Lois* had been in the hospital for weeks. She had multiple medical conditions, many of which had uncertain cause and most of which were only temporarily treatable. Her husband, whom she married at age 18, was dedicated to doing everything possible to save her. Her three children slept outside in the waiting room and told me “She is everything to us. She holds the family together”. She had recently taken turn for the worse and was now intubated (meaning she had a tube in her windpipe so that a mechanical ventilator could assist her breathing). She was so sick that she no longer was able to interact with her family and was taking multiple medications to keep her blood pressure high enough so her organs could at least get some blood flow.
The family frequently mentioned God and wore clothes that mentioned faith or God. When the doctors shared how sick Lois was, the family acknowledged this, but informed us they were praying for a miracle and not going to give up.
I was a player in Lois’s story as an intern, a first year resident, on the team of doctors who were caring for her in the Intensive Care Unit. Not only was it my first year as an “official” doctor, but my very first month of residency.
On a particular bad day for Lois, on my way out the door, I approached one of her daughter’s in the waiting room and asked if I could pray for Lois with her. I knew it was okay to pray with patients and families, but I had rarely seen this modeled. I had been a Eucharistic minister in the hospital during medical school with the opportunity to visit patients and have short prayer services with them at their bedside, though this was slightly different than that as I was wearing my “doctor” hat and not my “church volunteer” one. At gathering of Christian physicians called the Global Health Missions Conference in Louisville Kentucky, I heard Dr. Walter L. Larimore speak on taking a “Spiritual History” from patients alongside the medical, surgical and medication histories we assess at every visit. With this he shared that the “Joint Commission, a regulatory body for hospitals, actually requires hospitals to assess spirituality with each patient”. From what I have seen, this is often done by asking a single question, amounting to “Do you have any spiritual needs?”. These prior experiences gave me the boldness and at least a bit of skill to initiate this.
Lois’s daughter did not find this offer strange, but instead called her father and siblings over to join us. I praised God for Lois’s life and all the people she touched, prayed for her comfort, asked God to guide the hands and minds of doctors and nurses. Afterward, her children and husband added their own prayers. As an intern, I often feel that what I did really did not make a difference, but I left that day feeling so thankful I could contribute by offering to pray.
Days later, Lois continued to decline, but the family,and her husband in particular, were still struggling to accept this. The husband was frustrated with the doctors for not being able to do more for his wife. If my grandparent were in the same scenario, I too would wonder, was everything done that was possible?
It was at this stage of frustration when the job fell to me to give the family the routine update for the day. Walking into the conference room to meet them, I was surprised to find about 15 family members crammed in waiting for me, rather than the 3 or 4 that were typically present. Yikes! Often my senior resident gave the update so I was a bit unsure if I was prepared – especially for such a large audience!
My update was simple and unchanged from the past few days: her kidney function was not getting better, her heart was not pumping well and her lungs were filled with fluid. Every medical intervention that could possibly help was being done. As they asked a few questions, there was a tension of accusation in the room – “Why can’t you fix this? “What if this or that would have been done sooner?” and I did my feeble best to answer. I could understand the thoughts running through their head, and might have asked the same ones in their position. It was becoming more clear that all the medical interventions we could do were not going to stop Lois from dying. I sensed a tone of denial and anger. Admittedly these are part of the grieving process, but it was sad to see that hinder them from cherishing the last moments with Lois.
When I sensed that continued questions were taking us in circles, rather than really helping, I transitioned to end the conversation. A thought crossed my mind to offer to pray again – but I was unsure. I took the plunge – offered to pray, said a short prayer. What happened next was, in my opinion, the “miracle” that the family had been praying for. No, Lois did not start to recover, but as I watched they started to accept and process that she was dying. The tone in the room changed from accusation and anger to sad, thoughtful processing and acceptance. Many family members in tears prayed for their mother, wife, mother-in-law, aunt – celebrating her life. A son-in-law walked across the room to give a hug to the tearful husband of Lois. Someone encouraged, “it is okay to let go”. For the first time, the husband said that if her heart were to stop beating, it would be okay to not do CPR and try to restart her heart. This mattered because the chance of CPR actually allowing someone as sick as her to live well again was ~0.0001% and would likely do more harm than good. Though we had tried to communicate this for days, it was not until now that he was able to accept this.
I believe in miracles, in faith healing, in God’s power over this earth. Yet, I have seen many wonderful people with great faith die. So I have come to think that miracles do not always look like a cure-against-the-odds, but sometimes as an acceptance of life and death.
It was not a happy day, but it was a good one. As an intern, this was one of the first times I felt I really may have made a difference. As a believer in the Holy Spirit, this yet another instance on my mental list of when I saw the Spirit at work.
The next day Lois died. She now knows if there is a God. What God is like. If there is heaven or hell.
I believe in God, a loving, forgiving, just, personal high power. I believe that this God responded to my choice to make other things my highest value (accomplishment, food, comfort, pleasure, independence) – and instead of turning from me, sent his Son Jesus to make a way so that I could be back in full relationship with Him. And so that I could have hope that as I sat praying with Lois’s family, a power bigger than me was entering into this icky broken world of death, and bringing some comfort, light and hope.
This above story is one way my faith has impacted my work in the medical field. God’s overarching gospel of grace, restoration and love can be intertwined in all careers, though. My friend who is a lawyer works daily for justice for the people least respected by society. Another friend who is pursuing her Ph.D in environmental engineering works to protect and value the creation that God has made. Yet, for me as a new physician, I see God’s healing and presence in suffering as the gospel within the medical field. If I look I see the gospel interwoven in even the most mundane of days, those that are not life-and-death, but rather filled with paperwork for ordering someone’s allergy medication. Whatever your current daily life is, I challenge you to see if you can find it as well.
Dr. Brittany Shrefler is a first year resident in Internal Medicine/Pediatrics at The Ohio State University Medical Center. A native of Willoughby Hills, OH, she also earned a bachelor's in Biomedical Engineering and her medical degree from Ohio State. After completing her residency, she hopes to practice in the Cleveland area.
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