Another New Heart

I raced to the hospital, crossing the Buckman bridge after midnight well over the speed limit while making arrangements with the operating room on my cell.  I was afraid of being too late, of another exercise in futility, of another sleepless and fruitless night.  I was afraid of the need to give another end-of-life speech to a family.

The case was not hopeless.  That would not have required speed.  Or fear.  I already knew the patient’s diagnosis:  an epidural hematoma.  If his head could be opened, the clot removed and the bleeding stopped within four hours of injury, he would live.  With any delay, he would die.

As I raced to the hospital, I sought to calm my frayed nerves and slow my pounding heart.  As a person of faith, I should be able to have peace.  So I prayed.

I thought about how easy it seemed to have been for Jesus.  He never rushed, he never appeared anxious.  Lay on hands, command the demons, maybe a little mud in the eyes, and poof!  Cured.  All without time constraints.  Your servant is in the next village a day’s travel away?  No problem; go on home, he’s fine.  He’s been dead for three days?  No problem; show me the grave.  Never racing through the middle of the night uncertain of the outcome.

To be fair, I will never know what it cost Jesus to heal and give hope.  But still, even if Jesus bestowed upon me His powers at that moment, I remained certain that an epidural hematoma would need an operation.

So I prayed I would not be too late.  Because I trust neurosurgery and I don’t trust faith.  Not for this, not tonight.  I finished with something like, So, show me how a prayer for this guy does any good.

The case went well–at least for an emergency in the middle of the night.  Two hours later, the hematoma had been removed and the major bleeding stopped.  Another hour or more of surgery remained, taking care of the important but less urgent tasks: preventing re-bleeding, replacing the skull flap and closing the scalp.  This is the time when I can stop working by reflex and start thinking about what I’m doing.  And why, and to whom.

The back story filtered into the operating room.  The patient, whom I will call Zach, was a thirty-year-old cook at local restaurant who had come in by ambulance after an epileptic seizure.  Over the previous several months Zach had been in the ER three times for seizures.  Each time his anticonvulsant levels were low and his toxicology screen was positive for cocaine.  Each time, the ER staff treated him with anticonvulsants, gave him a new prescription, cautioned him against recreational drug use and sent him home.  Tonight was no different.  His labs confirmed what the staff expected: a toxicology screen positive for cocaine and low anticonvulsant levels.  A CT scan was normal.

They treated him with anti-convulsant drugs, cautioned him to re-start his prescription, avoid drugs, then sent him home with a friend.  Getting only as far as his friend’s car, Zach had another seizure, this time striking his head on the pavement.  He was carried back to the ER, but this time a CT scan showed an acute epidural hematoma.

One of the great disillusionments in medicine comes with the realization that guys like Zach care less about their life than the people charged with taking care of them.  It is easy to become bitter at two AM.  I want to ask him why the whole health care team is working, resources are being poured out, and he doesn’t care enough to take his medications and stay clean.  I want to shake him and point out to him other people who are suffering with incurable diseases while doing their best to stay alive, and would give anything to have what he is so willing to give up.

But duty and diligence take over.  We treat because we believe in the right to second chances.  And third and fourth and fifth chances–as many chances as it takes when they come in on your shift.  And I know, when I get past the bitterness, that there is a reason for the self-destruction.

Addiction.

I’ve seen lots of patients like Zach over the years.  A life-threatening illness or injury as a consequence to addictions to drugs, alcohol, nicotine, would bring them to the hospital.  A complex and expensive treatment would “save” their life, and they would be discharged only to return a few days, a few weeks, or a few months later, still addicted and now dying all over again.

Zach was dying not simply because he had bled in his head, but because his actions were beyond his control.  One mother called her son’s addiction a terminal illness.  In religious terms, he was possessed by a demon, dying of sin.

The operation saved Zach’s life.

Or did it?  Preventing death and healing are not the same thing.  If he was going to really live again, his healing needed to go way beyond the sutures in his scalp or the screws in his skull; it needed to reach all the way to his heart.

Zach went home from the hospital a few days after his operation.  I waited to see if he would show up for his post op visit in three weeks.  Surprisingly, he did.  His wound had healed nicely.  He had no more seizures while taking his anticonvulsants.  He was drug free.  We talked about addiction as the root cause of his near-death experience.  He made another appointment, and I waited.  Six weeks later, he remained seizure free, drug free, active in rehabilitation.

That night I raced to the ER, he needed an operation that I could do.  But he needed something more, something that only God could do.  Maybe He gave Zach a new heart.  I hope so.

But I know He showed me some things.  I could do an operation, but I couldn’t save Zach.  Only Jesus could do that.

And how many operations for epidural hematoma had I done by then?  Fifty?  A hundred, maybe?  How many of those patients had I prayed for?  Only one.  Jesus kept coming back to give me a second chance, and a third, and a fourth, and a fifth, as many as it took.  Because it’s always His shift.