Spiritual Experiences from the Brain

A Physician Greater than I

I had just finished operating for the day and I had a meeting to attend but I told my wife before the meeting, I would join her and the children for a quick picnic, and if I didn’t leave soon I would be late. To say I was rushed was a bit of an understatement, but first I had to run up to the ICU and quickly see Nora Horace who I was scheduled to operate on the next day for metastatic breast cancer to the brain.

Nora had been diagnosed with breast cancer several years ago and had undergone treatment, including chemotherapy, but a recent PET scan was clear. So it was quite a shock when the emergency room physician told her she might have a brain tumor.

Nora had been having some imbalance and unsteadiness walking but she thought it might have been side effects from the chemo, but when it got worse, she and her close friend Diane felt it best to have it checked out further.

She actually had been admitted the evening before and I had been called during the afternoon and was told of her case. So when I reviewed the CT scan, I ordered an MRI to be done the following morning and told the nurse I would be by to see Nora the next day after I finished operating.

The MRI indeed revealed a large tumor in her left cerebellum which is the area of the brain responsible for coordination; in addition the pressure it exerted on the brain around it, caused compression and partial obstruction of the flow of cerebrospinal fluid within the brain. This was even more critical because if the flow became completely blocked off, the pressure within the brain would reach a life threatening level.

So it was clear I had to operate to remove this tumor. Unfortunately, Nora also had three ‘pea-sized’ tumors elsewhere in her brain which indicated her metastatic disease was more widespread.

As I walked into her room, she greeted me in a warm way similar to what I had experienced at a resort in the Bahamas many years before. This was her nature because she, in fact, was from one of the islands in the Caribbean.

I brought up the images of her MRI on the portable computer to show her and her friend the nature of the problem. After I finished describing the findings on the MRI and explaining the surgery I had planned, I fully expected her to be like most patients, a bit shocked, a bit depressed but resigned to what needs to be done. At that point most patients say ‘ok, whatever you say doc’. My reply is often a bit curt as I nod and tell them I will see them in the morning, as I turn to leave.

And this day I had planned on it playing out that way, so I could be on my way to where I had to be.

But what she said, stopped me… dead… in my tracks.

Nora then replied, ‘I am not afraid doctor… I know the Great Physician… do you know Him?  I said ‘Yes I do…very well.’ She said ‘that is good because sometimes when I ask people, do you know Jesus Christ? They tell me he was just some guy.’ I continued, ‘No, He is way more than just a guy’.

She then asked if I prayed to Him to guide me before I operate and I replied, ‘all the time’. Nora then asked, ‘Well tomorrow before you operate on me’, as she pointed to the sky, ‘I want you to call Him… collect!’ Practically with tears in my eyes, I promised I would.

I shook her hand with both of mine and told her I would see her in the morning, as I slowly turned, to walk out of her room.

Going into the surgery I anticipated that removing the tumor would be fairly easy, since most tumors of this type are not adherent to the surrounding brain. As it turned out removing the tumor was extremely difficult and I spent no less than six hours micro-surgically teasing the tumor out.

The amazing thing to me was that throughout the procedure, ‘ideas’ would pop into my head on how to proceed, which were not necessarily techniques that I usually employ. As a result I was able to completely remove the tumor without any complication whatsoever.

As I was finishing up, I thought about this, realizing that God had been with me and by my side guiding me every step of the way.

The following morning, I examined Nora and found her to be completely normal neurologically. Though the pain of the incision caused her to wince, she said ‘I am grateful to God, grateful that you are a Christian, and grateful that He worked through your hands to help me’.

for she said to herself, “If I only touch his garment,

I shall be made well.” Jesus turned, and seeing her he said,

“Take heart daughter; your faith has made you well.”

And instantly the woman was made well.

Matthew 9:21-22

Walking with Jesus

Jesus said to him, “Rise, take up your pallet and walk.”

And at once the man was healed, and

he took up his pallet and walked.

 

Afterward Jesus found him in the temple, and said to him,

“See you are well! Sin no more, that nothing worse befall you.”

John 5:8-9, 14

 

In my last post I included a passage from Luke’s gospel that told the story about Jesus giving sight to a blind man. The key statement by Jesus was: “Receive your sight; your faith has made you well”. Here, Jesus heals a paralytic but the implication, to me, is not just that the man was able to physically walk, which certainly was a miracle, but that he should also walk in the footsteps of Jesus. And just to be sure the man ‘got it’; Jesus finds him later and clarifies what is really important in his new life by saying, “Sin no more, that nothing worse befall you”.

Recently, my wife’s mother Janice, who had been ill, past way. Because we had been on Cape Cod at the time we had a funeral service there. She was then cremated and when we returned to Florida we had a funeral mass here.

At both services I was asked to deliver a eulogy celebrating her life and the person she was. In contemplating what this was, I kept being reminded that the single most important characteristic of her life was the love she had for her children and later in life, her grandchildren.

A passage from John’s gospel clearly spoke of this to me; It was when Jesus gives his apostles a new commandment that they love one another as He loved them. He then tells them, “by this all men will know you are my disciples, if you have love for one another”.

And this is what Janice tried to become in her life… a true disciple of Jesus Christ.

After we got home to Florida, my wife, Stacy found a journal that her mother had kept. In one particular entry from several years ago, she spoke over and over about walking with Jesus. And how she regretted earlier in life not ‘seeing’ that this is what she should have been doing all along. Yet, she was grateful for finally realizing that this was the path she should be on.

I guess I knew she was close to God; after all He used her to touch and change my heart many years ago when cynicism and selfishness threatened to derail me off my path to help others using the gift God gave me.

But, and I am embarrassed to say so, because she wouldn’t come to church with us on Sunday I merely assumed God was not playing a big role in her life. It is ironic that in our efforts to be ‘good Christians’ we allow the evil one to cause us to be judgmental of others when they do not ‘appear’ to be the same ‘God-fearing’ people we perceive ourselves to be.

Of course she had very real health reasons that kept her homebound but I felt she should have made a better effort to be there. Jesus, I suspect would have been more loving and understanding than I. As it turned out she was walking closer to Christ than I was…

When she was 16, she had a vision while she was hospitalized. She recalled that God appeared to her surrounded by the brightest of lights with a child at His feet. She then heard Him say ‘Do not fear, I am here’. At the time it seemed to me she was more confused rather than inspired by what she had ‘seen’.

Later in life as she looked back on this experience, she regretted not allowing it to influence her decisions in life more. I guess we all have our demons that constantly struggle with the good inside of us. Jan worried a lot and as a result became very anxious. Often she found herself being critical and judging others which led to what she called ‘tears of frustration’.

She realized that often she was not always able to forgive others for what they may have done to her. Quite eloquently she wrote that because of this particular failing she had deprived herself of the gift of God’s love and forgiveness.

The one thing that Jan did excel at all her life though, was her love for all her ‘children’. Very much like Jesus, Jan did cherish the innocence and hope that is embodied in every child.

 

And calling to him a child, he put him in the midst of them

and said, “Truly I say to you, unless you turn and become

like children, you will never enter the kingdom of heaven.

Whoever humbles himself like this child, he is the greatest

in the kingdom of heaven.”

Matthew 18:2-3

 

Later in life though, through much prayer Jan reached out to God in the ‘truest form’ and as result came to truly know Him and as a result was able to not only walk in the footsteps of Christ but ‘with’ Him. Of course she realized her first steps had to begin with forgiveness and in this she found such peace and love.

About 10 years ago, Jan’s husband Don or as he was called by his grandchildren, ‘Pa’ was diagnosed with Alzheimer’s. Throughout this time, Jan devoted every waking moment to him right up until his last day three years ago. She missed him dearly but she continued her journey with Christ. Not that it was always easy…

Two years ago she was diagnosed with lung cancer. Initially it was thought because the tumor was so small it could be successfully treated and perhaps cured with a specialized form of radiation. And for a while she did well and continued to live her life to the fullest traveling to Cape Cod with Stacy and with our family to the cabin in North Carolina.

But earlier this year the cancer recurred and so we all were forced to face the reality that she would die, although the end came more quickly than we had anticipated.

As the summer approached she had wanted to make one more trip back to her home on Cape Cod. A repeat PET scan showed the cancer still had not spread so we felt she would be able to make the trip and we fully expected her to make it back to Florida before the end would come.

In fact she was so happy and gleeful to be heading back to Cape Cod that she seemed to have new-found strength that overcame the weakness of her illness. And as she crossed the Sagamore Bridge she had a sparkle in her eye and a smile ‘ear to ear’.

Sadly, as soon as she got home, she weakened quickly and practically before we could realize what had happened, she passed away on the 4^th of July with her family and friends surrounding her, as a final tear rolled down her cheek.

Watching and helping my wife take care of her in the last several months, as she became more and more dependent on Stacy for her care, it seemed as though she became more and more like the child that Christ wanted her to become that day in the hospital 60 years earlier.

Just this past week, Stacy lay to rest the ashes of Jan (or Mimi as the grandchildren called her) and Pa at home in Sandwich, Massachusetts. Together again, they are surrounded by the love of her Lord, Jesus Christ.

 

‘When a woman is in labor she has pain, because her hour has come;

but when she is delivered of the child, she no longer remembers

the anguish, for joy that a child is born into the world. So you

have sorrow now, but I will see you again and your hearts will rejoice,

and no one will take your joy from you.’

John 16:21-22

A Test of My Feelings, Fortitude and Faith

Hector Gomez fell at home and was found on the floor by his family so he was brought to the hospital and he was admitted for further tests. Because he also complained of numbness and tingling in his arms and legs, an MRI of the cervical and thoracic spine was ordered.

The results of the thoracic spine MRI prompted a call to me for transfer to Mease Dunedin Hospital. The radiologist said Hector had a tear in the tissue layer that enclosed the spinal cord. As a result the spinal cord itself had herniated through this opening and was trapped causing the numbness in Hector’s legs. This report startled the doctors taking care of Hector and so they wanted him transferred ASAP, figuring he would need surgery right away!

Personally, I thought the abnormality was actually a cyst of spinal fluid which surrounded the spinal cord compressing and it pushing forward, but either way it looked like Hector would require surgery. Unfortunately because Hector was obese and had numerous medical problems surgery would be technically difficult and risky. Nonetheless I instructed the transfer center to arrange transport of Hector to Dunedin.

When Hector arrived, not only did he have numbness and tingling in his legs, they were weak as well, although his right leg was slightly weaker than his left. But before I could consider operating I needed an additional scan. But because of Hector’s size we had to transport him off campus to another facility because he could not fit in the MRI scanner at the hospital.

The additional scan was unremarkable. I spoke with Dr. Lopez, the neuroradiologist who reviewed all of Hector’s studies and agreed the problem causing Hector’s numbness and weakness was a cyst compressing the spinal cord. With this confirmation I took Hector to surgery the following week. Micro-surgically I was able to remove the cyst and take the pressure off of Hector’s spinal cord. Immediately after surgery the strength in his legs was stronger than pre-operatively although it was not yet normal.

Since the hospital was full to capacity, Hector was kept in the Recovery Room instead of being transferred to the ICU following his surgery. This arrangement actually turned out to be a blessing in disguise.

The following day I happened to be performing a spinal fusion and Allen, Hector’s nurse came into my room about 3 pm with some disconcerting news. Suddenly, Hector began complaining of numbness from his chest down and now he was saying he could not move his legs at all.

I was somewhat unsure of whether to believe Hector was truly worse since the numbness he had before surgery had persisted even after the operation; and his strength was still not normal, having examined him earlier that morning. But Allen was insistent that there was a real change, for the worse.

I asked Chad who was scrubbed in with me to go examine Hector while I finished operating and let me know what he thought. He returned to tell me that Hector indeed was worse neurologically. Unfortunately we didn’t have time to get an MRI off campus because if Hector had a post-operative hematoma compressing his spinal cord we needed to act fast.

I instructed Chad to see if there was any way he could be scanned in the MRI scanner at Dunedin. Randy, the MRI technologist seemed to think we could try. Unfortunately, as soon as Hector saw they were going to try to scan him here he became fearful he would get stuck and had a panic attack.

When I arrived, Hector was in a full-fledged panic, screaming to the top of his lungs that he wanted to get out of there, while everyone stood around not knowing what to do.

I went to his side and tried to calm him down and impress upon him the importance of getting the test so we could help him. But nothing I could say seemed to quiet him.

He then began rambling and at first I wasn’t sure what he was saying but then it became clear…he said, ‘If I cannot move my legs, I cannot work, so I want to die’. I told him ‘no’, that I was going to help him walk again, although at the time that was the thing I was least sure about.

‘No, I want to die’, he kept repeating. As I held his hand I closed my eyes and prayed, ‘Dear God give me the wisdom to know what to say’. So I said, ‘Hector, Jesus loves you’ figuring this would get his attention and hopefully focus him on the importance of getting the tests we needed to determine if I had to take him back to surgery.

Instead of quieting him, he said, ‘No, He does not, He has forgotten me!’ I replied ‘No, He has not’, but that did nothing to get Hector off the ledge he had crawled out on to.

He then started saying, ‘I want to be with my mother’, to which I replied, ‘where is your mother?’, although I was certain I didn’t want to know the answer. ‘In heaven’, he replied. ‘I want to be with my mother in heaven’ and he said it over and over.

At this point I did not know what to do. I had failed miserably to calm Hector and I still needed to know what was going on with Hector’s spinal cord. I was very close to giving up but the thought of Hector being permanently paralyzed forced me to do what I had to do to help him, in spite of himself.

So I decided since we could not get an MRI scan I would order a myelogram. For this test the radiologist would inject dye into Hector’s spine. If there was compression of his spinal cord the normal flow of the dye around the spinal cord would be cut off. Fortunately, Dr. Lopez just happened to be at the hospital to see another patient and he was kind enough to agree to perform the procedure, even though he was not on call.

As I walked into the myelogram suite with some paperwork that had to be filled out, Hector looked at me and said, ‘Are you my friend?’ and I replied ‘yes’. He then grabbed my right hand and placed my index finger against his temple and said, ‘then you kill me.’ I took a deep sigh, said ‘No’ and turned to leave as Patrick, the anesthesiologist started the sedative infusion and Hector drifted off to sleep.

The myelogram test indeed revealed Hector had a blood clot pressing on his spinal cord, and at the time of surgery at the bottom of the very large hematoma I found a small artery vigorously pumping blood. With the hematoma removed and the pressure relieved, I coagulated the artery and closed, praying and hoping Hector would recover.

The following day the strength in Hector’s left leg was close to normal but he had no movement in his right leg. Both he and I were somewhat discouraged but I told him to keep trying to move it and I would continue to pray.

The next day, still no improvement but on the third day, when Chad walked into his room, Hector said, ‘I am so happy!’ Chad was slightly confused as he walked toward Hector’s bed with a quizzical look on his face. At that moment Hector lifted his right leg off the bed. When Chad told me, I said ‘man, now that’s a miracle!’

Within a week, Hector was walking with a walker with some assistance and was discharged to a rehab center where he continued to make progress and was then discharged home after about a week of intensive physical therapy.

For me, the most difficult part of taking care of Hector was not the stress of worrying about whether he would ever walk again; it was not knowing what to say to him when he wanted to give up. Granted at the time he was in such a state of high anxiety he probably wasn’t even aware of some of the things that he said. Nevertheless I wasn’t very inspiring either.

What I did do well however was knowing to listen to the angel tapping me on the shoulder telling me ‘Forget about trying to minister to Hector’s soul, and do what you do best. After all, God is depending upon you to take care of the sick for Him.’

‘But when he heard it, he said, “Those who are well have no

need of a physician, but those who are sick”’

Matthew 9:12

 

Guilt, Gratitude and a Good Laugh

‘Then our mouth was filled with laughter,

and our tongue with shouts of joy;

then they said among the nations,

“The Lord has done great things for them.”

The Lord has done great things for us;

we are glad’

                                 Psalms:126:2-3

 

I pray for many things. The thing of it is that what I pray for isn’t always what I need’s God’s help for. Fortunately He is merciful enough to help me anyways…and my realization of this shows me He has sense of humor too!

 

Quite a while back I operated on a gentleman, Grant Lisset, who had a brain tumor. Unfortunately the surgery did not go as I had planned. At the time of surgery I encountered an unexpected degree of brain swelling which prevented me from removing the tumor completely. Not only that but postoperatively, Grant, my patient, who entrusted his life in my hands developed paralysis on his right side and an inability to speak.

 

After his initial recovery he gained back his ability to speak and a significant amount of strength in his arms and legs to the point where he was able to walk with assistance.

 

Ultimately, a second surgery resulted in removal of the remainder of his tumor, although I had felt guilty…no, remorseful that I wasn’t able to completely remove his tumor the first time without complication. What had transpired during his first surgery likely would have happened to anyone else who might have operated on him but I, still, felt personally responsible.

 

The thing of it is that my approach to a difficult case is directly influenced by my experience with the one that preceded it. So, when Barbara Nelson came to my office with a similar tumor to what Grant had, I hesitated, initially, to even do the case. However, the tumor had increased by 40% over a year and a half period so despite her age of 81 years, it had to be removed.

 

What made the decision somewhat easier was because of her advanced age I knew I didn’t have to achieve a complete resection. This was because radiation could be administered following surgery and would, in all likelihood prevent it from recurring during her remaining lifetime.

 

In addition the tumor was right on the surface of her brain and from a technical standpoint would be (relatively) easy to approach surgically and remove. Nonetheless, I prayed hard for God to guide my mind and hands that I might successfully remove Barbara’s tumor.

 

The tumor was located essentially in the back of her head on the left side, just above the occipital part of her brain which is responsible for her vision. The only difficult part of the surgery would be exposing the tumor because it was right up against the superior sagittal (venous) sinus which runs in between the two hemispheres of the brain.

 

Essentially, the arterial blood which carries oxygen and nutrients is transported to the brain by the carotid arteries. After the arterial blood passes through the brain it becomes venous blood and drains into the superior sagittal sinus on its way back to the heart. Should any damage occur to this venous sinus the build-up of arterial pressure in the brain can cause a major hemorrhage or worse, death.

 

So it was critical for me not damage the superior sagittal sinus as I removed the skull overlying it to expose Barbara’s tumor.

 

As it turned out the surgery was ‘textbook’. I completely removed Barbara’s benign tumor and she was on her way to the recovery room less than four hours after I started the procedure.

 

The irony of my day in the OR, however, lay with my next case, where I would need every bit of God’s answer to my prayers!

 

It was by every indication a routine case. On Wednesday, the week before Deborah Grant had come to my office complaining of severe pain that started in her neck and radiated down her right arm into her hand. She described the pain as ‘a searing type pain that felt as though it was deep within the bones of her arm’ and nothing she did, not the medication, the therapist nor the chiropractor had lessened the pain a bit.

 

In addition her index and middle fingers were completely numb and when I examined her, the muscles of her right arm were severely weak as well. When I looked at her MRI the reason for her signs and symptoms was clear. She had a ruptured disc between the 6^th and 7^th vertebra that was literally squashing the nerve up against the bony opening through which it normally passed easily.

 

Having successfully removed Barbara Nelson’s tumor earlier in the day, I was feeling quite confident (perhaps even a bit prideful) so I figured correcting Deborah’s cervical disc problem would be a ‘walk in the park’ by comparison. In fact what happened couldn’t have been further from the truth!

 

I had just finished removing the majority of Barbara’s disc and with the use of the operating microscope I was closely inspecting the back part of the disc for a small tear in the ligament that separated the disc itself and the nerve root. Ninety-nine percent of the time I would have expected to find a fragment of the disc that had torn and ruptured through this ligament to put such excruciating pressure on the nerve traveling into Barbara’s right arm…but I found nothing.

 

Immediately I had a sense of dread come over me…I must be at the wrong level! Quickly I looked at the x-ray I had just taken…1, 2, 3, 4, 5… 6 and 7. No, I was at the correct level. But where was the herniated disc! I turned to review the MRI scan. Yes there was the fragment on the scan but why couldn’t I find it surgically?

 

In most cases a cervical disc will herniated more towards the central part of the spinal canal but in Barbara’s case it was far out to the side. Just beyond this was the vertebral artery which is similar to the carotid artery but it travels close to the spinal column to the base of the brain. Once, many years ago while performing a cervical disc surgery I punctured the vertebral artery and I had never witnessed such extensive hemorrhage before or since.

 

And I didn’t want to ever see that kind of bleeding again.

 

But I really had no choice at this point in Barbara’s surgery. I had to make a cut in the ligament to see if the fragment of disc was hiding beyond my surgical view. So I took a deep breath, said a quick prayer and then taking a micro-surgical instrument I separated the fibers of the ligament until I punctured through….

 

Fortunately there was no bleeding but what I did see created a sigh of relief…the fragment of disc I had agonized over not finding for the past 20 minutes! In fact as I probed out along the nerve root I found several large fragments.

 

As I stood there peering through the oculars of the surgical microscope it occurred to me I needed God’s help on this case a whole lot more than I did with Barbara’s brain tumor. And it was that case that I was way more fearful of doing in the first place. I really had to laugh at myself over that one.

 

God really does have a way of getting our attention. And I guess this day He reminded me that even the most ordinary, every-day, run-of the-mill events of our individual lives can be the most important or possibly the most treacherous if we take them for granted.

A Chance Encounter with a Patient... or an Angel?

A few weeks ago I was in the mall and I saw by a big, tall man with a cane. He limped slightly as he walked. As I passed by, I looked at him and realized he was somewhat familiar, and old patient of mine I thought. I smiled and mouthed ‘Hi’ as I continued on to my destination, a health/vitamin store.

As I turned from the shelf from which I grabbed a box of fitness bars, I was startled because that big tall man was right there in front of me. He must have walked softly because I didn’t hear him come in. Of course there were two other customers at the counter and the sales girl talking so that must have covered up his footsteps.

He began, ‘Doctor Colbassani?’ I said ‘Yes’. He said, ‘You still doing that brain surgery thing? Feeling slightly uncomfortable with it being put that way, I nodded yes.

Up close his size was more readily apparent. He was over six feet tall (although he was bent slightly forward leaning on his cane) and weighed at least 260 pounds. When he reached out to greet me I felt dwarfed by the size of his hand.  Face to face he reminded me of my father’s cousin who used to play for the New York (football) Giants.

‘You may not remember me’ he said; to which I interrupted, ‘yes, you are familiar, but it has been a long time’. ‘1996’, he said. He then continued, recounting his recollection of when he first met me…

‘I remember lying in my bed in the ICU when you came in and said’, ‘You are lucky to be here’. And I said ‘What do you mean?’; Then you said, ‘You should be downstairs’. ‘Downstairs, what’s downstairs?’ I asked you. Then you told me, ‘the morgue!’

At this point I felt a bit embarrassed, because I didn’t think I would ever say such a thing, at least not in that manner. But, given my arrogance at that time of my life, I might have said just about anything.

 ‘Then you told me you were going to have to operate but that I probably would not survive the operation anyway, but that I had no choice. And I remember my wife standing outside my room with our pastor and they came in and he prayed over me.’ ‘It’s hard to take the knee but sometimes you have to’. To which I replied, ‘Well sometimes being on your knees is the best place to be’.

The interesting thing about this encounter was, here was this big tall grizzly-like man speaking to me and not quietly, but no one else in the store turned around to look. You would think the words ‘brain surgery’ or ‘morgue’ would pique someone’s attention to look over.

As he continued to speak of his problem and my treatment of him I gathered he had a severe problem in his spine, and at this point I vaguely began to recall his illness. He mentioned something about having a high fever and an elevated white blood cell count, so I remembered he had an abscess pressing on his spinal cord.

‘So you did the surgery’, he continued, ‘and I did survive and my temperature became normal and my white blood cell count dropped to normal as well. But when you came in to my room the next day you said, ‘OK you made it through but you will never walk again’. ‘Well here I am and I guess not doing too bad.’

Usually when I encounter patients that I have treated, if they come up to speak to me, it is usually to say thank you. But this gentleman never said that, and yet it didn’t seem like he wasn’t being critical of me either.

I have been to that mall hundreds of times since 1996 and never once saw that gentleman before so I’m still not certain why I had this chance meeting with him. In fact I had just finished in the office and it was late, and I was going to forgo going to the mall but my wife told me, ‘no you should go and check out that bed we were thinking of buying’. As I was leaving that particular store, I saw the GNC store out of the corner of my eye and figured I would go and buy those protein bars I had been meaning to get.

At one point he asked me how my family was which I found curious, because in 1996 I was not married and though I did have a daughter and a son, I had not yet starting dating my wife seriously at that time.

When he finished his story, I still felt a bit uncomfortable, perhaps even a bit guilty, so I shook his big hand and told him ‘Well it was good to see you and I’m glad to see you are doing well’, to which he lifted up his cane and shrugged his shoulders. Struggling for something else to say I blurted out ‘Well, it is still a good day when you’re upright and able to walk’ (And I’m glad I was wrong about that too, I thought).

That night when I got home I searched my records for this gentleman’s name. I had my notebooks of my surgical cases from 1988 through 1998 but for some reason I had misplaced the one that had the list for 1996. At the office the next day I asked about the medical charts for patients that year and was told after 10 years the charts were destroyed.

So here I was at a loss to find out what was this man’s name, and why our paths had crossed the night before.

Although as I think about it, I’m not sure any of that matters. Of course we always want to know the reasons why things happen but sometimes it is just best to trust in God that there is a reason and leave it at that. I do realize that is not enough nor is it possible especially when tragedy strikes our lives. We feel despair, we are confused, and angry all at once.

And at those times it may be difficult to believe God truly loves us but it is precisely at these times when He wants us to turn to him for comfort and peace.

Now I am not certain how it is that my story which began with a chance encounter with an old patient of mine turned into comments about loss and grief, but it did. I am not sure of the reason anymore than I know why I met that man on that night at that particular time. Maybe it was to keep me from being somewhere else had I just gone into the store, bought my protein bars and left.

Or maybe while he was grateful for what I had done for him, he really needed remind me that I didn’t have all the answers and I wasn’t the one with power over life and death.

It is likely I will never know, at least here on earth. I just trust God sent him as an angel to be there for me.

 

‘he will cover you with his pinions,

and under his wings you will find refuge;’

 

‘For he will give his angels charge of you

to guard you in all your ways.’

Psalms 91:4, 11

Blind Faith and Praying For a Cure

As humans we are slaves to our senses. If we can not see it, or touch it, it doesn’t exist. And that is why faith is so hard for many. It requires believing without seeing. But when we are able to believe at the very depths of our soul, our faith can change lives.

Quite a few years ago, shortly after I had finished my active duty service as a neurosurgeon in the US Navy I began my private practice of neurosurgery in Palm Harbor, Florida. One of the first patients I took care of was Shelly Birch. Shelly had a brain tumor and one that I told her would have to be removed surgically. After I explained this to her as well as the details of the surgical procedure and its associated risks, she politely thanked me and got up to leave. When I asked her if she was going to schedule her surgery, she proceeded to informed me she would be having the members of her church pray over her so God could perform the miracle of removing her tumor without surgery.

I was shocked at her suggestion. With an incredulous tone, I told her, ‘that wouldn’t be a good idea’. I continued, ‘if the tumor got even the slightest bit larger it would put you in a coma and you could die’. She smiled and told me resolutely she would be fine.

Several weeks later she returned without any additional neurological problems, actually feeling better than she had in years. She requested that I order I repeat MRI scan so she could see that prayer had cured her. I almost scoffed at the idea, knowing that the tumor would still be there and perhaps even larger. But I agreed, only to show her that she would need me to cure her.

Indeed the tumor was still there, and Shelly consented to having the surgery which I performed without complication. (Interestingly, when I reviewed the follow-up scan with her she didn’t appear all that disappointed. It was as though God’s will was still at work in her life even if the outcome wasn’t as she or her church had been convinced it would be).

Now flash forward almost twenty years. I am more experienced for sure, certainly more mature but without a doubt more religious than I had been when I first met Shelly Birch.

Praying to God for a cure is something that people who are ill should do, but as I have pointed out previously, praying that God would place before us those who can help and possibly cure us is what I believe God would want us to do first. Quite honestly when I treated Shelly Birch, I did not believe God would cure her but I also did not believe God had anything to do with me successfully removing her brain tumor either. At the time I firmly believed that she was cured of her tumor solely because of me. Today, I know that was not the case.

Granted, her story is different from many of the patients I treat with brain tumors because she had a benign meningioma which I was able to completely remove. Not that it wasn’t difficult to do so, it is just that her prognosis happened to be brighter than patients with, for instance, a malignant astrocytoma.

A colleague of mine once said, in reference to malignant astrocytomas and in particular the glioblastoma, ‘we aren’t even treating these patients’ brain tumors (effectively), it’s more like we’re beating them with a stick’. Perhaps from a medical standpoint this may be true, but I think Shelly Birch had more to teach me than I realized at the time.

Actually my experience with Shelly came to mind the other day because of a conversation that I had with the wife of another patient of mine.

Tom Renner is 47 years of age. He had been experiencing symptoms of sinusitis and so he went to his primary care physician. Since he had also been having a low-grade fever and night sweats, his doctor prescribed an antibiotic. After finishing the prescription, his symptoms persisted and so his doctor prescribed a stronger antibiotic. But this didn’t help either and in fact he began to develop some pretty severe headaches. It was at this point his doctor sent him to the emergency room at Mease Hospital.

An MRI revealed Tom had a tumor in the right frontal part of his brain. Because most of the tumor appeared to made up of a cyst and he had been having a fever at night we thought this could represent an infection or a brain abscess. Although deep down I didn’t feel he would be so fortunate.

Indeed it turned out to be a malignant astrocytoma. Surgery went well enough but because the tumor extended to wall of the cerebrospinal fluid ventricle within the brain I purposely did not attempt a more aggressive resection but instead implanted some chemotherapy wafers on the surface of the tumor that visibly remained.

Tom was discharged within five days, with arrangements made for him to begin his radiation treatments in two weeks. Unbeknownst to me, he and his wife Renee had sought out additional opinions at Moffitt Cancer Center in Tampa and then at Duke University in North Carolina. Because of logistical difficulties starting Tom’s treatment nothing was done and two months passed.

Tom then began to experience some increasing headaches and a repeat MRI was done. Because of the findings I called Renee.

‘The tumor has come back’, I told her. ‘In fact’, I continued, ‘it’s probably bigger than it was when I operated on it two months ago’. She was devastated, although she was not that surprised given Tom’s symptoms. She explained the events of the last two months and how frustrated they both were that they could not get the physicians from the different institutions to co-operate with one another.

I told her that additional surgery would probably not be the answer at this point and they should pursue the aggressive chemotherapy and radiation recommended by the local oncologist Tom had just seen. Not having much more to add medically, I told her I would keep Tom and her in my prayers. She thanked me and I hung up.

The next day I remembered Shelly Birch and how I could not believe she was going to walk out of my clinic to pray that her tumor would disappear and now I was praying that would happen for Tom Renner. If only the depth of my faith could be a fraction of what Shelly had, I thought.

As I take care of more and more patients with malignant brain tumors (on occasion, with God’s help, using a ‘very big stick’), I have become convinced that God has a larger role than I could ever have in trying to cure them. In reality, I only treat these patients and it is only God that can cure them… and He’s probably responsible for most of the long-term survivors, too.

‘And Jesus answered them,

“Go and tell John what you hear and see:

the blind receive their sight and the lame walk,

lepers are cleansed and the deaf hear,

and the dead are raised up,

and the poor have the good news preached to them.

And blessed is he who takes no offense at me”.

Matthew 11:4-6

Dying with Acceptance and Dignity

Chuck Durbin was one of those patients who always was appreciative of the care he received from his doctors.  (Though his warm acceptance of others extended not only to those that he knew, but to strangers as well.) Consequently every encounter with him felt nonthreatening even if all you had to give him was bad news. As a result he made me feel good about myself and confident I was doing the best possible job I could for him.

Chuck was 63 years of age and had been diagnosed with prostate cancer. Unfortunately cancer was not unfamiliar to him as his father had died from lung cancer and his mother, from colon cancer.

Three years ago during the course of a routine blood work, Chuck was found to have an elevated PSA, or prostate specific antigen. This is a very sensitive indicator of prostate cancer. In many cases when prostate cancer is first diagnosed, it is confined to the prostate and men have a number of treatment options available in an effort to eradicate and cure the cancer before it spreads.

Sadly, this was not the case for Chuck. His biopsy indicated extensive infiltration of the cancer and a further workup indicated the cancer had already metastasized to his bones. In fact he had soon developed metastatic cancer to his spine, pelvis and the femur bones in his legs. Yet Chuck kept upbeat and was determined to fight his cancer no matter what the odds.

Because the metastatic cancer in his spine was particularly painful Chuck underwent radiation treatments. He also received chemotherapy but because his cancer seemed to be refractory to the drugs he received he participated in several experimental protocols both here in Florida and in New York. But in spite of the efforts of all of his doctors and Chuck’s dogged perseverance, his cancer never went into remission.

And if that was not enough, as a result of the treatments he received, his bone marrow was damaged to the point that it would not produce the normal amount of blood cells necessary for everyday life. This meant that with a low red blood cell count he would feel tired; with a low white blood cell count he was at risk for infection and with a low platelet count he could spontaneously hemorrhage anywhere in his body.

It was because of this last problem that I came to know and become involved with Chuck Durbin’s care.

In receiving his chemotherapy, Chuck would occasionally experience nausea and even vomiting, but usually with some medication these symptoms would pass. This time they did not and because he also had developed a headache, a brain scan was ordered by his oncologist. The CT revealed a subdural hematoma, or a blood clot on the surface of his brain and so he was admitted to Mease Hospital.

Fortunately, surgery wasn’t immediately necessary.

When I walked into Chuck’s room in the ICU for the first time and introduced myself, he made me feel as though I had known him for ten years. In spite of his terminal condition he welcomed me as he would the rest of his family, who surrounded his bed. I reviewed the findings on the CT scan with him and told him that for the time being we would not have to consider surgery. As his headache had subsided with intravenous administration of dexamethasone he was grateful I wouldn’t have to drill any holes in his skull.

I followed Chuck for that week he was hospitalized, stopping by to see him on a daily basis even though there wasn’t much I could do. Despite the numerous transfusions which he received his platelet count remained low, too low to even consider surgery. In addition, because of the persistent low platelet count, there was a constant risk of further hemorrhage.

Although I would later discover surgery wasn’t something Chuck was willing to consider in any event.

Though he fought a long hard battle, he had come to the realization that the end was likely near. Not surprisingly, he did not become depressed… actually quite the opposite. He did however, make his wishes known to his wife Claire and their children. If the ‘time’ came he did not want any extraordinary measures and he definitely did not want to be resuscitated should his heart stop beating.

Over the years of performing neurosurgery, I have not always been successful, but my training has nonetheless conditioned my inherent being to want to save patients from death. I cannot always know what the outcome will be, so in most cases I do what I can and leave the rest in God’s hands. I have to admit this has not always appeared to have been the best approach. Often time’s, patients die anyway and the family rides a roller coaster of emotion having hope, then becoming distraught followed by the inevitable grief of the loss of their loved one.

Sometimes however it does give the family the opportunity to come to accept what has happened because things happened so quickly. Families would tell me, ‘We can’t believe it…just last week mom was fine without any complaints and even had gone bowling like she did every Monday afternoon’ and now, ‘without warning she is lying in a hospital bed in a coma’!

With Chuck, however, he, Claire and all his family were well aware of the terminal nature of his disease and knew this day would eventually come. Though they hoped it wouldn’t be so soon; in a way, they were ready.

So they all sat by Chuck’s side every day, every night, just talking and enjoying his company whenever his headache would permit. And though he had been comfortable for the first few days his headache seemed to be getting worse.

On Saturday I was making rounds in the Intensive Care Unit and Chuck’s nurse, Barbara came up to me and told me that he had become less responsive. One look at him from my seat across the hall told me all I had to know. His breathing had become labored and I knew this likely was the end.

I told Barbara to get a CT of the head, stat, and I asked for Claire’s cell phone number. I called her and told her of Chuck’s condition. She told me that she was on her way.

As soon as she got to the ICU the CT was completed. I reviewed the scan with her and showed her where there had been more bleeding in the brain and that the subdural hematoma had increased significantly in size. ‘Now’ I told her, ‘there was pressure on the vital areas of the brain stem controlling Chuck’s breathing and his heart’. She nodded in agreement… and acceptance.

I told her I would do whatever she wished, although surgery in Chuck’s case would be extremely risky and would probably not alter the events of what were now transpiring. She said, ‘No, he knew this was coming and he was ready’.

I went outside the room to the sitting area where the hospital charts were kept to write my progress note. Claire came out briefly to ask me, ‘Is he in any pain?’ Instinctively my military background took over as I looked up and said, ‘No, Mam’. She looked at me somewhat embarrassingly and said, ‘Please, call me Claire, and thank you for all you have done’ as she turned and walked back in to be at Chuck’s side.

The Importance of Never Giving Up...or Giving In

Emma Grandsom was a very pleasant woman with a proper English accent, even though she had been living in the United States for quite some time. One afternoon, about three weeks ago, her son, David took her out for lunch. As she sat there with the menu in her hands, the waitress asked her what it was she would like to order. Just at that very moment her mind became a jumble of confused thoughts and she couldn’t figure out what it was she wanted to say, let alone tell the woman what it was she wanted to eat for lunch.

David immediately realized there was something wrong as his mum had a puzzled look on her face and her lips were writhing as if to mouth some words but nothing came out. He immediately put her in the car and drove her 'straight away' to Mease Hospital. A CT scan, and then an MRI were obtained and they revealed a grape sized tumor very close to the speech area in the left temporal lobe.

She was admitted to the hospital that evening and by the time I saw her the next morning her speech problem had cleared completely. This was no doubt due to the lessening of the extensive cerebral edema or brain swelling (which surrounded the tumor), as she had been receiving intravenous dexamethasone or Decadron through the night.

After I introduced myself to her, I asked her how she was feeling. She told me, ‘I feel fit as a fiddle’. In fact she didn’t understand why she had to be in the hospital at all. I reminded her she had a small tumor in her brain and almost immediately a look of incredulity came across her face. ‘I can’t believe it’ she said, ‘because I feel so well’. I replied, ‘I know’. She then asked what it was and I told her it looked like a cancer and probably one that came from somewhere else in her body.

The look of surprise never left her face, as she muttered, ‘How can that be, I always have been healthy and I’ve never felt better than I do now’. I explained to her that the medication she had been receiving was partly the reason she felt so well. I then told her that more tests would be carried out that day to see if we could find out where the tumor came from. She nodded in agreement but said, ‘Well if it is cancer I’m not going to have any radiation and most definitely no chemotherapy’. At 82, I could hardly disagree with her but I told her, somewhat weakly’, ‘Well, we’ll talk more after the tests’ and I backed out of her room in the Critical Care Unit.

I called David, her son at the request of Emma’s nurse. I explained that I had seen her and spoke to her about the findings on the MRI scan as well as informed him that additional tests would be needed before we could come up with a plan. He agreed. I also told him that she told me she would not want any radiation or chemotherapy, let alone any brain surgery. He acknowledged this and I told him I would speak with him once the additional scans were complete.

Somewhat surprisingly all of the tests were negative. To me this meant the only other possibility was a primary brain tumor or astrocytoma; but ‘darn it that scan still looked like a metastatic cancer’ I thought. ‘Perhaps its site of origin, elsewhere in the body, was so small that the scans did not pick it up. That would not be unheard of, after all’.

And so I returned later that day to speak with Emma and her son, David to discuss the results and possibly a surgical plan. Upon entering the room, Emma was sitting in a chair by the window while it rained incessantly outside. David, who was rather tall at 6 feet, was standing quietly by her side. Both of them had their attention on the door as if I would walk through at any minute.

After I informed them of the results of the scans, I realized they had already been told that they were negative by another physician, who had also told them the mass in her brain could be an infection. While I did not particularly agree with this diagnostic possibility I acknowledged that until the pathologist examined the tissue under the microscope we could not be 100% sure.

And so because David wanted to ‘know’ what it was he convinced his mum to, at least, have the biopsy. Emma looked at me and asked me what I thought it was. I paused as I thought what I would say, but merely told her I believed it was a tumor. ‘Cancer?’ she inquired. ‘Yes’, I replied. Tears came to her eyes as she said ‘He’s all I got’, gesturing toward David. David held back his emotions as he turned to her and said, ‘But we won’t know for sure until the biopsy’. She nodded and said ‘OK’.

There were no complications during surgery but when the pathologist called into the room he told me what I expected. ‘It’s a malignant astrocytoma, and probably a glioblastoma’, his voice echoed through the intercom. Though I had hoped for different news, I was not surprised and yet, my heart sank a bit.

After surgery I went out to the surgical waiting room to speak with David and his wife, and gave them the bad news. I explained to them that without any further treatment his mother might survive a year but probably closer to six months. They shook their heads in disbelief; I said I was sorry and turned to go check on Emma in the recovery room.

The next morning I went to see Emma in the Critical Care Unit and found her sitting up in bed having some coffee. I asked how she was and she told me, ‘I’ve never felt better!’ What was strange to me, however, was that most patients as soon as they see me the morning following surgery want to know how the surgery went and what I found. Not once did she ask any of those questions.

After examining her and reviewing her lab work, I volunteered, ‘Well the surgery went well and it was not an infection’, expecting her to make the conclusion that it was a cancer instead. All she said was, ‘Well that’s great it was not an infection’ and she breathed a visible sigh of relief and said nothing more, as she took another sip of coffee.

Emma recovered quickly and was discharged that weekend, 3 days after her surgery.

The following Monday I received a call from Dr. Diaz, the pathologist who informed me that after studying the permanent microscopic sections of the tumor, he determined that it was not a glioblastoma but a primary CNS (central nervous system) lymphoma. Now that may sound just as bad, but in reality Emma’s prognosis went from a survival of 6 – 12 months to possibly being cured with only some radiation treatments!

I immediately called David and told him of the news and how he should convince his mother to have radiation. I explained that other than losing some hair, the course of treatments was generally tolerated very well. He thanked me and hung up. Later in the week, Francy told me that they had made an appointment with the radiation oncologist.

I have to admit I was doubtful from the start that Emma’s prognosis would be anything but dismal; and initially I was willing to let her leave the hospital without any treatment at all, if that was her desire. Quite frankly the only reason I operated in the first place was that one of her doctors made the incorrect conclusion that it could represent an infection.

Many times I draw my own conclusions as to the nature of a patient’s problem and the prognosis and present it to them as ‘gospel truth’. And most of the time I am correct. Emma reminded me however, my knowledge truly is finite and that God is the only one with ‘all the answers’.

Granted my human traits allow me to do what it is that I do. But in the end they are gifts from God and I must always be open to giving up control and allow God to mold me so that my hands truly become His instruments here on earth.

‘Then the word of the Lord came to me:

“O house of Israel, can I not do with you

as this potter has done? says the Lord.

Behold, like the clay in the potter’s hand, so

are you in my hand, O house of Israel.

Jeremiah 18:5-6

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