Very Touching Story
Miracles do not happen in contradiction
with nature, but in contradiction with what we know about nature Saint Augustine I was an
intern in pediatrics, fresh out of medical school. A lot of facts and figures
were crammed
into my brain, but my clinical experience was somewhat limited. But that's what it means
to be an intern. One of my most memorable first patients was a young lady named Karen. She
had been referred to our city hospital from a small community in North Carolina because of
symptoms of weakness and anemia. I knew when I first met Karen that I was
dealing with
someone out of the ordinary. She was not the least intimidated by the title
"Doctor" or the white coat, and she always spoke what was on her mind.
During our first interview, Karen wanted to know my credentials down to a tee, and wanted
me to know that she knew that I was, indeed, "just" an intern. She was fourteen
years old and full of life. Unfortunately, our evaluations revealed that she had a type of
leukemia that was somewhat unusual, and not as responsive to different treatment
modalities
as were other types of leukemia. In fact, the prognosis for her surviving even one year
was unlikely. Chemotherapy was initiated, and Karen was never shy in telling us how sick
we were making her with the medicine. She never spoke in a mean way, but simply in a way
that always made her feelings known. If we had difficulty with an IV she would readily
point out our incompetence. However, she would just as readily forgive us and compliment
us when an IV was maintained in her fragile veins on the first try. Remarkably, within
three months Karen went into remission, becoming free of her disease. She continued to
come in for routine chemotherapy. During those short visits, Karen and I became friends.
It was almost uncanny how, during random rotations, I would turn up as her physician.
Always when she would see me coming, she'd gasp, "Oh no, do I have to have Dr.
Brown?" Sometimes she was kidding, sometimes she wasn't, but she always wanted me to
hear her.
About a year after her original diagnosis, her disease returned. When this type of
leukemia returns, it is almost impossible to regain remission because all of the
therapeutic modalities have already been spent. However, once again-remarkably if not
miraculously-Karen went into remission. I was now a second-year resident, a little more
competent and quite a bit more attached to this family. I continued to see Karen and her
family over the next year and a half. She proceeded in her high school career and remained
an outspoken, fun-loving teenager. I was now in my chief residency year, spending my last
month on the inpatient ward prior to completing my training. Karen came in once again with
an exacerbation of her disease; she was extremely ill. There was involvement of every
organ of her body, including her brain, and literally no other chemical agent to be tried.
There was nothing we could do. Karen was made comfortable, given IV fluids and medication
for pain. After long discussions, Karen's doctors and family decided that the goal would
be to keep her comfortable and pain-free. No unnecessary heroic measures would be
performed to prolong the inevitable. In fact, there were no heroic measures left. Karen
soon slipped into a coma. After viewing the CT scan and seeing the diffuse brain
involvement, it was easy to see why. We expected each day to be her last. Her eyes were
fixed and no responsive, her breathing shallow. Her heart was still strong, as we knew it
would be. However, the disease was ravaging her blood system and brain, and there was
evidence of opportunistic pneumonia involving both lungs. We knew that she would soon die.
I began to have a tremendous dread of Karen dying while I was on call. I did not want to
pronounce her dead. It came to the point where I hoped that her death would come on nights
that I was away from the hospital because I feared that I would not be any emotional
support for the family, or that I would even be able to perform my duties as a physician.
This family had come to mean so much to me. It was a Wednesday night, and Karen had been
in a coma for four days. I was the chief resident on call for the wards. I spoke with the
family and peeked in on Karen. I noticed her breathing was very shallow and her
temperature quite low. Death could be imminent. I selfishly hoped to myself that maybe
she'd wait until tomorrow to die. I went about my chores until about 3:00 A.M., when I
finally tried to get some sleep. At 4:00 A.M. I received a STAT page to Karen's room. This
puzzled me somewhat because we were not going to make any heroic interventions.
Nevertheless, I ran to her room. The nurse greeted me outside the room and grabbed my arm.
"Karen wants to talk to you." I literally thought this nurse was crazy. I
couldn't imagine what she was talking about-Karen was in a coma. At this point in my life,
my scientific, Newtonian way of thinking ruled my thoughts, primarily because this is the
approach we are trained in day in and day out in medical school. I had neglected other,
more important spiritual aspects of my being, ignoring the instinct that knows what reason
cannot know. I went into the room, and to my amazement, Karen was sitting up in bed.
Her mother was on the left side of the bed, her father on the right. I stood next to the
father, not saying anything, not knowing what to say. Karen's eyes, which had been glazed
over for four days, were now clear and sharp. She simply stated, "God has come for
me. It is time for me to go." She then went around to each of us at the bedside and
hugged us tightly, one at a time. These were strong hugs, hugs that I kept thinking were
impossible. I could only visualize her CT scan and the severe degree of brain damage. How
could this be? Then Karen lay down. But she popped back up immediately, as if she had
forgotten something. She went around the bed to each of us again, with her penetrating
eyes fixing our stares. No hugs this time. But her hands were strong and steady, squeezing
our shoulders as she spoke. "God is here," she said. "Do you see him? Do
you know him?" I was scared. Nothing in my experience could explain what was
happening here. There was nothing else to say, so I mumbled, "Yes. Good-bye. Thank
you." I didn't know what to say. The entire time, I kept visualizing that CT scan.
Then Karen lay back down and died-or I should say, she quit breathing and her heart
stopped. Her powerful spirit went on living. It was years before I could tell that story,
even to my wife. I still cannot tell it without feeling overwhelming emotions. I know now
that this experience is not something to be understood through the limited viewpoint of
the scientific realm. We are, in essence, spiritual beings in a spiritual universe, not
primarily governed by Newton's laws, but by the laws of God.
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