One soon-to-be physician, Kevin Guzman, OMS IV, of Georgia Campus–Philadelphia College of Osteopathic Medicine (GA-PCOM), has learned first-hand what it’s like to be the loved one of a patient at the same time he’s undergoing the didactic and clinical training required in medical school.
Guzman and his fiancee, Alyssa Ouano, both 25, met in 2009 when they were a freshman and sophomore in high school, and they’ve been a couple ever since. They graduated from the University of South Florida in Tampa, Florida. Guzman obtained a bachelor’s degree in cellular and molecular biology and Ouano got a health sciences degree. It was Ouano who encouraged Guzman to apply to medical school.
“Alyssa pushed me to become a doctor, “Guzman said. “I wanted to be a paramedic. Alyssa thought I had what it takes to be a doctor.”
Between the time Guzman graduated from college and started medical school, Ouano was diagnosed with IgA Nephropathy, a kidney disease that results from an antibody called immunoglobulin A (IgA) lodging in the kidneys. The subsequent local inflammation can make the kidneys unable to filter wastes from the bloodstream.
Health scares complicate original plan
The decision was made for Ouano to receive a donated kidney from her father “before her kidney function declined to the point of failure,” Guzman said. However, a week before the transplant, doctors found a mass in his kidney.
“She saved her father’s life because of the work-up required to donate,” Guzman said. Her dad was diagnosed with stage one renal cell carcinoma and is now cancer-free.
“I wasn’t compatible,” Guzman said, “so Alyssa started dialysis the same week I attended orientation at GA-PCOM.” The complications soon began. Guzman recalled, “We tried to make things easier for her to do dialysis at home, but unfortunately because of the surgery to put a catheter in her belly, she ended up with a blood clot in her lungs, and then her heart failed.” That meant Ouano was taken off the transplant list.
“Alyssa’s heart was at 20 percent, which meant she was ineligible to receive a kidney because her heart wasn’t able to withstand any kind of surgery. We had to wait for her heart function to go back up to 35 percent,” he explained. “This occurred during my first year, second semester of medical school.”
The two were living together and Ouano’s dad also moved in to help take care of his daughter. She continued on dialysis for two years until she became eligible for a transplant. In the meantime, Guzman had been learning about the paired kidney exchange program.
Finding a match
“Since we’re not compatible, they put my blood type and her blood type in a nationwide database, so every week they run the program and find the best match possible,” Guzman explained. In March 2017, a match from Michigan was found. “In exchange I would donate on her behalf to a separate family in Michigan. They would exchange to another family in California. At least ten families were matched down the chain.”
The transplant surgery was planned for April 2017. Guzman would donate in the morning. Ouano would receive a kidney in the afternoon. However, the person receiving Guzman’s kidney became ill, so his surgery took place in June of 2017.
Guzman reports that both he and Ouano are healthy. “She has her kidney. It’s fully functional. We’ve done a year of follow-up.”
The health crisis unfolded during a time that is often described by most medical students as very stressful. “I honestly don’t know how I did it,” Guzman said. “Ultimately it was me saying I can’t let her down. Just get through it.”
Despite the tumult, the couple have had some fun along the way as well.
Guzman proposed to his fiancee in September of 2015, during his first year of medical school. Their wedding will take place in 2020 “when I’m getting paid and not paying tuition,” he said.
The director of marketing at Piedmont Atlanta Hospital heard their story as Ouano’s transplant surgery took place there. She knew the producer of the TV reality show “Say Yes to the Dress” and arranged for the couple’s story to be told. Guzman and the show surprised his fiancee with a donated wedding dress and a visit from Ouano’s best friend from high school who flew in for the filming.
With graduation planned for May, Guzman said, “I always have Alyssa in the back of my mind when I work with patients. How would Alyssa feel if I neglected to ask them a question? I don’t take things that patients tell me for granted.”
With plans to specialize in internal medicine, Guzman said, “Ultimately, I feel that this experience will make me a better doctor. I’d go through the torment again if I knew I was supposed to experience this to help more people.”