With our scrubs in various phases of disarray, we heaped cubes of cheese onto our plates, collapsed into chairs, and reviewed the final details of a man’s life.
The surgical resident fastened her gaze to her paper, as if the printed words centered her. She spoke in monotone, as we must when we revisit images the mind cannot bear.
He was brought in by paramedics after being struck by a car at high speed. He was alert and protecting his airway upon arrival, but altered, with a Glasgow Coma Score of about 11. His heart rate was 150, and although he had a carotid pulse we couldn’t get a blood pressure. Then he became agitated. . . .
Despite the lexicon of detachment so fundamental to our training, the scene evolved for us in garish brushstrokes. We had all witnessed the suffering that played out beneath the bright lights of the trauma bay. We understood the visceral, irreparable, heart-breaking ramifications of each data point.
He was hemorrhaging. As his blood pressure dropped, so did oxygen delivery to his brain, and he became confused. His sympathetic nervous system kicked into overdrive. It squeezed his blood vessels, throttled his heart to a frenzied pace, and flooded him with panic.
She Held His Dying Heart
As the narrative progressed, her bottom lip quavered. He lost consciousness, she reported. Then, he lost his pulse. They performed CPR. They opened his chest in the emergency department (ED). They clamped his aorta, rushed him to the operating room (OR), and surgically explored his abdomen. A collection of blood, swollen and dark as an overripe pomegranate, welled up from his pelvis. They jammed gauze into each crevice, transfused blood, and yet still he bled. They massaged his heart between their gloved hands. Still, he bled. After an hour, despite every effort, his heart remained empty. Its stillness overtook the room.
When she finished her monologue, she raised her eyes. In them I saw the familiar grief, the mourning for someone whom she had touched so intimately, yet did not know. She had witnessed the passing of someone whom others called son, brother, mentor, friend, greatest love. She had witnessed the final surgings and heavings of his life, had fought to hem in their calamity, and yet she knew only those surgings, those sighs, those peaks and valleys on the monitor. As she held his heart in her palms and felt its feeble quiver, she could not see him scouring riverbeds for fool’s gold, or scrawling love notes in crayon to his first crush. She could not envision the road trip to Joshua Tree, the painting that misted his father’s eyes, the first dance with his wife. Their encounter had been violent and brief, a momentary gale. She was left stranded with the lack of him.
I understood this grief, as did all of my colleagues assembled around the table. Yet as I watched her, with her jaw set against the turmoil, I recognized something else.
“We didn’t have the right OR table,” she said. “I didn’t specify the OR table. Maybe that would have made a difference.” Then the tears came. “It’s my fault,” she whispered.
The Wages of Sin and the Work of Medicine
Her efforts to save his life were literally heroic. By the time this patient arrived in the ED, the acid concentration in his blood exceeded four times the normal level. His proteins had already unfurled from their compact configurations, and floated adrift among deformed blood cells. Hypothermia paralyzed his enzymes. His blood, thinned to the viscosity of water, could not clot. When paramedics rolled him into the trauma bay, he was already speeding into the presence of Jesus.
No special operating table would have averted his death. Yet, her shoulders sagged beneath the heft of her remorse. I watched her struggle to compose herself, and I knew she analyzed each minute, each decision, each word, each turn of the wrist, and felt their gravity. No words would assuage her guilt. Our shared framework was rooted not in the gospel, but in secular medicine. It was a philosophy that offered no vocabulary of atonement.
The wages of sin is death, and physicians toil in its preamble. Cancer, car crashes, widespread infection, organ failure — such catastrophes arise from our fallen state, and signify the terrible price of rebellion (Genesis 3:22–24). The suffering of the dying reminds us of the chasm between us and God, and our desperation for a Savior. Creation groans for freedom, patients groan in pain, and Christians groan as we await redemption of our bodies (Romans 8:22–23, 2 Corinthians 5:2–4).
Although mired in the groanings of our sin, healthcare providers operate in a system divorced from conversations about God. Ingrained in secularism, medical training ignores both the origin of illness and death, and God’s sovereignty in the process. We learn to analyze every data point, and to take personal responsibility for the rise and fall of those values. We study the intricacies of biochemistry, pharmacology, anatomy, and biology. We take courses in ethics. We surrender our needs for sleep, communion with family, nourishment, maintenance of our own bodies, all for the sake of the patient fading into the hospital mattress. When we take the Hippocratic Oath to “do no harm,” we admit first and foremost our capacity to inflict harm. The threat of inadvertently hurting people forever looms, stalking our thoughts like a phantom.
Meanwhile, the tension between human moral responsibility and God’s supremacy plays out around us daily. Patients die despite technology, expediency, and finely tuned protocols. Cancer recurs despite our declarations of cure. Sin churns and hums through every corridor. When we lose a patient, we consider our flimsy books, our hands that could not deliver, and we despair. We offer our report in monotone, while the full weight of our sin bears down upon us, stealing all breath, and sight, and hope.
Pray for Your Doctors
The physician suicide rate is twice that of the general population. This is no surprise. Without Christ, the daily fodder of medicine crushes the heart. Medical training mandates practitioners witness sin in graphic detail, yet the textbooks, instruments, and decades of study offer no context for forgiveness. Joseph understood God’s will at work in the face of evil (Genesis 50:20); medical training demands its practitioners confront evil, yet heaves culpability upon them.
Pray for your healthcare providers. When you go to your general practitioner’s office to have your cholesterol checked, or to titrate your blood pressure medicine, or if you are in the throes of chemotherapy, or undergoing surgery, or even struggling in the ICU, pray for them. While you pray for their skill and focus and knowledge as they care for you, please also pray for their faith.
Pray that they would see and embrace Christ, who shed his blood so that life may one day swallow up death (1 Corinthians 15:54).
Pray that they would see and embrace Christ incarnate, who took on the groans of pain and death in this life, to liberate us from death’s sting (Hebrews 2:14–15).
And pray that they may come to know God’s divine will always at work, even in the hospital, even within the clinic, even when their own meager hands fail to revitalize a lifeless heart.