Thursday, October 18, 2007

The Proposal

or, ...

How My Coffee Got Cold

Between Mass and our parish picnic on Sunday, October 14th, we went to pick up some lemonade for our picnic contribution. We also stopped to buy a coffee for me, due to my slight headache--which Colin always assumes is caffeine withdrawal, for some reason... :)

Upon returning to the church grounds, there was still about a 30-minute wait until the picnic was to begin. Colin suggested we go into the church and say the Rosary. There is an icon of Our Lady of Czestahowa inside (my favorite image of Our Lady, as she is the patroness of Poland under this title) so he had a grand scheme going.

However, having just purchased a coffee, and wanting to enjoy it warm, I declined the idea of going inside the church, and suggested we go to the outdoor statue of the Sacred Heart and do it there on the benches. That way, I could bring my coffee with me.

"The church is the better place to pray," Colin dutifully reminded me. Feeling the beginnings of guilt and self-accusations of heathenism coming on, I acquiesced and asked if we could put my coffee in his car. After I did so and he locked it up, he glanced up and saw the peaceful, quiet, outdoor Sacred Heart Shrine that I'd been referring to, and said, "Oh, yeah! We can just go there. There are probably a lot of people in the church right now, anyway."

"So, can I get my coffee, then?" I asked. He started laughing and shaking his head (while backing away from the car) and so I decided that I was being nudged to give up my coffee while we prayed the Rosary.

We sat on one of the benches and prayed the Luminous Mysteries. It was a beautiful day; we were shaded by overhanging branches that moved softly in the light breeze. There was only the occasional shout in the distance of the parish kids running around on the large church lawn.

After we were finished, Colin started telling me that he had spoken to my Dad a few weeks beforehand, and that both my mother AND my dad had given him their blessing. I responded by asking when and how and where this all took place, and he gave me a few cryptic responses. Then I realized that I was trying to draw information from him that would ruin any potential surprise effect of a proposal in the future. At the same time, I realized that he had brought it up in the first place!

"Why are you telling me all this?" I asked, accusingly.
He smiled and leaned back, saying, "Because I finally got the ring!" I saw then that he was leaning back so that he could put his hand in the front pocket of his pants. My hands went to my mouth and I started tearing up.

"Oh, God!" I said as he pulled his hand out to reveal the ring, so little between his thumb and forefinger.

I didn't cry beyond the first few tears of shock, because he's so funny: As he took my hand and slid the ring on my finger, he remarked, "I hope today is a good day to get engaged!"

I didn't know what to say, except, "Of course it is!" as I gave him a big hug.

We talked for a little while--and then it was time for the picnic.

Since he was pretty hungry, Colin requested that we go to the picnic, and call our parents later. I reluctantly agreed, but told him we still needed to stop by his car:

I needed to grab my coffee!

Wednesday, October 17, 2007


And peacefully happy.

Thank you for your prayers!

Monday, October 08, 2007

A Better Monday

Prayers are answered, and weekends have a way of ironing things out....

When I came into work this morning, I saw that the young man with C.F. that was just re-admitted last week after a long hospital stay was discharged again quickly--over the weekend.

And Jimmy? I went to see him this morning. His eyes were open; he was extubated! He's still physically in the ICU, but only because there are no available beds in the Step-Down Unit. I walked in while his nurse, "Mark" was doing his morning assessment. Mark asked Jimmy, "Are you hurting anywhere?"

Jimmy laughed and said, "I won't be when you let go of my wrist!" Apparently, Mark hit a bruised spot when he was feeling for Jimmy's pulse.
Mark replied what I was thinking, "Wow! It's good to see you smiling, that's for sure!"


And this afternoon, I saw another patient of mine with C.F. that's in the ICU, who's been wasting away because of a failing lung transplant and needs to get into good enough shape for a re-do. He actually was able to get into a sitting position in the chair next to his bed! It was a Max Assist transfer (meaning, he did, at most, 25% of the work and I did the rest) from the bed to the chair, but he did it!

It WAS a good Monday.

Thursday, October 04, 2007

Suffering and Courage

"Are you going to--oh my gosh, what's the matter?" Ginger, one of the ICU nurses, interrupted her own question with a look of worried concern.

I'd had my head down as I was looking over my patient's chart. I thought I'd gotten the last of my tears out in the nurse's break room a few minutes earlier. But as I looked over the chart and glanced over into "Jimmy's" room, I couldn't stop more from shooting from my eyes. Jimmy has been my patient for the past month. He's been Ginger's patient since 7 o'clock this morning, when she arrived for work.

Jimmy is barely in his 20's and has cystic fibrosis. He happens to be a really sweet Catholic kid who doesn't show much distress on his face when he's struggling to breathe. "I guess I'm just used to it," he told me once during an exercise walk around the hospital hallways. I always have to ask him directly if he wants to change anything we're doing in physical therapy. If I don't, he doesn't complain.
All the nurses love him. All the hospital visitors from the local parish love him.
But the fact that he's a sweet kid is beside the point.

The point is that his breathing has been getting more labored, and that despite increasing breathing treatments and physical therapy interventions, he's been needing more and more supplemental oxygen over the past few months. But he was getting better. The Pulmonary Team was going to discharge him from the hospital earlier this week, but he opted to stay "until I get my transplant."
His status on the lung transplant list is "active" -- meaning, he's waiting for the phone call that notifies him when matching lungs are available. "Good" lungs are not abundant. Organ donors, even with the same blood type and tissue type, don't always have healthy organs when they pass away. "Dry runs" are the rule, not the exception--a dry run being, when a patient is all prepped and ready in the O.R., only to find out that the long-awaited lungs are "bad."

Last night, a Rapid Response was called to Jimmy's room up on the Pulmonary floor of the hospital. A Rapid Response is a hospital-wide overhead page that calls for immediate medical intervention by a specialized on-call team. Jimmy's oxygen saturation was dropping. That is, there was not a sufficient amount of oxygen being carried through his body by his blood. This sometimes happens to people when the inner walls of the lungs become so congested or fibrotic, that no matter how much oxygen is sent in, there is too much of a barrier between that oxygen and the blood that is trying to pick it up on its way through.

Jimmy ended up being transferred to the ICU, where he was intubated. This means that a tube was sent through his mouth down his airway, to deliver oxygen to his lungs from a ventilator. The ventilator does the work of breathing for him, so that he does not have to use up his energy on an activity that we do without thinking. He won't become exhausted trying to get enough oxygen, and the Respiratory Therapists can monitor how much flow of oxygen he needs. Because people are not naturally designed to have machines "breathe" for them, it's a scary, agitating condition to be in. So people who are intubated are generally also sedated.

When people with cystic fibrosis are intubated, it is a serious event. It is not done lightly. Their lungs are already in sub-optimal health, so the chances of recovering breathing function with their own lungs is slim. It is difficult enough for people with healthy lungs (who need to be intubated temporarily because of other injuries) to wean off the ventilator, nevermind those with diseased lungs. For people like Jimmy, their primary hope is for transplant: for "good" lungs to become available sooner rather than later.

One of the Physical Therapy Technicians paged me while I was sitting in my team's meeting at 8:30 this morning, to tell me that Jimmy was intubated in the ICU. Upon reading the text message on my pager, I turned and whispered to Allison, our Pulmonary Senior Therapist, that I "hate pulmonary" (my current team assignment); then I completely lost control and had to excuse myself to the restroom to let myself cry for several minutes. When I arrived at the ICU 45 minutes later, I stood with clenched teeth and prayers to my guardian angel for strength, while I stood with the medical students, the interns, and the residents, and listened to the Chief Pulmonary resident on rounds give her report of Jimmy's status to her attending physician. I tried to numb my mind to much of what she said, "desatting into the 70's on non-rebreather mask ...tachycardic in the 150's ... PCO2 of 109 ... chest x-ray films ... worse ... hopefully he'll move up on the transplant list ...".
After I clarified with them that they did want us to continue chest PT (manual percussion on the patient's chest and back to help physically shake excess mucous from the walls of the lungs) I retreated to the nurse's break room for another semi-breakdown while I prepared my note for his medical chart.

And then I was standing outside his room, listening to the "click"s and "sigh"s of the ventilator, and hoping he was sedated enough that he wouldn't open his eyes and see my red ones looking back at him.

"Are you okay?" Ginger asked. "What is it?"

I motioned to Jimmy's room.

"Do you know him?" she asked.

"He's been my patient for the past month," I squeaked. "I'm sorry. I guess I'm just not handling this well today."

"We all have days like that," she assured me. "I hope yours gets better."

I thanked her, wrote my note, and left.

Another patient of mine with C.F. just moved to the ICU earlier this week from the floor. He is a staunch Christian and has been refusing to be put on the lung transplant list for years: he's waiting for a miracle. Yesterday he was lying in bed with his eyes closed, an oxygen mask on his face, his heart racing. His wife was reading to him from the New Testament. As I reviewed his medical chart outside his room, I heard her strong, steady voice read the story of the man born blind that Jesus cured on the Sabbath, and the Pharisees summoned his parents to ask if he really had been born blind.
Then I entered the room and reviewed the plan with her for continued chest PT treatment. I know the team is considering intubating him--but since he is not on the transplant list, that would mean he would be intubated ...indefinitely...? I hope he gets his miracle.

Last week, one of the young women with C.F. that I have as a patient experienced the "dry run." I had stopped into her room that morning, had congratulated her on "getting" some lungs, and had promised to pray for her that night as she went down to the O.R. The next morning, she was still on the floor. In that case, it was bad news that she was still on the floor. "The lungs were bad" was all I heard.

This morning, I looked up a patient in the computer, and saw another patient with a similar name listed one row beneath --and this other patient is one that I know: a young man with C.F. that just left the hospital this past week after several weeks' stay and a hard fight back to his prior level of health. I walked by his room this afternoon, saw that he was on the phone, and waved. He smiled and gave me a shrug.
I'm sure he'll be on my schedule tomorrow.

Thankfully, when I opened my email this evening, I received the timely encouragement of a message that Dad sent today to all of his children:

"We rejoice in the hope of the glory of God. Not only so, but we also rejoice in our sufferings, because we know that suffering produces perseverance; perseverance (produces) character; and character (produces) hope. And hope does not disappoint us." (Rom. 5:2-5)


"Courage does not always roar. Sometimes it is the quiet voice at the end of the day saying, "'I will try again tomorrow.'"

"We all have days like that," Ginger told me today.

Hopefully, tomorrow will be better.