Oct 31, 2009

A Holy Ghost Story

On Halloween night, I thought I’d scare you with a ghost story. My patient Jim, (not his real name) was admitted with breathing problems and treated for pneumonia. He also suffered from gradually worsening pain and weakness in his legs after back surgery. During his hospital stay he developed respiratory failure and was intubated. The usual culprits like pulmonary embolus, sepsis and cerebral bleed were ruled out. Despite aggressive treatment, his respiratory failure worsened. He failed spontaneous breathing trials, and was given a tracheostomy. His diagnosis was ALS (Lou Gehrig’s disease). I was transporting him to a facility for rehab and long – term care. I was grateful they waited a few days for the transfer. My last vent patient still had fresh blood on his tracheostomy.

Jim appeared stable. He had all the usual lines and tubes attached but no IV meds running. This should be an easy transport. The only potential problem was fear. He was extremely anxious about the transfer. The nurse said she’d give him some Ativan. He also had a lot of chronic pain which earned him a Fentanyl patch. His med list showed a few other narcotics he took as needed, and just as many stool softeners to help move things along. The nurse said she’d give him some Dilaudid before the trip...Sweet!

I prefer it when anxious patients are well-sedated. Snowed into oblivion is even better. When I worked as a flight medic we had to institute protocols for mandatory chemical or physical restraints because of a few “incidents” we had in the air. I’ve had a few patients unexpectedly leave the ambulance…on the freeway. That's another story.

As I got my equipment ready, I overheard the RT taking care of Jim remind him of all the things Jesus already did for him to pave the way. She told him to trust God that everything would work out for the best. I love running into fellow-believers in the ICU. I joined in. Together we encouraged him. I told him the story of Scott Buzzell, my friend with ALS, who’s going to be healed. After tweaking the settings and getting Jim accustomed to my vent, we moved him over.

The first ten minutes were spent adjusting the settings on the vent, and trying to keep Jim calm. He was nervous; fidgeting and motioning to me frequently that he wasn’t getting enough of a breath. I’m a terrible lip-reader. I couldn’t understand what he was telling me. But his color and vitals were good, his CO2 was OK. He was as nervous as a cat in a room full of rocking chairs. I began to pray for the Holy Ghost to come into the ambulance and bring Jim peace. I prayed with him for the next 10 minutes and encouraged him to trust in God. The more I prayed the more calm he became. I kept telling him to let go of his fears and let God be in control.

I noticed he became very, very relaxed. Too relaxed…now he was unresponsive. I looked at the monitor His sats and heart rate were in the toilet. Crap!! I told my partner, “Pull over, NOW. And get back here.”

I checked his eyes…nobody home. He still had a pulse. As my pilot looked for a safe place to land, I disconnected the vent and grabbed the BVM sitting next to me. Our crash landing kicked up a few large rocks. Nobody got hurt. My partner asked what was going on. I gave him the lowdown. Squeezing the bag, I continued trying to wake Jim up. He finally opened his eyes and looked around, obviously confused. He had no idea where he was. His confusion lasted about a minute. Once I explained what happened and where he was, he was fine.

My EMT shut off the vent and helped me take the Velcro tie off the tracheostomy cannula, spin the adapter 180 degrees and reattach the BVM. I wedged myself between the gurney and the bench seat. My knees were already sore from crouching next to him so I could pray, but I didn’t care. My partner asked if I wanted another unit to help. I said no. We moved things around so I could see them better and told him I’d be fine bagging the rest of the way.

The rest of the trip was a breeze. No worries about the vent settings. I just kept squeezing the bag every time he took a breath. His vitals remained rock solid. I love automatic monitoring. My laptop looked at me with a silly grin. We don’t do paper reports anymore; it’s all electronic. I hadn’t even started yet. It’s nice to get your charting done early, sometimes it doesn’t happen. I didn’t care about anything right now except getting Jim through this crazy ordeal without another incident. Here’s your Kodak moment; two grown men holding hands, praying in the back of an ambulance flying down the freeway at mach 2.

Something happened to Jim while he was away for those few minutes. When he came back, he wasn’t afraid, not even slightly anxious. No fidgeting, no fussing, not a wrinkle on his brow. He was perfectly at peace and wide awake. He seemed like a different man. Later that day I wondered what happened. Why did he suddenly check out? My first thought was that he had too much happy juice in the ICU and it caught up to him. It’s certainly possible. But if he was overmedicated, why did he suddenly become alert within a few minutes? And why was he suddenly at peace? Was it because I was bagging him?

I think something else happened. I’ve never experienced this, but stories about it are common. As I prayed for the Holy Spirit to come into the ambulance, I encouraged Jim to lean on God and trust him with everything; to let go of every fear and rest in God’s love. It was at this point when he became unresponsive. I think maybe he had an encounter with God. I hear a lot of stories about people who leave their bodies and travel in their spirit to hang out with God for encouragement, instruction or other divine business. They often come back with a new perspective on their problems. I hope to meet Jim in the future and get to ask him about the trip. God has ways of putting those people in your path. If I do I'll let you know what happened.

I hope you have a safe Halloween. If you get a chance, pray for someone. Maybe they’ll have a Holy Ghost story to tell, too.

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