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Resurrection

Healing is the great intersection of faith and science, the eternal and the incarnate, where hope and truth are inextricably entwined.  Names and identifying details have been changed to protect patient confidentiality, but the stories are true and deserve to be shared.  Here’s the first:

I stood at the bedside in the ICU of a patient I’ll call Sandra.  I had run out of options, knowing the battle was lost and wondering why.  I wondered who would mourn her death, why a capable, attractive young woman would disappear, a death notice in the local paper, a vacancy to fill at work, an abandoned apartment somewhere.  I wanted to weep for a life lost before it appeared to have been lived.  I wanted to shout in frustration over the operation that had seemed perfect yet turned out to be lethal.

I had met her two weeks before.  She was thirty-seven, single, without children, and worked as a manager at a dental office in a nearby city.  Recently she had a severe headache at work followed by collapse and evacuation to the nearest emergency room.  A CT scan and subsequent MRI confirmed a colloid cyst of the third ventricle.  She appeared in my office the next day with the scans and a world of questions.

A colloid cyst is uncommon but benign in terms of malignancy.  Yet for some, like her, the cyst causes a potentially lethal obstruction to cerebrospinal fluid (CSF) circulation, leading to headache, loss of conciousness, and frequently sudden death.  As we talked she described headaches that were becoming increasingly frequent with two other episodes involving a brief collapse and loss of consciousness.

I recommended surgery.

A few days later she underwent an operation that seemed to go smoothly.  She awoke with minimal headache and transferred to the ICU with a ventricular drainage tube to monitor her intracranial pressure (ICP) and drain CSF if necessary, a common post-op precaution.

Eight hours later her, ICPs went up.  Initial treatment with CSF drainage brought the pressure back to normal for a few hours.  Then the ICP rose again to dangerous levels.  Post-op CT scans showed an inexplicably swollen brain.

The swollen brain caused a severe headache, then confusion.  Without dramatic treatment she would soon lapse into a coma and die, exactly the thing the operation was expected to prevent.  Anesthetic levels of sedation, control of her breathing, medications to reduce brain swelling were all used with only temporary benefit.  Artificial coma by use of high-dose barbiturates and hypothermia (lowering her body temperature) were used as desperate measures–again with only temporary benefit.

Now, as I stood by her bedside, she was in coma on a respirator and, by the only measurable criteria, brain dead.  Brain death is usually diagnosed by a clinical examination that shows no sign of brain function coupled with an EEG showing no activity.  For the diagnosis to be accurate, the patient must be free of sedative drugs and have a normal body temperature.  Since Sandra was sedated and cooled, the brain death diagnosis could not be made by the usual means.

But neurosurgeons and those who care for patients in coma from increased ICP know that when the ICP is equal to the systemic blood pressure, the blood cannot circulate in the brain and the brain cells die rapidly from lack of oxygen and nutrition.  A clear record of ICP equal to blood pressure for several hours also demonstrates brain death.  This was Sandra’s situation.

In despair, I laid my hand on her bandaged forehead.  I talked to Jesus.  I told Him how I couldn’t see this death as a good thing, how that even if He has a bigger plan, her life now couldn’t exactly be a bad thing.  I confessed that I lack any proximity to perfection and may have messed up my life, and may even have messed up the operation.  But as far as I can tell, I did the best operation I knew how to do without a known error and gave her the best post-op care available.  Why take out divine retribution on this innocent woman?

I reminded Him that once He raised the dead, like Lazarus.  Maybe He still did.  I told Him that this one didn’t even have to be a big publicity stunt; I was the only one who knew she was dead.

I stood there for another moment, one hand on her forehead, another on her arm, hoping to hear from heaven, but expecting nothing.  I raised my eyes to the monitors.  They beeped the same lethal numbers.   I turned to leave the room.

Her nurse stood at the door, chart and clipboard in hand.  She tilted her head, curious, as if seeing something she had never seen before.  “Were you praying?” she asks.

I wanted to say no.  Because I’m a doctor, a scientist.  But I said, “Yes.”

I left the ICU and saw hospital patients with more mundane problems, then went to the office to see more patients, all of whom were suffering to one degree or another but were still blessed with the illusion of their own immortality.  For the next several hours I expected to be interrupted at any moment by a call from the ICU telling me that Sandra’s ICP was out of control again.  The ICPs had to be out of control, and the nurse should be calling to ask what else to do.  I had no answers, but I still expected the questions.  Finally, I phoned the ICU to speak to the nurse.

“The ICPs are normal,” she said.

I didn’t believe her.  Prayers don’t reverse brain death.

Not trusting the nurse, I left my office and returned to the ICU to see for myself.  I checked lines and re-calibrated the ICP monitor.  Still normal.  Blood flow to the brain was now restored.  Her pupils were constricted due to the barbiturates, but they were reactive to light, a sign of life.

The lethally uncontrolled ICP was now controlled.  Still, whether the ICP would remain normal as her body temperature returned to normal and the barbiturates were discontinued remained unknown.  More importantly, had irreversible brain damage already occurred?

I left orders to discontinue the cooling measures.  By the following morning, the ICPs had remained normal and I discontinued the barbiturates.  Next, she was weaned from the respirator.  Finally, the ventricular drainage catheter was no longer necessary to monitor the ICP.  I hesitated to remove it, having spent ten days worrying over each pressure reading.

But she had awoken.  Weak and confused, she could speak and move all her extremities purposefully.  Her vision was normal.  Her wounds from the original surgery seemed healed.  I pulled the ventricular catheter.  A few hours later she started out of bed for the first time in two weeks.

In a few days she was transferred to a rehabilitation hospital, and three weeks later she went home, aware of her life, but unaware of her resurrection.

I have a scientific theory on what post-op complication led to the uncontrollable brain swelling.  Possibly a large vein had a thrombus that formed at the time of surgery and resolved spontaneously a week later, the morning I prayed for her.  Perhaps she did not suffer extensive brain damage because of the protection offered by barbiturate coma and body cooling.  Perhaps the important faith was not in God but in the power of medicine.

But then again, if you ask God for a miracle and it occurs at the very moment you ask, can you honestly tell yourself it was a coincidence?

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3 thoughts on “Resurrection”

  1. Dean, thanks for sharing your stories. As you may remember, my grandson Jason and I went on a mission trip to Costa Rica which you led. I believe it was the year 2001 or 2002. When we were hiking in the mountains I found I was unable to keep pace with the rest of the group and fell behind. Jason dropped back to stay with me. Then the group stopped to let us catch up. I had no idea why I couldn’t hike any faster and I had no pain or discomfort. Other than this I had no problems during the mission trip.

    A short time after the mission trip I started having similar problems and felt the Holy Spirit telling me my heart wasn’t getting enough oxygen. I went to our family doctor who questioned me about my symptoms. I told him what the Holy Spirit revealed to me, but had no pain or other observable symptoms. My doctor, a Christian, said “I think you may have something there”. He sent me to have a nuclear stress test ASAP.

    I flunked the stress test, was given a handful of Plavix pills and told to report to St. Vincent’s hospital the next morning. Knowing I may be facing heart surgery or at least a stent or two, I recalled visiting a dear friend in the same hospital several months earlier when he was recovering from open heart surgery and progressing nicely. He told me if I ever faced heart surgery to be sure to have Dr. Lee as my surgeon. I thought to myself, “Fat chance of that ever appending”.

    But now I was in the same hospital, probably facing surgery, and felt it was too late to make arrangements with Dr. Lee. The doctor who sent me to the hospital would not be present because it was his day off. I was sent in to have heart catheterization, but I was too far gone for a stent or stents because I had five substantial blockages , the worst being 99%. So I was sent for open heart surgery. But, because of all the Plavix in my system, I would have to wait until the next day, Friday.

    But the designated surgeon wasn’t available on Friday, so anther surgeon had to be called in. Later that afternoon while lying in bed, the door opened and in walked a large Asian fellow. He extended his hand and said, “Hi, I’m Doctor Lee and I will be your surgeon tomorrow.” Dr. Lee was the fifth of the designated physicians to attend me after the other four were unable to perform. I was instantly aware that this was no coincidence and that God had sent for Dr. Lee.

    The next morning in recovery, after having five bypasses, I actually felt wonderful because I was aware that my heart was getting enough oxygen again. As soon I was able to receive visitors I was deluged with visits from my family and other Christian brothers and sisters–fellow church members, Cursillistas and fellow volunteers from the Kairos Prison Ministry. Then, in walked Bishop Gallione of the Diocese of St. Augustine, who happened to recognize my name posted outside the door–another God-incidence. I had only met him once, two months earlier when I was one of five Protestants attending a Catholic Bible study he led.

    The next morning I was directed to take a short walk if I felt up to it. I was told to follow the signs posted in the hallway describing the route. After passing the first couple of signs I saw no more of them and kept on walking, feeling well and that I was probably still on course. After walking all over the hospital I was tracked down because I had failed to return to my room, and had became the object of a frantic search. But I was no worse for the wear and feeling just fine, knowing God was with me. It happened that the remaining course signs had been removed by painters who were painting the hallways!

    To make a longer story short, I made an amazingly rapid recovery, feeling the presence of the Lord all the way, and have never felt better in my life. Twelve years after my surgery I am now 79 years old and still in great shape (as far as I can tell) and have nothing to fear, knowing God is ever with me as I try to serve Him daily.

    Another God-incidence — ten years ago my wife and I became charter members of a new church, the same one your son Adam and his wife Leslie joined shortly afterward. We regularly worship together at the same service and have become good friends.

  2. In response to “Resurrection,” all I can say is the patient ( Sandy) was blessed to have you as her surgeon and physician. You went above and beyond in your concern for her outcome ,and ultimately I know her miraculous recovery was a result of your skill and knowledge ,followed by your humble and deep faith. You asked, and God answered. She was blessed. Wonderful and inspiring story.

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