while (my $row = $sth->fetchrow_hashref) {
      $$patients{$row->{'pat_id'}} ||= {
          first_name => "$row->{'first_name'}",
          last_name => "$row->{'last_name'}",
          pid => "$row->{'pat_id'}"
      };
      push(@{$$patients{$row->{'pat_id'}}->{files}}, $row->{'file_name'});
      $x++;
}