Spiritual Experiences from the Brain

A Confession

 

I have a confession to make.

In my last post, “Decision, Direction and the Holy Spirit”, I made the following statement: “And having operated my way out of seemingly impossible situations many times before it is easy to understand how I would come to believe that I am indeed the ‘most talented neurosurgeon in the world’”.

The fact of the matter is that for many years I not only believed I this, I considered myself god-like. That all my talents and my skill came from within, and that the illnesses I cured and the lives I saved were entirely because of me. Ironically, as neurosurgical residents we would say, ‘as soon as you would think you were the best, a complication would occur or a patient would die to remind you that you weren’t as good as you thought you were!’ But my memory of these ‘minor setbacks’ was short and in no time I would be convinced they had nothing to do with anything I did or failed to do.

During my training in Atlanta an article appeared  in a magazine pullout of the Sunday paper which referred to neurosurgeons as the ‘High Priests of Medicine’. To me at the time it seemed an accurate portrayal of our supernatural powers.

All this may seem at the very least arrogant, although sacrilegious is probably closer to the truth. Unfortunately I held tight to this view of the world around me for many years.

It would only be years later with the help of my wife that I would place Jesus Christ in the center of my life. Only then would I realize that my talents and skill were gifts from God. Thus becoming more grateful, I also realized my patients deserved not only the work of my hands but to know my ability to treat and heal them was from God not me. That, I no longer ‘walked on water’ as so many of them had said in past.

I am compelled to share this with you because of a CD I was listening to in my truck on Wednesday as I was driving to meet up with the rest of my family for my daughter’s wedding this weekend. It is a talk by a well know theologian, Dr. Scott Hahn who was speaking on Understanding the Lord’s Prayer.

He was speaking about the petition, ‘Lead us not into temptation’, only Dr. Hahn said that the actual meaning of the word ‘temptation’ was a trial or test. He then went on to say that God tests us not to see how much we know, because he already knows that, but to show us how much we don’t know. Dr. Hahn says, ‘He allows us to enter these tests because we tend to overestimate our own strength and that we underestimate how much we need God’s strength; and how often we find ourselves in over our head and yet God is only a prayer away.’

It was at that point a light bulb went on over my head. I certainly had come to appreciate that my abilities were gifts from God, and as I have pointed out previously prayer during surgery has become very important to me as well. But, all those times I found myself in over my head and got out ‘without a scratch’ had falsely convinced me of my own superiority. It was only now that I truly realized God was testing me all along and then delivering me from my trial in the hopes I would come to give glory and thanks to Him. It just took me a while to shift the praise from myself to Him.

‘I am weak yet unafraid because Jesus is my friend.’

Decision, Direction and the Holy Spirit

 

‘The greater you are, the more you must humble yourself;

so you will find favor in the sight of the Lord.

For great is the might of the Lord; he is glorified by the humble.

Seek not what is too difficult for you,

nor investigate what is beyond your power.

 

   For their hasty judgment has led many astray,

and wrong opinion has caused their thoughts to slip.’

    Sirach 3:18-21, 24 

 

Just yesterday I saw a patient, Susan Curry, in the office who had been recently diagnosed with breast cancer. Following her surgery she began experiencing a number of neurological symptoms which led her doctor to order an MRI of the brain. This scan revealed she had a small tumor on the surface of her right temporal lobe, which had the appearance of a benign meningioma, which was unrelated to her cancer and her ongoing symptoms. But because her surgical oncologist could not be certain of this he sent her to see me.

As it turned out she had an MRI, 7 years earlier which in retrospect showed the tumor, although it was smaller; so my conclusion was that it was indeed a benign tumor and because of its current size I told Susan we could simply follow it with serial or future MRI scans. I did tell her and her husband Jim I wanted to run some additional tests because of her symptoms but for now we would just keep an eye on the tumor to make sure it was not going to continue to grow.

Susan, however looked at me and with an insistent tone asked me, ‘Are you sure you don’t want to take this tumor out? After all, in your blog you said how excited you get when you have a patient with a brain tumor.’ I told her, ‘Well that is true, but only if the tumor needs to be removed.’ Seemingly, she was not completely satisfied with that answer, as if to imply she wanted me to take the tumor out anyway. She went on to say that she was fine with knowing the truth but it was not knowing that upset her so I assumed she just wanted to be absolutely certain it was not cancer, but in the end, said ‘OK’.

In many ways the decision-making of when to operate is more difficult than actually performing the surgery. And in some cases it is not whether surgery should be performed but whether I should be the one doing it. There may be many reasons for this; perhaps I don’t have all the equipment that I may deem necessary to take care of the problem at hand or perhaps it may be that it is a procedure that I don’t perform regularly and so I should refer that patient to a neurosurgeon that is more experienced.

To be a brain surgeon one cannot be short on ego or confidence and so admitting that I may not be the best one for the job can be a difficult pill to swallow!  

Of course no patient wants someone to operate on their brain if that surgeon doesn’t believe he is the ‘best and most talented neurosurgeon in the world’! And so for me it is a delicate balancing act between confidence and honesty. Although there have been many times in my life when in the middle of a surgical procedure I have literally said to myself, ‘What am I doing here?’, only to deftly navigate myself through the procedure without complication.

Once I operated on a patient with a ruptured aneurysm and for reasons beyond my control I went into the surgery not having a complete picture of the surgical anatomy. As it turned out it was an extremely difficult surgery and an aneurysm I had never clipped before but I performed the surgery flawlessly. Had I known going in where that aneurysm was located I might never have agreed to do the case but as it turned out I was indeed the best man for the job.

So in practically all instances my skill, talent and knowledge is more than enough to get the job done. And having operated my way out of seemingly impossible situations many times before it is easy to understand how I would come to believe that I am indeed the ‘most talented neurosurgeon in the world’. But this is exactly why I must always turn to God, and ask for guidance.

Such was the case with Maria Papadakis. Maria, 22 years of age was involved in a car accident. For some unknown reason she became dizzy while driving one day, passed out and drove her car off the road and hit a telephone pole. On arrival to the emergency room she had a headache but otherwise was perfectly fine that is until she had a CT scan done of her brain. In the left frontal lobe was a tumor, just above the speech area and right up against the motor area controlling the right side of her body. Later, the neurologist would conclude she likely had a seizure which caused the accident.

She was admitted to the hospital that evening and I saw her in consultation the following morning. As it turned out I had operated on her mother Helena for a ruptured disc in her cervical spine a couple of years earlier. I then ordered an MRI scan to be done. After reviewing it with the neuroradiologist we concluded that the tumor likely was a low-grade astrocytoma, or perhaps it might even be a relatively benign tumor. Nonetheless, it would have to be biopsied so I could determine what would need to be done surgically.  I discussed this with Maria and her mother and told them I would perform the biopsy the following Monday and depending upon the results I would tentatively plan on the actual craniotomy for Thursday of that week.

On Saturday as I operated on Michael Dubois who had spread of his lung cancer to his brain, I thought of Maria and the difficulty I might encounter operating on her brain tumor. It was fairly large and although it’s location was above her speech area it extended right up to the motor area controlling the right side of her brain. Since it was likely to be a low-grade tumor the visual and tactile difference between it and the surrounding brain might not be that great. Thus, I could have trouble knowing if I had adequately removed the entire tumor; conversely I might not realize if I had also removed normal brain tissue in my attempt to resect the tumor.  

So my dilemma was should I be the one to remove her tumor as I knew I could, probably doing a better job than most neurosurgeons. Or refer her to be treated at the University of South Florida where they had an intra-operative MRI and more experience performing an awake surgery where they could accurately map out the speech and motor areas of her brain.

On Sunday making my rounds at the hospital I stopped by Maria’s room first and sat down to talk to her. I explained to her my concerns and that I decided she would receive better care if I referred her to Dr. van Loveren. As I spoke with her she finally comprehended the seriousness of her condition, as her face changed from her usual bright and carefree look to one of apprehension, although she thanked me for doing what I believed was best for her.

 

Faith, Belief and Doubt, and a Night at the Movies

 

Just the other night my wife and I watched the movie, ‘Angels and Demons’. In one scene Tom Hank’s character, Robert Langdon is asked by the Camerlengo, ‘Do you believe in God sir?’ To which he ultimately replies, ‘I am an academic…my mind tells me I will never understand God’. The Camerlengo then says, ‘and your heart?’ Langdon answers… ‘tells me I’m not meant to…Faith is a gift that I yet to receive.’

And in my mind and heart, that about sums it up… that belief in God is only possible through faith alone.

Even my 8-year-old son who ‘knows’ that Jesus Christ is God because of what he has been taught, can appreciate on a very basic level the difference between a belief and reality. One night a while ago as he went to sleep he expressed his fear of being alone because he was not physically near his mother or me. I tried to reassure him that Jesus was with him in his room but since he could not see or touch Jesus, that thought was no more comforting than knowing his parents were just 20 feet away in another room. 

Unfortunately this conflict between belief and doubt exists in the lives of adults and perhaps to a degree even within the Christian community. Because we are human we have human weaknesses, and fear and doubt are just that, weaknesses. And this is why prayer is so important. Prayer, particularly when it is truly contemplative redirects our thoughts away from our weaknesses and our imperfect world and focuses them on God. And I firmly believe that when our innermost being, our soul, has God at its center, the belief that God exists is no longer a metaphysical concept but a physical reality.

(As an aside, just the other day, my son asked me, ‘Dad, can you transplant the soul?’ I proceeded to explain that you could not; that the soul was not an organ in the body that could be taken out. He asked me what the soul was. So, I told him that it was a gift from God that lives all through our body and allows us to be like Jesus and close to him. Seemingly satisfied with that answer he then asked me what organs could be transplanted and which one was the hardest to do…)

And so if prayer is a daily part of our lives, God will become a part of that life, and then our actions will truly become a reflection of Jesus Christ in the world in which we live.

 ‘Then he said to Thomas, “Put your finger here, and see my hands;  and put out your hand, and place it in my side; do not be faithless,   but believing.” Thomas answered him, “My Lord and my God!”  Jesus said to him, “Have you believed because you have seen me?    Blessed are those who have not seen and yet believe.” ‘  

John 20:27-29

 

A while back I had been performing a spinal surgery in which I had to stabilize an area in the lower back by inserting some rods and screws into the bones of the spine. It is a procedure I had performed hundreds of time before but on this particular occasion I was employing a new technique. Thus, I relied on intraoperative X-rays and electrical neurologic monitoring rather than open visualization to insert the screws into the spinal bones.

For some reason I had difficulty positioning one of the screws despite the fact the X-rays indicated I had selected the exact entry point and trajectory that I should have. After multiple attempts, my frustration was apparent to all in the operating room.

It was at this point, I paused for a moment as I will occasionally do and took a deep breath. This time, however I rested my hands on the patient one over the other, bowed my head slightly, closed my eyes and said silently to myself, ‘God, Please help me’. I then opened my eyes, resumed the case and proceeded to immediately place the screw in the correct location on the very next attempt. I then let out a verbal sigh of relief, lifted my head and said aloud, ‘Thank you God’.

From the corner of the room, Peter, the X-ray technologist spoke out, ‘You just said a prayer there, didn’t you?’ I looked up and said to him, ‘You bet I did’. As I said that something occurred to me… not only did I rely on God to help me, which I often do but I professed it openly, which I don’t do enough! Not only is praying helpful to me in doing what I do but letting others know that I do and that it is important to me changes more lives than just the patients that I treat.

And so this brings me back to my original thought… the importance of faith in resolving the never-ending battle between belief and doubt…good and evil. Even I have doubts that creep into my consciousness:  not that, ‘is there a God?’ but, ‘do my prayers really make a difference?’…  ‘How can I be sure God really hears me?’  The thing of it is we can never be humanly certain, only faith can galvanize certainty in our soul. Faith truly is a gift and those without it should pray that they receive it.