I’ve had messages from God–a sign I asked for, a voice when I cried out in desperation, an answer to a prayer, a vision to bring me out of the deep depression, an unexpected visit from someone with a word of encouragement. But I’m hesitant to claim that God speaks to me in special ways. To believers, I sound prideful; to people without faith, I sound quite insane.
But really, what good is a God who doesn’t speak to you?
On a Sunday afternoon in August a few years ago, the temperature was brutally hot, the drive across the Buckman bridge was aggravating, and the call was urgent. A fifty-year-old woman had arrived by ambulance at the Orange Park emergency room unconscious and hypertensive. A CT scan showed hemorrhage deep in her brain.
A shadow of hopelessness started with the first call and hung over all subsequent events.
A bleed like that normally causes death or severe disability, and rarely does surgical intervention do anything to alter the dismal course of events. But the first task is to decide if the problem is indeed hopeless, and this requires urgency. If anything beneficial can be done, it must be done quickly.
I finally arrived and walked across the frypan hot surface of the parking lot in back of the hospital, the shortcut to the radiology department. I wanted to see the scan before I saw the patient. I wanted to know how bad the bleed before the family asked.
Blood filled the deep areas of the brain called the basal ganglia and dissected into the upper reaches of the brainstem, the part of the brain that allowed for consciousness. With a bleed like that, one could survive, but one would never wake up.
The problem is that it is always hard to stop saving a life. Families have difficulty giving up. Doctors are trained to keep people alive at all costs. Liability lies with doing too little, never doing too much–even if the cost is prolonged suffering for both the family and the patient. I headed to the ER for what I expected would be a difficult discussion with the family.
The emergency room doctor intercepted me. “There’s something you should see before you talk to the husband,” he said.
“I’ve already seen the scan,” I replied.
He nodded. “Yes. But we got a chest x-ray after she was intubated and put on the respirator.”
I had only a moment to wonder why he wanted me to see it. He led me to a view-box upon which hung a chest x-ray that showed lungs riddled with tumors of various sizes. “Metastases?” I asked.
“Yes. Breast cancer,” the ER doctor said. “I went back after the x-ray. She’s got a big mass in her left breast.”
We went together to the patient. Her depth of coma was expected from the findings on the scan. A tube protruded from her mouth, connected to a respirator that filled her lungs every five seconds. Cardiac monitors beeped in the background. I untaped her eyes for a brief exam of her pupils and reflex eye movements, then re-taped them and confirmed a three-inch mass in her left breast.
You can’t die twice, but two things can kill you. If I had any doubt about the advisability of recommending aggressive intervention, that doubt was now dispelled. If, against all odds, we could save her life with an operation and a long, difficult hospital and rehab course, the likely result would be to leave her in a vegetative state. Now her exam and the chest x-ray told us that if we intervened, she would also die a prolonged painful death from disseminated breast cancer.
I went to talk to the husband, uncertain how approach this double tragedy. But I had time. The urgency was gone. Only the cloud of hopelessness remained, now darker than ever. So I asked him what happened.
He started her story a few months back. They were simple people, living in a small house on a rural lot. She had lost her job and her health insurance, and didn’t have the energy to find another. She stopped taking her blood pressure medications. Although public assistance was available, she didn’t want to be beholding to the government. Then today she had a headache and collapsed.
I told him about the bleed in her head, and that the prognosis was very poor. Even if she lived, she would never be able to live independently again. Then I told him that she also had breast cancer, a large tumor that had already spread to her lungs.
He told me she’d discovered the lump a few months before, but didn’t want to see the doctor about it–possibly for the same reasons she didn’t get the blood pressure medicines. She didn’t want to be beholding. But she seemed to have another reason. I don’t want to know, she told her husband.
I understood. Every day she didn’t go was one more day no one could give her bad news. But inwardly she must have been preparing for the end.
I recommended that we treat her with comfort measures only.
He nodded as he stood looking somber and alone.
I murmured something in the line of sympathy and started to move away to begin the process of reversing the well-oiled medical system that prolonged lives and change it into a system that provided comfort.
Then he said, “It’s a funny thing about the cat, though.”
For a moment, I thought I misunderstood. “The cat?”
He kept his gaze fixed on the curtain around his wife’s gurney. “Yep. About two months ago a stray cat showed up on our porch. Never had a stray before. She started feeding it and it stuck around. Since he looked like he was going to stay, she took him to the vet. She asked the vet about a lump on the cat’s side.”
“Uh-huh,” I said. People had many different responses to sudden loss. He was the first I had heard talk about their cat. I didn’t want to discourage him. “Go on.”
“The vet said the cat had cancer. We should put it down.” He continued to stare at the curtain. “But she said no. As long as the cat was comfortable, we would take care of it. The lump is bigger, but the cat is still there.”
He turned his eyes from the curtain and met my questioning look. “So I’m just saying. It’s a funny thing about the cat.”
The patient died thirty-six hours later, comfortable with her family at her side. I don’t know about the cat. But I had to agree with the husband: it was a funny thing.
I am convinced of God’s personal love, and that He will use any means to to bring us a message that we need to hear. One day we will face our death or the death of a loved one. Often we face difficult decisions at the end. He tells us in His Word to prepare, and to not be afraid.
But sometimes we need a very personal message that He is with us always, that even in the shadow of death there will be time and space for love. I am confident that He will find a way to give us that message, and comfort to those left behind. Sometimes He even sends a cat.