Sunday, March 26, 2006

End of Life Thoughts - 02

Well, again I find myself in the position of wanting to write something, yet not being quite sure how to express it in words. I have been thinking off and on about this all day, but few cohesive thoughts have formed about it, at least in a manner that’s conducive to writing. CS has been constantly on my heart and in my prayers since I last wrote about him a couple of days ago. I learned, I think, more about prayer during this time. At times, I found it hard to pray for him. Not because I don’t know him, but because many times I’m not “good at prayer.” I found, with him, as with myself, I didn’t quite know what to pray for. I am eager to pray for the needs of others, and I really do try to, but it’s just I am inept at it (Romans 8:26). I am sure this is the direct result of my rebellious heart and desires being completely opposed to the Holy Lord. I think this is what makes it sometimes very difficult to come to the Father in prayer; because I know what a wretch I am, and I don’t feel like I should be at His feet asking for anything, but this is exactly where I want to be. By His grace alone, I lay at His feet, waiting for anything benevolent He might choose to do on my behalf. The Father is so much more than my feeble mind can imagine, though, because He is always choosing to do benevolent things on my behalf (Romans 8:28, Jeremiah 29:11, Matthew 7:9-11)! And I don’t deserve them! Anyway, when I got to the hospital this morning I decided to go see some of my other patients first, in hopes that I would then be able to spend more time with CS. I guess it was around 10am that I made it down to the CT-ICU, where he was. I looked in his room and saw a patient on a ventilator, but it wasn’t CS. My heart sank a bit. I guess I could’ve asked a nurse if they knew about him, but I couldn’t bring myself to. I didn’t want anyone to tell me what I already knew. I quickly located a computer over in the corner that wasn’t being used, and I logged on to look up my patients. When I checked his name, it said he had died the evening before (March 23). I just sat there looking at the screen, replaying the times I had seen him, replaying the things I had said to him, replaying the prayers I had prayed for him, the tears I had shed for him. Around me, the ICU was abuzz, but time was still, at least where I sat. I don’t know quite what I was feeling inside. Certainly, sadness was there. Joy, that he was at the feet of the Father. Disbelief. Awe, in the sovereignty of God, to take those whom He chooses to take, at the time He chooses to take them. I got up from the computer and retreated from the noise of the ICU to a back hallway that afforded me a little solace, at least for a few minutes. I briefly prayed for his family, and I tried to praise the Lord the best that I could, though I’m sure it sounded forced. I contemplated, what a crazy profession I am a part of. One minute, we’re trying to solve mysteries, treat problems, and save lives; death interrupts our best efforts, but only briefly, then we’re off to the next patient with all the fervor we can muster, as if nothing ever happened. Something about this just seems so wrong, so misdirected. It seems almost like we’re looking directly at the awesome power of God, yet we’re completely blind to it, or by it. The best mental picture I can think of is trying to look at a plane flying in the sky, next to the Sun, and saying, “gosh, it’s hard to see the plane because there’s some kind of bright light in my way.” My focus should be on the power of the Sun, not the plane! Ok, that was a bad analogy; don’t stare at the Sun. I am certainly not advocating that we neglect our responsibility to treat patients; our roles within the hospital, Christian or not, are given by God alone, and we are to carry out these with energy. I guess I just kind of wonder, am I the only one moved by the death of these patients?! Does no one else see the hand of God in this? Do any of them see the awesome power of God, and not tremble? I am so humbled in my heart by my experience in these situations, but I’m also thankful for them. I don’t have to save the world. I try my best to glorify the Lord at my job, by studying, by caring, by pressing forward, but only He can add the necessary “ingredients” to make my endeavors successful. As I sit here, I think of my other patients:

1) Mr. T: We were consulted to see this 86y/o man, who had broken his hip, to assess the likelihood of intra-op and post-op pulmonary complications, should he choose to have surgery. It was late in the afternoon a couple of days ago, when I first saw him, and I had been struggling with CS in my mind all day; I was emotionally drained. I was probably a bit curt with the concerned family, and if I wasn’t openly, I was in my heart. I’m such a wretch. It appeared clear-cut, by all of his medical problems, that if he had the surgery, he would likely not come off the ventilator, but the family was in denial, and was having difficulty coming to terms with end-of-life decisions. I’m normally patient in my heart regarding these conversations, but because I’m a wretch and I’m prone to wander from the God I love, I wasn’t this day. I don’t know if the family even noticed, but I did. This morning, shortly after I found out about the death of CS, I learned Mr. T had died from respiratory failure. I never got to see the family again. I failed to minister to them with patient love; I did not love my neighbor as myself (Romans 13:9).
2) Ms. B: I got an urgent call this afternoon from the vascular surgeons about this patient that was two days post-op from a L femoral – renal venous bypass, who had developed acute abdominal pain. Since they suspected mesenteric ischemia, they decided to take her to angiography to see if there was a clot they could break up. While she was there, she decompensated, and went into respiratory failure, hence the phone call to me. She was intubated and placed on a ventilator. After we got her back to the ICU, surgery came and decided they needed to emergently take her to surgery to explore her belly for dead bowel. This is a high-risk procedure, with very high intra-op mortality, but without it, the patient surely dies from sepsis.

Again, I’m amazed at the frailty of life in all situations, even though it is most clearly demonstrated in these medical situations. There is such a fine line between the “apparently healthy” people and those who are sick, barely clinging to life. Most of us never even see it, or realize it; we kind of walk along, happily convinced of our invincibility. In truth, it’s only the restraining hand of God that prevents us from death. Another thing I’m amazed at is my crappy attitude in so many situations. Do I work at my job in such a way that honestly is worship to the Lord? I can get all excited about spending time with the Lord, and praying with a patient, or a family; yet, I walk out of the room, and my heart has already started to wander, my faith has started to wane, and my thoughts are sinful. Is this ministry pleasing to the Lord? It’s the best I have to offer, which is nothing before Him; but I weakly hold up my heart to Him, not because I think He should take it and use it, but because I hope He will take it and use it for His glory. It is my prayer that I would walk worthy of the life to which I have been called (Ephesians 4:1-3; thanks Diana), with the humility, gentleness, and patience my weak condition mandates.

The Cry of a Convicted Sinner
Thou righteous and Holy Sovereign,
In whose hand is my life and whose are all my ways,
Keep me from fluttering about religion;
fix me firm in it,
for I am irresolute;
my decisions are smoke and vapor,
and I do not glorify thee,
or behave according to thy will;
Cut me not off before my thoughts grow to responses,
and the budding of my soul into full flower,
for thou art forbearing and good,
patient and kind.
Save me from myself,
from the artifices and deceits of sin,
from the treachery of my perverse nature,
from denying thy charge against my offenses,
from a life of continual rebellion against thee,
from wrong principles, views, and ends;
for I know that all my thoughts, affections, desires and pursuits are alienated from thee.
I have acted as if I hated thee, although thou art love itself;
have contrived to tempt thee to the uttermost, to wear out thy patience;
have lived evilly in word and action.
Had I been a prince, I would long ago have crushed such a rebel;
Had I been a father, I would long since have rejected my child.
O, thou Father of my spirit, thou King of my life,
cast me not into destruction,
drive me not from thy presence,
but wound my heart that it may be healed;
break it that thine own hand may make it whole.

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