Part I: The Hand of God?
By Edison McDaniels, MD | surgeonwriter.com
This is the first in a series of nonfiction articles on the miracle of brain death.
Keywords: nonfiction, brain death, coma, miracle
Here’s a heartbreaking scenario that seems all too common.
A family gathers around a bedside. Except for the ever present and rather harsh florescent lighting, the mood in the room is somber. Tears flow freely. More than a few of those present hold tissues to their face, dabbing at their eyes. Grandma sits in a corner shaking her head. A young child, a girl dressed in pink, is on her lap. There is a look of bewilderment about her. A nurse stands at the door, ready to offer assistance to whomever should need it. A chaplain prays silently to one side. At the center of all of this attention is a young man, Joey. He is old enough to vote, but only just. He lies motionless under a thin, sweat stained sheet. A few drops of blood soil the bedding here and there.
A bite block separates Joey’s teeth and a breathing tube sticks out between his rosy lips. It is attached, via a length of plastic accordion hosing, to a ventilator at the bedside. The sound of the bellows swooshing up and down as that ventilator forces air in and out of Joey’s lungs is the exact sound of a breaking heart and a life unrealized.
Joey’s eyes are closed but he does not look to be sleeping. Indeed, he has never looked less like he is sleeping than he does in this moment.
Mom, or perhaps dad, bends to kiss Joey gently on the cheek. She feels the warmth against her lips. Mom’s hand finds Joey’s fingers—they are not as warm, in fact the fingers could reasonably be described as cold—and she takes his hand in hers and bows her head onto the bedsheets. A prayerful gesture. She is thinking how a human hand, this one especially, is a miracle of God on earth. She is thinking how this hand was the first part of Joey she truly appreciated in the delivery room. She remembers counting his fingers, how relieved she was to see he had ten little indians. She would give anything to see that miracle hand move just one more time.
Joey’s hand lies still in hers.
The physician, looking tall and professional in his starched white lab coat, steps forward. He is standing now beside that ventilator. He has told them to take all the time they need, but his stance seems to suggest otherwise. Mom has heard that time sometimes seem to stand still by a deathbed, but that’s not the case here. Time is running away, growing short. Her own breathing is proof of that.
The chaplain offers to pray with them yet again. “Not now,” mom says, “not now.”
The suffocating cacophony of the heart monitor beep beep beeping above the headboard is torturous. Joey’s heart is very much alive. It pumps blood, mostly unencumbered, to the far reaches of Joey’s body, to his kidneys, liver, lungs, bones, muscles, and all the sinews that serve to keep his body whole and his brain sound. Except that Joey’s brain is not sound; there is no master at the helm. Joey’s body—or so they have all been assured—is on autopilot. It cannot go on.
And yet it must. In her not so silent prayers, Joey’s mom implores him not to leave them, to come back, to show her a sign the doctors are wrong. “You are still with us,” she says, “I can feel it.” She continues in her tearful way, giving him a list of those present—the doctor excluded, their chaplain included—as if doing so will show him how much he is loved, will cause him to turn away from the light and walk back to them.
He does not look dead. He looks, she thinks, exhausted in the extreme. Tired to the bone. As ill as he has ever been, yes, but not dead. He needs time, that’s all. They all need more time.
The heart monitor beep beep beeps like a timer ticking down.
There is no more time. It has been a week, or ten days. Or even longer perhaps. She can’t remember any longer. It seems as if her entire life has been spent in this room. It seems a short, frantic life. All that could be done has been done. The tests have been run. No hope. Brain dead. The words ring like a dirge against her soul. It is the wrong order of things, a parent losing a child.
“Can’t you just try?” she implores. “One sign. That’s all we need. One sign to show us you’re still Joey.”
“I’m sorry,” the doctor says as his hand moves toward the circuit breaker on the front of the ventilator. He lifts the protective cover. It’s not a switch anyone wants to pull accidentally.
“Wait!” Mom shouts of a sudden. “His hand, he squeezed my hand.” Her eyes are wide with astonishment. She looks at the doctor. Stares at him really.
“I’m sorry. It is a trick of the mind. I’m sure—”
“Again, he did it again.”
The doctor turns his gaze to his patient. A nurse at the door steps further into the room. Now dad steps forward. The chaplain too is looking, his bible now resting on the foot of the bed. Grandma is out of her chair. The little girl in the pink dress stands just tall enough to see over the mattress, to see her brother’s hand squeeze her mother’s hand.
“It is the hand of God,” the chaplain says. “Glory hallelujah.”
The doctor replaces the cover on the circuit breaker. He glances at the nurse. “Oh my god,” he mouths soto voce. “His hand moved. It shouldn’t—it can’t—but it did.” The doctor, suddenly realizing this is no longer a deathwatch, begins to shout orders.
The hand of God? A miracle?
Maybe, but I doubt it. This scenario, or some variation of it, seems to play out every few months or so in this land of the twenty-four hour news cycle. A loved one is declared brain dead after a stroke—or a gunshot wound to the head, a closed head injury from a car accident, a bludgeoning, a fall from the monkey bars at school, a near drowning, etc.—and lives to prove everyone wrong when he or she miraculously awakens before the machines can be turned off.
What’s going on here? Does this sort of thing really happen? Can a person truly come back from brain death? And what is brain death anyway?
As a neurosurgeon, I have been involved in too many brain death scenarios to count. Let me say at the outset I have never encountered a hand of God miracle—not around the issue of brain death anyway; I have encountered something close in another vein and we’ll touch on that. But first let’s look at the elephant in the room—brain death—and how it can seem a miracle when somebody “comes back.”
That’s next time at Neurosurgery101—TheBlog.
More great creative nonfiction by Edison McDaniels, MD