surgery

A single surgical clamp, placed on the bleeding vessels of a ruptured fallopian tube, can save a patient’s life. I know this because I have placed these clamps myself. Ten years ago, a patient arrived at the emergency room of Grady Hospital in shock from such a rupture and the resulting loss of blood. I was a fourth year Chief Resident on call for the surgical emergency. After placing the clamp, I instructed my pretty, wide-eyed junior resident to suction the half gallon of blood and clots from the patient’s abdomen and pelvis. I remember keeping my voice calm, to emphasize the achievement of total control—“Just another day in the operating room, ma’am.” I tried to limit my swagger as we walked to the waiting room to reassure the patient’s family and give them the good news. But afterward, alone in the call room in my blood-stained scrubs, I allowed myself to bask in the full power of my accumulated years of study and training. I felt a Cheshire cat smile of self-congratulation steal over my face. Always a mistake. A superb textbook on obstetrics and gynecology opens with Alexander Pope’s famous refrain, “A little learning is a dang’rous thing; Drink deep, or taste not the Pierian Spring; There shallow draughts intoxicate the brain, And drinking largely sobers us again.” Many times I had flipped to re-read that quote before diving into my studies. It was a warning to the overconfident. But on that day toward the end of my eighth year of training, I fell into the deep sleep of the self-satisfied. At last, I knew exactly what I was doing and what was going on in the world. A phone call the next day proved how wrong I was. The caller was Ife Sofola. Ife (pronounced Ee-fay) was one of my classmates from medical school. A tall, muscular Nigerian, Ife was not only a brilliant student, but a man of deep compassion and undeniable charisma. His easy smile, booming laugh, and lilting Nigerian accent were a comfort and delight to both friends and patients. At the time, he was a flight surgeon at the renowned Bethesda Naval Hospital, where our Presidents receive their medical care. Ife had called to let me know that his mother had died. But it wasn’t the sorrow he wanted to share. It was the miracle. Months earlier, Ife’s family learned that his mother was dying from liver failure. Brought to the Bethesda Naval Hospital, she fell into a coma. She was put under a DNR order—Do Not Resuscitate. Those orders are reserved for patients who cannot be saved. The words are a kind of final acknowledgement: that modern medicine has failed the patient, that we can do nothing, that Death is coming. But Ife and his siblings were not ready to let go of their mother. They had been already heartsick with the loss of their father, who had died earlier that year. The looming loss of their mother was too much to bear. Desperate to do something, Ife’s sister sought out a friend of a friend of a friend who was reputed to be a “healer”—someone who could save life where others had failed. Ife’s sister flew the healer to America from Nigeria, keeping it a secret from her family until the healer showed up at Bethesda. A student of medical science, Ife was dismayed and agitated by his arrival. But there was nothing to lose, so he and his siblings permitted the healer to stay. The healer directed them to hold hands around the dying woman’s bed. They prayed in silence for five minutes. Then the healer announced, “It is done.” With that he departed, taking a taxi back to the airport. Twenty minutes later, Ife’s mother awoke. She smiled and greeted her family and got out of bed to take a shower. Ife said there were no words to describe how dumbstruck her physicians were. Ife himself, exuberant, believing, brimming with unadulterated joy, raced and leaped down the hallways in his white coat, yelling so all could hear, “A miracle has occurred! Here, at Bethesda! A MIRACLE!” Within a few weeks, Ife’s mother succumbed to her disease and died. But not before she had left the hospital and spent precious days with her children at home saying good-bye. Her explanation of what had happened was simple and profound. “I came back,” she said to her children, “so you would have faith.” The power of modern medicine is an illusion. The physician’s sense of mastery, the gratitude of patients and their families—all these constitute a thin veneer which sometimes covers the truth. The source of the healing lies far beyond our earthly skills. It emanates from the realm of the Unknowable—from God, the Source of Life. The other day a patient told me she was confident about her upcoming surgery, “because I have faith in you.” A decade ago I would have enjoyed that kind of comment. The trust and respect of patients is a blessing. But the truth is that we are all participants—patients and physicians alike—holding hands in a circle of healing and praying for a miracle. And we are blessed with this miracle of healing every day we live. Ife concluded his call to me with his own revelation. His tone was not one of grief, but excitement. “Michael,” Ife said to me, his voice trembling, “how many hours did we spend in the lecture hall? How many books did we read? How many operations have we performed? We think we are doctors, so we must know something about life and death.” He paused for a long moment. “I tell you this, Michael—we know nothing. Nothing.” I fumbled for words. I said his story was just amazing, that it had changed my life. Ife laughed his large, unforgettable laugh. “And well it should, Michael—well it should.” -Dr. Mike Litrel