Life, Death, and Miracles

Beneath the haze of an induced coma a glimmer of awareness illuminates a single ray of reality penetrating the heavily medicated fog and compelling my eyelids to part. Through a filter of lashes and desiccated tears an image emerges more dreamlike than real with impressionistic strokes smeared and rippling across the panorama.

There are shadows. There are lights. There is a woman with dark hair standing in the threshold of the doorway looking at me. Her eyes are concerned…questioning. Perhaps there is also a tear. Others are present.

Moving hurts. Breathing hurts more. Someone sits me up pushes me forward telling me to cough out the tube. Coughing hurts most of all and the agony fans out like sluggish bolts of lightning searing across the chest and down the sternum. The tube heaves out from the depths of my throat.

“Don’t be afraid,” a calm voice whispers, “I’m with you.”

The words comfort.

Fear was not in my thoughts, neither was gratitude. Those require analysis to render meaning and that takes time and that takes effort. This is all far too new and unexplained. The calm voice has spoken to me before in times of extremity: when hopelessly lost as a seven-year-old alone on a bicycle in Yucatan and again as a young man beaten by a mob in Ecuador and at other times as well. It is always comforting, always welcome, always there when things seem hopeless in times of utmost despair.

Heart beats feel like loosely tethered salamanders speedily maneuvering in an inescapable wrestle inside the cage of my thorax.The pericardium was severed in surgery and the heart chambers pulse against each other in a much less restrictive space flopping and slopping against the glands and surrounding tissues in the cavity of the rib cage.

My throat is rough but unobstructed now. Shallow breaths, very shallow, they don’t hurt. Breathe, breathe breathe oh wonderful blessed air.

I am no longer dying.

The prayers of friends and family are felt so personally and intimately at this moment that the whispered breaths of their blessings trace across my awareness like soft healing caresses.

Now comes gratitude. Now comes wonder. Now come tears.

There is no knowledge of the efforts given to save me. The complete drama and the complete trauma passed without my conscious awareness. Someone did something maybe many people did many things and sacrificed greatly but it wasn’t me, it wasn’t my work at all. My role was simply as an object for which their labors were done. Still my life continues because of those efforts. How do you say thanks for that?

No turning back to the calmness of the coma. Whatever the discomfort, whatever the impairment this is reality; this is the direction of life. This is the way forward. This is the way home.

What raw information can be gathered through sight and sound and feeling is noted and stored but not made sense of immediately. Eyes close again. Meditation…put the pieces together. What’s going on? What is really going on?

It is a hospital room. There are tubes, three of them draining my chest and side into separate rectangular plastic boxes on the floor with clear numbered markings so the quantity of fluids siphoned from each of the wounds can be precisely measured and noted. My sternum has been sawn and mechanically cranked open then sutured closed with wires. There are lines piercing my neck and my arm. They must have catheterized me too since there is no way for me to get up to pee. Only that much is established. There is much more to learn.

Medicine is an empirical science demanding lots of work and diligence so there are metrics for everything and they log the quantities, and the types of the fluids that drain, the heartbeats, the O2 saturation and pressure of the blood and the body temperature. They measure, record and compare datasets establishing probabilities within a distribution from the most highly likely to the asymptotic fringe of almost zero probability…and then there are the miracles, the things that do not exist in probability space. They are outside the conceptual framework, beyond reason, outside our powers to adduce a causal connection.

There is a shiver in my core. Eyes open again. It is night outside. The woman with dark hair is still standing in the threshold. The shadows of the coma are in retreat.

My wife is here.

“Hi Kathleen,” I say, pushing the whispered words through my lips with effort.

“He’s awake.” she says into her smartphone then turns and smiles at me.

–“What happened?”

“You died.”

_________________

John arrived at Steiner aquatic center for a nightly swim. It was after 8:00 pm. and the pool would close in less than an hour. There was some unusual activity In the locker room but it was not until he saw the body on the bench with Mike doing CPR that anything seemed really out of place.

My body had no pulse, no breath and my flesh had turned a cool colorless grey. It was not that death was close, death was already present and would stay unless something changed the course.

Mike is a nurse at the VA. On Tuesday he finished his re-certification in CPR. On Wednesday he used that fresh knowledge to coax on my heart and keep oxygen flowing to the tissues.

He was waiting for the defibrillator to charge its capacitors again and calculate the advisability of a second shock. The first shock did not accomplish the task. He had been doing CPR for a long time and the lifeguards had gathered and brought the equipment.

Again the automated voice of the external defibrillator sounded:

Do not touch patient…. Analysing rhythm…shock advised…charging…stand clear shock will be delivered in …three…two…one….shock delivered. It is now safe to touch the patient.

500 jules of focused energy shot through my body causing it to convulse.

Onlookers cheered as a hesitant twitch and a familiar spiked pattern appeared on the monitor which until then had been a hauntingly still flat line tracing across the screen. In a few moments the flat line returned and the emotional silence left everyone staring.

Many of those in the locker room knew me, but not one knew my last name. John had an idea approximately where I lived. He ran to his car and drove to our house a few minutes away.

Kathleen met him at the door and he told her my heart had stopped and they needed to know my name. She wrote it on a scrap of paper gave it to him and he left. She called the pool and was told the ambulance had arrived and that they would take me to the University Hospital.

They never got my name and twice more my body coded in the ambulance while the EMTs rushed with sirens and spinning lights to the ER. Again in the hospital the flat line returned and they shocked the heart into conduction one more time.

By all reports more than fifty minutes had passed and six defibrillating jolts had been given since the initial collapse. The hospital staff were caring for me, a nameless patient known to them as: No Last JoKi. My consciousness was elsewhere.

________________________________________________________

Not sure if what followed was a dream or a memory, Grandpa Cachimuel was a friend when I was in Ecuador and his posterity are friends to this day. He passed away decades ago but appeared pleasantly in my thoughts without expectation or warning. He never learned to read or write but knew how to make black powder and fireworks and that fascinated me. His hair frizzed a bit on the sides so his wife would braid the wandering ends into diagonal lines knit across his temples converging into a pony tail that extended down his back, what we would call French braids and they looked really really cool. He was a philosopher of sorts or at least he wondered deeply about things and about being and asked profound questions. We would talk when there was time.

He was a purebred native from one of the last tribes overcome by the Inca before they themselves were conquered by the Spanish.

While we were talking on his patio he grabbed a pinch of corn kernels and held them up to my face, “do you know what this is?”

— “uh–corn?”

“These are miracles!”

— “Hunh?”

“Take a rock and put it in the soil, you can work all day watering and weeding and fertilizing and if you wait a week or a month or a year, and what happens?

— “um…well I don’t know.”

“Nothing happens, the rock doesn’t change, it doesn’t grow, it doesn’t make flowers it doesn’t make fruit. It doesn’t make anything and why not?”

— “Because it is just a rock.”

“It is dead. It has no miracle in its heart. And it is the same with rabbit poop, the same with ashes, the same with everything except…” He paused for me to finish the sentence. When the silence was getting awkward he continued.

“…except the miraculous. Corn is different. Seeds are different. Seeds have life. Seeds have magic, they have miracles in their hearts and if I do my work: watering and weeding and making sure the animals don’t eat or trample what I have planted, the miracle grows. Leaves emerge and buds and flowers and fruit and more seeds. Life…miracles!

Without the miracle you have nothing. You have to have the miracle first. And then you have to do the work. Even if it is hard and even if it takes a very long time you have to do the work.That is where the flowers and the fruit and the food and the seeds and everything comes from. And it happens all the time and it happens wherever you go but even though it is common, it is a miracle.

_____________________________________

A nurse not seen before enters the room. She is from Viet Nam and tells me she will get married in two weeks. She places a cup of pills in my hand and offers me a small glass of water. The pills look like so many seeds of different shapes and colors. Some are to inhibit and some are to promote normal biological operations. One is to kill pain. None of them has a miracle in its heart, they are the products of diligent rational study and that is respected. They are part of the necessary work but the miracle lies elsewhere .

The incisions still hurt but healing has already commenced. Signals in the form of peptides, protein fragments and other ligands bind to receptors in cells that have not yet differentiated instructing them to become fresh new skin or blood vessels or another tissue type to repair and replace what has been damaged or at least that is how we currently describe the process but life and growth and healing are at their deepest foundation miracles.

We nudge some of processes and mask some of the others, but that is just our work, without the miracles all our work is pointless, like cultivating and caring for a stone that will never sprout or grow or live.

_________________________

Mike called the hospital but the name he gave was not among the patients. Conclusion: I didn’t make it.

The following days he searched the obituaries and wondered what more he might have done. His wife, Shelley is a professor of nursing and has many of her students at the University Hospital. She kept an eye out for anyone fitting my description especially in the ICU thinking there was a remote possibility that there had been some error with the name and that the friend her husband had done so much for was, despite the odds, still among the living.

In the evening after the medical team had induced a coma and chilled my core temperature hoping to preserve some organ and cognitive function after such an extended period without adequate oxygen Shelley stood in the threshold of the doorway to my room. The details of this patient fit perfectly the one she was searching for. She stood for some time just staring then called her husband:

“I think I found him. He is alive.”