The Valley of the Shadow

You may know by now that I recently went through a rough patch.  I am happy to report being very much on the other side of it.

Last week, I underwent a routine gyn surgery. I did not undertake the decision lightly and had several conversations with my doctor, maybe too many from his perspective. I might be considered one of those high maintenance patients. After six years of dealing with untimely, inconvenient, post-menopausal bleeding, and with the nagging concern for the big C looming in the back of my mind despite multiple benign biopsies, I sat firmly on the fence.

The deciding factor may have come after a mysterious phone call from my son, Jacob, early one April morning.  I was already at the office preparing for my clinic day when Jacob called somewhat out of the blue.

A long way away in Atlanta, Jacob is faithful about coming home every few months and calling me on a regular basis. In fact, he had recently coordinated his time off to coincide with Elena’s Spring break as well as Zach and Carol’s.  Only Zeke would be missing from our family gathering. That was not acceptable to Jacob; so unbeknownst to me, he orchestrated an elaborate surprise visit from Zeke to complete our tribe’s rendezvous.  

Even so, this Monday morning phone call was out of his normal routine.

“Hey, what’s up?” I asked in that voice of motherly concern assuming he needed something.

“Nothing” he replied nonchalantly, “Just making sure you’re ok.”

I assured him I was ok. I was getting ready for the day, putting out fires. Stay ahead of the game was my constant refrain having studied under the master of being two steps ahead.  Always be prepared, my mentor’s boy scout motto echoed in my brain.

Jacob talked about nothing in particular. I would have grown impatient; but motherly intuition picked up on a hidden agenda.

“What’s up?” I gently nudged him, this time with my eyebrows furrowed and my head tilted.

His position shifted on the other end of his phone. I could hear him sit a little straighter as if to build up the courage to ask what he was really calling about.

“Have you been checked?” He questioned me very soberly.

“Checked for what?” I really did not know what he was getting at.

“Whatever they check people your age for. When is the last time you saw your doctor?”

I thought about it. Truth was, I only saw my GYN. I did not have a PCP. My last labs were all normal and I was relatively up to date on screening tests considering the recent Covid postponements. Still the bleeding had started again, not heavy, but it was constant these last three months.

“What brought this on,” I asked Jacob who has always been attentive but never overly doting. (That is Zeke’s job.) He explained that he had recently attended the funeral of the mother of one of his buddies. And that this was one of three buddies who had lost their mothers early to cancer in the last year. And he did not want to be counted in their ranks.

“Just get checked,” he ordered gently but firmly, and we ended the conversation with my promise.

That same day I called for an appointment and in short order the surgery date was set.

I was well prepared. I understood the risks. I felt confident and healthy going in, having paid particular attention to my diet the days and week prior to surgery, what I ate and what I avoided.

“It’s going to be the slickest surgery you have ever performed,” I teased my surgeon on the way to the OR.

The surgery did go smoothly and within an hour I was in recovery. It was the recovery that did not go so well.

My blood pressure was low and not responding to the usual fluid resuscitation.  I had lost some blood during the procedure but not an inordinate amount. The anesthesiologist added pressors to the treatment regimen; but still my blood pressure swooned. I was alert enough to know something had gone or was going awry. Skilled nurses swarmed my bedside and attended my vulnerable body.  I was vaguely aware of conversations about next steps: an arterial line, a central line, a blood transfusion. Every so often the questions “Are you feeling dizzy? Are you having difficulty breathing? Do you have pain?” came into my consciousness.

Well, I did not feel my usual self but then why should I? I had been poked and prodded and pushed and pulled.  I slowed my thoughts even slower and took a closer inventory, like the ultraslow motion of a Hollywood movie. Pushing away the pain I had anticipated from a surgical procedure and all its shrapnel, (I could feel the IV sites, the catheter, the area of incision) I decided, yes, I suppose it does hurt to breathe, under my diaphragm.

The veteran PACU nurse sounded the alarm. The surgeon acted expediently. A stat CT and my languishing vitals clarified the diagnosis. I had internal bleeding and was in hemorrhagic shock. I received two units of packed red blood cells and was taken back to surgery. A liter of blood was suctioned from my abdomen and the offending vessel cauterized. An insulin drip was started as my blood sugars were in the 300s from the stress and medications. An arterial line monitored for acidosis. Two IVs and a central line stood ready to avail me more fluid or blood should I need it. Every vital sign was carefully monitored in the ICU for the next twenty-four hours as my body ached toward recovery.

“Yeah, though I walk through the valley of the shadow of death, I shall fear no evil.” I had been memorizing and reciting Psalm 23 as well as Psalm 139 and Phil 4: 4-9 the weeks and months leading up to these exact moments and now they were faithfully and irrepressibly flooding my mind. The verses were being infused into the core of my  being right along with the fluid, and blood, and medication. “The Lord is my shepherd.” “He makes me lie down in green pastures. ” “Be anxious for nothing.” “Let your gentleness be known to all men.” “The Lord is near,”

This past May during a visit with my sister-in-law at her West Texas home, I felt the conviction to try scripture memory once again.  Amy shared how she had experienced God in a radical way during one of her daily walks through wildflower fields thick with Bluebonnets and Indian blankets. A believer for as long as I have known her, the experience was a turning point in her spiritual life and she was not going back. A changed woman she logged time in God’s word and was eager to share how scripture memory was transforming and renewing her mind. I took her up on her exhortation and committed to memorizing not just verses but whole passages, something I had struggled with in the past.  

I can honestly say I did not fear for my life, lying there in that hospital room.  In those moments when something was very wrong, I felt at peace, apparently it was “the peace that passes understanding”. Even though it was serious, I was sure I was not dying. “All the days ordained for me” including July 9 and better yet July 10, had been “written in his book before one of them came to be.” I knew I could not rush through the valley like my usual impatient self would want to. I had to walk through it and experience each moment and know he was with me and know that he knew my anxious thoughts and I could not go anywhere from his presence that he had knit me together in that secret place and that I was fearfully and wonderfully made.   

I may not have come that close to death, but let’s just say I came as close as I want to come. And I am so grateful for modern medicine with all its annoying bells and whistles. I am grateful for skilled and meticulously observant nurses, surgeons and anesthesiologists. I am grateful for the generous people who donate lifesaving blood. I am grateful for the prayers and all the many pray-ers who are still praying for me.

I am especially grateful to God and God’s word and for the admonition to hide it in my heart. I will endeavor to meditate on it day and night. “Surely goodness and mercy will follow me all the days of  my life and I will dwell in the house of the Lord forever.”