Most love stories don’t start with a gunshot wound to the head…but this one does.
Being the only doctor in their rural emergency department for a few travel shifts meant having no team of highly-trained surgical specialists standing by like I had at the trauma center countless miles away. When the EMS call came across the radio that they were bringing in a patient with a gunshot wound by a BB gun to the head, I failed to get alarmed until I heard the actual description of the patient. He was unconscious and had stopped breathing. Life support had been initiated but his vital signs indicated his brain was being squeezed out of his cranium by the rapidly expanding blood from his wound.
Jumping into life-saving preparation mode, there was only one thing I could think to possibly do for him as an ER doc with no backup. Grabbing the drill, I was prepared to bore steel through his skull, release the pressure, and buy him some time. I had it all figured out before he even arrived. I would save this man. It was my job. As long as the bleeding was isolated to just below the skull, he might live long enough with this heroic measure to get him flown out. Otherwise, his chance of survival was grim.
Rushing him to the scanner, I watched intently as the pictures developed one after another, showing me the path of destruction the BB took from his left temple across the entire other side of his brain, shredding neurons and shifting his brain from the massive hemorrhage. Soon there would be more blood than tissue and he would be dead. Even the most skilled surgeons could not fix this injury.
And so I switched into my other role as an ER doc. It’s one that is just as important as saving a life and sometimes a lot harder: helping loved ones grasp when it is time that a life must end. Taking a moment with my patient and a nurse, I bathed his body as a way to honor him, and secretly asked him to give me the words to extend his love. The police arrived just as I was leaving his room.
“What is his status?” the husky officer barked.
“He is critical and terminal. There is no recovery in this case”, I offered matter-of-factly.
The tears that welled in his eyes moved me to ask what had happened, as this rightfully jaded warrior was clearly shaken. The officer explained that it was my patient’s ten-year-old son who had taken perfect aim and hit the bulls eye of the target, as his father watched with pride. The ricochet of the bullet then entered his daddy’s temple, dropping him immediately. The child was already overcome with anguish. He had no idea how he would be able to live with himself once he knew that he killed his own father.
And so I entered the conference room knowing that this man was not going to live, that this husband would be no more, and that this child would most likely be scarred for life, riddled with guilt. And that I, as this man’s physician, had a choice to make. I could keep him alive long enough to send him to the ICU to die under someone else’s care, or I could do the deep work here and now of bringing clarity and peace to his death. Taking a deep breath, I chose honesty. No false hope, no sugar coating, just pure open-hearted, painful honesty is what I gave this poor family.
And then they had a choice to make. How would this father die? Would it be on life support, prolonging his fate? Or would we remove the tubes and allow his body to finish dying? What would this father, husband, and brother want? There was no right or wrong answer. The only thing I asked was that they honor the man they knew so well and what they believed to be his wishes.
The family gathered around his body. Each were given their time to touch, speak, pray, and love on this man. Nearly twenty people filled the small room, making it seem so much bigger with their love. His sister came and got me once she was sure all those who had needed their time with this man had been given the opportunity. As I entered the room, I beheld one of the most precious sights of my career, and I let my own tears flow.
Wrapped over his chest, directly on top of his heart, lay his sobbing wife, wailing that she just could not let him go. She could not do this. And standing next to her was their young son, caressing his father’s bleeding head. He whispered through tears that he was sorry and that he loved him so much, too. And then the most courageous, selfless words left his lips.
“I don’t want him to go either. But he would never want to live like this. We have to love him enough to let him leave us.”
His eldest, adult son walked up behind me and with a firm, commanding voice and spoke for his entire family.
“Take him off. Take him off now.”
I obeyed. The entire family stayed as we removed the machines. His breathing stopped immediately, but his heart continued on. Gently each one left the room as his heart slowed. Only one was left till the very end.
A new calm had taken over her body. Maybe she was remembering all their moments together: their favorite song, dancing in his arms, his silly hats, flowers he’d sent her. I could imagine his spirit already dancing next to her, comforting her pain as she swayed to the melody of their memories.
Their love was so very strong. Death would not keep the father of her children from sending his love from the other side. All she had to do was listen to the music. I felt that in my own heart as his stopped, and I called his time of death.
