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Miracles Deferred

Snow quiets a city like New Haven, especially at night.  Traffic slows, tire sounds and footsteps muffle.  Even the sirens seem softer.  Silent night, I thought.

It had already been a long day when I lay down in the call-room and closed my eyes, grateful for the quiet.  The time was just after midnight and it looked like I could get in six hours of sleep before the alarm and the chaos started again.

I heard a pop.  My eyes opened, and I thought gunshot.  The noise had come from somewhere out in those downtown streets where all the other sounds had been muffled.  I re-calculated my expected rest time to how long it would take for police to clear the scene, the ambulance to arrive, and the victim be transported to the ER.  Forty-five minutes maybe.

Then I closed my eyes again and tried to convince myself it was nothing.  A car could have backfired, I told myself, but I knew it wasn’t true.  I had heard handguns and I had heard cars.  This was a gunshot.

Then I reassured myself it was someone else’s problem.  I had heard only one shot, and whoever they were 1) could have missed, or 2) could have hit something other than the head or spine.

I dozed off.

Forty-five minutes later the phone rang.  The intern in the ER had a young man with a gunshot wound to his shoulder who wasn’t moving his legs.  X-rays were still pending, but maybe I could come and take a look?

By the time I arrived the x-rays had been done.  The bullet had entered the shoulder but skimmed along the top of the scapula and lodged in the middle of the thoracic spinal canal, a place normally reserved for the spinal cord.

I talked to the victim.  Apparently the issue had been a card game; he still swore he hadn’t been cheating.  His spinal cord injury was complete: no sign of any function in either lower extremity–no movement, no sensation, no reflexes.

I called our director for spinal cord injury, and he agreed with me that the prognosis for recovery was nil, but scheduled the patient for emergency surgery to remove the bullet and seal the wound to prevent infection.  I assisted in the surgery.  We opened the spinal canal and retrieved the bullet.  The cord was completely destroyed.  I remember the clank as the bullet dropped into the metal basin.

I didn’t see the patient again for five years, and would never have seem him again except for a quirk in the department schedule.  I had finished my residency, but was still on the payroll for another month.  The department chairman figured I could do some work in our research lab and specifically get some of the difficult data into our database for long-term outcomes of spinal cord injury.

The secretary gave me a file for a patient in Bridgeport, a bad neighborhood in a bad city.  The patient hadn’t been seen by our department since discharge to rehab five years before.  Although nobody thought his outcome would be anything except complete paralysis, an exam had to be done for the data to be entered.  I headed to Bridgeport.

The man who answered the door was the same man who hadn’t cheated at cards.  It had been five years, but it was clearly the same guy.  I remembered him specifically not only because I had reviewed the record but because I remembered hearing the gunshot that had paralyzed him.

The surprise was that he wasn’t in a wheelchair.  Yes, he had a wheelchair in the back corner of the living room and used it when he went out, but he got around the house on his own two legs using a cane or balancing himself on the furniture.  Though his gait was nowhere near normal, he walked sufficiently for self-care at home.

What I witnessed was a bonafide medical miracle.  Gunshot wounds to the thoracic spinal cord always, always, always result in complete paralysis.  Victims never walk.

But since that exam in Bridgeport, I never say always and I never say never.  I was humbled into allowing room for hope in every hopeless case.

I would like to claim that this miracle occurred because of radically new medical or surgical care, and I know he received good care–but only the same care that everyone else who never did walk received.  I would like to claim he was healed by the intervention of prayer and faith, but the card-player never mentioned it, and back then it never crossed my mind to ask.  So I have no explanation, or even a testimony, but that’s what miracles are always: unexpected hope without explanation.

But without hearing the gunshot on a quiet winter night five years before, I wouldn’t have remembered the circumstances and understood that what I saw later was a miracle.  I would have just filled out a form for the research project and been oblivious.

So here’s the curious thing about some miracles: you might not know you are witnessing the beginning of a miracle.  You might not get to see the end of the story.  Or, conversely, you might be witnessing a miracle, but because you don’t know the backstory, you don’t know it’s a miracle.

Sometimes God gives us signs, though.  To me he gave the sound of a gunshot on a silent night.  To shepherds outside of Bethlehem, He sent an angel.  To men who searched for the truth, he gave a star.  He sends us signs to remember so that when we are privileged to witness another sign five years later, or thirty years later, we will know it for the miracle it is.

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