Spiritual Experiences from the Brain

A Colleague, a Friend and a Missed Opportunity

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Part 2. Life After Death...Life After Life

 

Tom certainly did not want to die, and Marianne definitely did not want God to take him from her either, but they both trusted in God’s plan, no matter what the ‘earthly’ outcome would be. They truly understood the meaning of the words of St. Paul to the Romans, that it is God, not us, who is in control and that “…in everything God works for the good with those who love him, who are called to his purpose.” And perhaps it is not how Tom lived his life that was an inspiration, although I am certain it was, but more importantly it was how he lived it while he was dying that deeply affected mine. You see I truly believe that all things happen for a reason and while we may not understand nor see the purpose behind all that happen to us, we must have faith and trust in God’s plan for us. There is good in everything. This is a bold statement and one that many would scoff at, and perhaps even think is crazy. But that’s the thing about faith, it doesn’t make sense…it doesn’t have to.

God put us on earth to enjoy His creation and for us to be happy. But in reality, even if we live to be 100 years old, and most of us will not, that time is minuscule in relation to eternity. We spend so much time trying to keep ourselves looking young and accumulating possessions and when we die, none of it, is coming with us.

Why is it that so many people try to keep a ‘death grip’ on their life in this world? Perhaps it is reflected in the lyrics to the blues song sung by Coco Montoya, ‘…Ya know I hate to leave this old world, cause I don’t know what the next one is all about’. This phenomenon however is not confined only to nonbelievers, but the faithful as well. I suspect it is because as human beings living everyday in this world we are easily distracted into thinking that our appearance and worldly possessions actually matter. After all we are weak and frail, emotionally and sometimes spiritually, and often need to boost our physical self to feel happy. There is nothing inherently wrong with this as long as we remember what is most important to us long term, and I mean ‘long term’! Personally, I am guilty of this as well. Quite a few years back when I was single and had few responsibilities, I used to work out regularly in the gym, lifting weights. Three or four times a week, for at least 2 - 3 hours at time, I trained intensely. Often, during my work out it would occur to me…I spend so much time and effort focusing on my physical health, that if I spent a fraction of this time on my spiritual life, how much better a person I would be and how much closer to God could I be! But that thought, though it frequently recurred in my mind, would dissipate almost as quickly as I moved on to my next set. It would only be years later when an injury sidelined my weight training that I would finally start doing my ‘spiritual reps’.

But I digress….Assume that through the scientific method and intensive research using our (God-given) intellectual power we discover the fountain of youth. Thus ends all illness and disease. No more cancer, no more lives stripped of their vitality by the ravages of Parkinson's and Alzheimer’s disease, no more tragic deaths of mothers and young children. Our physical beings live forever or at least for a long, long, long time. Then what? I am not saying we should not try to find cures but I believe all life is sacred both from a philosophical and Christian perspective. So do we indirectly or directly promote the death of one being for another? How do you make that choice? How can you? And to what end?

Glioblastoma multiforme is a monster of a brain tumor. For years it has proved to be a stronger and better adversary than anything we have used to kill it. Surgery, radiation, chemotherapy. If we have been able use something successfully to treat it, it mutates into something resistant and more aggressive. I have even ‘completely’ resected this tumor as evidenced by MRI scan, only to see it grow back, twice the size in less than 30 days! Recently, significant strides have been made in chemotherapy that has been hugely successful, even if on a relative scale. (See post of January 16, 2010: Humility and a Malignant Brain Tumor). And one day I pray we find a cure, although I suspect we will always have death to face at some point.

It will be at that point that our true character will finally be revealed. Will we be afraid because we don’t know what the next world is all about or will we embrace it because we trust in Jesus’ promise of an everlasting life with Him.

A while back when my wife and I were in the process of adopting our daughter we met a couple like us, Mark and Karen, also looking forward to becoming united with their adopted daughter from China. He was an ophthalmologist. And it is quite interesting to me how many ophthalmologists I have met that are deeply committed Christians. Perhaps it has something to do with the realization that the ‘eyes’ truly ‘are the window to the soul’. Anyway, he told me of a story of a colleague, a friend of his that had a malignant brain tumor and he had exhausted all forms of treatment, and had death staring him squarely in the eyes. Mark asked him how he felt, was he afraid? And this other physician looked at him and said no. In fact he was excited! He was finally going to meet his creator and spend all eternity with him. “It’s going to be an awesome journey”.

Our life here on earth is far from inconsequential but it is in the way that we live that life that we will be judged by those we leave behind and by God in heaven.

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.