Tag: faith

Mountains and Mustard Seeds

Number Thirteen in the Healing Miracle Series

When they came to the crowd, a man approached Jesus and knelt before him. Lord, have mercy on my son,” he said. “He has seizures and is suffering greatly. He often falls into the fire or into the water. I brought him to your disciples, but they could not heal him.”

“You unbelieving and perverse generation,” Jesus replied, “how long shall I stay with you? How long shall I put up with you? Bring the boy here to me.” Jesus rebuked the demon and it came out of the boy, and he was healed at that moment. (Matt. 17:14-18, NIV)

Jesus had been coy with patients before, taking his time before responding to their requests, calling them out when they touched his robe, forgiving sins instead of commanding healing, casting out demons from the violent men of the Gadarenes without being asked–all unexpected responses to human suffering. But never had he been impatient, even rude, as he was now to a father with an epileptic son.

Or maybe his comments about the “unbelieving and perverse generation” had been directed elsewhere. Maybe to the disciples, because of their failure to cure the child in his absence? But even this seems unfair, and out of character, for the Jesus we have come to know in the previous chapters. Or maybe he’s human–not just human, but still human like you and me.

He had just come down from the mountain. He had been in the presence of Moses and Elijah, the great leaders and prophets, both of whom the world thought to be long dead. And God Himself spoke to them, and Jesus, in the presence of three witnesses: This is my Son, whom I love; with him I am well pleased. Listen to him! (Matt. 17:5, NIV)

How many of us wouldn’t love to hear those same words from our earthly fathers! Or if we were lucky enough to hear them, don’t we treasure those moments among the best in our lives? Imagine hearing the clear voice of God the Father while communing with the saints of the past. This had to be the pinnacle of his life on earth so far–what he had meant when he talked about “The Kingdom of God,” a place he knew in faith and in hope but had yet to experience in earthly life.

Then he came down from the mountain and found the same kind of problems he had left behind the day before, along with disciples that couldn’t seem make any headway without his presence. No doubt the disciples looked sheepish. After Jesus had his little outburst, he did what Jesus does; he cast out the demon.

“How long shall I stay with you?” he cried out, but maybe he was really questioning his Father whom he had just left: How long until I can come home? How long until every soul has unity with You? How long will our created world be filled with diseases and demons?

The Kingdom to Come

Our internship class inherited a man named Archibald, or “Archie” as everyone quickly came to know him. About a week before our internship started, he had suffered a shotgun wound to the abdomen when a heroin deal went south, and had his first of many operations to save his life. Any abdominal wound can be fatal, but a shotgun is particularly nasty because of the multiple intestinal perforations each of which can be the source of infection–peritonitis–and potentially life-threatening sepsis. Some of the intestine can be sacrificed, but if too much intestine is taken, the body cannot absorb adequate nutrition to survive.

Archie survived his first operation, but had recurring bouts of peritonitis and sepsis. At one point his respirations failed and he needed a ventilator for nearly a month. To “rest” his intestine and minimize further infection he required total parenteral nutrition, TPN, through central intravenous lines. Over the next few months, he underwent several more operations to find and repair damaged intestines or drain abscesses. Every one of our surgical interns rotating through general surgery took care of Archie.

He was a likable guy. We–all eighteen interns–suffered with him, and never lost hope for his eventual healing, even though every week seemed to bring a new complication, and the months dragged on. In all those months, no friends or family members visited. We had the feeling that he had become part of our family at the hospital–the pseudo-family that comes together when dedicated people work together for a common purpose.

Finally, one day in early Spring, word spread throughout the interns scattered through the hospital: after nine months, Archie had made it out of the ICU! Then a few days later–miracle of miracles–he was released from the hospital. The interns and ICU nurses actually had a party for him. With cake!

Three days later, he was back in the ER with a new abdominal problem. This time he had been stabbed.

He actually looked sheepish. He knew how much literal blood, sweat, and tears had poured into his care. Then we did what we do; we took care of him. But we were deeply disappointed.

The care was simpler this time. Knife wounds are ever so much easier than shotgun wounds. A few weeks later, Archie was discharged again and we never saw him again. Maybe he mended his ways. Or maybe he moved, or maybe he died after the next injury. I don’t know.

What I know is the change in us, his caregivers. We lost a certain enthusiasm for our unbridled altruism, recognizing that sometimes we care more and work harder at fixing our patient’s injuries than they work at saving their own lives.

Or that’s the way it seems. Another way of saying this is that we could fix complicated abdominal injuries, but we couldn’t fix addictions and broken neighborhoods and broken relationships, and if those things don’t get fixed, all our other efforts are in vain.

Maybe that’s something like what Jesus felt. Every effort falls short unless “the Kingdom comes.”

A few months ago I went hiking in the Smoky Mountains with my friend Gee. We experienced wilderness solitude and a healing miracle. We tested our physical endurance and renewed our appreciation for simple things like food, water, shelter, and rest, and explored a fast from all the other things we liked but didn’t need: TV, electricity, cars, hot showers, cell phones…No, wait, maybe we did need cell phones.

The fourth and last day should have been the easiest, and it started out that way. We got up, ate breakfast, and walked about five miles on mostly flat trails. The several stream crossings were very doable, and we reached a campsite at the edge of Lake Fontana around 2pm, well ahead of schedule. I had arranged for a motor launch to meet us there at 4pm and bring us to the marina where the truck was parked. If all went according to plan, by 5pm we should be on the road home.

We ate the last of our food, took off our boots, and stretched out–resting, meditating, enjoying the sunshine and blue sky under the shade of a giant sycamore tree at the edge of a calm lake. We prayed thanks for a great trip, and for guidance in our future steps. This seemed like the perfect end to a renewal in the wilderness–a real “mountain top experience.”

Around 4PM, I put on my boots and packed away the sleeping pad that had given me comfort. I started listening for the sound of a boat motor. Around 4:15, I decided I had misunderstood, and the pick up time was really 4:30. Around 4:45, I realized the boat wasn’t coming. In other places, a cell phone call would fix the problem in a minute, but Fontana Lake, we discovered, is a blessed and cursed by cellular silence. We would have to walk out.

The Lakeside trail to the top of the Fontana dam has no net elevation gain or loss, but the five plus miles from Eagle Creek are marked by steep ups and downs. Fast hiking would be impossible for two senior citizens with packs. Sunset would be at 6:45, but here on the east side of the ridge, darkness in the forest would come earlier.

We walked the last thirty minutes in complete darkness, our headlights giving us just enough illumination to stay on the trail. Antique auto body shells, crashed in the woods ninety years ago when the trail was still a road, eerily appeared in the shadows. At last we made it to the parking lot that marks the junction to the Appalachian Trail and the gravel road spur to the Fontana dam. We stashed our packs off the road behind a tree, hiding them from opportunistic thieves, but we needn’t have troubled. The parking lot was deserted, as was the gravel road, the Fontana dam, and the remaining three miles of paved road to the marina parking lot. Not one person, not one moving vehicle. And, except for the streetlights on the dam, the night remained pitch black.

We made it to the truck and returned to retrieved our packs, then started driving toward home. By now we were about three hours overdue check-in with our families. We knew they would worry, and soon the Park Service would be called to report us as missing hikers. But the cell phone black hole continued for nearly an hour after we left Fontana.

Finally, around 10 PM we reported ourselves to be alive and well. Shortly afterward we found a reputable chain hotel with a vacancy, and immediately after that started looking for food.

I’m always hungry after four days of hiking, and especially so after missing dinner and hiking an extra eight miles or so in the dark. The only place open was the local Waffle House.

A Waffle House at a rural crossroads in eastern Carolina around midnight on a Friday can be a scary place, a dive with unhealthy food and dangerous people, and nothing like how the day started–walking along a sunny stream in the Smokies. We found a rusted pick-up truck in the parking lot with a caged and howling hunting dog, an Elvis impersonator at the counter inside, a middle-aged couple dressed like teenagers and carrying motorcycle helmets, and a very short and very round elderly waitress with a short pencil and shorter attention span. Nobody we met lacked visible tattoos.

The mountain top experience was gone. I got the cheeseburger with fries and a malt, and cleaned my plate. Gee got the “Big Breakfast”–eggs, bacon, pancakes, grits–and at least had the good sense to leave some of it uneaten. We could have been mugged in the parking lot, or died of coronaries before we got back to our hotel. But this time, the Waffle House wasn’t scary. It was a place filled with people who, like us, a little dirty, a little desperate, and a little lonely, found food and fellowship and light in the darkness. An outpost for the Kingdom to Come. 

A Little Faith

Then the disciples came to Jesus in private and asked, “Why couldn’t we drive it out?”

He replied, “Because you have so little faith. Truly I tell you, if you have faith as small as a mustard seed, you can say to this mountain, ‘Move from here to there,’ and it will move. Nothing will be impossible for you.” (Matt. 17:19-20, NIV)

Jesus had previously commissioned the disciples to “Heal the sick, raise the dead, cleanse those who have leprosy, drive out demons.” (Matt. 10:5, NIV). When Jesus returned, they couldn’t understand their failure. They had to know.

One of the most common spinal conditions I cared for was a herniated lumbar disc. The results in a typical case were gratifying–90% of patients felt improved and returned to normal activities. But 10% didn’t, descending into a nightmare of chronic pain and disability, and the reasons for failure were often obscure. Sometimes I felt the failures were my own–misdiagnosis, clumsy handling of the delicate nerve, failure to remove enough of the disc, or even removing too much disk or too much bone during the exposure. More often, I could tell no difference between the operation I would do on a successful case from the operation on a failed case. Nevertheless, failure was always personal. I wanted desperately to know why this time I couldn’t drive out the demons of pain and disability.

Jesus gave the disciples a cryptic answer: Because you have such little faith.

Whatever could that mean? They had apparently faced similar problems before quite successfully. They had given up their jobs and homes to follow Jesus. What did more faith look like?

I don’t know. But I think the mountain he was talking about was the mountain he has just come from–the Kingdom of God mountaintop experience of being united with our Father and the saints. If you have faith like a mustard seed, you can move this mountain of misery to the mountain of the Kingdom.

One of the most difficult things for a surgeon to do after a failure is to see the next patient. When I walk out of the room of one patient still in pain weeks after what should have been a successful operation and go to the next room of a patient in pain after weeks of non-operative treatment for the same condition, sometimes it’s hard to turn the doorknob. I know what is most likely to give the patient relief and I know it is an operation that I am trained to do–as well as anyone in the world–and I know what the patient wants and what medical science recommends and what I am going to say. But sometimes it’s hard. Because after the doorknob is turned, and I step into the room, everything else will happen, and the results will be on me, and at those moments I have little faith, no bigger than a mustard seed, and I don’t want to do it.

Then I turn the knob, take a step into the room, hold out my hand to theirs, and listen. We do the examination and look at the images, and we work out a plan together. And, most of the time, the mountain of pain and disability moves from here to there. Then, to one more little corner of creation, the Kingdom comes.

Big Man Down and the Procession of Life

There was a man in New Haven known for his size, his vast appetite for food and drink, his violence, and he feared not man nor God.  He stood six-foot-six and weighed an estimated 400 pounds.

One night he angered his girlfriend.  She revved his car, a sizable 1970’s style sedan, and threatened to run him down on Howard Avenue.  He stood in the middle of the street and dared her to do it.  She made one pass and swerved at the last minute narrowly missing him.  She turned the car around, and he laughed, daring her to try again.  This time she didn’t swerve and she didn’t miss.  After the impact he was dragged another full city block before falling free in front of the ER entrance at Yale-New Haven Hospital.  An ambulance still had to be called because none of the hospital personnel who rushed out could lift his massive frame onto a hospital gurney.

Once in the emergency room, he proved equally difficult to evaluate.  He was too large for the CT scanner, and X-Rays penetrated his thick flesh poorly leaving blurry images and much guessing about internal injuries. Cervical spine x-rays had been able to penetrate only as low as C-3.  Normally all seven cervical vertebrae can be seen on x-ray, or in very large individuals perhaps only five or six, but in his case the lower four vertebrae were completely obscured by his massive shoulders.

One thing that was clear: he was paralyzed from the waist down from a fracture at the lower thoracic/upper lumbar spine.  Surgery was scheduled for the following day.

The operation was long and difficult with much blood loss. Whether it was successful or not became quickly irrelevant when he woke in the recovery room now paralyzed from the neck  down.  Further efforts at x-rays of his cervical spine determined that he had a fracture at C-4 and now a new cervical spinal cord injury.  Unable to breathe adequately, he was left on the respirator, an endotracheal tube placed during surgery remaining as his airway.

Up until this point I had little involvement in his care.  My primary responsibilities were in the research labs, and I covered the clinical patients only one night per week and one weekend per month.  But when Saturday rolled around, he was still intubated, and dependent on the respirator in the Neuro ICU, and I was the sole resident on-call for the weekend.

On Saturday morning rounds, the staff neurosurgeon, also covering for the weekend, told me the patient needed a tracheostomy and we should do it that day.  I had done enough tracheostomies–the procedure itself didn’t intimidate me–but this case frightened me.  I argued that the procedure would be difficult, and ENT consult should be considered, and it wasn’t an emergency.  The procedure could be done the following week when plenty of back-up help was available, perhaps even in the OR where adequate light and and equipment would be available.

The surgeon would have none of it.  Back then, neurosurgeons did tracheostomies on their own patients.  To consult ENT or another surgical service would a sign of weakness, and neurosurgeons never admit to weakness.  Why mess up a busy operating room schedule with an annoying procedure like a tracheostomy that could be done off hours in the ICU?

I argued my other responsibilities to the seventy-odd patients under my care.  He simply said to call him as soon as my routine work was done.

My routine work was not done until six PM.  I called the staff physician, hoping the late hour would put him off, but he remained undeterred.  He showed up a the NICU at eight PM determined to help.

A trachea is normally immediately beneath the surface of the skin at the throat, often less than a quarter inch from the surface.  In this patient the trachea was a good four inches deep in the neck.  The standard retractors and indeed the tracheostomy tubes themselves were too small.  The light was poor, and we struggled for two hours over a procedure that normally takes thirty minutes.

At last he had an airway in the trachea.  I sutured it in place and tied it around his neck for good measure.  The staff physician went home, and after fielding the calls and tasks that had accumulated during the time I was involved in the procedure, I went to bed.

At two AM, the phone rang.  The patient had coughed out his airway and was now in respiratory distress.  I ran to the NICU and tried to replace the tube, but after the recent procedure the path from the skin to the trachea is no longer easy.  All the recently dissected tissue planes provide false passageways even in normal individuals.

I struggled to find the trachea and a tube large enough to reach it, but working alone and with poor light, I was frustrated and unsuccessful.  His breathing became more and more labored.  I called the resuscitation team, but they too were unable to re-intube him in the conventional manner.  His heart rate slowed and he lost consciousness as I struggled to find his trachea.

Then he died.

It’s a great thing to do a good tracheostomy.  Lives are saved in hospitals (and sometimes restaurants) frequently.  But sometimes it doesn’t work.  It’s been over forty years.  I stood between the big man and his death, and I failed.

I didn’t kill him exactly.  His girlfriend in her fury bore the legal responsibility.  Alcohol intoxication, lust, anger, and hubris (standing in front of a speeding car twice!) had a lot to do with it.  And I was only the last person in a line of medical providers who failed to stand between him and the hereafter, and between the girlfriend and a murder charge.

There is a poignant story in the Luke 7:11-16 in which Jesus and his followers are entering the town of Nain just as a funeral procession meets them on the road.  The dead man is the only son of a widow. Jesus, against all common sense and against the Jewish tradition that to touch the dead that renders one ritually unclean, stops the procession, touches the body, and raises the young man to life.

It’s an easy story to slide over.  Jesus was healing people all the time; now he stepped up the game and healed a dead kid, a widow’s son no less.

And it is all of that.

But Jeff Hoy in his Words of Faith (Stopping the Procession. Words of Faith.5-11-18.Dr.Jeffrey D. Hoy © 2018 jeff.Hoy@faithfellowshipweb.com) draws attention to the metaphor.  Normal life in the world is a procession toward death.  It’s where we’re all headed.  We fear it, we avoid thinking about it–we don’t touch it.

We handle our despair in different ways.  Some of us party–eat, drink and be merry, for tomorrow we die.  Some of us exercise, diet, take vitamins, avoid germs, obsess about safety, putting off for today the looming disaster of our end.  Some of us become religious, earning our place in heaven so we don’t have to worry about our end on earth.

Some of us, for example, me, learn about medicine and how to cheat disease and death, and, as we win daily battles, we hold onto the illusion that we will win the war.  But sooner or later, we meet the procession of death.

Backed by 2500 years of medical tradition, a 500 year history of surgery, an armamentarium of drugs and surgical procedures, my medical procession is powerful against impending death.  I put out my hand, I touch the corpse, the boy rises, the procession stops.

Sometimes.  This time I put up my hand, I touched the corpse, and the procession rolled over me.

Because I’m not Jesus.

In reality, the death procession never stops.  The medical procession can only slow it down.  The death procession only stops when the people weeping and wailing and those carrying the coffin stop believing in chaos and death and start believing in purpose and life.  Believe you are a child of God, believe you are loved, believe you are made for a purpose, believe that when your body dies you will exist on a new plane of experience–even when all that belief is beyond your intellect and your sensory experience.  Then the procession stops.  Then you can turn around and join the procession of life.  You can walk with Jesus.

The death of the big man with the failed tracheostomy is but one of many experiences that haunt me after forty years in medicine.  The sense of failure is pretty big when someone dies and you feel like you could have, should have, done something better to prevent that death.  It is easy to slip into despair camouflaged as a supposed “realism,” which is only cynicism after all.  One learns to go on, live in the moment, do the good one can do, and let the rest go.  It’s possible to live like that.

But if I want to live with joy instead of despair, I have to turn around and join the procession of life.  I have to walk with Jesus.

Some Kind of Miracle

Dean

Denise was nineteen and had been married for two weeks.  Her husband said they had been together that afternoon when she suddenly complained of a headache and lost consciousness.  He called rescue who resuscitated and intubated her at the scene and transported her to the hospital.  A CT scan demonstrated hemorrhage in an area of the brain that was both critical and inoperable, the brainstem.  She was placed on a respirator sent to the ICU.

I saw her there, a tiny black woman, not more than five feet tall, weighing no more than a hundred pounds, beautiful still in spite of the distortion from the endotracheal tube and other lines and monitors.  An EEG had just finished, and the technician was leaving.  An official reading would take a few hours, but I saw the flat lines consistent with no brain activity.  Her neurological exam was also consistent with brain death.

She met all the criteria for a diagnosis of brain death except a repeat confirmatory examination to be performed eight to twenty-four hours later.  Once the diagnosis was confirmed she could be removed from the respirator without any further ethical concerns, either before or after her organs were harvested to be donated.

The family entered as I finished my exam.  Denise lay between us like a sarcophagus.  I replaced the gauze pads that covered her eyes.  The cardiac monitor beat out a steady string of slow beeps.  Every five seconds the respirator made a clunk-wheeze sound and Denise’s chest rises and falls beneath the thin, white sheet.

Her husband, not much older than she, is so diminished by shock that he stands like a mute child with large, fearful eyes.  Her mother, a formidable looking woman flanked by a small army of family and friends, takes charge.

Color separates us: my white coat and white skin, her dark dress and dark skin.  Language separates us: my Midwest accent, her Southern drawl.  I see in her eyes the sins of  generations of white men and know that trust would not be earned easily, and my authority would be recognized only grudgingly.

“Doctor?” she says.

I ask what happened, although I already knew.  I ask about her prior health, though it mattered little now.  I ask because I want to listen to their voices and I need to earn their trust.

And I don’t want to talk.  I don’t want to tell her that her daughter is dead in every sense except that her heart beats on.  I listen to the story of her short life, her childhood illnesses, her graduation from high school, her recent marriage.  I hear, as she describes Denise’s plans for the future, the hopes and dreams of her whole family.

Finally there is silence, and they look at me.  I tell them that she likely had been born with something that now caused bleeding in her head.  This is nobody’s fault; it could not have been prevented.  An act of God.

“She’s in a coma,” I say.

Mother’s face steels.  “She going to get better?”

The monitor beeps, the respirator wheezes, and Denise’s chest rises and fells.  I shake my head.

Mother’s face almost crumbles before it steels again.  “We a praying people, Doctor,” she says.  Soft voices behind her murmur assent.

“I pray, too,” I say.  I pray for forgiveness, I pray for comfort for Denise’s family, I pray I can leave this tragedy and go home to my wife and children.

I tell Mother about coma and brain death, how brain death is not only a diagnosis; it is the end of hope.  I speak about transplantation, how life and hope can be salvaged from death and despair.  I am met with stony looks.

“We be praying for a miracle, Doctor.”

I nod and look down at Denise, small enough to be a child, then explained about repeating her EEG and exam the following day.  We set a time to review the results.

The following day her exam is unchanged.  The EEG is still flat.  Her vitals signs are normal and her labs are normal.  She is brain dead, I tell her family.

“What now?” Mother asks.

I explain how transplantation works, how she can remain on the respirator until her organs are harvested then the body is released to the undertaker.

“No,” she says, “No transplants.”

I want to explain again but the steel has returned to her face, and I am forced to agree.  Denise is my patient; I am responsible only to her, and by extension, her family, not the unknown recipient of a transplant.  I nod.  “Then we can remove the respirator.”

“My son is a preacher up in Georgia.  We need him to lay on hands and pray over Denise.”

Technically, Denise is dead.  A death certificate could legally be filled out now, but I am in no hurry. Death and grief are hard enough without inflicting more wounds with technicalities.  “When?” I ask.

“Tomorrow morning.  Ten o’clock.”

Sunday.

I wonder what happens when you pray with such certainty for something that is so impossible.  Do you give up God?  Do you give up prayer?

And I wonder what happens if you pray for the impossible, and your prayer is answered.  Do you give up your faith in the expected?   Is the science of medicine so frail?  Does reality and experience know no boundary?

The next morning I enter the ICU and feel like I am in the wrong church.  Twenty souls are gathered in their Sunday best, including Denise’s brother.  Her mother introduces him, and we shake hands over the bed.  I examine her, self-conscious of the audience.  No change, brain dead, I tell them, and step back into a corner, uncertain what to do with my hands.  I cross one over the other and stand with my head slightly bowed but eyes open.  Respectful, but I feel like an alien.

Her brother lays a hand on her forehead.  He begins murmuring a prayer and the room fills with others praying out loud or saying amen.  A babbling hum fills the room and competes with the heart monitor and the respirator.  His prayers become louder with the cadence of a practiced orator.

“We love our sister,” he calls out, one hand on her forehead and one raised to the heavens.  “Now, in the name of Jesus, rise and walk.”

The room falls silent except for the monitor and respirator.  He begins again, the small congregation joining with encouraging words.  Again he cries for his sister to rise and walk, and again she does not.  A third time he cries out in the name of Jesus for his sister to rise.

I find myself praying with him.  I find myself willing to sacrifice all the certainty of the medical science for the life of this young woman.

The monitor beeps, the respirator wheezes, and no one moves, least of all Denise.  A tear streaks down her mother’s cheek.  Her brother’s hand rests still on her forehead.  A minute passes, maybe two, maybe three.

This is the moment, I think.  This is when we admit that God doesn’t answer prayers, at least not this one, at least not now.  And if not now, when?  Surely He must care.  But if He cares, does He not act because the power that raised the only son of the widow of Nain was for that time, those people?  Not now, not us.  Is now the time for bitterness and grief?

Her brother whispers something.  Then repeats himself, now loud enough that I can just make out the words.  I hear, “Thank you, Jesus.”

But why?  For what?

“Thank you, Jesus,” he says again, louder, the words unmistakeable now.  And again, even louder.  Murmurs of assent and soft amens from the family rise like a chorus to his solo as I stand to the side, puzzled and dumb.

“Thank you, Jesus,” he says one more time.  “For we loved our sister.”

I hear the chorus of amens.

“But You loved her more.  Thank you, Jesus.”

He lifts his hand from her head and steps away.  Family members file by, touching Denise, hugging her mother, shaking the brother’s hand, then leaving one by one until only the brother and his mother remain.  He nods to me as he turns to leave, surrendering the ground.

I shook his hand as he passed.  “I’m sorry,” I said.  Sorry your sister died.  Sorry your prayers weren’t answered.  Sorry that I, in spite all my scientific knowledge and skill, am completely helpless.

“Thank you,” he said.

Then I am alone with Denise and the ICU nurse.  We disconnect the lines and turn off the respirator and the clunk-wheeze stops.  The heart monitor beeps on.  I secretly hope that she will breathe and we will call back the family and celebrate a miracle.  But her chest no longer rises.  The beeps slow, then become irregular, then stop.

I sign the death certificate and go to church, joining my wife and children in a quiet Methodist congregation where all the men wear suits, all the women wear dresses, and we all pray for the will of God to be done, but never for the dead to be raised.  We are safe from disappointment that way.

But I wonder if we don’t ask for too little.  Though Denise did not rise from the dead, at least not in this world, I feel that because her family had prayed for something I wouldn’t have risked, we witnessed some kind of miracle.

Before their prayers, her family was lost in grief.  Her family asked God for more time with Denise in this world of suffering and sorrow; God assured them that Denise was living a perfect life now and they would see her again someday.  Because they prayed for a miracle in the hear-and-now, they witnessed a miracle in eternity.

The Best Thing

Being cured and being healed are usually the same thing.  But not always.

A few years ago I was already driving home at the end of a long day when I got a call from the ER.  A thirty-something year-old mother of two had been driving home from work when her car was struck broadside from someone running a red light. She had been briefly unconscious at the scene, but was alert and able to give a coherent history on arrival at the ER. Then she unexpectedly lapsed into a coma, the right pupil dilating.

By the time I arrived, a CT scan had confirmed my suspicions of an intracranial hemorrhage, specifically an acute subdural hematoma.  If the clot could be removed before she suffered permanent damage to the critical life-support and consciousness areas of her brainstem, she could live.  But the window of opportunity was narrow.  She had less than two hours.

An emergency OR team was called and the patient resuscitated with assisted breathing through a mechanical airway and medications to minimize brain swelling.  Blood for transfusion was reserved, labs were processed.  The clock continued to tick.  I shaved her hair in the ER while waiting for the OR to be ready.

Finally, she got to surgery.  I made a big incision and cut a big window in her skull to allow room to evacuate the blood clot and find the source of bleeding.  A large surface vein had been torn due to the accident, but the brain itself looked normal.  Once the clot was out and the bleeding controlled, the tension level in the OR dropped and the surgery finished without any problems.  I bandaged her head in a classic turban dressing.

Her post-op scan showed complete resolution of the intracranial bleed, and she quickly regained consciousness.  Early in the morning of the second post-op day I visited her in her ICU room surrounded by her celebrating family.  She had made a full neurologic recovery and, other than a black eye and a bandage, looked perfectly normal.

I needed to change her bandage.  Although it looked pristine on the outside, undoubtably the inner layers of gauze had blood and serum from the incision, and I wanted it clean there, too.  I cut away the old bandage and reached for the new gauze wraps when she quickly put her hand to her head and grabbed a mirror.

“My hair,” she wailed. “What happened to my hair?”  Tears welled up.

I re-bandaged her head and assured her that her hair would grow back.  Her family comforted her and told her how glad they were to have her alive and how little they cared about her hair.  But she was inconsolable.

I was disappointed.  She had a perfect medical result.  Yet, she would need many months of psychiatric treatment for post traumatic stress disorder (PTSD).  She had been cured by her surgery, but not healed.

A few months later I received a consult to see a patient that I knew I couldn’t help.  This patient had suffered paralysis due to a gunshot wound to the thoracic spine several weeks before and had been treated at another hospital before transfer to the rehabilitation facility in my neighborhood.  The question on the consult was whether or not she needed to continue to wear a brace (she did not).

All I had to do was talk to the patient, do a brief exam to confirm my findings and write a note explaining what I already knew from looking at her hospital records and x-rays.

“Can you tell me what happened?” I said.

“The best thing in my whole life,” she replied.

I stared at her, a thirty-something year-old woman who looked older than her stated age.  Her hair was prematurely gray, disheveled and greasy from too many weeks in the hospital.  She must have misunderstood me.

“No, no,” I said.  “I meant about the spinal cord injury, the gunshot wound.”

“Yes, of course,” she said. “It was the best thing that ever happened to me.”

I realized that I was not going to have a normal conversation with this new paraplegic.  “Okay, I’ll bite,” I said. “I’ve seen lots of people with spinal cord injuries. Some adjust better than others, some adjust quicker, but I have never heard anybody say it was the best thing that ever happened to them.”

“I was an addict working as a prostitute to support my habit,” she said.  “A family of Christians lived in my neighborhood.  They knew what I was doing.  Every day I would walk by their house, and these little children would say something like, ‘Miss JoAnn, won’t you come in?’ or ‘Miss JoAnn, Jesus loves you.’  The last time it was the little boy. He said, ‘Miss JoAnn, Jesus loves you and we are praying for you.’

“I remember thinking I’d come and visit the next day, after one more high.  But that’s what I told myself every day.  A couple hours later I got shot in a drug deal gone bad.  I woke up three days later in the hospital unable to move my legs.”

She paused, collecting her thoughts and trying to form an explanation.

“But three great things happened to me that day.  The first–I was delivered from 20 years of addiction to crack cocaine. The second–I was delivered from 18 years of prostitution. The third–I found Jesus Christ as my Lord and Savior.  I have joy in my heart for the first time since I was a child.  So if never walk again, which is what they are telling me, it’s a pretty good trade.”

I couldn’t offer her a cure.  But then, she didn’t need it.  She had already been healed.

The Hard Place

It was a Sunday of August 1991. I was lying/sitting in the hospital bed. The doctors had come and explained what they were going to do. My parents had gone to the hotel. I was sixteen, looking at the prospect of brain surgery. Earlier that day my mother tearfully told me that she didn’t know if I would live two days, two weeks, two months or twenty years. She did say that God had something for me to do and that he would give me the time to do it. There was a lot riding on the next morning’s procedure. If the biopsy came back badly, I would likely be dead by Christmas. If they didn’t put the shunt in I wouldn’t live long enough to care about the biopsy.

At sixteen I had a plan for salvation. I was going to become more and more holy and eventually become perfect as my father in heaven is perfect.

How could I have come up with such a doomed plan?

Hurt, pride and determination–they were what moved me from being a failing dyslexic in the 4th Grade to a thriving dyslexic at one of the best schools in the state by the10th grade. The lesson I had learned was that any problem could be overcome with hard work and uncompromising determination. Why should salvation be any different?

The problem I had lying in that hospital bed was that I’d run out of time. I could no more become spiritually perfect than I could write a book in a single night. I didn’t know if I would wake up from the surgery with brain damage. I didn’t know if the biopsy would come out malignant. I was in a hard place. I didn’t have any more wiggle room. I was scared and I needed a savior.

“Dear Lord, I always planned to become more holy and a better Christian. I’ve run out of time. Could you please just take me as I am?”

As far as salvation prayers go it was pretty pathetic. I didn’t even mention Jesus or even ask for my sins to be forgiven, but the Lord reckoned even my pathetic prayer as righteousness and I could feel the warmth of the Holy Spirit flowing into me. It hadn’t taken surgery or brain damage to change me. The Holy Spirit made me a new person. Since that day I’ve worried about many things: pain, incapacitation, isolation, and what would happen to my wife and children if I died. But I’ve never worried about death.

Everyone comes to hard places. Sometimes they are dramatic, like the night before brain surgery. Sometimes they are in the middle of sustained challenges, like depression or addiction. Other times they are awakenings to the fact that our salvation plans, like most human plans, are wholly insufficient. What are the hard places you have experienced in your life? What spiritual fruit has grown out of those experiences?