Spiritual Experiences from the Brain

A Colleague, a Friend and a Missed Opportunity

 

Today, a colleague of mine died. We were not close friends but I had known him for almost 20 years. He had been struggling a long time with cancer.

He was a neurologist so I had frequent interaction with him when I began my private practice in neurosurgery. He was an extremely bright man, in fact my former partner, Kevin and I used to say that he was so intelligent that he probably had little room for common sense. Nonetheless, we respected him greatly and always knew that if we had a difficult and puzzling case Bryce was one of only two guys we would go to.

Jack was the other neurologist I knew. He was more of a philosopher. Perhaps not as intelligent as Bryce (although I think we would be splitting hairs here!) but he had a ‘sixth sense’ about patients. He would tell me you had to have a gestalt about the brain and neurological problems. He would say ‘if a clinical finding didn’t make sense in the grand scheme of things you had to at least temporarily disregard it, if not throw it out altogether to see if a diagnosis could be made based on the remaining information’. Otherwise you could be ‘stuck in the weeds’ for a long time, so to speak.

When I was in medical school contemplating what area of medicine I would pursue, I gravitated to neurosurgery because it made sense logically (I was fascinated with neuroanatomy and I loved surgery), but probably more importantly I felt ‘at home’ being among other neurosurgeons. For neurologists, I am certain it is the same; it’s just that the cerebral aspects of the brain captivate them more than wanting to be ‘merely a technician who cuts out what we (the neurologist) have already diagnosed’.

In a way it’s a funny thing that our personalities influence our choice of hobbies as much as the medical specialty we are ‘drawn’ to. Many of the neurologists I have met over the years have been avid gardeners, which in a way is ironic. In neurosurgical residency the patients we would operate on who either had a major stroke or brain hemorrhage postoperatively often became unable to communicate or care for themselves. These patients, or the so-called ‘vegetables’ would then be passed on to the neurologists, who would take care of these chronic patients. We would joke that they essentially would ‘water the garden’ since there wasn’t much else they could do.

Of the two, Jack was the gardener although I’m pretty sure he would have turned up his nose at the notion anyone would have considered him an ‘amateur’ at it. In fact his depth of knowledge was so great it would have more appropriate to consider him a botanist. Bryce on the other hand was an avid photographer. So while Jack seemed to revel in the evolving colors of the plants and flowers that he nurtured, Bryce found immense satisfaction in capturing those brilliant moments of nature with his camera.

(By contrast, Jack was also a serious fisherman while I, the neurosurgeon would rather scuba-dive and spear the fish.)

Jack, too, had been sick. He had chronic neck pain and despite several surgeries he required frequent pain medication and occasionally oral prednisone. He also had an aortic valve problem for which he underwent open heart surgery, but apparently his heart had become weak from years of being overworked. And one day about a year ago his heart began failing and despite the heroic efforts of his doctors, he died. When Lora, his wife called me to tell me, I was shocked, saddened and I think, a bit upset. I had just seen and spoken with him on Halloween, several weeks earlier. While not the picture of health he sure didn’t seem like someone whose heart might fail him at any time.

Bryce, fought his disease courageously and at one point it appeared he had won. As of late, however he did not appear well; though because he was a private person and less vocal than Jack I could only make the assumption his cancer was no longer in remission, based on my impression of him. So when I heard he had been hospitalized and was not doing well I was not taken by surprise. Several days later when I heard he had died I almost felt a sense of relief for him.

At first this feeling did not seem strange. For I knew Bryce was finally well and at peace himself; just like he looked in those radiant, healthy, younger photographs of himself. But then I began to wonder why I felt one way with Jack and another with Bryce. I really didn’t socialize with either of them very much outside of work, but I felt more of a kinship to Jack than Bryce. I guess because Jack had ‘taken me under his wing’ when I was starting out, he was more friend than colleague. In a way I sort of had a feeling that he should have been a neurosurgeon rather than a neurologist.

Then I began to think about all the funerals I attended growing up. I came from a large Italian family with many aunts, uncles and cousins. And it seemed like someone was always getting married or dying. So I probably attended as many funerals as I did weddings.

Funerals seemed a bit odd to me. First of all the funeral homes were either Italian (Maiorana) or Irish (Murphy), and depending on your nationality of origin that is who you would call to ‘make the arrangements’. On the night of the wake in the front of the funeral parlor was the family of course but also older matriarchs of the family, usually of distant relation, that held their handkerchiefs in one hand and cried all night. Most of the people sat quietly in the center of the parlor after paying their respects to the family and remarked to one another how good the deceased looked. In the back the men milled around talking to one another as if they were at their favorite bar. The only thing missing was the beer… or was it Dewar’s!

Had I finally become so numb to the dying of patients and family that I was no longer capable of feeling sorrow?

No, that wasn’t it. I knew in the depths of my being that I when I died I would become united with Jesus Christ, my God and for whatever reason I felt that was where Bryce was. I really did not have first-hand knowledge of either Bryce or Jack’s spirituality or faith but I had a strong sense that Jack lacked this in his life.

Sure, I was saddened by his sudden death but I think more so I was upset with myself for not at least speaking with him about my faith and telling him how important it was to me personally and professionally.

Jack was a good, honest and kind person despite his seemingly abrasive exterior so I’m sure eventually he will be in heaven. But for my part I felt should pray for him and his soul that he would get there sooner than later. And so this is what I did for months afterward whenever I would pray the rosary… “O my Jesus, forgive us our sins, save us from the fires of hell, lead all souls to Heaven, especially those most in need of Thy mercy”.

And so, two men, both brilliant and talented neurologists had their lives snuffed out in the apparent prime of their lives. I have to believe there is a reason for this but I firmly believe one day they both will be united together with our Lord in Heaven.

Illness, Prayer and My Summer Vacation

 

This past week we had been on vacation. It was to be a road trip of sorts and one of the stops was to visit with my parents who at 88 years of age were celebrating 56 years of marriage.

 

It didn't turn out the way we planned and in fact we had quite a scare.

 

I have been on the other side of medicine a few times in my life. It always gives me an appreciation of what patients feel when they have to give up total control to someone else, who literally has your health and in some cases your life in their hands. Nothing can prepare you, however for what we as parents went through when our little boy became so sick that he wound up being admitted to the hospital for the first time.

 

During my internship in general surgery and my residency in neurosurgery, I never liked pediatrics. It wasn't that I didn't like children but dealing with anxious parents was ten times, no one hundred times worse than dealing with adult patients or even their families Of course at that time in my life, I could care less about the 'feelings' of my patients or their families. I considered it extraneous to becoming 'the most talented neurosurgeon on the planet'! In retrospect, it is ironic that I have come to realize that allaying the fears and anxieties of my patients and their families, often times, from a spiritual perspective is even more important than what my hands can accomplish.

 

So, I was keenly aware of the difficulty of being a pediatrician but it wasn't until this past week that I came to fully appreciate how important the care they provide truly is. Of course without the nurses and physician assistants that surround them, their job would be next to impossible. I say this because not only did they have to get our boy well, they also had to, and this is the hardest part, calm my wife and me down and convince us that they would do just that.

 

Upon arriving to Connecticut, Michael was feeling fine. That night after dinner, however he developed a fever. I didn't have a thermometer at the time but experience told me his temperature was certainly over 101 degrees. I began administering Tylenol every few hours or so but his fever didn't seem to break. The next day he only seemed to get worse and he began to develop severe gastrointestinal symptoms along with nausea and vomiting. Not only could I not get any Tylenol in him but because he would not drink any fluids, he was becoming dehydrated too. When his temperature hit 105, I knew it was time to go to the hospital.

 

On arrival to St. Mary's Hospital, I told the woman at the desk what the problem was and she immediately rushed us back. The nurse took his temperature and fortunately it was down to 103. They immediately got him a bed in the pediatric section of the Emergency Room and within a short period of time a seasoned nurse came back and effortlessly got an IV in his arm and drew blood for the necessary lab tests. I knew he was sick because he hardly put up a fight even when he saw the nurse coming with the IV needle and tubing in her hands.

 

Soon the pediatric ER doctor came back and told us they suspected he might have appendicitis. The thought of our little boy having surgery began to raise our anxieties and my blood pressure. 'That just couldn't be', I thought. 'His abdomen was so soft without any of the signs of an inflamed appendix'. But after all, I was just the dad who happened to be a neurosurgeon, not the pediatric surgeon. So we waited.

 

Soon, the surgeon, Dr Zarif came in and examined him. He impressed me as experienced and his demeanor was calm and comforting. He looked at us and told us he did not believe Michael had appendicitis but that he would need to be admitted for intravenous hydration and continued observation. We were somewhat relieved but still concerned because our boy was still so sick. Fortunately, it just so happened the pediatric floor of the hospital was actually owned and staffed by Connecticut Children’s Hospital.

 

Our worries however were far from over. I spent the next two nights helping to take care of Michael, getting up every one or two hours helping him get to the bathroom as I navigated his IV pole and then washed him afterwards.  It was a though he was an infant all over again completely dependent on my wife and I for his care .

 

By the following morning as a result of the frequent trips to the bathroom along with the occasional episode of vomiting, he began to experience abdominal pain. Dr. Zarif still did not believe he had appendicitis but rather a severe form of gastroenteritis and colitis. So he consulted a pediatrician, Dr. Jennifer Gannon, who was in contact with the pediatric gastroenterologist in Hartford, Connecticut.

 

Soon we were also told that Michael also had blood present in his urine which could represent a complication of the gastroenteritis, called hemolytic uremic syndrome. Quick research on my part revealed this syndrome could result in kidney failure and in worst cases, heart failure, or coma. And because many of the more effective pain medications could increase the likelihood of this potentially life threatening complication, the doctors and nurses were unable to use anything stronger than Tylenol.

 

It was agonizing for us. There was nothing we could do to make him feel better and it seemed that there was nothing the medical staff could do to either. We just had to wait it out.

 

On the second day of our hospitalization, I picked up a publication of the Connecticut Children’s Medical Center, called ‘Pediatric Matters’. It told a story of a 7-year-old boy who survived an illness much more severe than our son’s. As a result he was selected as a ‘Champion Child’ to represent the medical center as part of the ‘Children’s Miracle Network’ program designed to raise awareness of the specialized health care and research supported by the Children’s Miracle Network and its affiliated hospitals, like the Connecticut Children’s Medical Center.

 

I have to admit I was a bit sleep deprived when I read this but the use of the word ‘miracle’ struck me. The story did not mention faith, religion or prayer but to me the implication was clear. What we could do for our boy was to pray. Not that we would have ever considered not praying, but the urgency of our prayer was never more certain to me in that moment.

 

And not that our prayers would be any less important to God than the next person, but I do believe that the more people who pray for you the more meaningful the prayer is. And that is the interesting thing about Facebook. As a social media it allows people to communicate across the world to friends and strangers alike, though much of the information is often pointless. However, in this situation… in this crisis we found ourselves in, instead, it became a network of people who not only passed along their thoughts and concern but also prayed for us. I have to admit, however, this was not my observation but that of my wife, Stacy, once again reminding me that I don’t know everything.

 

We also found it comforting to be near my mother. She has always been a deeply religious and prayerful person. In fact she initially entered the convent before deciding that her true vocation would be to raise a family. Recently I needed her prayers and she was there for me and now she was there to pray for our son.

 

On the fourth day of our hospitalization, the staff was getting prepared to transfer Michael to the main hospital campus in Hartford for a colonoscopy and biopsy as the diagnosis was in doubt. That afternoon the third and final culture returned positive for Salmonella (the first two were negative) so the transfer would not be necessary. And almost as soon as we were told the results Michael became well. His temperature became normal, his abdominal pain subsided and he wanted to eat. The following day he was discharged and by the looks of him you would never know he had ever been so sick.

 

So our thanks go out to our family and friends for their prayers, and to Dr. Zarif and Dr. Gannon and all the nurses and physician assistants for their part in our little miracle.

 

‘And whatever you ask in prayer, you will receive, if you have faith’

Matthew 21:22