Postcards

My friend’s son is dying. He’s eight, and the cancer is proving to be just too much. He is still fighting, and at least for the moment he is doing OK. But at this point, everyone agrees, it’s just a matter of time. I recently came across an old picture of my friend and me, long before she had a child or was even married. She was just a happy priest. And looking into her eyes I had to ask myself – how could she have known? How could she have known the joy that would come with her son, and the agony of dealing with his death? How could any of us have known?

It’s not entirely uncommon at nursing stations in hospitals to see obituaries hanging on the walls. These are of patients who have recently passed. It’s especially hard with younger patients – the pictures are senior portraits or of prom or something. And I find myself again looking into their eyes and asking how could you have known? How could you have known, when that happy picture was taken, the tragedy that would befall you?

These images form postcards in my mind. Postcards of happy people destined for sadness.

And of course, at this time of year there is a postcard that, if it didn’t actually arrive in your mailbox, I know you have at least seen it. It’s a picture of a babe in a manger, with a star overhead, on a mysterious night long ago. And I ask myself again: how could you have known? How could any of you have known how that life would end in unbearable tragedy, and then, three days later, provide hope through salvation for all humankind?

I used to ask myself this question: what could have been going on in the course of human history that prompted God to send Jesus into the world at the precise moment he choose? What was so bad that the world needed God on Earth in that moment? But now I ask myself this: Why is it that we are blessed to live our lives knowing of the miracle of Christmas? Maybe it had nothing to do with what was going on; maybe it had to do with what could go on in that knowledge of that hope.

It is that hope that makes looking at those postcards bearable. My Christmas prayer is that the love that entered this world in human form long ago continues to enter our lives each and every day. So that when we look at postcards we see not tragedy but glorious hope.

Merry Christmas!

(Beating) Hearts

I guess I can’t stop thinking about hummingbirds. The little engine that powers that tiny bird is a marvelous thing. The hummingbird’s heart averages 250 beats per minute, and it can be as high as 1200 per minute under times of stress. To put this in perspective, the human heart beats an average of 60-100 beats per minute, and never really gets above 200.


It must be loud, don’t you think? All that beating. So much work for such a small thing. The little “lub-dubs” must almost blend together.


The human heart, while it doesn’t beat as fast, is equally marvelous. Its complex electrical system maximizes its efficiency, making it torque in such a way to maintain blood pressure and deliver freshly oxygenated blood to each and every cell in our bodies.


Of course, during open heart surgery we often stop the heart. A machine that is roughly 5 feet long and consists of various tubes, pumps, and canisters, and which is run by a specialty trained individual, takes the place of the heart and lungs. Dark red blood is diverted from the venous system into this machine where it is oxygenated, turned bright red, and is then pumped back to the systemic circulation. And to make sure the heart doesn’t die during this process (it too needs oxygenated blood), we shut it down. It is infused with a cold cardioplegic solution (ice water, blood, potassium…) and submerged in ice. And that’s it – the heart stops, and the machine circulates the blood. A gentle and continuous hum replaces the familiar “lub-dub.” The monitors become irrelevant. The operation can proceed.


And proceed it does. Carefully placed incisions and even more carefully placed sutures are used to replace valves or bypass blocked arteries. The stakes are high – a slipped knot can literally end a life.


And then it is time to finish, and re-warm the heart. The ice is removed; the solution is switched to something warmer. The tubes are removed in sequence. And like a moon or the sun coming out of an eclipse, the heart comes back to life. A bit shaky at first, but in time a regular rhythm, and a good blood pressure. The chest can be closed; the operation is complete.


Except in our last patient. He was only in his 40s, and was the victim of advanced kidney disease as well as his heart troubles. A few hours after the surgery his blood pressure tanked, and his heart gave out. We started CPR. Now I was literally compressing his chest wall against his heart, forcing it to beat, willing a blood pressure. I could feel the ribs cracking under my compressions. Not good enough. We opened the chest with a slash of the scalpel and a few cuts of the wire-cutter. Now we could see the near lifeless, fibrillating heart. We squeezed it with our hearts in sequence (“cardiac massage”) a more direct form of CPR. A few shocks with the paddles…a tantalizing blood pressure…the cycles repeated…and then, nothing. No blood pressure, no pulse, no beating heart. Only death.


I walked in half-way through his autopsy the following morning. His chest cavity was spread open, empty. The heart and lung had already been removed – the perky pathologist gestured to their place on the table beside our patient. And his heart sat there, totally lifeless. There was no coming back this time.


It used to beat 60-100 times per minute. Now it was on a counter. It used to move oxygen all around his body. Soon it would be cut up into slides for the pathologist to review. It weighed over 300 grams, more than 100 times the weight of an average ruby-throated hummingbird.

Birds of a Feather

When I used to visit my grandparents’ home in Maryland, one of the highlights was looking out the window at the hummingbird feeder. I know that sounds a bit odd – what little boy likes to watch miniature birds drink sugar-water? – but it’s what we did. Maybe part of the joy was my grandmother’s enthusiasm for the whole thing, or perhaps it was just the novelty of it all (if we had hummingbirds in Philadelphia, we didn’t’ know it). Either way, when we eventually moved to Maryland ourselves and my grandmother gave us our very own hummingbird feeder…well, we were all excited.

Just recently I was visiting my parents, who now live in Maine. My grandparents have sadly passed away, but my own parents still get lots of joy watching the hummingbirds of the northeast devour their sugary meals.

But something caught my eye. A hummingbird, dead, was on the deck. My father said he had watched several male hummingbirds take nose-dives at that bird, literally beating the life out of him. He must have encroached on some bird’s territory, or flirted with some bird’s mate. His life ended in a brutal way. And it was crushing to me.

How terrible, that birds should act this way. You’d think birds – especially the smallest ones of all – would somehow unite. Can’t they just happily fly around and eat their sugar water?

Of course, the irony is appalling. I’ve spent the last month at a trauma center in Reading, PA, where I witnessed all manor of evil. Assaults, beatings, shootings, stabbings…what we do to each other is enough to crush any Christmas spirit that is supposed to be swelling inside me. Peace on Earth, and goodwill towards man? Not in the trauma bay. And apparently, not even in the hummingbird kingdom.

It must make God cry, to think we are no better than the hummingbirds. Maybe we should all just drink our sugar and go home to bed. Try to resist killing each other, if at all possible.

Advent is a time of watchful waiting. A time of increasing darkness with the promise of eternal light at its end. And it is that hope, that promise of peace, which must keep us going forward.