Longtime pediatric trauma surgeon receives double lung transplant
Dr. Joseph Tepas’ life changed the day he walked into Katie Caples’ hospital room.
The 17-year-old looked like the pediatric surgeon’s own daughter, also named Katie, who was only four years older. Both were cross country runners and honor students. But Katie Caples had been in a severe car crash that left her severely brain damaged. Although Tepas would do everything possible to save her life, it would soon become clear she would never recover.
Although Katie’s brain damage was severe, many of her organs were strong and healthy. The time came for her parents, David and Susan Caples, to make a difficult decision; except they didn’t have to. Katie had made the decision for them already by signing up to be an organ donor when she got her driver’s license.
The Caples lost their little girl that day in 1998, but her brave decision saved the lives of five other people. A young firefighter received her heart, a single dad received her liver, a 9-year-old girl received one kidney, and a 30-year-old man received the other kidney. A 62-year-old grandmother received her right lung.
That was just the beginning of the impact Katie would have on organ donations. Her parents started the Katie Caples Foundation, which has educated thousands of high school students and community groups about the importance of organ donation. Every year, they support their cause by hosting the Katie Ride for Life, one of the nation’s most anticipated bike riding events.
Tepas, the chief of pediatric surgery and chief medical information officer at UF Health Jacksonville and associate dean for clinical informatics at University of Florida College of Medicine – Jacksonville, remained close with the Caples family. He, his wife and his son ride their bikes in the Katie Ride for Life every year.
But they had no idea another rider would one day save Tepas’s life when he needed an organ donation, himself.
A dedicated athlete, Tepas, 68, felt too healthy to notice his lungs were deteriorating last summer. His fitness level had masked a condition called idiopathic pulmonary fibrosis, which causes lung tissue to scar until the lungs ultimately stop working. On June 16, 2014, he felt the first signs of shortness of breath and was prescribed medication to help. A week later when the problem hadn’t gone away, he knew something was wrong. Fortunately he also knew who to ask for help.
His physician, UF Health Jacksonville Director of the Internal Medicine Residency, Jeffrey House, DO, immediately began a thorough search for the cause of the sudden health crisis. He consulted Director of Nuclear Cardiology Martin Zenni, MD, and ordered an echocardiogram to determine whether Tepas had experienced a pulmonary embolism (a blocked artery in the lungs, usually caused by a clot). The heart sonogram showed that the left side of Tepas’s heart was strong, but something was wrong with the right. It was dilated, which happens when blood flow from the lungs stalls. Then his pulmonologist Abubakr Bajwa, MD, the hospital’s chief of pulmonary and critical care medicine and sleep medicine, ordered a CT scan of his lungs. All three doctors were alarmed when they saw the results.
“Holy mackerel! There were no lungs at all,” Tepas recalls. Instead of an embolism, it was clear he had a spreading condition that was aggressively claiming his lungs.
Bajwa knew Tepas’s lungs couldn’t be cured: a transplant was his only hope of surviving. While UF Health Jacksonville is a national leader in organ procurement, it does not offer organ transplantation. Bajwa made a phone call to the Mayo Clinic in Jacksonville. Tepas was just over the age cutoff for a transplant, 65, but because of his excellent health, he would eventually qualify for the transplant list.
Tepas stopped working at the hospital and went home, unsure if he’d ever be back.
Connected to an oxygen machine, listening to talk about using a ventilator, and unable to walk across a room without losing his breath, Tepas, who leaned on his strong Catholic faith, began to accept that it was his time to die.
“I felt like I’d been put in a cage with a disease that was going to slowly strangle me. I made a pact with myself to bear it with grace and dignity, and was OK with dying,” he said. “But someone else told me she wanted me to stick around.”
His wife of almost 44 years, Jeanie, was at his side on July 16 after his condition had declined to a point that he could no longer stay at home. He would be evaluated for lung transplantation and stay in the hospital until he either received a transplant or died.
It had only been a month since Tepas started wheezing. Now, he required a battery of equipment just to make his way down the hospital’s hallway.
“It felt like we were living in an alternate reality. The whole time, you had to try to prepare yourself for what might be coming,” Jeanie Tepas said.
Her heart sank two days after they checked in when a doctor walked into the hospital room and turned off the TV. Her husband’s health was worsening so rapidly she feared he was about to be intubated, but that wasn’t the case. A 24-year-old man in Tennessee had just been pronounced brain dead. It appeared his lungs were a perfect match.
Tepas was prepped for surgery and introduced to his transplant coordinator.
“I remember you,” the man said. “You operated on my son.”
Tepas had planned to be a heart surgeon when he entered medical school, but he was recruited by his professors to pediatric surgery. He immediately found his calling and spent his career saving the lives and limbs of the youngest patients to come through UF Health Jacksonville’s doors.
Now his own life was in the hands of Cesar Keller, MD, director of the clinic’s lung transplant program. Like Tepas, Keller had ridden in the Katie Ride for Life almost every year for the past decade, but the two had never met. They agreed to someday ride in the race together.
After saying goodbye to her husband, Jeanie Tepas kept vigil in the waiting room for the next agonizing 12 hours. She didn’t know whether the lungs would in fact be a match or whether her husband would survive the surgery. Her son stayed at her side, the pastor from their church showed up with Scrabble, and a dear friend, Patti Frykberg, arrived with enough food to feed everyone in the waiting room.
Then a stranger approached her after overhearing Tepas’s name.
“He operated on my granddaughter,” she said. “We’ll be praying for him.”
Jeanie Tepas said those “angels” who kept appearing from her husband’s past gave her hope that it wasn’t his time to die.
At last, the word came that Tepas’s surgery had been a success.
Jeanie hurried to see him in his hospital room, but because she had caught a cold, she had to stay outside the door and wear a mask.
The staff removed her husband’s endotracheal tube and asked if they could get him anything, expecting his throat to be dry after the long surgery.
“I’ll never forget what he said,” Jeanie Tepas recalled, fighting tears. “He could barely talk at all, and the first word he said was, ‘Wife.’”
Today, Tepas is recovering from his surgery, but recovering may not be the right word for it. He comes to work every day. He goes bike riding with his wife. And, on April 18, he’ll be leading his own team – nicknamed “J.J.’s Brigade” – in the Katie Ride for Life.
This year, a cause that was always dear to him, organ donation, means even more.
Join Katie Ride for Life with Dr. Joseph Tepas
Every year for the past decade, Joseph Tepas, MD, has participated in the Katie Ride for Life with his wife and son Joe to raise awareness about organ donation.
This year he wants all of UF Health Jacksonville to join them in the 11th annual ride April 18 in Fernandina Beach in what has become one of the nation’s most anticipated bicycling events.
Tepas, the chief of pediatric surgery and chief medical information officer at UF Health Jacksonville and associate dean for clinical informatics at University of Florida College of Medicine – Jacksonville, will be riding with new lungs after requiring a life-saving organ donation, himself, and even more passion for the cause.
The main events are the bike rides for all skill levels, including 100, 64, 36 and 18 mile courses that promise gorgeous island coastal views. In addition, the Katie Ride includes a walk, marathon spin class, family-friendly courses and a fun run in Fernandina Beach, all to benefit the Katie Caples Foundation’s organ donor education program.
Go to katiecaples.org to learn more and register. If you would like to join Tepas’s team specifically, it is called Team Tepas – JJ’s Brigade.
“UF Health is a major source for good in our community and we want as many of us there as possible at this annual event to show off who we are and what we do,” Tepas said.
Associate Chair, Education and Quality Improvement; Program Director, Internal Medicine Residency; Performance Improvement Officer
Medical Director, Cardiovascular Off Campus Outreach Program; Medical Director of Nuclear Cardiology