The Man Whose Job Is Saving Barbaro

Dr.Dean Richardson, DVM

By Mike Jensen Inquirer Staff Writer

JOAN FAIRMAN KANES / Inquirer

Dean Richardson, 52, is the chief of surgery at the University of Pennsylvania's school of veterinary medicine at the New Bolton Center in Kennett Square.

A sinus surgery lasted 2 1/2 hours. Four more were spent taking a bladder stone out of a show horse. Dean Richardson was still at a friend's equine hospital in Florida on May 20 as Barbaro, the Kentucky Derby winner, was saddled for the Preakness Stakes.

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Richardson wasn't going to miss the race.

"He had blood all over him, and he was doing it in flip-flops, so we hosed him off," said Byron Reid, a veterinarian in Loxahatchee, Fla., just outside West Palm Beach.

The two men watched the Preakness on a six-inch screen in the hospital.

"You could see enough," Richardson said. "That's the sad thing. It was just crushing. My stomach started churning. As soon as I saw it, I knew it was a very bad injury. I knew which horse it was."

Richardson, 52, is the chief of surgery at the University of Pennsylvania's school of veterinary medicine at New Bolton Center in Kennett Square. Though he had done quite a few surgeries over the years for Barbaro's trainer, Michael Matz, Richardson didn't get on the phone right away.

"I was waiting for my phone to ring," Richardson said. "The people on site have the work to do. Then the phone calls started coming."

Within 30 minutes of Barbaro's devastating right hind leg fractures in the first furlong in Maryland, a decision was made: Get him to New Bolton. That was his best chance for survival. Thirty minutes after the horse had "catastrophically" broken three bones, Barbaro's digital X-ray arrived in Richardson's e-mail.

"I knew it was going to be a bad fracture," the surgeon said. "When I saw the radiograph, it was worse than I had hoped. I tried to sleep, but didn't succeed real well."

By Monday evening, a national newscast had the words Saving Barbaro behind the anchorman's head. But few on Saturday evening had been convinced that saving the colt was even likely.

"Nobody was about to put this horse down at the racetrack without giving him a chance at a hospital," Richardson said. "It just wasn't going to happen."

All sorts of lightning-fast, high-stakes calculations had been made at Pimlico Race Course. Jockey Edgar Prado had pulled up the horse expertly. By all accounts, the veterinarians skillfully had applied a splint to the leg. Richardson also saw something else.

"The horse's tremendous athletic ability, to pull up," he said. "Look at that tape, and the horse literally galloped on three legs for a few strides. He didn't drive his bad leg into the ground hard. That saved his life."

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There wasn't much question Richardson was performing the surgery. Never mind that he had worked on Matz's horses and gotten to know him well, or that co-owner Gretchen Jackson is on the board of overseers of Penn's veterinary school.

New Bolton's pool-recovery system made the place ideal for the surgery, and Richardson is one of a handful of surgeons, one former colleague said, equipped to tackle the catastrophic injuries suffered by Barbaro.

"I think all of us in this job who fix horses for a living know that Dean is somewhere in another space," said Patricia Hogan of the New Jersey Equine Clinic, who was his student researcher for a year.

In fact, he wrote the book on a lot of this stuff.

"All major textbooks that deal with equine-fracture repair, Dean is an author," said Alan Ruggles, a surgeon at Rood & Riddle Equine Hospital in Lexington, Ky.

Roy and Gretchen Jackson offered immediately to rent a jet to get Richardson back to Pennsylvania, but he didn't think that was a necessary expense.

"That would be like grandstanding, I thought," Richardson said.

He got on a US Airways flight out of West Palm Beach bound for Philadelphia shortly before 8 a.m. last Sunday.

"I got the back-row seat, next to the toilet," Richardson said. "If you want a real news story, [the flight] was on time."

As long as the horse's condition didn't demand earlier intervention, the surgery wasn't going to be earlier than Sunday afternoon.

"One of the big mistakes we used to make in the past: It's not generally a good idea to take a very fit horse that just broke down on the racetrack, is extremely stressed, and take them into a hospital, a strange environment, place them under general anesthesia, and expect them to wake up and act like they're halfway sane," Richardson said. "That's just putting the horse through way too much trauma."

Given a chance, he said, "they start understanding that, 'Hey, you know what, I've only got three legs to walk on. Let me figure out how to deal with it.' Then their chance of waking up from anesthesia and not injuring themselves is quite a bit higher."

The night he arrived at New Bolton, a helicopter buzzing overhead, Barbaro had calmed down considerably. First-year resident Steven Zedler saw Barbaro lie down for two naps that first night, both for about 45 minutes. The horse made sure he put his good limb underneath him.

"Horses have to lay down in order to get REM sleep," Zedler said, referring to rapid-eye-movement stage of sleep. "One day, two days, it doesn't matter. Long term, they start to get really sleepy and stumble occasionally. For him, it was just perfect. Some [injured] horses won't do it."

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A 1974 graduate of Dartmouth, Richardson showed up at New Bolton in 1979 for his internship right after graduating from Ohio State's veterinary school.

"I knew the day I met him he would be the best intern I ever had," said Midge Leitch, the surgeon in charge of Richardson's first rotation at New Bolton. "He was - he is - one of the smartest people I've ever known. He has a tremendous ability to recall and integrate information. I didn't know what kind of hands he had."

She said it was like finding a kindred spirit.

"We started arguing at 5,000 decibels," Leitch said, "to the extent, in his internship year, some of the students thought we hated each other because we argued so vehemently."

When Richardson was an intern, Leitch said, there were even staff members who were more comfortable when he wasn't around. It was a good thing, she said, that she had six years of experience on him.

"I think if I hadn't that much clinical experience, I would havebeen intimidated," Leitch said. "He is a powerful intellectual force, and it turns out he has magical hands."

He has a great sense of where the pieces go, she said, but what sets him apart is his grasp of a fourth dimension. He can see possibilities.

"He will work on cases that ordinarily would be unlikely to have successful outcomes," Leitch said.

Richardson was the reason she went into orthopedics, said Hogan, his former researcher, who got a lot of attention herself for treating Smarty Jones after his famous starting-gate injury in 2003. Hogan said Richardson's approval "still means so much" 16 years after working with him.

Now, Richardson lectures all over the world on equine orthopedics. His research on gene therapy and cartilage repair is considered cutting-edge.

"He's as tough on himself as on anybody else," Leitch said. "But he's a little tougher, so he can also take it better than anybody else. He's into the carrot and the stick. And if there isn't a carrot handy, by God, there's a stick."

There are some in his position who could - some who do - occasionally skip Grand Rounds, the weekly Thursday 8 a.m. hourlong get-together when students present their cases for critique. Richardson is there.

"The students fear his questions," said Corinne Sweeney, the associate dean for New Bolton Center and executive hospital director. "Some of them, you can see, are so delighted when they see he is out of the country. When there are no questions, somebody will say, 'Isn't Dean here?'... He even will critique their grammar."

He's renowned for remembering the name of every horse and every owner who comes through New Bolton. But they got him once, a year or two back. One of his buddies who is a surgeon made a referral, and somebody showed up with a lame horse. Richardson gave a full evaluation, but kept saying, "This looks like my horse." Finally, his residents and interns couldn't hold it together any longer and admitted it. It was his horse.

He rides his own horses, plays basketball once a week, gets angry at himself too easily on the golf course, is an avid bird photographer, and not a bad cook. His wife also is a veterinarian, in private practice. They live in Landenberg, Chester County, and have a son attending an Ivy League school.

Richardson is direct, if not always loud. On Thursday, during a relatively simple procedure to straighten the crooked legs of a newborn foal, he showed afirst-year resident how to put wire under the head of a screw properly so it wouldn't slip.

"You have to make sure you pay attention to which way you twist it," he told her, speaking evenly. "Remember, it doesn't have to be terribly tight."

At the news conference just before his surgery on Barbaro, Richardson came off as kind of brash. Asked what time the surgery would begin, Richardson said, matter-of-factly, "As soon as you stop asking me questions."

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By that time, Barbaro already was receiving anesthesia.

"I was pretty confident we were going to wake this horse up," Richardson said. "I would have said the only reason we would put this horse down - the only reason, period - would have been if I'd taken the splint off and the foot was cold and there was an obvious loss of blood supply. I would have talked to the Jacksons at that point and discussed the possibility that it might not be fair to the horse to wake it up."

Before the first incision was made, he knew the foot was warm and there were strong pulses in there. The skin was very badly bruised. If it had broken, the risk of infection would have increased dramatically.

"There's serum literally kind of oozing through the surface of the skin," Richardson said. "That's very badly bruised. But the skin isn't broken. It's about as close as it could be to being broken."

The horse was under anesthesia for almost seven hours.

"He maintained his normal body temperature throughout," said the chief anesthesiologist, Bernd Driessen. "Most, over time, get cold... . Maybe we'll find out sometime that, like Secretariat, he has an unusually large and powerful heart."

The tricky part of the surgery was repairing the pastern bone, which had splintered into more than 20 pieces.

"It would be like if you broke a china bowl and you try to put it back together but you're missing a lot of pieces," Richardson said. "So you have to fill in those areas with a bone graft, which was taken from his pelvis."

He was putting screws into some pieces barely more than a centimeter wide.

"We ended up doing what we'd planned; it was just harder than I'd hoped," Richardson said. "He had rubbed a lot of the bones together [after the fractures]. There was a polishing of the bone. Instead of nice jagged pieces fitting together, they become smooth and you can't put it together well."

He put in 27 screws and a 16-hole steel plate, asseen the next morning in newspaper illustrations all over the country. Operating-room nurse Erin Fabre - who had been listening to the race via cell phone the day before in the OR - said of Barbaro's operation: "It was one of the calmest surgeries I've been in."

"Throughout this, it isn't Barbaro really there," Richardson said of the surgery. "It's really not Barbaro. It's a horse with a very difficult fracture. It's Barbaro when I'm talking to the media. It's Barbaro when you have to face the consequences if you screw something up. But, you know, it's still the same work."

The horse is doing well. There are still risks of infection and other problems, but the real hurdle - the one that caused Richardson to call the prognosis "a coin flip" right after the surgery - is what happens weeks from now when the cast is taken off for good. The Jacksons and Richardson agree that this horse has to be comfortable.

"In the long run, I think we all think it's a 50-50 shot," said Liberty Getman, one of the residents who assisted Richardson during the surgery, holding some of the smaller bone fragments while he inserted a screw.

The only good that has come out of this, a number of Richardson's colleagues around the country mentioned, is that a linchpin of their profession got some recognition.

Not that they intend to tell him that.

"I talked to him Monday morning," said Ruggles, the Kentucky surgeon who had trained under Richardson at New Bolton. "He's an extremely competitive golfer. I told him, 'I shot 76. What did you do this weekend?' "

Contact staff writer Mike Jensen at 215-854-4489 or mjensen@phillynews.com.