[HSF] Do you believe in miracles?

Sun Aug 5 21:42:10 EDT 2007

I have some personal thoughts related to this subject that will come up shortly, but i do have a story that speaks somewhat to your title question:

Niels Bohr, the famous physicist, was paid a visit to his lab. The visitor saw the highly technical equipment in the lab, but noticed a horse shoe over the door to Dr. Bohr's lab. He turned to Dr. Bohr and asked, "Surely a man of your knowledge and sophistication does not believe in lucky shoes, do you?" 
Dr. Bohr answered, " Of course not.....but thing about lucky horse shoes is that they work whether you believe in them or not."
Keep you eyes open, even if your brain is closed.
tea

----- Original Message ----
From: Michael Firstenberg <msfirst at gmail.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Sunday, August 5, 2007 10:00:23 AM
Subject: Re: [HSF] Do you believe in miracles?

Ani,

Of course we all probably want to know the details of your case -  
being a VAD guy (especially in NYC) the speciality is grounded on  
hopeless, futile causes, when there is only maybe a glimmer of hope.   
That is what we do - provide hope, when there is none - and when  
everyone else has given up or there is "nothing else" that can be  
done.  The problem in your case is that you have gone down a path and  
boxed yourself into a corner.  Often we find ourselves in for  yard  
and in for a mile - just give us one more week and see if he or she  
turns around.  Yes, brain dead is brain dead - as Hal said - get an  
EEG and nuke med study, etc.  But, to answer your question - YES.

I have only been in this for a few short time - compared to the  
decades of experience that exist on this forum - but I have seen  
futility walk out of a hospital.  No, I have no seen brain dead  
people survive, but - I have seen amazing cases of the human will and  
spirit and things that science can not explain.  I have seen patients  
with systemic ICP for days walk out, horrific sepsis/infections  
recover, I personally got on a bed to do CPR on a 20 year/old with  
totally occluded PAs from a massive PE who was gray - not blue, but  
gray for almost an hour walk out.  I have seen paralyzed patients  
walk, I have seen massive doses of air pumped into a brain from a  
broken ECMO cannula walk out (and re-enroll in a major private  
university).

Ani - if we don't have hope and believe in things that we can not  
understand, then who is going to fight the losing battles and  
sometimes we win.  Obviously the wife still wants to believe - give  
her a break - afterall how many times have YOU convinced families to  
go on when they had no hope, but you did (right or wrong and for  
whatever reason).

Yes, a good topic for a Sunday morning.

good luck

-michael

On Aug 5, 2007, at 10:10 AM, Ani Anyanwu wrote:

> Some questions for a Sunday morning, lunchtime or night depending  
> on where you are.
>
> I have a patient I am in the middle of an ethical dilemma with  
> because I believe further treatment is futile but the family  
> believes otherwise and is waiting for a miracle.  I recommended we  
> discontinue treatment a week ago but spouse wants to keep going. I  
> have so far refused to undertake further surgery because I believe  
> it is unethical as treatment will be futile, but we have continued  
> to support him maximally - LVAD, Dialysis, Ventilator, big gun  
> antibiotics and all. Spouse though is convinced he is neither dying  
> nor dead, communicates with her everyday and will walk home. Other  
> medical staff looking after him think he has been dead a while now  
> - I was sort of the last man standing and only recently ceded that  
> there was not more we (medical staff) could do as humans.
>
> So my questions are
>
> - Has anyone ever told a family that all is done and we need to  
> withdraw support and then the patient subsequently walked home  
> because the family wouldn't give up and insisted you continue  
> treatment ?
>
> - Has anyone experienced a survival from an unsurvivable condition  
> that could not be explained on scientific grounds i.e. a state that  
> would be regarded as universally fatal and the patient survives and  
> walks home (NOT a case were odds are low and patient survives  
> against odds which we all have seen).
>
> Thank you
>
>
> Ani
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