Unforgettable

I had one of those unexplainable moments at work this week.

We had just admitted a little baby. He was born with so many birth defects, that the doctors had told the family there was nothing to be offered.  There were problems with his brain, his eyes, his mouth, his heart, his intestines were even formed on the outside of his body. Once the decision to focus on comfort was made, the breathing tube was removed and he was transferred to our hospice house.

Mom got here 1st with him. She was 20 something and overwhelmed. As I was meeting her and the little boy, I noticed some sudden breathing changes. His color was changing to more blue/grey and I realized the worst; this little baby was dying just minutes after getting here. 

We gently interrupted our process of admission to see if she wanted to hold her son, trying not to be alarming, but letting her know that her son's breathing was slowing and it looked like he was dying.  She cuddled him. I and the nurse hugged her from each side as we sat and cried.  The breathing was a pattern of long 40 sec. pauses with just a short little gasp/gulp in between.  I listened to his heart which had almost stopped, just an occasional out of sync little beat. 

If only his father was here, but he was still enroute. Mom prayed for more time...I prayed for more time, I think all of us were praying for more time. 

And then, something I have never seen.  That baby boy's color began to pink up. I listened again to the heart, confused at the color change, and as I listened that heart beat began again, strong and fast.  Simultaneously the breathing started again, quick and fast. 

Just like that, he was back, living and breathing.  The nurse and I were flabbergasted. She whispered to his mom, "You're son's spirit must be strong, he wasn't ready to go yet."  His mom wept anew, but this time with joy.

A little miracle.  I wish I could say he went on living, or that all those malformations were healed. But in truth his heart was much too weak. Instead, his father arrived a little later. The two of them, mom and dad, spent the next hours holding him and loving him, and then just as before, the breathing changed.  This time though, they were together as a family. They ushered him out of this world together, peacefully.

Visitors

There are unexplainable things that happen near death. Here's a story from this past week.  A 40ish female had been in hospice dying of lung cancer. I've had a chance to talk with her everyday, and watch the slow process of dying.  She made it clear in the beginning that she didn't believe in God, and thought death was either final or perhaps we'd be reincarnated...but she definitely didn't ascribe to any heavenly afterlife beliefs.

She started making some rapid changes indicating that things were getting closer. Hadn't had any fluids in days, was mostly sleeping, having spells when her breathing would stop for 20 secs. I went in one morning and sat on her bed, as was custom. "How are you doing today Sally?"

With all the energy she had she'd half lift her eyes to see me and then close them to talk. "I'm doing okay" She said weakly. I just waited in silence for her to talk. She started up, "However, there's this man that keeps coming in here." I was surprised, "oh really?" because no one else had been in to see her that day. She continued with a frown, "Yes, he keeps asking me to come with him, to come to the other side"  She didn't see my eyes get big.  She took a break and then went on, "I just wish he'd answer all the questions I have".  "Who sally?" I asked still wondering about this man that was visiting her. Then she really shocked me when she said, "The Lord". 

How to explain this medically? I think there is no way.  Sally died shortly after that, perhaps finally deciding to go with that man to a better place.

Works Vs Faith

The chaplain that works at the House told me when I started that he can always tell when patients are brought up under a works based or faith based belief system.  I started paying attention to this myself, and noticed the trend. Often when patients think that what happens to them after they breathe their last breath is based on what they've DONE in life, hey start getting nervous. They question if it was enough, they have bad dreams, they get agitated when awake and often fight dying right to the last moment. It's hard to feel secure if the only thing that counts was your actions in life.  In contrast, those who believe they are loved despite what they've done are always calm. They sleep peacefully, spend time sharing memories instead of questioning the past, and they die gently.  It seems oversimplified, but the pattern is present everyday that I work.  

Unintended closure

Emotionally she was worn down. Just weeks earlier, and very unexpectedly, her father, who lived continents away had died. She made the trek to mourn, but being so far away missed the official funeral ceremonies.  She returned to the states to continue her duties as a resident in my residency program. It was evident she was hurting, feeling guilt for not being by her father's bedside in death.  As a Hindu, her faith gave her no hope for closure.  And yet, how mysteriously God works...

She was working in the ICU after her return.  A tough month regardless, but compounded by her emotional instability.  Mr. J was an elderly lung cancer patient in her care. All knew he was close to his end. On this particular night, all signs pointed to this being the time. All day he had been inquiring about the arrival of his only son. He made it clear he wanted to tell him goodbye.  Sunitha, my friend, knew all to well how important it was for both of them.  His son arrived mid afternoon, and was by his bedside constantly.

Around 8 o'clock Sunitha came again to check on her patient, Mr. J's son decided to head to the vending machines to grab a snack and something to drink. He walked from the room and Sunitha inquired about those medical things like pain and anxiety.  Suddenly as the two talked, Mr. J looked at Sunitha and said, "The time is now, I'm dying." Sunitha in a panic looked for the son, wanting to escape and get him back in the room.  Mr J, however, looked Suintha in the eyes and quietly asked, "Please don't leave. Will you just hold my hand and say a prayer for me".

In that moment, Sunitha the Hindu, took this dying man's hand and though not clear on what kind of prayer this man wanted, she opened her heart to God on his behalf. She tells me that it became her father's hand that she held. She wept and told her father goodbye.  Such a profound peace and closure came over her as Mr J slipped away.

The timing of his death, though seeming to be at the worst time - in those minutes his son had stepped away, was perhaps perfect in a grander sense.