A Medical Mystery

In our recent email newsletter we referred to a young lady who very nearly died while in our hospital. I would like to write a bit more about her case, since I believe many lessons can be learned from it. 

I'll call her "Y" for short. Y is a lovely 17 year old Honduran girl, from a mountainous village about 2 hours from our hospital. She presented to our emergency department with chest pain and shortness of breath. These symptoms had been present for 2 weeks at this point. In fact, Y had been a patient at a public hospital in La Ceiba (the nearest large city) for 12 days prior to coming to us. She had a chest x-ray that showed a right sided pneumonia with a pleural effusion (collection of fluid inside the chest cavity). Pneumonia with an effusion typically heals with appropriate antibiotics, and only occasionally requires fluid drainage. She had received antibiotics for over 10 days already, so why hadn't she recovered? Could I have the wrong diagnosis? Hardly! Did the previous hospital use inadequate antibiotics? More likely...

Medical fact: recent antibiotic use is a risk factor for a resistant type of bacteria or infection. I started Y on broad spectrum (strong) antibiotics, supplemental oxygen and IV fluids. Like any doctor should, I was already considering next steps. If she didn't improve within 48 hours I was planning to sample the fluid in her chest to rule out a more something worse. Sure enough, after 48 hours she remained sick, with an elevated heart rate, low oxygen level, and symptoms such as shortness of breath, cough and pain in her right chest. I spoke with our surgeon, since I value his opinion and knew I was going to need his help for what I was planning next. The following day we placed a chest tube (a catheter about as thick as your pinky finger) between her ribs into her right chest. Immediate gratification came when ~100 ml of yellowish fluid drained out onto the surgical table and into the tube. This would be the missing link to getting her better, or so I thought...

Medical wisdom: when something doesn't work within 2-3 days, it's time to try something else. Y was not getting better. Not only did her right lung appear unchanged by the fluid drainage, but now her left lung was beginning to look sick as well. Her need for oxygen was worsening, as was her heart rate and breathing rate. On a hunch, I began to treat her for a pulmonary embolism (a blood clot in the artery that brings blood to the lungs) with blood thinners. I could not be sure of this diagnosis without a special lung scan (which I didn't have), but it was warranted in my mind given her deterioration. By day 5 of her hospitalization she was sick enough to be in any ICU in any US hospital. I'm talking on 100% oxygen, saturating 80%, heart rate of 140, respiratory rate of 40. I started everything we had: more antibiotics, steroids, pulmonary vasodilators. I didn't know what was wrong, but I strongly feared that she was going to die. 

I pulled aside her family and friends to share with them my concerns. Despite all we were doing, she was not improving. I told them straight up; "I am worried that without a miracle she will die tonight". Her cousin then suggested that we pray. Brilliant! We prayed for a miracle, that God would spare her life and heal her miraculously. I sat at her bedside for hours that night, holding her hand, telling her that Jesus loved her and praying with her. She had incredible peace with what was transpiring, whereas the rest of us were nervous and scared. She told me she was not scared, because she believed in God and knew He was in control. I looked at her intently and told her I would see her in the morning. 

In the medical world, no news is good news. I received no calls on my radio that night, which meant at the very least that she was still alive. When I came to hospital the next morning and looked into her room, she was sleeping soundly, with a normal heart rate, on half the amount of oxygen from the previous night. In short, she was like a new person. I was ecstatic! I came to her bedside and marveled, laughing with her at how well she looked compared to less than 12 hours prior. She was still a while from being completely cured, but this was incredible progress for one night. Later that day nearly 30 people from her church (from over 2 hours away, remember) came to her bedside to pray with and for her. I stood in a corner listening and observing, not wanting to take any attention away from the urgent pleas to God for her health and healing. Can you imagine this scene in a US hospital? Sadly, I cannot...

Over the next 5 days she recovered sufficiently to be discharged home. I plan to see her this coming Monday for hospital follow up. Praise God, she did not die.

What was is that healed her? Was it the antibiotics? Steroids? Anticoagulants? Pulmonary Vasodilators? Tincture of time? From a strictly medical perspective, I have no idea...

I rather believe it was her faith and our fervent prayers on her behalf. I am more confident in God's ability to heal than in my ability to treat. And while I was unsure of how best to treat her, God knew exactly what He was doing. Jesus never said "your western medicine has healed you", but what does He say? "Take heart, daughter; your faith has made you well." Matthew 9:22