful purpose. After much thought and discussion, we did what we believed was the right thing."

He had the support of Barbaro's owners, Roy and Gretchen Jackson, who live four miles from New Bolton Center and have been longtime hospital clients. (Gretchen Jackson is on the school's Board of Overseers.) At a news conference after the euthanasia, Roy Jackson says, "We've been overwhelmed by all the positives...Veterinary medicine learned a great deal about this kind of case. The general public was educated."

Among the tangible positives Jackson may have been referring to was the creation last May of the school's Barbaro Fund, now approaching $1.2 million and earmarked for capital improvements and for some new equipment. Its Laminitis Fund, for research into that equine malady, currently hit $200,000. The racing industry created its own Barbaro Memorial Fund to raise money for research into laminitis and other equine health and safety issues through fundraisers at the Triple Crown events; and other various scholarships, including one by Kentucky's Churchill Downs to help support veterinary students and Gulfstream Park in Hallandale Beach, Fla., worth at least $20,000, for high school students who plan to study veterinary medicine at the University of Florida.

Almost a flashback

The scene at Widener hospital on Jan. 29 was eerily reminiscent of the one eight months before, when Barbaro was rushed there directly from Baltimore's Pimlico Race Course 82 miles away.

Just as then, the somber mood of hospital staff members was juxtaposed with a heavy media presence and a worldwide flood of sympathy that continues.

"This time we had 19 radio and television stations represented, plus print reporters," says Penn Vet's Gail Luciani, communications director. "And so many condolences, just the way it was last year when we heard from so many from all over the world. Our message board again is constantly full. My own voice mailbox has a 500-entry limit and it, too, has been full."

Hendricks recalls that she was preparing to leave town Jan. 29, "but when I got the news I went back to New Bolton to find an enormous amount of grief. Faces were gray, there was tension all over the hospital — massive hugging and flowing of tears. The reception area was soon filled with flowers. There's been so much e-mail, so many cards. Some people send so many cards you begin to recognize some of the handwriting."

Human-animal bond

The condolences, Sweeney says, seem to carry a common theme, which she attributes to the human-animal bond. "So many people were saying, in one way or another, how this horse inspired them to make changes, or persevere in something, to work harder at improving their lives. They'd say things like, 'I've turned my life around,' or 'You're a fighter, so I'm going to fight my cancer that much harder,' or 'I'll try to be a better person every day.' Somehow they all were able to relate to this horse through his entire struggle, his successes, his setbacks, everything."

Of the human-animal bond, Hendricks says, "I find I've been re-phrasing the term recently as the healing connection between people and animals. This horse connected with people who never met him. He was so vigorous, mischievous – a very strong personality. How that gets across to people, connects to them, may be hard for some to understand, but it has."

Richardson concurs with his colleagues that the messages reflect the strong interaction between people and animals. "All vets are aware of this," he says. "There's an enormous segment of the population with a deeply-felt human-animal bond. And it's not species-specific. It's not just horse people, but many others — dog and cat owners, some who may not even own animals."

That's why Richardson wasn't surprised at the attention focused on his patient, himself and others at the hospital over the past several weeks.

"If you had asked me last May whether I was surprised to see this level of concern, I might have said I couldn't have imagined it. This time, though, I knew we'd be overwhelmed with messages. My wife and I spent the entire Super Bowl just opening and reading letters."

Richardson says feedback from DVMs has been "remarkably positive. So many of them – small-animal, equine vets, others – have taken the trouble to write and thank us for elevating the profile of the profession. I appreciate that, though I'm not trying to be self-congratulatory here."

Some comments were particularly touching, he says. "One letter that comes to mind was from a vet who told me his daughter got so interested in what we were doing here (with Barbaro) that she started talking to him seriously for the first time about what he does for a living. That to me was special."

Spotlight on profession

Sweeney also considers Barbaro's story highly positive for her field. "It's good for us at Penn, for New Bolton, good for the profession. This helped us – through all of you in the media – to spread the word, to educate people, about the level of care, the sophistication of care — not just in orthopedics, but for heart, lung ailments, you name it — that is available. Much of the world did not know about that.

Radiographs before and after surgery. With the locking plate system, the heads of the screws can be threaded directly into the plate. (Photos: University of Pennsylvania)

"He (Barbaro) was an avenue for education. Even people who never saw a horse- race or ever rode a horse, he drew their attention to what vets can do. That makes for a more-informed client base for the profession as a whole," Sweeney says.

Hendricks, too, finds it gratifying to see a better-informed public on veterinary care. "This story, as sad as the outcome was, makes us immensely proud to be the vessel for more people to find out just how great vets are," she says.

Hendricks is glad that funds now are in place (through the Barbaro Fund) to improve the hospital buildings at New Bolton, many of them dating from the 1970s or earlier. She has great hopes for what new research into laminitis, with funding help from the Laminitis Fund, can accomplish. "It we could even reduce the healing time to weeks, it would be such a great thing. I would love to talk to you in a decade and say, 'Isn't it great that laminitis is a thing of the past?' "

Hendricks contrasts the funding and effort that has been expended toward finding a cure for cancer over many years, to the much lower level of spending and effort toward curing laminitis. "Yet it's much more solvable than that (cancer)."

Richardson has less to say about Barbaro's impact on veterinary medicine, or what might be learned from the case. "I'm on the other side of that question," he says. "My chief concern is taking care of my patients as best I can."

He does acknowledge, however, that media attention helped raise awareness of the level of veterinary care now available, but he wants to emphasize that it's available in many locations, not just at New Bolton Center. "We're one of the best, I think, but it would be duplicitous of me to say we're the only ones who could provide this kind of treatment. There are many other fine schools and hospitals that could."

Regarding the pool-recovery system that was used after Barbaro's surgery, Richardson says that few other facilities have anything similar, "but some do have pools. None exactly like ours, but some do have them. I'm not asserting, though, that they are always needed to do good orthopedic work. There are some excellent hospitals that don't have one (pool recovery). It's a useful tool, but it's not the only way."

No cost comparison

Asked about the approximate cost of Barbaro's treatment over eight months, Richardson says "I know exactly how much it was, but I don't think it's something that needs to be made public. This horse got the same level of care, same treatment, for the same boarding cost, that any other horse would have. Veterinarians understand – your readers understand – that for what we did here the owner was charged perhaps a tenth of what a similar level of care would have cost in a human facility." Some published reports, quoting unnamed sources, said the total cost over eight months might have approached $500,000, but Richardson calls such a figure "far-fetched."

Sweeney adds, "Because people know how expensive human health care is in a hospital setting, they might assume that the cost of treatment for this horse was much more than it was. Actually, it was modest in comparison."

Richardson says his schedule is nearly back to normal, though not quite.

A typical day for him begins around 6 a.m., when he takes care of paper work and lab work (visiting Barbaro had been his first order of business). He begins his rounds of seeing patients around 8 a.m. Sometimes surgeries keep him busy the rest of the day. Fourth-year students scrub in on surgeries and help with patient care. He also has many lecture hours to second-year veterinary students in Philadelphia and to third-year students at New Bolton, and he mentors two interns and six surgical residents.

"Things aren't quite like the pre-Barbaro days just yet," Richardson says. "I'm a busy person anyway, but there's still a lot of press people and others who still want to talk about it. I try to be as responsive as I can. When there's so much general concern – all these letters, people sending money to the Barbaro Fund, all of it genuinely heartfelt – well, I can't just walk away from that."