Glimmers of Grace (eBook)

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I Will Declare Your Greatness

They shall speak of the might of your awesome deeds,

and I will declare your greatness.

Psalm 145:6

“You need to come in.”

I heard her draw a breath. We’d walked together through so many terrible months that I could picture her hand on her forehead, the creases at her eyes deepening as she raked her fingers through her hair. We’d shared upsetting phone calls before, but this time was different. In the gathering quiet between us, I could tell she knew it too.

“How much time do I have?” she asked, her voice cracking. “I’m over half an hour away. Do I have that long?”

I glanced at her husband’s monitor. His oxygen levels were dangerously low. The tracing of his heart activity spasmed, threatening to pitch into a fatal rhythm.

“Please just come as soon as you can,” I said.

Back at his bedside, the nurses and I fought to keep him alive. We pushed medications to prod his heart to contract and his blood vessels to squeeze. We gave him blood and calcium, and corrected the levels of acid that steadily leached into his bloodstream. His respiratory therapist hovered at the ventilator beside him, adjusting the volume and pressure of each mechanical breath.

But the numbers would not rebound. They continued their steady decline, and soon his skin turned mottled from insufficient oxygen. I performed a bronchoscopy, and saw blood pooling into his bronchial tree. I suctioned it free, and felt a flicker of hope as I glimpsed the pearly surface of his airways, but then blood surged into the field again.

We could not keep up.

The dismal numbers continued to blink on the monitor. I thought about all the months he had struggled, the surgeries, the catastrophes. The moments with loved ones lost. The pain. All the while, his wife had held vigil beside him. Sometimes, stretched to the breaking point, she snapped at nurses and doctors, and guarded her fragile heart with words. At other moments the suffering so bore down on her that she was stoic, her heart compressed into stone, the way pressure hardens delicate shells into limestone and then marble. Throughout, she was steadfast in her devotion to him. She would sit beside him for hours, even while he faded in and out of a medication-induced haze, even when he no longer recognized her.

After all they’d endured together, he was now proceeding across the threshold without her. He was dying, and she was stuck in traffic.

Please, Lord, let him hold on until she arrives, I prayed over and over. Please don’t take him until she’s said goodbye. They’ve been through so much. Please let them be together one last time.

I stared at the monitor, but struggled to focus. Its lines blurred. I waited for the alarms to sound, for his heart to finally limp to a stop. His nurse, too, waited. Our hands, always so frenetic, now itched from sudden inactivity, but there was nothing we could do.

We waited for the alarms. I paced back and forth, praying. I pleaded for God to grind the hands of time to a stop, to reverse the laws of physics for just this moment. I prayed that somehow the rows of cars that cluttered Boston could part like the Red Sea before Moses’s staff, the taillights aligned into two glowing processions, and allow his wife through. That she could say goodbye.

Still, his heart beat. Still, he held on.

His nurse and I both looked at each other in disbelief. The numbers hung abysmally low. His meager oxygen levels couldn’t sustain him. Yet still, he lived.

For another half an hour.

Finally his wife burst into the room, her jacket still zipped to her chin. She pushed past us, and grasped his hand. Her fingers interlocked with those she’d loved as a newlywed, and which she’d massaged when illness contorted and discolored them beyond recognition.

At that exact moment, his heart stopped. The alarm sounded.

I drifted from the room, sadness weighing down my steps, and incredulity gripping my chest. The memories from the last hours tumbled through my mind, cresting and breaking like waves against the shore.

He’d held on until the moment she’d touched him. Against all odds. Against everything the statistics and the rules and the workings of physiology would dictate, he’d held on. His oxygen levels were so low that his blood had turned to acid. His proteins had uncoiled, his enzymes halted their work. The envelopes encasing his cells had split open and spilled his DNA from their pores. Death draped over him like a pallid cloak.

But God (Eph. 2:4). God ushered him through that dark valley. God walked with him, even while the blood frothed in his lungs, even while life ebbed away. Out of mercy. Out of love, and out of mercy.

Christ bore the same torrent of blood and water and cried out for his Father, but he died alone. And that same God, who gave his Son for us, gazed upon a man alone in a bed, life dwindling from his ghastly body, and granted him mercy. One last handhold. One last touch.

This was an answer to prayer.

I was shaking. The only appropriate response was to worship, to fall to my knees and thank God for his steadfast love, for being who he is—the great “I am,” the one who saves. It was a moment to proclaim to all those who could hear. It was a moment worthy of ten thousand hallelujahs: Look, what our Lord has done! He who is mighty has done great things for me, and holy is his name (Luke 1:49).

But I didn’t praise him. I didn’t kneel, sing, or pray. I didn’t rejoice at how God had made himself known, how his grace had filled a hospital room as his robes once billowed through the temple (Isa. 6:1). I said nothing about God’s work that day in the ICU.

Instead, my pager went off, and I went back to work. There were nineteen more sick patients to see. There wasn’t time to pause, or to reflect.

And in the hospital, we don’t talk about such things.

The Wilderness of Medicine

Modern medicine enables healing at rates unprecedented in history. HIV is now a chronic condition, rather than a death sentence. Improved treatments and resuscitation techniques have dramatically reduced mortality rates from severe infections. We surgeons can now perform gallbladder and colon operations through tiny incisions, freeing patients to return home in a day or two rather than weeks after surgery.

Yet for all its merits, the field of medicine often ignores the human dimensions of disease, especially the questions illness stirs up about faith. In medical school, my peers and I learned to trace out the courses of vessels and nerves, and to glean meaning from the concentrations of salts and molecules in the bloodstream, but we learned nothing about how illness compels us to grieve, to pray, and to search for meaning. We cultivated fluency in medical jargon but were left with no vocabulary for suffering, faith, or empathy. And so when your heart cries out for help in the hospital, my colleagues and I are more likely to check your labs than to partner with you in your pain.

In my first year of medical school, hints of this disconnect between the science and the humanity of medicine prompted me to chuck my anatomy textbook against a wall. I’d been drowning in test preparation for weeks, and unfamiliar terminology slowed my progress as I repeatedly stopped to cross-reference a medical dictionary. Finally, the word decussate pushed my aggravation to the brink. A quick heave, and the book slammed against the wall of my dorm room and slid, mangled, to the floor.

“Why can’t they just say cross over?” I shouted to the air. “How can I talk with patients when medicine is a foreign language?” I’d majored in biochemistry in college, and so was accustomed to scholarly discussions within laboratories, but I knew medicine reaches beyond the realm of microscopes and pipettes, into the lives of people who are scared and hurting. Wouldn’t technical language distance me from the very people I sought to help?

I vowed thereafter to always maintain my compassion, and to never lose sight of each individual as unique, layered, and loved by God.

Yet years later, when a census of forty patients to see by seven in the morning became the norm, I too morphed into the aloof, detached doctor—all science, scant humanity—I’d so loathed becoming. This humbling reality struck me at the end of my chief year of surgery residency, when my interns roasted me with a video during a graduation assembly. In the clip, an actress portrayed me barreling down the hallway on my morning rounds and shoving others out of my way like a bulldozer. Advisors and mentees in the audience snickered. I squirmed in my seat. Like most parodies, the depiction was funny and humiliating, because it echoed the truth.

Despite my pledge to the contrary, I’d learned to prioritize efficiency over tenderness, and hard, cold data over the content of people’s hearts. As laughter in the crowd died down, I wondered how many people with hard questions I’d stranded for the sake of expediency. I wondered how many concerns I’d dismissed, how...