A university professor collapses at his home in a Boston suburb. He can’t move the left side of his body. His speech is slurred. Someone calls 911, and an ambulance takes him to the nearest hospital. A scan shows a large clot blocking blood flow to his brain. His care team at the hospital knows what to do. He needs an endovascular thrombectomy or EVT, a specialized procedure to reverse paralysis and prevent permanent disability. But it’s only available at a comprehensive stroke center.
And getting him there takes time.
In stroke care, we often say “time is brain.” It’s not just a metaphor. Nearly 2 million brain cells die every minute a major stroke goes untreated. The faster blood flow is restored, the better the chance a patient regains normal functions and can return to their life. And the effectiveness of treatment declines rapidly with every passing minute. But the way things unfold in practice uncovers a stark reality — how the different parts of our medical system value time plays out in very real and conflicting ways…