"Charlie"
By Claire Cronin MD, MBA
I found out a few days ago that Charlie Murphy had died again. Charlie had been dead twice before but it was short-lived, so to speak. This time he succeeded. I am not really sure what he died of but I heard that it happened at home and therefore I suspect it was his heart.
My niece was the one who told me which was one of those weird “it’s a small world after all moments”. Unbeknownst to me, she had become best friends with his granddaughter at some point in the past five years since I had been up to my elbows in his blood. The girl’s mother, Charlie’s daughter, made the connection and told my niece that I might want to know that he had passed on.
I find myself at a loss as to what to write to Charlie’s wife on the blank card in front of me. I want to write that I am sorry that I almost killed him, and then saved him and then almost killed him and then saved him again. I want to tell them how special he was for thanking me for his life rather than blaming me for almost losing it. Charlie was a glass-half-full kind of guy. The way he saw it, we were forever bound together after what we had been through. Like in a fairytale.
My office called him my boyfriend despite the fact that he was 30 years older than me and happily married. He would stop by the front desk anytime he was in the hospital to say hello or leave a message that he was still kicking. Nurses from different departments would stop me in the halls of the hospital to let me know that Charlie Murphy had been in for treatment and regaled them all with stories about me. To this day I am conflicted by feelings of embarrassment for my medical error and pure joy for having him in my life whenever his name comes up.
I met my “boyfriend” on a July 4th week-end. He was in the ICU and bleeding heavily from his colon. The gastroenterologist could not stop it and we didn’t have the capacity for interventional radiology embolization of the offending blood vessel so it was left up to me to do something surgical about his diverticular bleed.
When I walked into Charlie’s ICU room, I was met by a view of his tremendous buttocks with a colonoscope snaked through the cheeks and blood pooling around it onto the bed. His loud and cheery voice came from the other side of this mound of flesh welcoming me to the party. He had received numerous transfusions and I told him there was nothing to do but to take him to the operating room and remove his sigmoid colon. He said, “I trust you to do the right thing”.
It took all hands to move Charlie onto the table as it was not only his personality that was larger than life. I opened his abdomen and proceeded to attempt to remove his colon. The CliffsNotes version is that operation wasn’t as straight forward as it usually is and because of that, there was some serious bleeding that led to the aforementioned blood-up-to-the-elbows scenario. The fourth year surgical resident standing next to me was shaking so badly out of fear that the operating room bed was vibrating. We both were grasping blindly in the pool of blood for the source of the bleeding, unable to suck it out quickly enough to identify the source. To this day whenever I am faced with a difficult task, I think about that moment and realize that nothing can ever be that scary again.
Eventually, I found the source of bleeding and tied it off. I never ended up removing Charlie’s colon which just proves the surgical dictum that “all bleeding eventually stops” (since there is no blood left to continue bleeding). Charlie never officially died in the operating room but it got close.
After I closed him, we went to the ICU with him intentionally sedated and on a ventilator. I left to find his family and explain the sequence of events when the operator’s voice announced a code red in the ICU. Even at midnight, the code announcement drew a large crowd of would-be-saviors that no actual life-saving measures could occur due to the inability to get anywhere near Charlie. He was already lined-up and intubated from the OR so there was nothing for a surgeon to do. I retreated to the north-east corner of his room and put my head in my hands not relishing a return trip to Charlie’s belly to control more bleeding. A respiratory therapist new to our hospital was assigned the job of chest compressions while the ICU doctors yelled out orders for medication. The EKG showed he was having a heart attack.
I would venture out of my corner for a moment or two to feel for a pulse or check the lines and then retreat back to it and continue my praying. I had become religious again in the OR when I was fighting to control the bleeding and now was bargaining with God for all sorts of acts of human kindness in return for Charlie’s life.
We got Charlie back and I went back to the ICU waiting room to update his family on the latest events and then Charlie died for the second time. The code team resumed their positions and after some significant chest pounding, Charlie decided that it wasn’t his time and he stayed with us.
Two days later he woke up and after the respiratory therapist removed his endotracheal tube and said, “Hey thanks buddy for saving my life.”
“It wasn’t me who saved your life,” the respiratory therapist answered.
Charlie said, “Sure you did, I saw you pounding on me.”
There were twenty people in the room and no one could have reliably pointed out the new respiratory therapist two days later but Charlie, whose eyes were closed and was drugged recognized him. Word of this made its way around the surgical service and eventually to me.
On afternoon rounds, I asked Charlie if the story was true. He said, “Sure it is Claire,” after all we had gone through Charlie had decided to drop the Dr. before my name and I was in no position to stand on principle. “I saw everything."
“But Charlie, your eyes were closed. I was right there. You were asleep,” I argued.
He shook his head and said, “I could see everything from above. Bob (he even knew his name) saved my life by pounding on my chest. The rest of the room was filled with people yelling. And you Claire…were standing over in that corner shitting bricks!” Charlie pointed to my corner and started to laugh. “Shitt-ing bricks!”
“I was,” was all I could say. “Did it hurt Charlie?”
“No not really. I could see everything happening but I couldn’t feel it. Anyway thanks for saving my life in the operating room.”
“Yeah about that Charlie, I never took your colon out because you started bleeding badly from something else. It was pretty touch and go there as well but we got you out of it,” I explained. “Did you see us in the operating room like you did when your heart stopped in the ICU?”
Charlie shook his head and said “No of course not. I was asleep in the operating room.” He used a tone of voice that implied that I was being ridiculous which was a little judgmental I thought coming from someone who had just told me that he was floating on the ceiling of his ICU room watching himself be resuscitated.
During his recovery, I became close with Charlie and his family. He told me stories about his grandchildren and I told him about my kids. Charlie was one of those guys who had long ago figured out that life is not about things but about connections. He loved people and I was lucky enough to be a part of his life for a little bit.
Charlie is the only patient of mine that has described an out of body experience. I don’t usually go in for other-worldly things except when I find myself awake in the middle of the night and then I unfortunately start to believe in all sorts of ghosties, but during the day I stick to a no-nonsense Calvinistic attitude. Despite the literature that explains these occurrences away, I believe Charlie was temporarily an angel, watching us in the ICU that night. How else would he have known that I was “shitt-ing bricks in the corner”?
I don’t share Charlie’s story with many people. It’s too special. I write it all down for Charlie’s wife. I tell her that I believe he was an angel in life and that he continues to be one in death.
