This is a story told by a physician, Dr. Amy Ho, in Medpagetoday, a medical journal I used to read. I saved it and thought I’d share it with you. It’s an incredible testimonial.
Today, we bring you another series of stories on higher power. Now, I’m biased because this is the episode where I share a story, but we see some pretty crazy things in our work. We see things that make sense, like, “You ate a supersized bag of Flaming Hot Cheetos and now you have chest pain? That makes sense.” But sometimes we see things with no explanation, that make no sense, that are frankly things that make you believe life is unfair or that give you new hope in the universe. This isn’t an episode on religion or beliefs, but we certainly touch on it today because doctors and surgeons, particularly, get a bad rap for playing God sometimes. I can’t imagine anything farther from the truth, because sometimes we see miracles and sometimes we see tragedies, all with no explanation. In those times, we just have bewilderment and the stunned feeling of humility that there are things out of our control. Believe what you will, but if nothing else, I’ve learned to believe in humility. Check out my story now, an old one from when I was a resident, but one that I still think of and lean on today.
A few years ago, I was a physician in a chilly Chicago winter working at one of our community hospitals. We got an EMS call, a 6-year-old, respiratory distress with history of leukemia. When we heard the radio, we all immediately asked, “Is it Connor?” You see, Connor was a boy who lived just a few minutes away from the hospital. His mother had the great tragedy of losing her husband, Connor’s father, in a freak accident just weeks before Connor was diagnosed with leukemia. Connor was now undergoing chemo at the specialty children’s hospital 45 minutes away, but we were almost always their first stop when he became ill just due to proximity and transportation issues. We knew Connor so well that the moment the EMS call came in the charge nurse was already calling transport for Connor to go to the children’s hospital. She knew that, like always, we would stabilize him, but that he would ultimately need to be where his specialists were.
Connor arrived minutes after the call on full non-rebreather, febrile, tachycardic, hypotensive. Without a doubt, this was sepsis and we talked him through, like we always do, through the rush of staff, IVs, boluses, monitors, and alarms. Like someone decades a senior, he took it like a champ, not a flash of fear in his eyes. He was numb to the chaos, but I guess cancer and chemo will do that to you. As we prepared him for transport to children’s, we discussed with his mother intubation. His x-ray had an obviously large infiltrate on his right lung. It was flu season and he had pneumonia requiring significant respiratory support. We’d already blasted him with antibiotics, antivirals, and fluids. His vital signs were improving, but we wanted to intubate him for airway protection and for the 45-minute ride to the children’s hospital where his risk of decompensating was very high.
As she was agreeing to the procedure, Connor interrupted, “I don’t want to go.” It turns out no matter how fearless he may seem, he was still a 6-year-old. We rushed over to his bed to hold his hand and assure him that he would be just having nice dreams while the medicines helped his body heal. He interrupted again, “I don’t want to go,” this time speaking not to us, but to a spot in the upper right corner of the room. We followed his gaze and saw nothing, but the cold white wall of the resuscitation bay. “Who are you talking to, Connor?” He responded, “Daddy.” His mother choked down a sob, buried him in a hug and said, “Baby, daddy is not here anymore.” Connor, getting increasingly agitated said, “Yes, he is. He’s right there,” motioning towards the corner. “He says to not be scared and come with him.” Connor paused, broke his gaze from the wall, and looked at his mother, “But I don’t want to leave you.”
We watched this exchange between boy and mother a bit quizzically. At this point, I didn’t know what to make of this, and we needed to get things a bit more medically stabilized, so I tried to gently interject. “So about intubating him.” [CHUCKLE] Connor looked at me this time and said point blank, “No.” Baffled, we looked from Connor to his mother, back to Connor, back to his mother to see if she was comfortable with making the decision despite his protest. Connor looked at his mom again and says, “Daddy says it’s time to go.” His mom replied, “I know, baby. The ambulance is almost here.” Connor, now looking at the corner of the room again, repeated himself, “Daddy says it’s time to go.” His mother cradled his arm and cradled his head and kissed his hair and said, “I know, baby.” Without hesitation, eyes still fixed to the upper right corner of the room, he said, “Don’t be sad, mommy. I’ll be with daddy.” With that, alarms sounded.
Connor had gone limp, his skin pale, pulses gone, and we fell into the chaotic order of coding him. He was in asystole, not even the slightest bit of cardiac activity for us to hang our hope on. Epinephrine, bicarb, more epinephrine … we never got anything back. A flatline the entire time.
We worked on him for 45 minutes, probably more for us than for him, none of us willing to give up on the kid who we’d all come to know and love. It was his mother who said with tears streaming down her face from the back of the room where she’d been witnessing the entire code, “He knew he was going, didn’t he?” There wasn’t a dry eye in the room when we, too, knew it was that time. Vision clouded by my own tearing eye, I looked at the clock and called it. “4:14 PM. Time of death.”
As we held a moment of silence for Connor and the overwhelming feeling of defeat started to wash over us, I happened to glance at the same corner of the room Connor kept glancing at. I’ll be damned if I didn’t see a shimmer of something, of light, of movement? I blinked a couple times and it was still there. “Doc,” one of the nurses called me. “All right,” I mumbled as I broke my gaze and started to shuffle out of the room so paperwork could be filed and Connor’s body prepared. I glanced back at that corner again for that shimmer, but nothing.
As I sauntered back to my desk, I started to piece together the medical pieces of what had just happened and none of it made sense. A kid comes in with clear septic shock, an obvious source. He’s appropriately and successfully resuscitated, and then he suddenly goes into asystole seconds after talking about his possibly ghost father? I had to know if I was missing something and I marched into the room that now housed just his body.
His mother was still standing next to him stroking his hair. I paused, uncertain what to do or say. A long silence passed and I mustered up the courage to utter, “I am so sorry.” She didn’t take her eyes off him, but she said, “I saw it, too.” “Excuse me?” I asked. This time she turned around to look me straight in the eye. “I saw it, too.” She motioned with her head a nod towards the corner of the room. “Connor knew,” she said with finality. Something in that room spurred me to step forward and put my hand on her shoulder. The next thing I know we’re clutching each other both sobbing.
I went home later that day still thinking about Connor. Was there something else we could have done? Was it just his time? Did he come in already knowing that? How could he know? Did he see an angel of his father? Is there even such a thing as angels? Days later, I had the impulse to look at his chart again. Only then did I realize his birthday, 4-14, the same as his time of death. I swear hot tears bubbled up in me again when I saw that. I’m not sure why. It was a potent cocktail of sadness, fate, tragedy, and understanding. It was the feeling that something greater than myself was out in the world — whatever you want to call it — a God, a higher power, a spirit, or to many, just something else.
We rely so heavily on science and medicine in our field, but even that has its limitations. It is true we bring the dead back to life when we get ROSC. We can jumpstart the heart with electricity and drugs. We can sustain life with ECMO, dialysis, and ventilators. We can prolong a lifeline in all sorts of artificial ways, but even then, we can only do so much. Sometimes medicine meets its limitations. Sometimes we meet our limitations and sometimes it’s just time.
Now, I normally comment on the stories, but seeing how this one is mine, I’ll just say this. There’s a constant struggle of what science and medicine can and cannot do. It’s hard for us to swallow because we’ve dedicated our lives to taking science and medicine to the furthest extent we can to help people. When it’s not enough, it’s dissatisfying to accept that everything we know, everything we learned, and everything we were trained to do has a limitation. But it’s also powerful to accept that fact and internalize it and still just try your best. That’s what I do.