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Ray of Hope

Dean

I drove home from the emergency room at 4AM feeling tired, frustrated, and depressed.  As I angled off Beach Boulevard onto Hogan Road I passed a low, triangular-shaped black building topped with a cross formed by lighted letters.  Horizontal letters read Jesus Saves; Vertical letters proclaimed Jesus Heals.  Nobody believes that, I thought.  Otherwise the ambulance would have come here instead of the ER.  And I wouldn’t have blood on my shoes.

The victim that night was a twenty-one year-old man named Ray.  He had been in a single-car accident after midnight and looked brain dead on arrival.  He had been intubated in the field, was now on a respirator without motor tone or reflexes, and his pupils were fixed and dilated.  But he was drunk and hypothermic, so an official diagnosis of brain death could not be made.  Resuscitation continued.

A CT scan showed a diffusely swollen brain and multiple facial fractures.  He was placed on a respirator, given heating blankets, IV fluids, anticonvulsants, steroids, antibiotics, a room in the ICU, and little hope.  Blood dripped onto my shoes when I drilled a small hole through his skull to place a tube to monitor the pressure inside his head (the ICP).

I left him in the ICU after giving his nurse instruction on his care then looked for family or friends.  No one.

Driving home I felt like I’d performed a great exercise in futility.  Ray’s prognosis was dismal.  If he survived (an unlikely event in my estimation), he would likely be left with severe brain injuries and exist (at best) for a few years institutionalized in a neuro-vegative state.  I wished the ambulance had taken him to the faith healers; the outcome was likely to have been the same.

After a few hours of sleep I returned.  Ray’s temperature had been restored to normal and his alcohol level had fallen below the legally drunk range.  His ICP was controlled with minimal intervention, but his pupils were fixed and he still had no muscle tone or reflexes.

Again, he looked brain dead.  But since he was sedated for the respirator, an official diagnosis could not yet be made.  I felt as if I was not so much treating Ray as I was keeping his organs viable as a possible transplant donor.

This morning Ray’s parents were in the ICU waiting room.  I went to meet them and steeled myself to deliver bad news.

The first thing I noticed was they were surprisingly well dressed–he in a coat and tie, she in stockings and heels.  The second thing I noticed were the little gold crosses–one on his lapel, another on her necklace.

I told them what I must while their eyes searched me, listening carefully for the words I knew they wanted to hear–okay, recovery, rehabilitation–words I did not speak.  I said coma, paralysis, brain damage, blindness and, yes, even death.

Then we faced each other, silent for a moment.  Her face begged for better news; tears welled up and overflowed, creating fall lines in her makeup.  He studied me and asked about chances, searching for the thin comfort of statistics.  “I know you can’t say for certain,” he said.

“Less than fifty-fifty,” I replied.  It was worse than that, but I was unwilling to lie but didn’t want to hurt them more than necessary.  It was the best I could do.

“When will you know?” he asked.

“A day, a week, a month,” I said.  “I don’t know.  Everyday he lives, he’s beaten the odds.”

“There’s hope?”

I pause.  I am careful dispensing hope.  Too much is a lie called false hope.  Too little is another kind of lie.

“His response to the treatments we started last night gives us some hope,” I said cautiously.  Some hope.

His shoulders dropped a fraction, perhaps shrugging off the worst, but his eyes narrowed as he continued to fix his gaze on me.  She breathed now without sobbing.

“If he continues to get better there will be room for more hope,” I say, dispensing the possibility of more hope.  “But if he gets worse…”

“Yes?”

“If there is no hope, I will tell you.”  The possibility of no hope.

He nodded.  She sniffed.  “We will pray for him,” she said.

“And for you, too, Doctor,” he said.

“Thank you,” I said.  I wished without much faith that the prayers would help.

I’d like to report that I went back to the ICU and witnessed a miracle healing.  But it was not so simple.  Ray had a rocky course, fighting for his life for the next month.  His ICPs gradually came under control and he was weaned from the respirator and sedative medications.  He woke from his coma and, although his vision was impaired from bruised optic nerves caused by the skull base fractures, he was otherwise neurologically intact.  Then, a few days later, he had an attack of meningitis–a complication from his basilar skull fracture.  After a course of antibiotics, he required an operation to seal the cerebrospinal fluid spaces and prevent another bout of meningitis.

But he exceeded my expectations.  He recovered and was discharged home walking and talking.  Eventually, he made a near complete recovery and has led a normal life, left with only a moderate visual impairment and a well-controlled seizure disorder.

As I look back, this was when I started to wonder if the prayers helped.  At the time, I thought he got better because of good neurosurgical care.  But he looked dead, I thought his care was futile, and, in spite of my expectations, he lived.

Later, when he came in for office appointments, Ray always wore a little gold cross somewhere, usually a pin on the collar of his shirt.  It made me remember the night I had no hope and the lighted cross I saw.  Jesus Saves, Jesus Heals

Could the faith healers at that little black triangular-shaped building have done better?  Almost certainly not.  But I know now that there is room for both kinds of healers.  Some are called to don latex gloves and get blood on their shoes; others are called to fold their hands and fall on their knees.  Ray needed both.

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