To Heaven and Back

by Mary C. Neal, M. D.

  When I speak of experiencing God’s presence and knowledge that He would show us the way, I don’t necessarily mean that He, God, was planning to personally escort us out of the cave. I’m surely not that fanciful. I mean that I felt the manifestation of God’s love and grace, and knew that one of His messengers (a spirit, an angel?) would somehow show us the way. This knowledge allowed me to slow my breathing and pray for my instructor’s wisdom.

  The silt began to clear and we saw several fish darting back and forth before lining up together, swimming in the current. They seemed to beckon us to follow, which we did. We made one last dive down to the bottom of the cave in the direction of the fish, then swam upward and broke through the surface of the lake just as my instructor’s air tank emptied completely.

  My instructor and I discussed our shared experience at length. He was entirely focused on himself, and was distraught at having lost control of the situation. He felt responsible for the mistakes that were made and what he thought was his poor judgment. He believed that we had survived because of pure luck. He judged himself a failure and proceeded to drink himself into a state of oblivion. For my part, I had a profoundly different response to our survival. I did not believe that luck was involved. I had experienced a profound sense of calm and a knowledge that God was with us in the cave. I believed we had survived because God intervened, even though we had been such knuckle-heads and He essentially had to push us out of the cave.

  The experience in the Florida Springs stimulated a reawakening of my spiritual being. I had the intense feeling of being sure that we are all on earth for a reason, and that I had survived because my work on this planet was not yet complete. This left me with a sense of responsibility to seek God’s will for my life, and to follow, as best as I could, the path that was being laid before me. This time, I was determined not to relegate God to the background of my life, but to consciously keep Him present in my thoughts and actions.

  CHAPTER 5

  GOD IS FAITHFUL

  “The LORD bless you and keep you;

  The LORD make his face shine upon you and

  Be gracious to you;

  The LORD turn his face toward you and give you peace.”

  —Numbers 6:24–26 (NIV)

  Upon graduation from college in 1980, I moved to Los Angeles, California, to begin my medical training at UCLA. My time in medical school was, predictably, stressful and demanding. The first two years of medical school were spent primarily in the classroom, which was interesting but not very enjoyable. Clinical training began in the third year and I thoroughly enjoyed the time I spent learning about the many areas of medicine and surgery. I soon discovered that I was much more interested in the surgical fields than the medical ones, as I liked to “fix” problems more than I liked discussing them. I elected to spend a block of time learning about orthopaedic surgery and quickly found that I had discovered my niche. I enjoyed the mechanical aspects of orthopaedics and relished the idea of restoring patients’ function and increased activity. It was also a fortuitous choice, as I met my future husband while spending time with the orthopaedic team.

  Bill graduated from Stanford University’s medical school and although he had intended to stay at Stanford for his surgical training, his girlfriend’s job lured her, and thus him, to southern California. That story has its own set of “coincidences”; suffice it to say, he was meant to move south. Their relationship dissolved by the time he came to UCLA for some of his orthopaedic surgical training, where my friend, Peggy, and I had been assigned to his same surgical team. I found him to be quite charming and when I was no longer on his surgical team, we began dating. I soon knew that I would be spending the rest of my life with him.

  Before completing medical school, I was accepted into a prestigious orthopaedic surgery training program in New York City. This program required two years of general surgical training elsewhere before starting their focused training program to become an orthopaedic surgeon. My relationship with Bill was flourishing, so this arrangement worked well and I was happy to be chosen to stay at UCLA for my first two years of training.

  My general surgical training was very intense and left little time for eating or sleeping, let alone for something not directly related to my work. Although I continued to listen for God’s will, tried to follow His lead and live according to Christ’s directives, it was easy to let God drift into the background of my life. I just really didn’t have time for Him.

  It was as if I consigned God to the backseat of my car. I wanted Him to be present, but didn’t want Him to distract me and I certainly wasn’t ready for Him to drive the car. Thankfully, God is patient and God is faithful. He sits in the backseat just waiting for our invitation to move up to the front so that He can steer and press the pedals. If we give him the car keys, He will take us on an unbelievable ride.

  That is not to say that there were not small glimpses of God along my journey. Although the medical profession has recently, and somewhat tentatively, recognized the spiritual component of healing and of dying, patients have experienced this connection throughout the ages. I encountered many patients during my training who wanted to tell me about their spiritual experiences. It was usually done apologetically and with a tone of embarrassment, as they did not want to offend me and did not think “medical people” would listen or believe. Science and spirituality were presumed to be incompatible.

  I remember Jennifer, a girl who suffered complete liver failure at the age of fourteen. When I began to care for her, she had just undergone liver transplantation. This was at a time when liver transplantation was still being developed, so her prognosis was poor. There were many complications after her surgery and her new liver was not yet working properly.

  An important function of the liver is to produce factors that help a person stop bleeding by forming clots, which effectively plug the “breech in the levee.” Without these factors circulating in the bloodstream, a patient does not stop bleeding from raw or cut surfaces. In the 1980s, we did not have useful alternatives to these factors, so while we waited for her new liver to start functioning, we gave Jennifer repeated transfusions of whole blood and factor-rich plasma. We returned her to the operating room almost daily, trying to find and control points of significant bleeding. Keeping her alive was not an easy task and she soon grew tired of the process.

  One day Jennifer told me that she was not afraid of dying, but was afraid of what would happen to her parents. Apparently when her liver had initially failed, she tried to explain to her parents that God was with her and loved her, and that He wanted her to “come home.” Her parents refused to accept this, so she agreed to undergo liver transplantation.

  One day as I prepared her for yet another trip to the operating room, she told me that she would not be coming back. She thanked me for everything we had done for her and told me that her angels were with her so I should not be sad. She told me she was sad for her parents, but it was time for them to “let me go.” I listened and accepted the truth of her words. Still, my tears flowed freely later in the day when her heart stopped beating.

  CHAPTER 6

  AN ATTITUDE OF JOY

  “Set your minds on things above, not on earthly things.”

  —Colossians 3:2 (NIV)

  My time at UCLA was passing quickly and when the time for me to go to New York and begin my specialized orthopaedic surgical training neared, three things were clear:

  1. Bill and I were meant to spend our lives together.

  2. Bill, who had finished his orthopaedic training, had a great job, and whose family lived in Los Angeles, wasn’t enthusiastic about moving to New York.

  3. Neither of us was interested in a long-distance relationship.

  We both decided it would be best if I could stay in Los Angeles for my orthopaedic surgery training. The one problem with this idea was that positions in orthopaedic surgery training programs were highly sought after, were filled long in advance, and were rarely available at the last minut
e. We met to discuss this with a friend of Bill’s family who, at the time, was the chairman of one of the orthopaedic surgery programs in southern California. He was understanding and gracious, but assured me that there would not be any positions available and that my best option would be to complete my training in New York as previously arranged. Bill and I were quite disappointed and left that meeting feeling gloomy.

  I did believe that Bill and I were meant to be together, yet I also knew that I did not want to abandon my plans for further surgical training. I gave my worries to God and asked Him for guidance. A few days later, I was told that one of the young surgeons in the orthopaedic training program at the University of Southern California was unexpectedly taking a leave of absence and there might be a position available. I immediately called, sent my résumé, and was subsequently invited for an interview.

  One of the questions asked by the panel of interviewers was, “What is the last book you read?” This is a pretty standard question and one that most people, including me, would usually try to answer in a way that might show some intellect or highlight an unusual interest. I had recently been vacationing and read The Hobbit or some such book of fiction. Try as I might, I could not think of any other books that might seem more impressive to the interviewing panel. I sheepishly told them the title of the book and made a comment to the fact that I had been on vacation and that the book was “nothing important, just fantasy.”

  I was given the job position and later was jokingly asked if I had been able to read the minds of the interviewers. One of the people on the panel told me that before meeting me, they had already interviewed a number of candidates for the position. They asked each candidate the same question about which book they had most recently read, and each one responded with the name of some sort of intellectually challenging book that seemed unrealistic, considering each candidate was in the midst of surgical training. Just before I walked in they had exasperatedly wished among themselves that a candidate, for once, would just say that the last book he or she had read was nothing but fantasy.

  The Los Angeles County Hospital is part of the USC system and provides care to the indigent population. Throughout my training, I cared for many people who existed on the fringe of society, those that were incarcerated, and others who were just trying the best they could to make their part of the world better for all. Similar to my observations in the mountains of Mexico, it was clear that nothing separates these people, or any people, from God’s promises or love if they just ask that God’s door be opened to them.

  I certainly learned a great deal during my time at USC and one life lesson that I still think about from time to time came from an unlikely source. The old Los Angeles County Hospital had one central bank of elevators serving thirteen floors of constant activity. Each elevator had its own operator, who organized the occupants and pushed the buttons for their requested floors. The operators were usually quite territorial and swatted away the hands of people who tried to push the buttons themselves. It was a thankless job, as everyone was in a hurry and none of the young doctors, including me, understood why someone else was needed to push the buttons.

  There was one elevator operator who arrived by 6 A.M. each day with a large smile on her face and obvious joy in her heart. She was always like a beacon of light in that dark and gloomy building, and many of us would wait longer just to ride in her elevator. She was old, wizened and uneducated. She was often treated rudely. But she never let anyone or anything darken her day, and she shared her joy with anyone who cared to receive it.

  Over my years at USC, I developed respect, admiration, and a little envy for this elderly operator’s world view. One day I asked her how she was always able to maintain such a rosy outlook. She told me that her joy and strength came from the Lord. She knew the only part of life she could control was her reaction to it, so she chose to react with love.

  I was reminded of her comments many years later when I asked one of the operating room nurses in the hospital where I worked in Wyoming how she could possibly work for her current supervisor and administrator (both of whom were making life quite difficult for the operating room nurses). She just looked at me and said, “I don’t work for them.” When I questioned her further, she replied, “I don’t work for her (the current operating room director) or for him (the administrator of the hospital). I work for God.”

  Point made.

  CHAPTER 7

  GOD SHOUTS WHEN NECESSARY

  “We are either in the process of resisting

  God’s truth or in the process of being

  shaped and molded by His truth.”

  —Charles Stanley

  By the summer of 1991, I was thirty-three years old, had a husband, one child, Willie, and was about to give birth to our second child, Eliot. I had completed twelve years of high school, four years of college, four years of medical school, one and a half years of general surgery training, five years of orthopedic surgery training, and one and a half years of specialty training in trauma and spinal surgery. Mentally, emotionally, and professionally—on every level—I was more than ready to begin my “real” life. Within the context of our rapidly expanding family, I felt I could finally set my own goals and control my own future. I accepted a position as the director of spinal surgery at the University of Southern California, as I enjoyed teaching and enjoyed the complexity of the surgical cases that are common in a university setting.

  The university environment was exciting, stimulating, and ego gratifying. My position there was entirely satisfying to me for several years, and it seemed that my life was reasonably well balanced. With the help of Dawn, our delightful live-in nanny, who nurtured our kids during the day, Bill and I were both able to freely pursue our careers during the work-week. Our evenings and weekends were completely devoted to spending time with our children, and we savored every minute. We lived by the ocean, so often took them to the beach or sailing. We had barbeques in the sand, visited the museums, and taught them how to ride bicycles. Bill’s parents, who lived nearby, would visit frequently, and the kids adored them. On the weekends, we would often drive several hours to our cabin in the mountains north of Los Angeles. There we would kayak, build forts with the kids, swim, and just relax. I would say that we were quite content with the way our lives were evolving.

  The time demands on me to teach, develop a medical practice, perform research, publish scientific papers, attend meetings, and commute more than two hours each day began to take its toll after several years. Rather than spending my best time and energy nurturing my relationship with God, my marriage, and encouraging my children, I began to feel that my job claimed most of my life. My children were beginning to blossom into the people they would become, and I did not want to merely be a distant observer. My long commute to downtown Los Angeles meant that I was rarely able to attend daytime school functions, and could never attend on short notice. This also meant that I had very little time or energy to think about the role God played in my life or how I fit into God’s plan. I had made a commitment to keep God in the foreground of my life and I did not feel like I was fulfilling this adequately.

  I find this to be a commonly shared reality of young people and young families. To paraphrase what my minister once wrote: “We are constantly bombarded by those who want a piece of us; seeking our time, talents, and energy. Sometimes we weary of those demands and, at times, we feel God’s call on our lives as just another pull when we already feel pulled apart.”

  Another commonly shared reality, to which many, many women can attest, is the difficulty of being a working mother. Today, women are told they can be anything and achieve everything while simultaneously being great wives, great mothers, and great people. Women have convinced themselves that they can and should be “super-women,” which is exactly what they would have to be in order to do everything well. Reality is always a compromise. There are only twenty-four hours in a day and everyone must prioritize their work responsibilities, family needs, and perso
nal desires in order to decide where and how to make sacrifices. Appropriately prioritizing these various aspects of life is challenging since the right balance point is constantly shifting as a woman moves from one phase of life to another. I think it is healthy and essential to re-evaluate this balancing act occasionally and make changes when needed.

  Early in 1993, after I gave birth to our third child, Betsy, I began to reflect on the course of my life (What else is there to do during the many long hours of nighttime baby feeding?). I clearly saw God’s fingerprints and influence in my earlier experiences with surviving the car crash as a teen, my service in Mexico, the scuba diving incident in the cave, and elsewhere, and began to wonder whether or not I was truly following God’s plan for my life. We attended the United Methodist Church, attracted by their doctrinal social creed that demonstrates a commitment to environmental stewardship, human rights, justice, and seeking peace in the world, but I didn’t think that was enough. The spiritual welfare of my children was of critical importance to me and I wanted them not only to attend church services, but also to make their own commitment to God and experience a daily relationship with a living God.

  I realized that my life was beginning to tip out of balance. Not only was I becoming increasingly convinced that if I stayed in academic practice, I could not prioritize my life the way I wanted it to be, but the secular environment of the university increasingly began to weigh on me. Not only did I want balance, I wanted the various aspects of my life to be fully integrated. My spiritual yearnings did not match the desire for ego, power, and/or money that most of the other faculty members seemed to have. Despite feeling more and more disjointed, I nonetheless found it difficult to leave my job. I knew what to expect in that environment, and was not sure that the situation would be any different or better elsewhere. For me, like for most people, a known situation, however unpleasant, is often more comfortable and easier to accept than the fear of an unknown one.