With ‘coin of excellence,’ Air Guardsman recognizes expert partnership

On Nov. 13, 2014, Delaware Air National Guardsman Barry Orbinati drove to the Middletown Emergency Department for help with what felt like a debilitating migraine.

But the pain was a symptom of a medical crisis, and because of the careful examination of Physician Assistant Manager Ed Knox, who worked in collaboration with a team of ED providers and diagnosticians, a lifethreatening aneurysm was discovered.

As a result, the 53-year-old Orbinati was immediately transported by ambulance to the Christiana Hospital campus, where he was operated on by neuro-interventional surgeon Sudhakar R. Satti, M.D., in the Center for Heart & Vascular Health. The surgery prevented a hemorrhagic stroke.

“I had a seven millimeter aneurysm that no one had caught until I met Ed Knox,” said Orbinati, who lives in Townsend. “Without his careful work, I don’t know that I would be here.”

On the eve of Memorial Day weekend, a time of remembrance for the American military, Lt. Col. Orbinati thanked the providers on the medical team that helped him. And as special tribute to Knox, who Orbinati describes as a hero, he presented the physician assistant with a “coin of excellence” bearing the Air Force emblem. In the military, such coins are given in recognition of outstanding service, expertise and accomplishment. The brief ceremony was held in the lobby of the Center for Heart & Vascular Health.

“I’ve had bad headaches for years, and without Ed Knox to discover the aneurysm, this could be a different Memorial Day for my family,” said Orbinati. “I might not be here. So it was my good luck to meet him and all those I encountered at Christiana Care.”

A soft-spoken man, Knox said he was grateful for the tribute and humbled by it. “Barry is awfully kind and doesn’t need to thank me,” said Knox. “I’m part of a large group at Christiana Care that made the diagnosis.”

Thomas A. Sweeney, M.D., associate chair in Emergency Medicine, was part of the team that helped Orbinati and also praised Knox. “It’s very easy for this to be mistaken as something harmless, but Ed Knox is very experienced, and he’s also a very special person,” said Dr. Sweeney. “He’s quiet, unassuming and he’ll listen to people.”

Orbinati said he is also grateful to Dr. Satti, who called his family prior to the surgery so they would understand what was about to happen. Dr. Satti said it was the least he could do.

“This poor guy came to the ED and had no idea he would be operated on,” said Dr. Satti. “I never like to do a procedure without talking to a patient’s family. So I called his sister, and that helped put Barry at ease.”

For Orbinati’s part, if he had more coins to give out, one would go to Dr. Satti. “My sister said he was the nicest person she’s ever talked to and had a great bedside manner,” said Orbinati. “Afterwards he had a nurse call my sister, and he later called her again.”

Orbinati is a deputy commander at the Air National Guard Base in New Castle but was sidelined by a terrible headache the day he sought help. He said it was remarkable that he could report to the Middletown ED at 1:30 p.m., be transported to Christiana Hospital by ambulance and be ready to be operated on at 4 p.m., then be in his hospital bed recovering at 7 p.m.

“I had a positive experience with everyone,” he said. “But it was Ed Knox who is my hero. He caught my problem and I will always be grateful.”