I want to start this story at the end. I said my goodbye while suppressing tears of joy. I was discharging a patient to his home, the same home he had been missing for more than 40 days. We discontinued his IV lines and turned off all oxygen. We dressed him up in normal clothes and placed his shoes on his feet…the same clothes that he had come in with on that fateful day. His wife held his hand as he got out of the bed and started walking around his room, eager to leave. The ear to ear smile was simply priceless. I knew I had the privilege of being part of a miracle.
Let me rewind here…
DF was brought into the ER after being found comatose at home by his wife (approx 40 days prior to today). Almost immediately, his heart stopped. He was repeatedly resuscitated until a pulse was stabilized. Meanwhile, the cardiologists prepared to insert a catheter into the main vessels of his heart (aka cardiac catheterization). Pop! They opened up the blocked vessels of his heart and his heart was given a second chance. But the damage suffered to his brain due to a lack of oxygen was unknown. As days passed, he was unable to talk or communicate with his wife or nursing staff. He would become agitated from repeated fevers. He underwent the placement of more stabilized breathing tube (to be left in place for years to lifetime) and feeding tube. He continued to be agitated and the hope of any neurologic recovery was growing weaker each day. He was finally stabilized enough to be transferred out of the Cardiac Care/Critical Care Unit but still unable to communicate or follow any commands. He was a threat to himself because of his agitation. We started engaging him in conversations, even though we were unable to measure how much he understood. After aggressive weaning trials, multiple sessions of cognitive and physical therapy, and 24hrs intense monitoring and protection from himself, he started to show us signs of improvement. Just like an infant, the first sign was a smile. Then, he started tracking our movements around his room. Then, he started holding and squeezing our hands. Finally, in the span of a week he was able to tell us he wanted to eat. He wanted the tube out of his throat. And miraculously, we were able to remove the tracheostomy tube and he passed his swallowing evaluation with flying colors. We brought him his first meal – a jello cup! (although he wanted fish soup – a Jamaican tradition)
The credit for his recovery goes to every person who cared for him – from his family to his physicians to nurses to PCAs and all the ancillary staff in the hospital. His recovery is a rare phenomenon, and to be a witness to his recovery is a gift. Medicine is a world where many battles are fought – you win some and lose others. But when there is a win like this, it is truly a win for the entire team. It feels as if we hit a home run at the bottom of the 9th inning with 2 outs and bases loaded. It is truly awe-inspiring.
Fast-forward to today…
After eating a few more meals and walking a few more laps around the Nurses’ Station, DF was ready. He wanted to go home. And I said goodbye, holding his hand as he warmly said “Thank you.”
This entry is dedicated to my untiring colleagues – Thank you for helping create this miracle. Every day your efforts reaffirm my faith in Medicine.