When
the Curtains of Death Parted
By
MARTIN C. SAMPSON, M.D.
It was a hot Philadelphia summer day, and the air in
the old Pennsylvania Hospital hung heavy and still. I had been up all night in a vain fight to save a little girl
from meningitis. In reaction of her
death I was feeling completely disheartened.
As a young intern I had seen so much of dying in the past months that
life seemed fragile and meaningless. I
was face to face with cynicism. Faith
seemed to exist only to be mocked by death.
The first patient I was to examine that morning was
a man I shall call John Bradley. He was
in his late 40s, with deep-set brown eyes and a gentle face. During the few weeks since his admission his
condition had declined steadily. As I
looked through the window of his oxygen tent I saw that his lips were blue, his
breath fast and strained. I knew that
his heart had been weakened by rheumatic fever in his youth, and that in recent
years hardening of the arteries had taxed it even more.
I couldn’t help thinking of his wife, a small,
white-haired woman with a face in which the shadows of work and sorrow mingled
with faith and trust. She and her
husband had constantly looked to me for help.
Why, I thought bitterly, did they ask so much of me?
I went over Bradley’s medications again in my mind,
hoping to think of something new to relieve his suffering. He was getting digitalis to control his
failing heart, an anti-coagulant to prevent the formation of clots in its
damaged wall, and injections to help rid his body of excessive water. The amount of oxygen being pumped into his
tent had been increased. This day, as
on many previous days, I inserted a needle to draw off any fluid that had
accumulated in his chest. Still, when I
left him I had the feeling that all my efforts were fruitless.
Shortly after six o’clock that evening the nurse in
charge of Bradley’s ward called me to come at once. I reached his bed within seconds, but already his skin was ashen,
his lips purple and his eyes glazed.
The pounding of his heart could be seen through the chest wall, and the
sound of his breath was like air bubbling through water.
“One ampoule of lanatoside C and start rotating
tourniquets, quickly,” I said to the nurse.
Intravenous lanatoside C would give the rapid action
of digitalis. The tourniquets would
keep the blood in his legs from circulating and temporarily relieve the failing
heart—but only temporarily.
An hour later Bradley began to breathe more
easily. He seemed aware of his
surroundings and whispered, “Please call my family.”
“I will,” I said.
He closed his eyes.
I was just leaving when I heard a deep gasp. I wheeled and saw that he had stopped breathing. I put my stethoscope to his chest. The heart was beating, but faintly. His eyes clouded over, and after a second or
two his heart stopped.
For a moment I stood there, stunned. Death had won again. In that moment I remembered the little girl
who had died the night before and a wave of fury came over me. I would not let death win again, not now.
I pushed the oxygen tent out of the way and started
artificial respiration, meanwhile asking the nurse for adrenalin.
When she returned, I plunged the syringe full of
adrenalin into the heart. Then I
whipped the needle out and listened through my stethoscope again. There was no sound. Once more I started artificial respiration,
frantically trying to time the rhythm of my arms to 20 strokes a minute. My shoulders were aching and sweat was
running down my face.
“It’s no use,” a flat voice said. It was the medical resident, my senior. “When
a heart as bad as this one stops, nothing will start it again. I’ll notify the family.”
I knew he had the wisdom of experience, but I had
the determination born of bitterness. I
was desperately resolved to pull Bradley back though the curtains of death. I kept up the slow rhythmic compression of
his chest until it seemed so automatic it was as if a force other than myself
had taken over.
Suddenly there was a gasp, then another! For a moment my own heart seemed to
stop. Then the gasps became more frequent. “Put the stethoscope in my ears.” I said to
the nurse, “and hold it to his chest.”
I kept pumping as I listened.
There was a faint heartbeat!
“Oxygen!” I
called triumphantly.
Gradually the gasps lengthened into shallow
breaths. In a few minutes Bradley’s
breathing grew stronger and so did his heartbeat.
Just then the screen around the bed was moved
slightly, and Mrs. Bradley stood beside me.
She was pale and frightened.
“They told me to come right away.”
Before I could answer, Bradley’s eyelids
quivered. “Helen,” he murmured.
She touched his forehead and whispered. “Rest, John, dear—rest.”
But he struggled for speech. “Helen, I told them to call you. I knew I was going. I wanted to say good-bye.”
His wife bit her lip, unable to speak.
“I wasn’t afraid,” he went on painfully. “I just
wanted to tell you—“ he paused, his breathing heavier,”—to tell you that I have
faith we’ll meet again—afterward.”
His wife held his hand to her lips, her tears
falling on his fingers. “I have faith,
too.” She whispered.
Bradley smiled faintly and closed his eyes, a look
of peace on his face.
I stood there, filled with a mixture of exhaustion,
wonder and excitement. The mystery of
death was right on this room. Could I,
in some way, begin to understand it? I
leaned forward and very softly asked, “John, do you remember how you felt? Do you remember seeing or hearing anything
just now, while you were—unconscious?
He looked at me for a long moment before he
spoke. “Yes, I remember,” he said. “My pain was gone, and I couldn’t feel my
body. I heard the most peaceful
music.” He paused, coughed several
times, and then went on: “The most peaceful music. God was there, and I was floating away. The music was all around me.
I knew I was dead, but I wasn’t afraid.
Then the music stopped, and you were leaning over me.”
“John, have you ever had a dream like that before?”
There was a long, unbearable moment; then he said,
with chilling conviction, “it wasn’t a dream.”
His eyes closed, and his breathing grew heavier.
I asked the ward nurse to check his pulse and
respiration every 15 minutes, and to notify me in case of any change. Then I made my way to interns’ quarters,
fell across my bed and was instantly asleep.
The next thing I heard was the ringing of the telephone beside my bed.
“Mr. Bradley has stopped breathing. There is no pulse.”
One glimpse of his face told me that death had won
this time.
Why, then, had the curtains of death parted briefly
to give this patient another few minutes on earth? Was that extra moment of life the result of chance chemical
factors in his body? Or did it have a
deeper, spiritual meaning? Had his
spirit been strong enough to find its way back from death just long enough to
give message of faith and farewell to his wife? Could it also have been meant to give a small glimpse of eternity
to a troubled and cynical young intern?
Whatever the meaning, and whether of not it had a
purpose, the incident made a deep impression on me. This was my first step toward acceptance of certain mysteries as
an essential part of life. This
acceptance, the gift of a dying patient whom I could not save, put me on the
road back to faith.
