Spiritual Experiences from the Brain

Walking on Water

'but whoever denies me before men, I also will

deny before my Father who is in heaven.

Matthew 10:33

When people are sick they will say most anything if it means getting well, and if I should happen to ‘cure’ them of their affliction, they often heap ‘praise’ upon me that makes me feel at the very least uncomfortable.

They will say things like, ‘you walk on water’ or you’re a miracle worker. Most times when this happens I am caught off guard and I struggle for something polite to say. I have said things like ‘no, last I checked only two people were able to do that and I wasn’t one of them’, or ‘I'm not the one who works the miracles’.

I often pray that the Holy Spirit will inspire me and give me the correct words to say but it doesn’t always seem that my words are said with conviction.

The odd thing about this type of encounter, is that when these patients say these things, they seem visibly upset when I deflect their ‘words of gratitude’. I sort of understand this because I may appear to them as ungrateful. But while I am truly appreciative of their recognition of what I had done for them, I just can’t accept what they are saying as a ‘gospel truth’!

Perhaps they say these things because they are so overcome with emotion they don’t know what to say. But in part it may be because their faith is not strong enough to acknowledge where the true source of healing comes from. The irony, of course, is that many years ago I would have completely agreed with them.

Human emotion being what it is, we like to be complemented on our accomplishments, particularly when it involves saving someone’s life. But I am always mindful of the fact that I am able to do what I do because I have been blessed by God with intelligence, talent and a 'sixth sense'.

On the other hand, there are other patients that have said to me, ‘I thank God for putting you in my life to help me’, and those times I am in complete agreement.

Recently however, I took care of a woman who said something that really startled me.

Theresa Purvis had been diagnosed with and treated for breast and lung cancer, and surprisingly had done well. That is until she developed a headache and became somewhat confused. An MRI of her brain did not reveal a metastatic tumor, per se, but evidence that the tumor may have spread somewhat surreptitiously to cerebrospinal pathway around the brain.

I was asked by her oncologist to perform a simple procedure, a spinal tap, to obtain some fluid which would be analyzed to see if in fact the cancer had spread to the brain.

To be sure that Theresa would be as comfortable as possible and that I wouldn’t encounter any difficulty with the procedure, I arranged to have it done in the operating room instead of at her bedside on the regular ward. This way she could be easily sedated and I would have available all the supplies I might need.

Everything went very smoothly, and I was done in less than 15 minutes. Of course Theresa had been lightly sedated but when I stood up and leaned over her to tell her I was done, she had a surprised look on her face. Amazed, she said, ‘you’re kidding, right?’ I said, ‘no, I’m done’. She then said boldly, ‘you are God’!

‘No’, I replied. ‘I’m just here to give Him a hand’.

Perhaps it was the medication she received or maybe it was the cancer that had infiltrated her brain, but she appeared to dismiss my remark and turned back to lie down on the stretcher.

Nonetheless, afterwards I felt deeply grateful that for the first time I was able to say the right thing at the right time, regardless of whether the patient was inspired by my remark or not. After all there were others nearby, nurses, doctors and perhaps a patient or two that may have overheard what I said.

In the end we never may know the full impact of what we say or do on the lives of others. All we can really do is try to be the best version of ourselves and have faith that others follow our example.

Charity and the Price of Eternal Salvation

‘And Jesus looking upon him loved him, and said to him,

“You lack one thing; go, sell what you have, and give to the

poor, and you will have treasure in heaven; and come, follow me.”

At that saying his countenance fell, and he went away

sorrowful; for he had great possessions.’

Mark 10:21-22

How difficult is this request for us to follow?  I suspect for most of us, myself included, if we are to be honest, it is practically impossible! And not only does Jesus want us to give up our material possessions, he also wants us to follow Him, relying not on the life that allowed us to accumulate those things in the first place. And I believe, in these words also is the inference that Jesus wants us to be happy with the choice.

This command not only pertains to material possessions, but our time and talent as well. And it is with these gifts that I am not always such a ‘cheerful giver’.

In the course of my practice I am on call for emergencies and not every patient that is brought to the emergency room has insurance. And for many of these patients this is the reason they stay away from the doctor in the first place.

Granted, many of these patients are there because of self-destructive behaviors, such as abuse of alcohol and drugs. But, there are some who find themselves incapacitated, frightened and without a choice. It is these patients that remind me that God has given me a gift that I must give freely to others.

Darnell Benjamin is a patient that reminded me of this recently.

In April, Darnell decided he would get back in shape since he was about to begin a construction job he was lucky enough to have landed. During one of his workouts he felt a pop in his neck followed by some pain but he figured it was a muscle strain so he just took some Tylenol and ignored it.

Over the next few months he developed some weakness in his hands and actually noticed some of the muscles had atrophied but since he could still lift and haul the lumbar that his construction job required he quietly went about his work. His daughter tried to convince him he should see a doctor but since he did not have health insurance he told her ‘no’. In late October, Darnell began to notice his legs were a bit sore and weak but he just figured it was due to all the hard work he had been doing.

About 3 weeks ago he awoke one morning and his legs were so weak could barely get out of bed. And when he tried to stand up his legs gave out from under him and he fell to his bedroom floor. It was at this moment he also noticed he could barely pull himself back up because his hands and arms had gotten much weaker as well.

Unable to ignore his problem any longer he allowed his daughter to call 911. Shortly after he was brought to the Emergency Room by the EMTs, he was examined by the ER physician on duty who then ordered an MRI scan of his neck and lower back. As soon as the radiologist interpreted the scans and informed the ER doc of the results, I was called.

Darnell was actually in a hospital 20 miles to the north of Mease Hospital where I practice and because the emergency room doctor there believed a neurosurgical emergency existed, she wanted Darnell transferred because they did not have a neurosurgeon to take care of the problem there. After reviewing the MRI scan I agreed Darnell would need surgery.

Darnell had ruptured a disk in his neck and because there also was injury to the ligaments of his spine it created additional weakness that resulted in damage to his spinal cord. Not only would I have to operate on his cervical spine through an incision in the front of his neck and remove the disc and fuse the vertebra together; I would also have to operate on his spine a second time through an incision in the back of his neck and insert screws and rods into his spine to prevent further damage.

(When I meet patients I try not to be judgmental, but unfortunately since I make assessments and deductions based upon the patients’ history, examination and MRI scans all the time, I too often make conclusions why they have come to see me. Often it is obvious; they are in pain and want to know what their options are to alleviate or eliminate the pain. In other cases it is not so clear; the person may have been in a car accident or had an injury at work and they may only want to collect a monetary settlement or obtain a medical disability so they do not have to return to work.

In some respects it is up to me to try to make this determination so I can decide whether the patient truly is injured and may need surgery or whether they are malingering.

But sometimes I find myself making superficial judgments as to the patient’s appearance. When patients’ such as Darnell are brought in to the Emergency Room and are poorly dressed and without impeccable hygiene, the thought, ‘do they have insurance and will I be paid for the surgery I might have to perform?’ may cross my mind. In those cases I say a prayer to myself and refuse to look at the patient’s face sheet which indicates this information before I have decided what needs to be done and I have done it.)

By the time Darnell arrived at Mease Dunedin it was the following morning. He was then prepped for surgery and brought to the preoperative holding area. As I walked in he looked frightened, which was understandable since he could barely move his legs and could not move his arms much more. I introduced myself, took his hand to shake it and told him what I would be doing. He nodded and thanked me.

The surgery went well and by the next morning he could move his arms and legs quite a bit better. As I walked in to the preoperative holding area this time Darnell was actually smiling. I asked him, ‘Are you ready for round two?’ He said, ‘Yes’.  This operation was more difficult than the first but everything proceeded as planned and there were no complications.

When I rounded on Darnell the following morning he was sitting up in bed eating his breakfast, feeding himself which he was unable to do the previous day. I asked him how he was doing and he said, ‘Very well’. He went on to say, ‘Thank you so much for what you have done. I was so afraid because I could not walk and my hands were so weak. And now I am so much better. Thank you’. I smiled and said, ‘You are very welcome’. As I left his room and walked to my office I felt grateful for being able to help him.

By the end of the week Darnell was walking without any assistance and was discharged home. I figured I would not see him again until his six-week postoperative check in my office. Unfortunately that would not be the case.

Thanksgiving morning, though I was not on the schedule for emergencies, I received a call at 5 am from the ER of another hospital to the north. Apparently something happened to Darnell at home and he became unconscious. When the EMTs arrived his blood pressure was more than fifty points lower than it should have been. By the time he arrived at that hospital he was awake but the ER physician examined him and found him to be almost completely paralyzed in his arms and legs once again. I told the ER physician to transfer Darnell back to Mease Dunedin Hospital.

At this point I thought, ‘Boy, God is really testing me now. Not only did He want to see if I would be cheerful operating on Darnell, gratis, He wanted to see if I would still be smiling now that my Thanksgiving plans might be completely disrupted!’

By the time Darnell arrived in the ICU at Mease Hospital the movement of his arms and legs was almost back to where it had been when he was discharged. After reviewing the scans that were done at the other hospital I concluded Darnell became weak because the blood flow to that damaged area of his spinal cord was compromised when his blood pressure had dropped so low. Fortunately, he would recover completely.

When I returned to see him the following morning, Darnell’s weakness had continued to improve and as we talked about his condition he told me that everyone in the ICU had been great except one nurse who had taken care of him the night before. In fact he told me that nurse was actually mean to him. He then proceeded to tell me in a very articulate way that he had said to the nurse, ‘I want to apologize to you if I had said or did anything that had upset you (‘which I did not’, he said as an aside to me) because I really need your help and I don’t want you to be mad at me and ignore those needs’.

I told him I was sorry that he had that experience and that I would look into it. Darnell then looked at me and said, ‘and I’m sorry if I have inconvenienced you in any way over this Thanksgiving holiday’. I told him not to worry about that and with lump in my throat and a slight feeling of guilt myself I said, ‘that is why I am here, to take care of you’ as I grasped his hand tightly and looked deep into his eyes. Darnell merely said, ‘thank you’ as I turned to leave his room.

Lately, collections have been off a bit and yet the bills continue to pile up and it is hard to ignore when I spend no less than 15 hours operating and taking care of a patient without physical payment. What Darnell reminded me however, was that my time spent was hardly in vain and that God will truly pay me back a hundred fold if I am a ‘cheerful giver’.

 ‘The point is this: he who sows sparingly will also reap sparingly,

and he who sows bountifully will also reap bountifully. Each one

must do as he has made up his mind, not reluctantly

or under compulsion, for God loves a cheerful giver.

And God is able to provide you with every blessing in abundance,

so that you may always have enough of everything

and may provide in abundance for every good work.

2 Corinthians 9:6-8

A Godly Man Does Not Belittle His Talents

 

Human nature being what it is, we will occasionally compare ourselves to others. To a degree this may be a good thing because we can gauge whether we are being a good Christian, for instance. On the other hand if we use others as a barometer of our own personal worth or wealth we may find ourselves drawn to the darker side of jealousy and envy.

A few of weeks ago a friend sent me an email that contained a video story of a young patient with a brain tumor that had undergone surgery at the Johns Hopkins Hospital in Baltimore, Maryland. It was a wonderful and inspiring story about Carlos who had a grade 2 astrocytoma and his surgeon Dr. Henry Brem, the chairman of Neurosurgery.

 In the story, Carlos is described as an upbeat, positive and fearless man who had braved the jungles of South America. As a result of the treatment he received at the Johns Hopkins Hospital he was deeply grateful for Dr. Brem saving his life and yet because of his diagnosis he had become a bit more cautious not wanting to venture out too far from Baltimore. Dr. Brem is a brilliant man described by Carlos as ‘one of the best in the world at what he does’ and at the same time one who is compassionate and keenly aware of the importance of treating Carlos as a human being and respecting the dignity of his personality and life.

Arthur Grand is a patient of mine. He is a 62 year old man who had fallen several weeks earlier and developed a subdural hematoma, or a blood clot in between the inside of his skull and the surface of his brain. On Wednesday of the week preceding, my partner had removed the blood clot and Arthur was doing so well he was discharged on Friday. In the early morning hours of Saturday, however, Arthur suddenly became aphasic, or unable to speak. His wife, Ellen immediately called 911. Upon arrival to the emergency room, a CT scan was done and revealed there had been another hemorrhage which resulted in the recurrence of the subdural hematoma which was now putting pressure on Arthur’s speech area. And so I was called. After reviewing the CT, I contacted the nursing supervisor to call in the surgical team.

As I drove into the hospital that Saturday morning to operate on Arthur, contemplating Carlos’ story, I began to feel insignificant.  I thought about Dr. Brem and what an incredibly skilled neurosurgeon he was to maneuver through Carlos’ brain removing a tumor that visually, looks very much like his normal brain tissue. And here I was heading into the hospital to perform a surgery that a junior neurosurgical resident could execute flawlessly.

Once I arrived at the hospital, I reviewed Arthur’s scan once again and determined the recurrent blood clot was immediately underneath the previously removed skull flap. So, all I would need to do was to reopen the skin incision, unscrew the bone flap that was secured to the surrounding skull, wash out the blood, control whatever bleeding had caused the recurrent hemorrhage and then replace the skull flap and close.

As I removed the last screw, the bone flap popped off, and indeed there was a blood clot beneath it but there was something wrong. I would have expected that once the blood clot was removed and the pressure released, the brain would become relaxed, but that was not the case. The brain still appeared swollen and under pressure. And if I didn’t do something quickly the brain might continue to swell out through the opening in the skull. Immediately, I realized I would need all 20 years of my experience to figure out what the problem was and what I would need to do to fix it. So much for this ‘simple’ procedure!

First, I had the anesthesiologist raise the head of the bed thereby decreasing somewhat the effect gravity might be having on engorging the brain. Secondly I took a malleable brain blade or ½ inch wide flat metal retractor that I used to gently retract the brain so I could inspect subdural space beyond the limits exposed by my craniotomy. In this way I could determine if there was an additional blood clot beyond what I could immediately see. Indeed there was both clotted blood and fluid that was trapped in this space and upon releasing it the brain began to relax.

However, also located in this space was a membrane or tissue layer that Arthur’s body had formed in response to the presence of the blood clot in an effort to isolate it from the underlying brain. The problem now was there was active bleeding from the edge of this vascularized membrane.  And so with the brain blade in my left hand retracting the brain, I first cut away the membrane with a scissors in my right and then took a bipolar forceps, also in my right hand to coagulate the edge of the membrane to stop the bleeding. I then inserted strips of surgical foam soaked in a substance that would assist in clotting the blood and soon the bleeding had stopped and the brain was completely relaxed. I was now able to replace the skull flap and close.

Before surgery, Arthur had difficulty speaking and appeared confused but was wide awake so to look at him you might not think he had a serious, let alone life threatening problem. But, in the recovery room, he awoke speaking fine and said something that made me realize how bad off he really was. When I asked him how he was he said, ‘where am I? …what happened?’ When I saw him in the office 10 days later he was smiling, looking perfectly normal. I asked him how he was. He said, ‘great’, so I jokingly said to him, ‘good, stay that way’ as he laughed and smiled even wider.

The experience of Arthur’s case taught me two things. One, I should never underestimate the impact I might have on someone’s life no matter how ‘insignificant’ that act might seem. And two, I must never disrespect the gifts given to me by God by thinking that the actions of someone else, even a neurosurgeon are more important. Everything in life is relative… There will always be someone that is smarter, or more skilled surgically, or more gifted athletically. But everyone has unique talents that are gifts from God and they are just as remarkable as the abilities of others. So, for me to diminish the importance of my intelligence and skill is not only wrong but an insult to God – a sin. And not surprisingly to me God has a way of periodically reminding me of this by placing before me people and situations that hammers that point home.

‘For as in one body we have many members, and all the members do not have the same function, so we,   though many, are one body in Christ, and individually members one of another. Having gifts that differ according to the grace given to us, let us use them: if prophesy, in proportion to our faith;’  Romans 12:4-6

 

 

Is it Necessary to find a Cure for every Illness and Disease? (Part 1)

“We know that in everything God works for the good with those who love him, who are called according to his purpose.” Romans 8:28

Tom and Marianne Tremain immediately impressed me as wonderful people. Despite his diagnosis of a glioblastoma multiforme, or the most malignant form of brain cancer, they were at peace. While they both believed steadfastly in the power of prayer, they also believed that God bestowed intelligence and skill to Tom’s doctors, and that it was God’s will that they make use of these God-given talents. It truly was their belief that how else would God work His miracles but through the hands of these many men and women.

I had my first contact with Tom and Marianne in May of 2007. He had presented to the emergency room with some difficulty getting his words out when he tried to speak. His MRI scan revealed a large tumor in the frontal area of the left side of his brain. I performed surgery within a few days of his admission and all went well. Following surgery, his speech was actually improved and the post-op MRI revealed I had resected the majority of the visible tumor, although there was a suggestion the tumor may have had the early beginnings of growth towards the right across a pathway of fibers that connected left and right halves of the brain.

Nonetheless, Tom and Marianne were certain that God would take care of them. Mind you, they did not necessarily believe that Tom would be miraculously cured but that had not given up hope, either.

Tom begun his radiation treatments and chemotherapy and was tolerating them well. In October, he had a routine follow-up MRI which revealed a mass in the area of his surgery which the neuro-oncologist thought could represent either excessive cell death from the radiation (radiation necrosis) or recurrence of the tumor. I saw them back in my office one month later with another follow-up MRI, and as I reviewed the images with Tom and Marianne, it was clear the tumor had come back as this mass had increased an additional 30% in size, in that one month’s time. And for sure, the tumor had begun to spread towards the right half of his brain.

I discussed with them the options, including a second operation. Somewhat apologetically, I told them that if they opted for surgery that I knew I would not be able to remove the entire tumor. Marianne quickly brushed my caveat aside, telling me, “Well, that still does not mean that you are not doing God’s work”. I nodded affirmatively, and told her that I would pray for myself that God would guide my mind and hands to do the best job that was possible. She then said, “I know you will, and we will be praying for you too”.

Surgery went well, and Tom was without any speech difficulty or weakness afterwards and left the hospital within five days. When I saw them back in the office for a postoperative check in January of 2008, Tom had resumed chemotherapy and was doing fine. Marianne told me they had contacted the MD Anderson Cancer Center at the University of Texas and were hopeful Tom might be enrolled in an experimental chemotherapy protocol there. Unfortunately, Tom never did make it to Houston, as he died in July of that year.

Facing the possibility of dying terrifies most people I treat. It is certainly understandable, particularly when the patient is a 32 year old woman with two small children. But even patients that I have treated that are elderly, and have lived a full life don’t want to die.

In fact many people don’t even want to get old let alone die. Annual expenditures in the United States for plastic surgery procedures exceed $8 billion dollars, and the amount that is spent on all anti-aging products and services exceeds $70 billion dollars.

Stem cell research and nanotechnology which is being supported publically and privately has become a leading area of biotechnology that initially was hailed as the only field of research that could find cures for Parkinson’s disease, diabetes and heart disease among others. In reality, the goal of this research has become an attempt to treat what is thought to be the basis of all these diseases, aging itself! It is not science fiction to think we could ultimately bypass the idea that we could ever get sick, at least as we know it.

It is true that God has given us the ability to discover treatments to diseases and even cures but the implications of our knowledge raises many ethical questions. Just because we can, should we? And I have to wonder, in our attempt to play God ourselves, are we just trying to prove scientifically we have (an illusion of) control over aging, disease and death.

…to be continued.

A Rich Man and a Camel

 

Greed…jealousy…anger.

 

These are probably some of life’s most powerful and darkest emotions. They invite evil into our hearts and poison our souls. Sure, one might argue they are merely human feelings but have any other ‘feelings’ caused the ruin of so many lives.

 

As human beings we are weak and frail both physically and spiritually. We get sick; we contract illnesses, diseases, and develop tumors that destroy us from the inside out. But these sinful emotions, like the physical diseases I treat, can eat at us spiritually, also from the inside out and if left unfettered can kill us too. The object of our desire doesn’t have to be just money either. It could be the need for importance or the need to be in control, which may start out as innocent human emotions but taken to their passionate extreme can morph into idolatry and demonic obsession. How can these be simply ‘human feelings’?

 

The irony is that we have so much to be thankful for…our health, our ability to walk upright on two legs and reach out and grasp what we need, but we are not always satisfied with that…we want more.

 

Which brings me to Joseph Spera. He was a patient whom I came to care for right about the same time as Michael Santini. While Michael was an outgoing and talkative guy, Joseph was quiet and introverted, and very sadly had been bedridden for many months because of an unexplained paralysis in both of his arms and legs.

 

Prior to being admitted to Mease Hospital, Joseph had severe weakness in both of his legs and could not walk, but the strength in his arms was strong enough that he could hold himself up on the parallel bars at physical therapy.

 

On the previous Friday, inexplicably, he developed the sudden onset of complete paralysis of his right (dominant) arm. After I examined him and reviewed his x-rays and MRI scan of his cervical spine, I told him I wasn’t sure if I could help him, in fact I told him, “I seriously doubt it”. There were however, some bone spurs in his neck putting pressure on the nerves going to his right arm and so it was possible, I thought, that removing them might help Joseph gain some strength back. As I looked into his eyes which were desperately trying to grasp any glimmer of hope, I once again was moved with pity.   

 

Unlike most of our desires, all Joseph wanted was to get the use of his right arm back. He didn’t even care if he ever got to walk again. Sure, that would be great but if he could just use his right hand again that would be good enough! How many of us could say that. We seem to be more concerned about money, power, excitement and pleasure. All Joseph wanted was to be able to feed himself again.

 

So, after much thought, weighing the possible risks and benefits, I decided to take Joseph to surgery in the hopes that it would help. After all he did have some arm pain which likely would be lessened by removing the bone spurs. From a technical standpoint, the surgery was a success, although immediately after surgery Joseph’s right arm was still paralyzed and it remained so at the time of his discharge four days later. But he was encouraged because he was accepted for inpatient physical therapy at a rehabilitation hospital that for some unknown reason, had previously denied him admission.

 

Unlike Michael who was boisterous and loud, each day I saw Joseph on my afternoon rounds, he was quiet and hopeful. When I visited with Joseph on the day of his discharge, he said to me, “I am ready to get on with it” (his therapy), and he hoped with a lot of hard work he would regain his strength. I wished him well, grasped his hand and told him I would pray for him. He thanked me and I turned and walked out the door.

 

Joseph’s condition was a poignant reminder to me that we truly have so much to be grateful for, most of which we often take for granted. Our life, our family, our God-given talents. Any of which could be taken from us without any warning. So often we put our selfish desires between us and the ones that matter the most. We become obsessed with having whatever our body desires, food, alcohol, sex and my personal favorite, always wanting to be right! And in becoming slaves to our human ‘needs’ we make it impossible to be close to our God who gave everything to us in the first place.

 

Saint Paul tells us in his letter to the Romans: ‘More than that, we rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope’ (Romans 5:3-4).

 

I read a story once about a man who was a coffee connoisseur. He had to have the best coffee beans, the best coffee grinder and coffee maker to achieve the perfect cup of coffee. While wanting a good cup of coffee is no sin he used the story as a metaphor of all the things we become preoccupied with, that taken together can reach such a critical mass that in the end serves only to erect a wall between us and our Creator. Luke 18:25.