Monday, April 28, 2008

Miracles do happen...

I was reminded of this last night, as I sat with some friends discussing the topic of miracles.

A few weeks ago, I had the privilege of being a missionary, of working on a new mission. Maybe I didn't look it, as I seemed to be doing my usual work. You see, I was able to cover the inpatient service of one of my colleagues from the community, so that he would be freed up and be able to join two of his children on a mission trip to Africa. I've heard it said that there are two kinds of missionaries - those who go, and those who stay home. I had the chance to be the latter. Several of my practice partners helped out in this service as well.

And, another doc from the community had taken a good deal of this work as well. After his days of work, he "handed off" over a dozen patients to me, so that I could continue to care for them in the hospital. One of those patients was an older woman, who was now on "comfort care".

One of the tenets of the ethics of medicine is that each of us has the right to direct our own medical care. In this situation, the patient, through the designation of a healthcare proxy, had declared that she didn't want any "heroic" measures if it appeared that she was terminal. She had been admitted with kidney failure and pneumonia, and after a few days, the decision had been made that, indeed, it appeared as though she would not leave the hospital, she would die from these problems. So, the plan of care switched from curing her to offering her comfort while she died.

When I met her, she was unresponsive, essentially in a coma. She was not eating or drinking; she was not responsive to pain, and did not communicate with staff.

Well, after I had watched over her for three days, I got a call from the nursing staff. On that morning, she had sat up in bed and asked, "What's for breakfast?"

I need to be reminded that miracles do happen. It is a privilege to witness, and sometimes participate in these miracles...

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