The Patient in Room Nine Says He's God

by Louis Profeta

  So, as a fifth grader at the Christmas program, I finally had enough of standing in the choir and singing Away in a Manger, Silent Night, or Little Drummer Boy . I stood in proud defiance, with my arms crossed and my lips sealed for the whole school to see. After the program I sat with my father and the principal locked away in her office, and I cried from years of the deep pain for always being excluded—only to be met with a look of understanding from both the principal and my father. From that day forward, school was forever changed for me.

  Sometimes it takes one encounter to change a person’s perspective, to shake their spiritual foundations. The tragedy of 9/11 is a perfect example about how one act can permanently alter the way we view the world. In 1993, one patient made me wonder if perhaps we are all really on the same plane worshiping the same God, with reservations in the same heaven.

  It was November 30; this girl was beautiful and late in her pregnancy. Unfortunately she had not felt the baby kick for a while, so she came to the ER where an ultrasound reading showed the infant was dead. The profoundly distraught mother was taken to labor and delivery, where she gave birth to a stillborn fetus. Immediately thereafter she became suddenly ill and was sent back to the ER. Her respirations increased, her oxygen level and blood pressure dangerously dropped off, and she broke out in a fine rash. Her lungs filled with fluid, her heart rate soared, and she lapsed into a coma—a victim of life-threatening septic shock. We gave her twenty liters of fluid and administered potent blood pressure-supporting medications at critical rates in an attempt to maintain a blood pressure that hovered at about 50 over zero. Her lungs shut down, her kidneys stopped functioning, and in less than six hours this fine rash had formed large blood-filled blisters covering nearly her entire body, confirming her diagnosis of sepsis due to a deadly infection of Neisseria meningitis. Her baby had died because of this nonselective assassin and now it was taking her mom, and we knew from the literature that the mortality rate was nearly 100 percent for a patient with her degree of illness. So my fellow resident Bill and I took over her care and awaited her death.

  It happened that she was assigned to our service for the ensuing month. We had just finished our November ER rotation in this small community hospital and were now, as third-year residents from the University of Pittsburgh, next to take over the hospital’s six-bed Intensive Care Unit (ICU). Thus, she went from the ER to being in our charge in the ICU.

  She was so ill that we literally had to sit at her bedside day after day, making minuscule adjustments in her ventilator and her medications, just hoping we could maybe beat the odds and help bring her back from the dead. Her body grotesquely swelled from all the fluid; large patches of skin blackened and died. Her eyes and skin yellowed from liver failure and her coma deepened, but somehow she still maintained a trace of a blood pressure. We tried high doses of steroids, and an experimental antibody serum flown in especially for her. We hit the library looking for something we could try, but all signs pointed to a fatal outcome. We placed her on a modified type of dialysis, taking off just enough toxins and fluids to sustain her life, and days remarkably became weeks. A CT scan of her brain looked surprisingly good, and an EEG showed that somewhere deep, deep inside this ill woman, her brain still worked, calling out, “My soul has not left; tell my mother that I’m still here and I’m not ready to leave.”

  For three weeks she languished, hovering between this world and the next. She lay casket-still, the only perceptible movement was the rise and the fall of her mechanical breathing, and it became clear that if she didn’t make a move toward recovery, she would probably die around Christmas.

  I worked Christmas Eve, as I have every year since medical school. I am keenly aware of the importance the holiday holds for my non-Jewish friends, and I always am quick to take the reins and volunteer. But let’s also be realistic. If you’ve seen all the latest movies and are not too keen on Chinese food, there is not too much for Jews to do on Christmas Day anyway. I also liked the notion that if the whole ‘Jesus’ thing was true, I’m sure he’d much rather I was attending to the sick and downtrodden on his birthday than going gaga over another new sweater. So, every year, we congregate on Christmas in cinemas, Hunan and Szechwan restaurants, and the local hospitals all across America. For me this Christmas Eve was different, though. There was not a sense of anticipation but of dread that she would die on this night, and this sacred holiday would forever link her family to her death.

  It was very quiet in her room that night; the radiator was lined with cards, unlit prayer candles, flowers, and scattered gilded-framed pictures of the Virgin Mary. Her family lay sleeping in the ICU waiting room, maintaining a Christmas vigil, no visions of sugar plums for them. I walked softly around the room, checking the lines, the monitors, and looking for signs of change. I meandered around the trinkets, touching the candles, reading the cards, smelling the flowers, and pausing at a picture of the Virgin Mary.

  “You know . . . I’m Jewish, just like you, and I don’t know if you listen to my prayers too . . . but if you have an ‘in’ with God somehow, the time is now to step up and help this poor girl, ’cause we don’t have much left to offer at our end . . . if you know what I mean.” And with that the air conditioner violently kicked on and scared the living crap out of me. After I composed myself and turned to make sure no one noticed, I laughed and then turned toward the young woman just in time to see it—she moved her hand and opened her eyes, and my own heart nearly stopped.

  She lived, and although she needed lots of surgeries, skin grafting, dialysis, and a subsequent kidney transplant, she went back to her life, back to her family and those who loved her, and lived to celebrate many more Christmas days with them.

  Now before you think that I turned in my Jewish Community Membership Card and joined the YMCA, trust me, it didn’t happen. But I do believe I experienced a deep spiritual connection, a brief closeness with God in a manner I didn’t expect. So many times in my career I have been on the razor’s edge of a catastrophe, and I had a feeling that God was helping me out, helping me to focus, calming my soul during chaos and crisis. In this situation, though, I was not asking for help or guidance for me. I was comfortable, even calm in knowing that I had done everything possible. The lines were in, medications were flowing, and all the tubes were in the right place. It was out of my hands, and the only real task left was to surrender to a higher power. It just did not feel right for me on Christmas Eve to pray to the God I knew, in the way I was accustomed. I was again a Jewish boy on the stage of a Christmas play. Only this time I was playing the part of the voice of a dying woman, pleading to the mother of God she knew, on the day that was profoundly special and sacred to her, in the only way I could—with frank, in-your-face candor, arms crossed in defiance . . . and I think she listened.

  Chapter Nine

  Maria, Maria . . . I Believe

  There you have it. I believe in God. Mind you that it’s not without a slew of questions, like the Holocaust, Rwanda, Stalin, and the Red Sox over my Yankees. But when it boils down to it, the basic concept of a divine presence, a force for good and humanity, I believe. I must admit that this has not come easy, and I certainly am not like those reborn types who always seem to have a smile, where everything is Jesus this and the lord that, though I am absolutely envious of their peace of mind and the way they go through life with their conviction of faith guiding them. No, I am different in this regard. I am deeply affected by the world around me. I fight and argue with God as much as a teenager with his father. I love God, I curse God, I thank him, and I blame him. I am an adolescent when it comes to my faith, and no matter what I do that does not change. Each year during the holy holiday of Yom Kippur, I tell God I am sorry for all my transgressions, and I apologize and promise not to repeat them, knowing damn well I will be here next year asking forgiveness for the same offenses. “Where does that leave me?” is the question I always seem to ask myself. Does God like me? No, not love me . . . does he like me? I have many relatives
that I love, but I don’t necessarily like them. Am I the obnoxious cousin who, when God checks his call-waiting, looks over to Moses and says, “It’s Profeta again . . . don’t answer it.” I like to think that’s not the case, but I suspect otherwise.

  I think God is the AAA of humanity: He gives you the roadmap but you still have to drive through life. You can avoid the traffic congestion and roadwork if you want, but ultimately it’s up to you which direction you go. But in my life, in my career, he has shown himself to me so often that I have no doubt as to his existence. I just wish I could have believed it earlier.

  I was working the nightshift. It was about 2:00 A.M. and fairly slow. Suddenly it hit me, like a blow to the chest . . . a kind of knowing. I looked up from my paperwork and said to no one in particular, “My Aunt Maria just died.”

  “What?” one of the nurses asked, peering up from her charting.

  “Uhhhh . . . what’s the number for the hospice? My Aunt Maria just died.” I fumbled around with the receiver, dropping it twice before getting it to my ear. I dialed the number to New Hope Hospice Center, where my dear aunt had languished for the last few months with metastatic colon cancer.

  “St. Vincent Hospice, may I help you?” the soft feminine voice on the other end of the line inquired.

  “Ummm, yes, yes . . . this is Dr. Profeta over at St. Vincent ER, and I was wondering . . . ummm . . . did my aunt . . . Maria Nichols just die?” There was a pause on the other end of the line. I already knew the answer.

  “Dr. Profeta . . . yes, she did, literally, just now . . . she just died. How . . . how did you know?” the female voice nervously cracked.

  “I just knew. Thank you for taking such good care of her,” I responded as I hung up the phone, my hands trembling.

  Aunt Maria, as I always called her, was not actually my aunt. She was my godmother, a Greek Orthodox woman who taught history and Latin at one of the local junior high schools. I was fortunate that she befriended my mother in her early twenties, and in all practical sense became the mother and role model that she never had while growing up. I have no doubt that my mom became a much better parent and person because of her friendship with Maria.

  Her legacy to this day continues through every person she ever met. Into their adult lives, her students always visited, called, and loved her. She never referred to them as her pupils as such. They were always: my son, my daughter, or my child. She was worldly and wise beyond her years and was fondly known for her colorful foul language, even in class. When a student would gasp or snicker sideways to her flowery verbiage, she would respond, “If you don’t understand that word, I’ll be happy to write it on the board and explain it to you in great detail.” She never had to oblige them. She taught into her late seventies and was actually grading papers in the hospice prior to her death. She rolled with the punches and laughed at everything.

  I recall eating lunch at her house when I was about ten years old. I noticed a little dried food had adhered to my fork. She saw me examining the dirt and gently asked for the fork. She proceeded to wipe it under her arm and give it back to me. “There . . . it’s clean now,” she said. That may have been my first lesson on how not to ‘sweat’ the little stuff.

  Most fascinating was observing the perspectives of others in regard to her ethnicity and religious background. She kept it a secret from her students. With her olive-colored skin, grey-black hair, and ethnic disposition, she was part every-student. The Jews knew she had to be Jewish; African-Americans were convinced she was a woman of color; Hispanics, Arab Americans, and even Midwest Protestants claimed her as their own. She could speak many languages including French, Italian, Greek, and Yiddish. She would color her dialogue with Japanese, Chinese, Arabic, and Spanish words, whatever it took to connect. No student really knew her ethnicity, and when they inquired, she would reply, “I am all of you.” She was literally a human UN unto herself.

  As a practicing ER physician, I would occasionally stop by her school, go to her class, and sit and watch her teach and interact with her students. I loved it. It was like watching Michael Jordan or Barry Bonds at work. In our tough public school, with all of its social and economic pressure, she was held in profound reverence by her students and the other teachers. They knew she absolutely loved them, and they loved her.

  Nothing fazed Maria. Life on this earth was a wonderful privilege no matter what came her way. She never missed school even while undergoing chemotherapy. A lymph node dissection and mastectomy left her with a chronically swollen arm to match her swollen heart. She went to school bald and sick, but she never gave up. Maria knew that every minute that she spent in the classroom was one more chance to make a difference, to touch a life, to shape a child. The classroom was her home, the desk was her kitchen table, the chalkboard her welcoming hearth. She saw the good in everyone and everything, even in those who had wronged her in life. She was profoundly spiritual and thanked God every day for the blessings she had been given: She defined forgiveness, and it was that quality and my lack of it that seemed to trigger the events that transpired in the ER the night of Maria’s death.

  Now, let me preface this story by telling you that it is absolutely true (except for changing some names). I make this claim because it is so coincidental and bizarre that even I have trouble believing it sometimes. These events were, however, one of the pinnacle moments in my life when I knew that God was real, and that perhaps I just needed to open my mind and my heart to him more often. It was the day I finally learned to forgive, forget, and move on with my life. It was the day I learned that letting go of hatred is liberating and godly in its simplicity. It was the day that I learned how to laugh at myself. Because in the wee hours of the night of Maria’s death, she showed up and taught me a final lesson I will never forget.

  After I confirmed the news of her death, I went into my office adjacent to the ER and sat there with my head in my hands, with tears welling up in my eyes as I grieved the loss of my beloved Maria. My mind wandered filled with memories of her, of Mediterranean pastries, basset hounds, black coffee, long hugs held tightly against large matronly breasts. Then, it happened. An image of Kris Reich intruded on my reflections of this glorious woman.

  Now that you know how wonderful my memories of Maria were, multiply that by a negative one thousand, and you get a glimpse of my memories of Kris Reich. This kid was evil incarnate. Growing up as the only Jew on the east side of Indianapolis, he made my childhood a living hell. His last name was Reich to boot—go figure. He was probably about four or five years older than I, and I hadn’t wasted any mental energy on him for at least ten years. Truly, this angry and disturbed kid had not entered my mind at any time in the past decade. But now, only moments after Maria’s death, all I could think about was the absolute hatred I had for him, a hatred bordering on homicidal rage.

  When I tell you that this kid tortured and terrorized me as a child, it is a severe understatement. He constantly called me cheap Jew, kike, Christ-killer, and a myriad of synonyms related to the female anatomy. He threw my bike into the fish pond, bloodied my lip, and beat me to a pulp at every chance. He even pulled a knife on me once, and later threatened to have my parents gassed. This was the most emotionally disturbed kid I have ever known. I trembled at the mere thought of him. I know how a victim of parental child abuse must feel. He was always older and much bigger than I, always capable of hurting me. And while I should’ve been thinking of nothing but my deceased aunt and my love for her, all I could picture was tracking him down and evening the playing field. You see, I was thirty-seven, now six-feet tall and 200 pounds with a black belt in karate, and was capable of bench-pressing a small village. In addition, I had the resources to track this son of a bitch down. But I didn’t have to because thirty minutes later he came to me.

  The soft rapping of a fist against the wood door brought me back to reality. “Medics called, they’re bringing in someone in severe respiratory distress,” came the nurse’s voice from the other side.

&n
bsp; “Be right there.” I composed myself, wiped the tears from my eyes, blew my nose, took a deep breath, and walked back into the trauma room to await my patient. She was an elderly lady, probably eighty or so. She was slipping out of consciousness in severe respiratory distress from end-stage emphysema or pneumonia; I can’t really recall.

  I quickly placed an intravenous line in her, sedated the patient, and put her on life support: a breathing tube placed into her lung and a mechanical ventilator to maintain her respirations. She briefly stabilized, but it was clear that with all the other comorbidities that she would, in most likelihood, die in the next few days. They told me her name and that she was a resident at a local nursing home. From all indications she did not have a signed living will on file. “We need to call a next of kin and get someone in here,” I indicated to one of the nurses.

  “Here we go,” said Gaynell, the nurse in charge. “The next of kin is a sister . . . a Mrs. Reich.”

  My heart stopped. “Do they have an address for her on Wittier Lane?” I asked.

  “Yeah . . . that’s it. Do you know them? Are they F.O.P.s?” (F.O.P. is an acronym the nurses jokingly used to describe a ‘Friend of Profeta’.)

  “Yeah, I know them. And no, they’re not F.O.P.s. Would you call Mrs. Reich and fill her in on her sister, and tell her she probably needs to come in.” I paused, and for some reason added, “She’ll tell you she needs to call her son to bring her in.” The nurse just looked at me, appearing to be even more confused. She flipped through the paperwork until she found the phone number and called Mrs. Reich. I returned to my office.

  “Dr. Profeta?” Gaynell stuck her head inside the cracked office door. “I reached Mrs. Reich and she is on her way in. And she said she had to call her son to give her a ride. Now what is going on here . . . what don’t we know?” she asked tersely, hands on her hip.