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connected to various monitors emerged from his warm, perspiring body. I always spoke to him while I performed the exam, letting him know what I was about to do next. While I was not sure if he could hear me, or honestly if he would even live another day, speaking out loud to this teenage boy seemed like the right thing to do. Maybe a part of me was hoping that one day he'd say "Good morning" in return. I never heard Mike speak or even withdraw from pain, but he did make progress in the PICU. Each day I checked his ventilator settings, monitored his intracranial pressure, kept track of the modifications in his complex medication regimen. I looked for sores, contractures, infections, and clots. I perused lab tests, imaging results, and assorted consultants' opinions and helped communicate our team's plan to his family.
A couple of weeks into his hospitalization, planted as a stinging reminder that time moves on even when life seems to stand still, Mike turned 15. Members of his extended family and numerous friends showed up throughout the day, including the guilt-ridden driver of the wrecked car. We sang an enthusiastic albeit off-key rendition of "Happy Birthday." The usually quiet and spare hospital room buzzed with energy and filled up with balloons, cake, cards, and photographs. I distinctly remember one picture of a mud-covered, invincible teenager, grinning after a soccer game, his arm around his little brother. But through all the commotion, Mike didn't stir or open his eyes.
I often thought about Mike and his family before I fell asleep at night. I kept wishing that I could do more for them.
Four weeks after the accident, a bed at a rehab facility opened up. Mike, though still unresponsive, was deemed stable enough to be transferred. I figured I'd never see him again, especially since I was about to finish my month on the PICU.
I went on to rotations in other specialties and soon found my attention diverted by preparing my residency applications, planning my wedding, and studying for my boards.
There was my comatose patient, standing in front of me, taller than I, smiling and shaking my hand. "It's nice to meet you," he said. "It's great to see you again," I responded. He laughed a lot, and he and his parents teased each other when their stories about his recuperation differed. They showed me the "Miracle Mikey" video and newspaper clippings about his recovery. —Jen Talmadge '09
But six months after I'd last seen Mike, lying in his PICU bed, here were Diane and Rob smiling in the hospital cafe. I was thrilled to see them again. Diane had been at the hospital day and night for Mike's entire stay, and Rob had visited daily; I quickly remembered the fragile, human time we had shared. I sat down with them, as though I were catching up with old friends, and listened to the story of Mike's amazing recovery.
Soon after leaving the hospital, Mike had begun opening his eyes, responding to verbal cues, and even speaking—at first mostly cursing at those around him. A few months into his daily, physically demanding rehabilitation, he took his first step with a walker; after a few more months of practice, he'd learned to walk again. By the time I ran into Diane and Rob, he was living at home, walking, talking, using a treadmill, and attending school part-time. As I recalled my last glimpse of his broken and motionless body, it sounded like the closest thing to a miracle I had ever witnessed. Indeed, a local TV station had covered his story under the headline "Miracle Mikey."
Diane and Rob were at the hospital that day because Mike had just been readmitted with a
relatively minor upper respiratory tract infection. "He is in room 519," Diane said. "Do you have time to come visit him?"
This time, I entered the pediatric floor as a guest of Mike's parents, not as a member of his care team. I was wearing jeans and a fleece jacket—no white coat, no stethoscope, no reference books weighing down my pockets. Just as I had immediately placed his parents, I also knew Mike right away. The fluid had left his face, his spinal brace was gone, and the ventilator tubes were missing, but I recognized the blue eyes of the young man sitting on the hospital bed, playing a video game. He politely turned off the game when I entered and stood up.
There was my comatose patient, standing in front of me, taller than I, smiling and shaking my hand. "It's nice to meet you," he said. He spoke slowly, but his physical and intellectual capabilities astounded me. "It's great to see you again," I responded. He laughed a lot, and he and his parents teased each other when their stories about his recuperation differed. They showed me the "Miracle Mikey" video and newspaper clippings about his recovery. Mike thanked me for helping to take care of him, but I knew he was the one who had given me a gift.
My face and my heart were smiling for a long time after I left his room that winter day. Mike Powell is a patient I will remember forever. He reentered my life when I least expected it—on a cold Saturday morning when my mind was filled with anxiety about my upcoming board exam—and reminded me of the resilience of the human spirit.
In the medical profession, we become familiar with change, death, disease, and uncertainty. At times it can feel overwhelming. But I believe all health-care providers can recall a patient like Mike—someone who reminds us that even in the darkest of times, in one way or another, hope and humanity prevail. These are the patients who inspire us to go to work every day. These are the patients whose courage we hope to emulate. These are the patients we must never forget.