Tag: healing

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.

Broken

 

The patient had just murdered his wife.  A single shot from his handgun had sent her straight to the morgue.  Then, with a sudden loss of basic marksmanship, he failed to kill himself.  He placed the gun in his mouth, allowed an awkward angle, fired, and the bullet lodged in the right temporal lobe of his brain, narrowly missing the structures that would have led to his immediate death.

Frankly, I lacked enthusiasm for treating him.  He wanted to die.  He deserved to die.  I wanted him judged by the standard of an eye for an eye, a tooth for a tooth, and a life for a life.  But the discipline of medicine allows no such judgements, and I found myself in the operating room removing the bullet, debriding damaged brain, and sealing the cranial cavity from potential contamination from the tract through the mouth and sinuses.  Miraculously, and somewhat to my disappointment, he survived.

And he survived well.  On day one, I changed his bandage.  On day three, he regained consciousness with no loss of vision or paralysis.  On day five, I removed his stitches.  He suffered no complications despite the high risk of infection.  Physical therapy supervised his return to normal balance and ambulation.  For two weeks he wore a patch over his right eye because he saw double, but then that symptom also went away.  By the third week he could read again.

His discharge was delayed, however, because he had no place to go except jail, and he couldn’t go there until he reached sufficient physical and mental capacity to be competent and self-reliant.  For several weeks he lingered in the hospital with a sheriff’s deputy stationed at his door.

Each day I would come to see him.  Always he was courteous and cooperative with myself and the staff, and in my mind I tried to reconcile the gentle person before me with the raging lunatic who had killed his young wife.

I asked what would happen to my patient after he was transferred to jail.  The deputy shrugged.  “It’ll be up to the judge,” he said.  “But I think probably nothing.”

“But he murdered his wife,” I said.

“Yeah, but the judge is going to see that scar on his head and send him to a psychiatrist who will say he’s not competent to stand trial, and maybe he’ll go to a state mental hospital, or maybe he’ll just go home.”

I stared at him.  He shrugged again as if to say What are ya gonna do?

The next day I found the patient reading his Bible.  I wondered if he even remembered what he had done.  So I asked.

A cloud passed over his face.  “I killed my wife,” he said.

“Do you remember why?” I asked.

“I was angry.”

His memory was intact, but sometimes patients with temporal and frontal lobe damage will be incapable of remorse.  “How do you feel about that now?” I asked.

The cloud came back.  “I feel bad,” he said.  “I loved her.”  He paused for a moment,  then continued, “I’m not that person anymore.”

In his last statement, he was entirely correct.  Due to his self-inflicted wound, his temporal lobe and frontal lobe were significantly damaged, and changes to his emotional responses and intellectual capabilities were undeniable.  He may be incapable of anger.  In a way, he was broken.  Yet the changes left no outward signs.  Even the scar became hidden as his hair grew back.

I once watched a man in Wyoming break a horse.  The horse was dangerous and useless, but expensive with good breeding and therefore worth saving if at all possible.  As a last resort the horse had been sent to the trainer from New Mexico.  Unless the horse could become trainable and safe, it would be euthanized.

The horse bucked and snorted in his stall before being released to a circular corral about forty feet in diameter.  The man stood in the middle of the corral with only a light six-foot flexible rod and let the horse run around him, seemingly oblivious to the threat of crashing hooves and sharp teeth.  He then described his own life, full of passion and rage and despair, and stated he and the horse were alike until, on the eve of his own self-destruction, he was broken and began a redeemed life.  Over the next hour he talked to us about redemption as he let the horse run, made himself vulnerable to the horse, thereby building trust, and then gave the horse the opportunity to submit.  He never touched the horse with his rod or his hand until near the end of the hour when he faced the now calm animal, stroked his muzzle, and placed a halter on his head.  Then he mounted and rode around the ring.  The horse was no longer the dangerous bucking bronco that had entered the ring.  The changes left no outward sign, but the horse was “broken.”

I know that within myself is a streak that is wild and self-serving and ultimately destructive.  It is the voice that tells me that only I know what is best for myself, that life is short and I need to get what I want now, that I need to free myself from the people and the rules that restrain me.  This voice echoes the wild spirit of the stallion, the spirit that would have led to its destruction, and I expect that it echoes the demon voices that drove my patient to murder.

We all needed that spirit to be broken before we could become whole–at least whole in the sense of fulfilling our best destiny.  In other words, we needed to be broken to be healed.

But I don’t think we can break ourselves.  My patient may have come close by trying to destroy himself.  But the horse needed a gentle trainer.  And I also have a gentle trainer; His name is Jesus.

When we are broken, we can be redeemed from the wild and self-serving spirit that leads to rage and lust and alcohol and drugs and despair, the things that hold us in back from our best selves.  The best of us are broken.

Another New Heart

Dean

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.

God in our Fear

Adam

Having cancer is fear: like having a gun put to one’s head. The day before the diagnosis, one could go where he or she wanted. When the diagnosis comes down, the patient’s autonomy boils down to a single question. Will I accept or refuse treatment?

As they were prepping me for surgery they screwed metal bolts into my skull. It was like something out of a horror movie, and I just lay there acting like it was normal while they tightened the metal halo, and my head felt like a grape being squeezed. A few minutes later they had me lie down on the gurney. I was encased in a metal cubic framework screwed into my skull.

Then, a month later I could actually smell my skin burning during radiation therapy.

During cancer treatment there dozens of atrocities visited upon a patient’s body. I had to have my blood drawn every week. My veins weren’t so good so it took a lot of sticks. I can remember telling myself that if I got better I would never let anyone stick me again.

Then there was morning when I came in for a CT scan. They gave me a “Big Gulp” sized cup of contrast. I drank a little less than half and couldn’t get any more down. My mom urged me to keep drinking; I did my best. Then I started throwing up.

I feared not only dying or discomfort. I also feared of my utter lack of autonomy. They could have told me that they were going to have to cut off my leg or my nose or blind me and I would have had to say yes. In this way being a cancer patient is like being in a concentration camp, except that a concentration camp seeks to kill while cancer treatment seeks to give a long, arduous road to life.

Where is God in the midst of this journey? He carried me when I wasn’t strong enough or brave enough to walk. I wasn’t particularly pious or spiritual. I just had a feeling, a spiritual feeling, that I was going to be ok.

During my cancer treatment I suppressed my fears and thoughts of trauma. Later, when God put me down I had to deal with them. God carried me through a horrific wasteland, like a battlefield inundated with explosions, shrapnel, barbed wire and terror. When he put me down I had to look back over that wasteland and examine the scars on my body, my spirit and my soul.

 

“As the sun was setting, Abram fell into a deep sleep, and a thick and dreadful darkness came over him. Then the Lord said to him, “Know for certain that your descendants will be strangers in a country not their own, and they will be enslaved and mistreated four hundred years. But I will punish the nations they serve as slaves, and afterward they will come out with great possessions”(Gen 15: 12-14).

 

The Israelites did not come out of Egypt without scars. There were the literal scars from the whips of the Egyptians and the overseers. There were the memories of the babies killed by the soldiers or eaten by crocodiles in the Nile. Bodies were broken by decades of slave labor. More than all of these, they lived with constant anxiety. They had lived for four hundred years in a setting where one simple change, like not gathering enough straw, could bring utter ruin.

My biggest anxiety was the MRI machine. To me, going into an MRI was like being buried alive. Less than six inches separated my eyes from the top of the tunnel. The sides of the tunnel pressed my arms to my side, and it was always cold, around sixty degrees. The mechanical voice on the intercom told me time after time not to move. Even swallowing my saliva worried me. A typical MRI takes about 50 minutes. Of course, in the machine I had no way of sensing of time. All I had was my thin, cotton gown. About halfway through the scan they would move me partially out of the tunnel, stick me, and add contrast to my veins.

Above all the unpleasantness hovered the fact that one MRI in August of 1991 had changed my life forever. One bad MRI took me into the wasteland of cancer. Any MRI after that could return me to the same wasteland.

It was the summer of 1992. I was going for my first annual MRI scan. By that time I’d started to rebuild my life. I was driving again, taking tennis lessons. I had enough hair to brush, and I looked forward to my senior year of high school. I walked into the imaging center determined to put on an optimistic face.

In reality, I was absolutely terrified.

God must have laughed at my phoniness.

When I registered, a new Christian manned the desk. We talked about the cancer and my fear that it would come back, and I received the gift of peace. God knows and ministers to our fears, even the ones we are afraid to admit to ourselves.

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.