Spiritual Experiences from the Brain

Hearing a Voice in the Wind

I had just finished my second case of the day, a cervical fusion, when Chad, my PA got a consult to see a patient at Countryside Hospital.

Aaron Cook, 81 had been diagnosed with multiple myeloma, which is cancer of cells in the blood that accumulate in and weaken the bones of the body.

Chad had spoken to the nurse and was told, Mr. Cook was paralyzed in his legs.

An MRI of his spine revealed that the cancer had replaced most of the bones of his spine. In his mid back, the cancer had weakened so much of one of the vertebra that it crushed upon itself. As a result the bone and cancer cells were pushed back into Mr. Cook’s spinal cord causing his paralysis.

Given Mr. Cook’s age, his paralysis, and the appearance of his MRI my initial reaction was that there wasn’t much that could be done. I spoke to his physician, Dr. Reynolds, who told me Mr. Cook had initially presented with severe back pain.

But because the cancer was so widespread it was concluded by the oncologist and radiation specialist that any treatment would be palliative, which basically meant the cancer could perhaps be slowed down but not cured.

Dr. Reynolds informed me Mr. Cook had been in the hospital about ten days receiving radiation treatments to his spine. ‘The excruciating back pain that he had on admission had subsided’, he continued, ‘but now he was unable to get out of bed because his legs were paralyzed’.

I told Dr. Reynolds that it was unlikely anything could be done surgically to help Mr. Cook but that I would go by and evaluate him if he wished. He said that would not be necessary. He just wanted me to look at the films and let him know if there was anything that should be done.

As soon as I hung up I was called back to OR room #4 for my next surgical case of the day. I finished up operating at about 6pm, and after I dictated my surgical note and checked on my post-ops I thought about Mr. Cook. I knew I wasn’t expected to see him but I felt compelled to drive over to Countryside Hospital and see him nonetheless.

As it turned out I had performed surgery on Mr. Cook’s wife many years earlier so he knew me, and in fact, he was expecting me. As I talked to him about how he wound up in the hospital he told me that up until about 4 weeks ago he was just fine. He and his wife had gone over to the Florida east coast but because he ‘just didn’t feel right’ he told his wife they needed to cut their trip short and return home.

When I was given his history earlier in the day I just assumed he had been diagnosed with multiple myeloma several years ago and that now his MRI revealed the end stages of the disease. But he had just been diagnosed 10 days ago.

When I examined him, I discovered he was ‘paralyzed’ in his right leg but that the strength in his left leg was only mildly weak. I then discussed with him options and prognosis. ‘In most circumstances such as yours I would remove the crushed vertebra and replace it with a metal or plastic cage filled with bone’, I told him. ‘Then I would place screws and rods in the spine above and below the fractured vertebra to stabilize it’, I continued.

‘But because the cancer had affected so much of your spine, I can’t do any of that. And because of your age, I’m not sure you would survive such an extensive surgery anyway’, I concluded.

‘So, what does that mean’, he asked. ‘Well’, I said hesitantly, ‘I’m not sure you will ever walk again’.

Choked up, Mr. Cook said, ‘Oh my God, my wife is too ill to take care of me…’ Looking down at him lying in his bed, still in pain and unable to get up and walk, I was sorrowful, wishing there was something I could do, yet realizing surgery was too risky.

I told him I was sorry and that perhaps with continued radiation treatments, he still might get better, although I knew this was not likely.

As I stood at the nurse’s station writing my progress note in Mr. Cook’s chart, I felt compelled to look at his MRI scan again. As I flipped through the images I thought to myself, ‘there’s got to be something I could do that might help’.

I called Chris, one of my colleagues to discuss his case. He too, agreed that Mr. Cook at 81 years-of-age would never survive a major surgery. But perhaps if I removed some of the bone from the back part of the spine, he suggested, this would free up enough of the pressure on the spinal cord so that his strength might improve to the point where he could walk again.

I thanked him, hung up the phone and walked back into Mr. Cook’s room.

I told Mr. Cook that I had given his problem more thought and there was something I could do surgically that might help him. ‘However, while I cannot promise you it will be successful, I think it may be worth the risk’. Not surprisingly he was willing to take that chance.

I spoke to Dr. Reynolds and explained my plan who then agreed to have Mr. Cook transferred to the hospital where I would perform surgery in the morning.

Surgery went well and though the cancer had destroyed most of that particular vertebra I was able to relieve the pressure on Mr. Cook’s spinal cord. Over the ensuing weeks following surgery Mr. Cook gradually regained strength in his leg and began to walk using a walker and some assistance.

For me, Mr. Cook’s case reinforced to me the importance of several things. The first is that nothing replaces talking to and examining the patient myself.

Not only does this allow me to get a real sense of the patient’s problem but also helps me to understand the true impact of the illness on the patient and his (or her) life.

In Mr. Cook’s case I initially dismissed ‘out of hand’ that anything could or should be done surgically in someone who had widespread cancer. However after speaking to him I realized he was living a normal life just 2 weeks earlier. Not only that but his wife was very ill herself and there was no way she could take care of him.

So as I stood there leaning up against the counter at the nurse’s station, I felt a change of heart. Was it merely my sense of compassion… or was it an angel, or the Holy Spirit that inspired me, reminding me I was given my gift to help others.

And so, grateful once again for be able to hear that voice in my head, I did what I could to help Mr. Cook, and his wife.

“The wind blows where it will, and you hear the sound

of it, but you do not know whence it comes or whither

it goes; so it is with every one who is born of the Spirit.”

John 3:8

The Love of a Mother

Understandably, with the passing of my mother-in-law, my wife Stacy has undergone a life altering experience. And as much as I might try to comfort her and tell her I understand, the reality is… I don’t. It is more honest to say that I am trying (to understand).

On the other hand, my mother is quite elderly, 89 to be exact and though she has lived a full life and I might think I will be able to accept her passing when it is time, until it happens I really won’t know. What I have come to realize however, from witnessing my wife’s experience and speaking with others, is that losing a mother seems to be a greater loss than when a father dies.

I can’t speak for everyone but while I love and have a great appreciation for my father, I would have to say that the bond between my mother and I is stronger.  In part it is because our personalities are so much more alike, but somewhere in the recesses of my brain I feel it goes deeper than that.

A father loves and provides for his children, as I have done and I would have to say without hesitation that I would lay my life down for my children.

But a mother will sacrifice everything, including herself, every day of her life if necessary, for her child. After all her child is flesh from her flesh.

Recently this occurred to me as I was making rounds in the ICU.

When Jesus saw his mother, and the disciple whom he loved

standing near, he said to his mother, “Woman behold your son!”

John 19:26

Bobby Waters is a 24-year-old ‘boy’ who had been complaining of a headache after having sustained what he thought was only a minor head injury. He then began having some difficulty speaking, but because he did not have insurance he avoided going to see a doctor. However when he became lethargic and his girlfriend found him lying on the floor of his apartment, she called 911.

Bobby was a tall, well-built, good-looking boy who had an equally good-looking girlfriend. Unfortunately, during his hospitalization a lot of that would change, all except one thing.

On arrival to the hospital, a CT scan was done which showed that Bobby had a large hemorrhage deep within his brain on the right side. The size and location couldn’t have been worse for this young, previous healthy boy. It extended into the top part of his brainstem resulting in paralysis of the left side of his body.

And there was nothing that could be done surgically to safely remove the hemorrhage and reverse the damage that had occurred.

The hemorrhage also blocked off the normal flow of cerebrospinal fluid within the brain causing it to back up and resulted in an elevation of the pressure within his brain to critical levels and as a result, Bobby was in a coma.

The neurosurgeon on call emergently performed a ventriculostomy, which is basically drilling a small hole in Bobby’s skull and passing a thin, soft catheter through the brain into the fluid filled ventricles within the brain to drain off the cerebrospinal fluid and thus relieving the elevated pressure.

Unfortunately this only prevented other problems from developing, because Bobby still remained paralyzed and in a coma, and on the ventilator.

Over the next several weeks, Bobby would develop a collapsed lung, pneumonia, an infection in his blood stream and a suspected infection in his brain. And though he survived it all he remained dependent upon the ventilator to breathe for him. And while his brain condition improved to the point where he would open his eyes, if you were to look at him you would hardly consider him ‘awake and responsive’.

Ultimately the CT scan revealed that the hemorrhage resolved although whether Bobby would recover was uncertain at best. The catheter which stuck out from the top of his head that drained into a bag on the side of his bed was removed. In its place was an internalized shunt with a valve that would regulate the pressure within Bobby’s brain so that it would be normal.

He also became less dependent on the ventilator but nonetheless the tube coming from his mouth was converted to a tracheostomy coming from the front of his neck.

Through it all, Bobby became a shell of the vibrant young man he was going from almost 170 to 115 lbs.

One day after about 4 weeks into his hospitalization, as I happened to walk by his room in the ICU I looked on to see a solitary person sitting by his bedside, as she had from morning till night each and every day since his admission a month ago…his mother.

Gone was his brother. Gone were the friends. Gone was his father who as near as I could tell only came to town briefly mid-way through Bobby’s stay in the hospital. Now, she was the only person there, as if keeping a vigil awaiting her baby boy’s first words.

He still has not spoken though he has shown some movement on his paralyzed side. He does know when his mother comes into the room and he tracks her with his eyes as she moves from the door to her usual chair by his bedside.

To me, this epitomizes the devotion and complete self sacrifice of a mother, which as I think about it mirrors the depth of love that Jesus has for each and every one of us.

So, as a child when you lose this person, your mother, there can be no loss that equals the pain that you must feel. I suppose the only consolation is to know that one day you will once again be reunited with her, although the pain persists nonetheless, taking time to lessen. Of course, we still have the ever present person of Jesus Christ who is always there to console us.

Peace I leave with you; my peace I give to you; not as the

world gives do I give to you. Let not your hearts be troubled,

neither let them be afraid.

John 14:27