Episode Transcript
[00:00:01] Hi everyone, this is Dawn Clem and you are on my podcast, Milkweed and monarchs.
[00:00:08] Today, I will be telling you the third story from my patient, Cindy, that she shared with me. And at the end, I have an interesting situation, very similar to this story, that I'll be sharing with you. So I hope you enjoy the story. It is an interesting one.
[00:00:29] So, the name of this story is called unresponsive.
[00:00:34] Doctor Megan Uxley waited in the intensive care unit of an inner city Detroit hospital for her patient. The emergency department was transferring Marvin Anderson to her for care.
[00:00:50] Marvin, a black male, 27 years of age, obese and developmentally disabled, was brought to this hospital after experiencing an epileptic seizure at home, that lasted for over an hour.
[00:01:07] The emergency department team induced paralysis and then placed him in a coma.
[00:01:14] This requires intubation and that procedure had not gone smoothly.
[00:01:22] Marvin's current condition now required the skill and care of the intensive care. Doctor Oxley knew she had a difficult case. Her long brown hair was tied back and she was wearing comfortable blue scrubs. Her large, bright blue eyes shone under the skull cap. The gravity of the situation changed her usually cheery, infectious smell. Smile into pressed lips. She had a face of determination and a steely calmness.
[00:01:56] When Marvin arrived, Oxley's first procedure was to bring Marvin out of the coma slowly. She wanted assurance that the seizures had stopped.
[00:02:08] So far, so good, she thought, as his body remained still. However, he did not wake up from the coma. If Marvin had been without Oxygen too long, and the records indicated this may be the case, then he would be brain dead. He no longer could breathe on his own. If the intubation tube were removed, he would die.
[00:02:34] Doctor Oxley did not remove the breathing tube.
[00:02:40] Her eyebrows and cheeks became slack. How she wished things could be different for Marvin. It was time to tell his mother the grim news.
[00:02:53] Doctor Oxley knew how to deliver the message of a reality that contained no hope. To a heart that would know grief. But it was never easy.
[00:03:06] She left Marvin's small room, which was now filled with life support and monitoring equipment, and walked to the visitors center.
[00:03:19] Misses Anderson sat patiently and wearily in the waiting area.
[00:03:25] When Doctor Oxley arrived, she took her place in a private booth. Misses Anderson was called over.
[00:03:35] She wore a blousy floral print shirt that hid her size. Her black hair was shoulder length, yet tightly curled on top.
[00:03:47] Her back slouched, and she was short.
[00:03:51] As she walked to the booth, Doctor Oxley wondered how this grandmotherly person could care for such a large son.
[00:04:01] The two greeted one another.
[00:04:04] Misses Anderson asked about Marvin.
[00:04:08] Her question sounded so tired.
[00:04:12] With a heavy heart. Doctor Oxley spoke to her with carefully chosen words. With the sensitivity for which she was well known by co workers and families of patients.
[00:04:29] She slowly and carefully recapped what had been done since Marvin's arrival to stop the seizure. And then explained why she did not expect Marvin to recover.
[00:04:48] Misses Anderson listened and said, me and my Marvin have been through this many times.
[00:04:57] He be right as rain. Show nuff. You'll see.
[00:05:03] Doctor Oxley wanted to say no. This is not like the past.
[00:05:09] This is very, very different.
[00:05:12] His brain went without oxygen for too long.
[00:05:16] He's not coming back from the procedure. He is not responding.
[00:05:22] Instead, she gave a tender smile. There was nothing more to say. Doctor Oxley went back to her patient to prepare him for life without life. One tube provided him with oxygen. Another tube was inserted into his stomach to provide nutrition.
[00:05:43] Other procedures were performed which would ensure his comatose body could be brought back to self sustaining life.
[00:05:55] Doctor Oxley monitored his condition twice a day. She noted with each visit that Marvin's eyes remained closed. He did not move.
[00:06:08] Marvin's hospitalization in ICU continued for hours. And then it was counted in shifts. And then it was counted in days.
[00:06:19] Soon it became a week. Then two.
[00:06:24] Doctor Oxley noticed his mother's faithful daily visits.
[00:06:30] She greeted her son, kissed him, and turned on the tv and found the cartoon channel.
[00:06:39] She watered the small plant on the empty tray table. And as she told Martin about the neighbors and the activities at church, she always left before the sun was low in the sky. She would kiss him good night and then return home.
[00:06:58] Doctor Oxley had an evening routine as well.
[00:07:02] As the hospital activities waned into the nighttime schedule. She walked the corridors, checking on each of her charges.
[00:07:12] The residency program required a long work day, and she preferred to know that all was well with her patients before settling down for a few hours of rest.
[00:07:25] One evening, at the end of the second week, she walked into Marvin's room and noticed his eyes were open.
[00:07:36] She greeted Marvin, turned on the tv, and tuned in his favorite cartoon.
[00:07:43] Just as his mother would do. She talked to him, removed his intubation tube, and wrote a note on his chart. 10:00 p.m. patient alert. Breathing on his own, adjusting to this new reality. At this unexpected turn of events, Doctor Oxley pondered whether she ought to call his mother. It truly was such a surprise. Such great news. But it was late at night.
[00:08:17] Still contemplating her next steps, Doctor Oxley left Marvin's room.
[00:08:25] She walked down the hall and pressed the plate switch on the wall. The door swung open. To a second surprise, Marvin's mother was standing on the other side of the doors and looked right at her.
[00:08:41] Some might have gasped and shouted, what are you doing here?
[00:08:48] But Doctor Oxley simply whispered, misses Anderson, I was just about to call you. Marvin is awake.
[00:08:59] I know.
[00:09:00] I know, honey. I heard my Marvin calling me. He was calling me, so I came.
[00:09:11] Doctor Oxley's eyes filled with tears.
[00:09:16] Chills went through her.
[00:09:18] Let me escort you to the room. Then she said, marvin is waiting for you.
[00:09:25] Marvin left the ICU the next day and was released from the hospital later that week. Doctor Oxley never saw Marvin or his mother again.
[00:09:38] But she never forgot that patient and his mother.
[00:09:45] So that it doesn't seem possible, that story. And I wonder if the story is true, because Cindy's daughter is a physician, and I think she does work in Detroit somewhere. So I would not be surprised if this actually happened to her while she was a physician. And it moved her so much that her mother wrote a story about it, which is great. It is something that we need to hear.
[00:10:19] But my story is that I was working as an LPN in San Diego, and I was working at Mercy hospital.
[00:10:28] And I had told you previously that I was working on the orthopedic floor. Well, one night when I came into work, they were short of help up on the neurology floor. And a lot of times, neurology and orthopedics go hand in hand. So they asked me if I wouldn't mind going upstairs and floating to give neurology a hand. And I was like, yeah, sure, no problem. You know, every float to me was a learning opportunity. So I was still learning in my career, and it was good for me to see as much as I could. So I happily went up to the 10th floor. That's where neurology was to help them out. So they gave me my assignment, and I was assigned to work directly with the nurse. And we were making rounds together, and we got to a patient's room, and the patient's name was Phil. I'll never forget it either. And we get in the room and Phil is comatose. And I'm like, well, what's Phil's story?
[00:11:39] And the nurse said, phil's been in the hospital for four years. So for those of you that are listening, this is why some of the changes have occurred in healthcare. Because when you look back and you think that a patient was actually in the hospital for four years, but that did used to happen. We used to keep patients long term until they had a place to go or they actually recovered or, you know, things like that. So.
[00:12:13] But can you imagine the amount of finances that went into this whole case? And taking care of Phil for four years? It's incredible. He also had a tube feeding, so he was getting his nourishment that way. He was so thin, and he was young. I think he was, like, 37 or 38. And that's another reason. When they were young like that, we made every effort to keep them alive, and the family wanted to keep them alive, so we honored the family's wishes.
[00:12:48] So we were, you know, getting him pulled up in bed, and I kind of gave him a bath, and we gave him his medications. A lot of times, you can give the medications through the tube feeding, so you disconnect it from the. The feeding coming in, and there's a little outlet there, and you can use a syringe and give liquid medications to him.
[00:13:12] When somebody's been in a coma like that for a long period of time, their muscles become either spastic or tight. So we would do range of more motion exercises on his legs and his arms to make sure that we. We were keeping him flexible.
[00:13:32] And we spent a good amount of time in there making sure he was getting everything he needed. And we'd turn him from side to side and keep him off his bottom so he wouldn't develop a bedsore.
[00:13:45] But everybody had known Phil for so long, so he was like part of their family. People would go in there, turn the tv on, talk to him about what was on tv, talk to him about know what was going on in their life. I mean, he was a captive audience, but people really had grown to love him, even though he never responded. No one ever gave up hope on Phil. No one ever gave up hope. And that, in and of itself, is quite an amazing story. Kind of like Marvin's mother. She'd been through this before.
[00:14:27] She knew the drill, and she knew Marvin was coming back. Even though everybody else had already assumed that Marvin was not going to make it with Phil. I mean, he'd been there already for four years, so no one really thought that Phil wasn't going to make it. Everybody was thinking, when is Phil going to wake up?
[00:14:54] When are we going to be able to talk to Phil? And Phil's going to talk back to us? Everybody was waiting for that moment. And no one gave up on Phil. Not as doctors, not as nurses, not as therapists, physical therapy, occupational therapy. No one gave up on him. And his family sure as heck didn't give up on him either.
[00:15:23] So I went about doing my rounds with everyone else for the rest of that night, all the other patients in our patient assignment, and made it through the shift and got out of work and went home that day and never really gave Phil too much thought again. Actually, I learned a lot that night, and it was a good experience.
[00:15:53] So I'm back on the orthopedic unit, and I was probably, you know, doing my regular shift, and it had been at least six weeks to two months since I had been floated, and the night came again where they needed me to go to the orthopedic unit, and I was like, okay, yeah, I'm gonna go. I'm happy to go up there. I'm gonna learn some more stuff and see some new things. That'll be good for me. I don't mind going up there at all, and I'm gonna check in on Phil and see how Phil is doing.
[00:16:33] So I get up there, and I meet the registered nurse, and I get my assignment with. With the nurse that I'm going to be working with. And we were on the opposite hallway from where Phil is, and I didn't ask about phil right away. I was too busy getting into my routine with her and figuring out what I needed to do and what medications I was going to be giving and who needed to be turned and repositioned, that whole kind of thing, and meeting the basic needs of the patients if they put on their call light, that kind of thing, but. So we get down the hall, we've done all of our care, and I was like, hey.
[00:17:23] Hey. I just remembered. How's phil doing? Where's his room at?
[00:17:29] So she's the nurse gets a big, wide smile on her face, and she brings me down to the hall, and we walk in the room, and there's no phil.
[00:17:43] I'm like, where? Where's phil? There was another patient in there, and she goes, don, you're never gonna believe what happened. And I go, what happened?
[00:17:54] She said they were all working the night shift one night, and it came to the 06:00 round time. So 06:00 a.m. on the night shift is when you're tying up all the loose ends, doing blood sugars on patients, doing your final treatments on patients, giving them sometimes their morning medications.
[00:18:19] It's a very busy time of the day, and they were all busy doing their work. And the nurse that was assigned to Phil walked into Phil's room, and Phil was sitting up in bed watching tv.
[00:18:39] I'm like, you no no, that can't possibly be true. She said, don, it's the truth. Phil woke up. Phil woke up after four years. I said, I can't believe. She says, it's the truth.
[00:18:59] She said he ended up staying there for, like, a week or two until they could get him situated into a rehab facility to start getting him to be more mobile. But they said it was like he was kind of stuck in a time warp because he had been out for four years, and now he was wide awake, and he was like, where am I? Anyway? What is going on? So I guess he had been in a car accident, and that is what brought him in there. And he had a head injury during that time. And for whatever reason, it took all that time for the brain to heal and. And start to function again.
[00:19:53] And Phil actually got discharged from mercy hospital to a rehab.
[00:20:01] But they gave him one heck of a party before they left. He left, I mean, because they were ecstatic that Phil woke up.
[00:20:16] So that's a real story that actually did happen.
[00:20:22] I've never forgotten it. And when I got this story from my patient, all it did was make me think all over again about Phil.
[00:20:34] And, you know, most of you know that I have been a neuro oncology nurse. That was the last seven years. But I've been involved in neurology for many years, off and on throughout my career. And part of the reason why I was in neurology is because the brain is so fascinating. And this is just a clear example, two examples of how we might have been ready to give up on either Marvin or Phil, but both of them prove to us with time and healing, that they were going to go on.
[00:21:19] That is an amazing thing.
[00:21:22] I mean, I think now, you know, I don't know how old her story is, but my story is quite old. It's like 40 years ago. And so if you think now we have, like, the mrIs, that we can see a lot more of what's going on, and we have the eegs, which checks the electrical brain waves and everything we do have, excuse me, different testing to be able to really delve into.
[00:21:57] Is the patient going to come around or not? But I still think there's those times when the patient comes back when all of us are like, no way. They're not gonna make it. And they prove us wrong. They prove us wrong. And that's the most fascinating thing about life and the human body right there. We think we know, but we don't know is really God's the one that knows, and he's going to let us know when the time is right. We're not going to know, right?
[00:22:38] I've seen people live with brain tumors a lot longer than you would ever think they would. So just that alone gives me encouragement and hope for the future of oncology patients. I mean, if you look back from where we started so many years ago and where we've progressed to now, it's an amazing, amazing movement forward.
[00:23:12] I hope you enjoyed these stories today, both true and both fascinating.
[00:23:20] And it makes you think about mortality or illness in a different light because, I don't know, it's hard to be in the middle of a crisis like that and not want to give up hope.
[00:23:39] But both times, both patients proved that there is still some hope out there. And that's amazing.
[00:23:51] If you have a story that you want to share with me, or you would like me to tell, I'm more than happy to interview you. Or you can just call me and we can talk about it and decide the best venue for telling the story.
[00:24:09] I love sharing stories from ordinary to extraordinary. It just lets us know that life really is exciting and there's so much more out there than what we realize.
[00:24:22] Please go on my website, milkmon.com. milkmon.com. All one word. The section at the very bottom of the page has my contact information. You can either call me directly or you can send me an email. Either one would be greatly appreciated by me. And also, on another note, I just wanted to let you know that we're going to be updating the website.
[00:24:52] I'm going to start adding pictures so that you can see pictures from each episode and the stories that we're sharing, who they're about. And I think that'll be kind of fun. And then I'll also start to add some comments that I get back from feedback from people that are listening to my podcast, so you can see how I'm getting there. It's a slow process, but I appreciate everybody hanging in there with me. So thank you very much.
[00:25:26] Until the next time. Bye.
