#21 Our Champion, Noah "Rocky Balboa" Riehm!

"Round 3, FIGHT!"  It sounds like the arcade game, Mortal Kombat. (A nod to those of us who were teenagers in the 90's).  I was never allowed to have a video game as a kid (thanks, Mom) but I did occasionally sneak away to the arcade tent at the county fair.  There was the game, Mortal Kombat, where you could joystick fight your opponent with your special character.  The match always started with the round number and then "FIGHT".  The ending would always be the "Finishing Move".  

Noah, preparing for Round 2

I've been thinking a lot about Noah's 3rd and final "round", in the trio of staged surgeries that are now the standard of care for HLHS.  After a brutal first time in the ring (I guess operating table, rather), I'm remember being out on a run somewhere and my mind got to thinking about Noah's nicknames.  Maybe it's a dad-thing to rhyme their kid's names, but somehow Noah "Rocky Balboa" stuck in my head.  For halloween (a few weeks before his second fight in the OR) we even dressed him the classic American flag boxing shorts from the movie Rocky IV.  OK, maybe that's a reference for an older crowd.  But, we all know the plot of Rocky IV.  Rocky enters the ring to face Ivan Drago, the Russian that looked like an anabolic steroid machine.  The referee has them "handshake" and the Russian smacks Rocky's gloves down and says, "I must break you".  Of course you know the ending, an unintimidated Rocky displays his own finishing move to win by KO.  

You are probably more accustomed to me using the sport of running in my analogies.  However, boxing seemed more appropriate to celebrate our champ, Noah "Rocky Balboa" Riehm.  Reflecting on why I maybe came up with that name, I feel like it was God's way of helping me focus, distracting me (and others) from the pain that lay ahead.  Every boxer goes in the the ring with confidence to distract himself.  He knows there will be a punch to the face that will hurt or worse, one that could kill you.  

I know a little bit about boxing because of my time in Youngstown, OH.  There are at least a couple of famous boxers who call Youngstown home.  "Boom Boom" Mancini was one.  He has a sad legacy of incidentally killing a Korean fighter during a match. Another, is the former middleweight champion, Kelly Pavlik.  When rotating in Youngstown as a medical student, I may or may not have been involved in some of his medical care .  Can you imagine, me, a typical distance runner body, standing next to him?  We actually were not too different in stature, except, the wingspan!  I guess thats why they call him the "Ghost", his fists could reach out and hit you out of nowhere.   It all sounds scary, I think thats why there are so many big personalities in the sport of boxing. 

Noah and his surgeon
5 days after Round 3

Here is where I'm going with this, sometimes in life there are periods we know are going to hurt.  Despite this, we have a lot to celebrate, even if we fall short of our own expectation (or, expectation of others). We can proceed with confidence.  We can arise victoriously no matter the circumstance.  When you know it's going to hurt or there is going to be a tough road ahead, use a boxer's mentality to help get you through. 

I can't imagine Muhammad Ali made all those grandiose claims before a fight because he thought he was the greatest.  He was the champion because he had the confidence to prevail.  Encouragement can go a long way.  Right now we are working on re-framing Noah's "I can't" to "I'll try".  We have been working on him getting in his steps.  First walking outside his hospital room, and then down the hallway. And, now out of the hospital. His chest hurts near the incision but he fights with every breath.  He is a champion.  He just may not know it yet, he's only 3.  

The day before his recent surgery, we met with one of the cardiologist that follows HLHS patients long-term.   There are now a cohort of these patients living into adulthood without a heart transplant.  We know a lot more because of the trailblazers like kiddos born in the 80's who did not have much of a chance at life.  Thanks to persistent healthcare workers and researchers, the 0% chance has become a much more promising number.  Looking past the hurdle of the last surgery, I asked the cardiologist if Noah could run a 5k one day.  His response, "Noah can run a 10k in the future".  A marathon didn't seem too far out of the question to me at that point, but, I didn't push it.  

Whatever Noah decides to do in the future, we can be there along with our little champion.  FIGHT!