The Horror of Losing Your Mind

"The Horror..."

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Open-heart surgery should be scary enough. I've found that people empathize rather quickly, promising to keep me in their thoughts and prayers. My experience with it was probably as good as it could be, with minimal time on the pump, everything going as good as could be expected, and so on. They say that early in ICU afterward, I sat bolt upright and pointed at the tubes in my mouth, such that they had to sedate me even more. Of course I have no memory of that part. There is no accounting for what people might do when only a few parts of their brain have started working again. I do recall having some discomfort with it, feeling a bit choked a couple of times and being reassured to just relax and breathe. For the most part, I was on enough Fentanyl to just enjoy that sleepy ride. Even being extubated only made a slight impression, now quickly fading among the hodge-podge of confused memories.

Overall, drugs saved the day. There is no telling how horrible the whole ordeal might have been if I had not been adequately "under". For most of the next day, I was in ICU, being carefully tended by a very experienced and excellent male nurse. Between hourly checks and occasional turns, "sit ups", and what-not, I was quite content to sleep through it all. Eventually I was moved out of ICU to a normal recovery room, where I experienced a constant turnover of new nurses, charge nurses, nurse aides, exercise therapists, and volunteers. Soon the remaining tubes came out and I retained only an IV line of Toradol. I quickly gained strength and was declared "independent" after just a few days. 4 days after surgery, I was released to go home. Leaving the hospital meant giving up some of the drugs that had helped me through it -- particularly the IV Toradol, an NSAID anti-inflammatory. I would retain round-the-clock therapeutic levels of Oxycontin (10mg twice a day, controlled release) and use hydrocodone (in the acetaminophen-laced varieties of either NorCo or Vicodin) as needed for break-through pain relief. In general, I had some itching from tape used with various dressings, some mild pain, and I got tired relatively easy, but otherwise I felt fine.

Everything was going well, until recovery day 8, when suddenly my pain increased to levels I had not experienced previously. Why? I wish I knew. Perhaps playing the guitar was just "too much". Perhaps I finally metabolized all of the residual Toridol. Whatever the cause, I had to take twice as much Vicodin during the night in order to sleep through. The next day, about the same time my home-care nurse was supposed to show up to check on me, I had what most would call a "psychotic episode".

...of Losing Your Mind

While my family members were busy with something in the dining area, I reclined in the family room and tried to take yet another nap. After sleeping just a bit, I finally decided to force myself up with the intent to relocate to a quieter location in the house. But then I was distracted by a CyberGuys catalog and decided to flip through it while I sat there. I was still sleepy, not completely awake, and reading through the catalog took my mind to other places. In the midst of it all, a dark cloud occluded my memory. I lost all sense of context. I began to feel as if part of brain were not functioning, and it alarmed me. I called out to my family members, saying something like this:"

• Did I just spend a few days in the hospital?
They thought I was joking. In my panic, I got up to walk to another part of the house, to do anything that might clear my head. My wife replied "Yes, honey, you just came home a few days ago". I was visibly upset, so she came to me and tried to calm me down.
• But why was I in the hospital? I honestly had no memory of it. My wife gently explained, "You had open-heart surgery."
• No way! That can't be, that's serious. I was crying. I could not remember anything. Why did I have to have open heart surgery? Again my wife tried to explain, "Remember? You had an aortic aneurysm."
• Oh yeah, we found it last December. This news had a ring of familiarity to it, finally, but it still seemed out of my reach. About this time, my home-care nurse came in and joined the party. Yes, she was familiar. I began to pour out a series of questions. My wife answered them, and also checked for signs of any motor or sensory dysfunction, and ruled out "stroke".

And that's how it went for a while, with me crying in terror at not being able to remember how I got to this present situation, while at the same time having it all refreshed, bit by bit, by her reminders. "I don't want to lose my mind. I can't afford to lose my mind;" I said. But she assured me that I was not losing my mind; rather, it was just a side-effect of too much narcotics building up. My pupils were tiny, etc. I eventually felt better, saying I felt I had 85% of my mental integrity back. But it wasn't until later that day, after I had finished a short nap, that I could honestly say I was fully back to normal in my cogitation.

This was the worst part of my recovery experience so far. Worse than waking up intubated. Worse than having the catheter removed (yes, that caused burning and bleeding that took a day to clear up). Worse than not being able to roll over in bed due to pain. Losing your ability to access memories and to use them in thinking is a terrifying loss. I was quite shaken by this, and have since had to find alternatives to simply taking more hydrocodone. In fact, I needed to wait quite a while for the levels of that drug to go down somewhat before taking it again.

Interestingly, my home-care nurse said it was good for her to be able to see my episode, because she cannot take Vicodin at all for the very same reason -- it makes her crazy. She said that at one point she was over her husband's face one night in bed saying, quite angrily, "Who are you?" So she cannot take it at all. But it was insightful for her to see it from the outside.

I would have preferred using oxycodone (like Percocet) for break-through pain instead of the inferior hydrocodone, but it is much more of a hassle to deal with outside of the hospital due to FDA regulations. Still, I'm on Oxycontin timed-release already, and we manage that just fine. I wonder if I would tolerate Percocet better. But in any case, I need to do whatever I can to avoid losing context like that again, because it is quite terrifying to lose your mind.

Don't let your heart be troubled

Don't let your heart be troubled

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4.9cm thoracic (root) fusiform aortic aneurysm with bicuspid valve, only .1 cm from class 1 indication for surgery, and that's up .18 cm from what it was 6 months ago (at which time we thought the value had the normal 3 leaflets instead of just 2). My wife says I should let God "circumcise my heart", but my cardio thinks a heart surgeon should do it. Literally. I.e., replace the aorta with a Dacron graft and the valve with a titanium doohickey.

Reasons to do it:

The risks might be less than the likelihood of kicking the bucket at some random time in the next few years from rupture. For my 11.5 year-old son's sake, I would rather not leave him fatherless just yet.

Reasons not to do it:

I don't think western medicine has a clue about holistic healing or systemic relationships. The fact that open heart surgery results in severe depression just goes to show that they really don't understand what they're messing with.

Some other non-western (alternative) system might claim to have a better way, whether proven or not, true or false, and I'm curious for perspective here. Since this is something that goes unnoticed until it kills you, it is doubtful. But I wonder also about people who are "healers" who might be occasionally effective, regardless of their world view, but claims float about like dust and pollen with no way to discern the good from the bad. Testimonials for placebos can be quite convincing, as well. I believe disciples of Christ are given divine authority to heal by faith, but I can only claim this with respect to spreading the gospel and advancing the kingdom, not for myself (as an already-believer).

While there are plenty of things I would love to do, I can't ever seem to find a way to get them done, despite being alive for many years now. So staying alive longer might not help with that.

I supposedly have dysthymia as well, the negativity of which causes problems for my family; and lately the losses of hope have been downright depressing. Sometimes I think it might be better to die than to go on, though I wouldn't presume to make that happen myself. I'm not being suicidal here, I'm just saying...

I've still not figured out my specific, personal purpose -- the divine intent for my unique giftings and drives. I've often wondered if God purposely keeps mum about it because I'll die young and none of it will matter. But now I'm not even young anymore. About the only purpose I accomplish is to make a bit of money and give it away to worthy causes; but never enough to make a lasting difference.

Medical costs are so insane that I almost just want to say "forget it". Even a simple echo-cardiogram costs $1700. Why? Heart surgery like this must cost about as much as a house. How do you enter that into the computation to weigh things out? At what point do you say "I'm not going to play this insane game!"? I don't want to be a slave to medical opinion/advise, but I also don't want to be negligent.

Next Steps:

So I'm still in info-gathering and persuasion mode, trusting God to close/open doors of consideration toward a final decision. I'll meet with one heart surgeon tomorrow. I should probably talk to another also. If God really does work all things together for good to those who love Him and are called according to His purpose, then theoretically I should be glad about every such challenge that comes my way. It's all good, right? But a sure Word about what He's up to would help. :-) For example, If I was already going to die of, say, cancer, within another two or three years, then it would seem quite a waste of money, time, and energy to deal with heart surgery. Would Hezekiah have been better off if he had not been granted those extra years? Doctors help, but their perspective tends to be influenced by the western medical mindset rather than informed by the Spirit of God.

As usual, it all boils down to the need to hear from God and believe Him. Even if I hear nothing, He is trustworthy, but I don't know exactly what trusting Him will look like in this particular instance. As it might be one of my last, I should be sure to get it right.

Good Judgment?

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Good judgment, good discernment, and proper discrimination between right and wrong is essential. So why is it that being "judgmental" turns out to be so wrong or damaging? In dealing with that, the oft-quoted maxim is to love the sinner and hate the sin. I don't think many people can really pull this off very well. We tend to fail at either one, or the other. Often, both.

Let's examine how it is supposed to be done. How does Jesus manage to maintain judgment against sin while extending mercy to not condemn the sinner? Look in the gospel of John, chapter 8, for the story of the woman caught in adultery. The accusers are trying to trap Jesus, placing him in a difficult situation in which any response a man might be likely to provide to the provocation would give them grounds for denouncing him.

So they bring the woman who was, as they said "caught in the very act". The obvious question is "where is the man?" The law did, in fact, demand that she be stoned, but also that the man be stoned. Note that adultery was when a man had intercourse with a woman who was married to another man (apparently, if a married man had intercourse with a woman who was not married at all, then he could thereby betroth himself to her, and he would obligated to take her as an additional wife).

Jesus seemed to ignore them, stooping to run his finger on the "ground" (this was inside the Temple) as if he was writing something, though there is no record of what he wrote, as if there was mark being made so no one could tell. After they persisted in questioning him, he stood up to answer, but then he immediately after went back to his stooped posture, and continued his writing with his finger.

Perhaps you remember his answer. It is important to point out that the question was posed as "the law says this, but what do you say?" But Jesus did not contradict the law. He did not tell them they should not stone her. He did not invalidate the Law. He did not even go so far as to say "Yes, the law calls for her death, but I grant her mercy." Rather, he agreed, implicitly. He effectively said, "Yes, go ahead and stone her." Did you catch that? Of course, that was not the important part of the answer. But it was there. The important part of course was the stipulation that he was adding to the Law, a way that it should be carried out. He said, "Let the one of you who is without sin be the one to start the stoning by casting the first stone." [sorry, my paraphrase]

While continued his writing the second time, they began to leave, oldest to youngest. Some commentators have suggested that he was writing out the sins of those men, and they saw their sin exposed, and left. But I don't think so. I don't think anyone could tell what he was writing, or else the text would say something about it. To me, the important part of this is to look at where else we find a divine finger doing some writing. One instance is recorded in Daniel, where it was a ghostly apparition delivering a message of judgment from God.

But look further back, all the way to Exodus. It was the finger of God, present on Mount Sinai in a physical manifestation, that wrote the commandments of the covenant onto tablets of stone. If you accept the concept of a theophany, where the pre-existant Christ appears in bodily form multiple times in the old testament, this leads to an interesting thought. By the way, it is soon after this passage that we find Jesus explaining that even Abraham rejoiced to see "my day", and that "before Abraham was born, I am." I don't know what Jesus was writing, but it was like a sign of remembrance; Jesus recounting that it was He who wrote that Law in the first place. And as he explained elsewhere, the whole Law hinges on loving God thoroughly and loving your neighbor as yourself. This is the Law. So he drove that point home to those accusers. Is this what they really want? Is this the kind of justice they truly desire? Justice without mercy? If so, then they themselves would likewise deserve justice without mercy. James had something to say about that in his epistle.

I don't want that sort of absolute justice. No thank you. I want mercy. But if mercy applies universally, across the board, then there is no justice at all, and mercy has no meaning. In order for mercy to be mercy, it must necessarily be the exception rather than the rule. Thus, only the remnant are saved. But back to the story...

Jesus is the wisdom of God, the Word, and the fulfillment of the Law. How interesting that He stooped to write with his finger -- just like he stooped with clouds to write upon the tablets of the covenant when the Law for the Jewish people was first delivered through Moses. I believe there was something significant taking place as Jesus wrote on the ground, but I'm not exactly sure what it was. You can guess along with everyone else. But it was effective as intended. Each accuser left. Finally, there were no more, so He rose up and addressed the adulteress woman for the first time. The accusers were gone, yes, and Jesus did not condemn her either.

But what about the adultery? What about the offended husband? Well, actually, yes, where was he? We have no idea. Was he one of the accusers? If so, he had left and given up his demand for justice. In any case, there remained no accusation, except what Jesus might retain, for (as David pointed out regarding his sexual sin) the sin was against God. But Jesus, having no sin of his own to require mercy, granted mercy by not condemning her.

Most of us would like to take this as our license of freedom to go ahead and sin. Hey, she committed adultery, not just some violation of ceremonial procedure, but something that was covered explicitly by both the ten commandments as well as the Noachide laws in effect (according to ancient Jewish traditional teaching) from the time of Adam, and codified in the 7 Laws of Noah. And still, Jesus let her off the hook. Cool. So we can do whatever we want. Right?

Oops, not so fast. What did Jesus actually say? "Go now and leave your life of sin."

Whoa, did you catch that? He called it "sin"! He judged her behavior.

He passed judgment on her lifestyle as a life of sin. Ouch. And moreover, he commanded her to stop it!

Has that been your view of mercy? Has that been the way you tuck away this story in your own mind? It is extremely important that we catch this. Jesus did not invalidate the Law, but actually upheld it. Adultery is sin. And Jesus commanded that it stop. That is judgment. You see, judgment that can say that what is wrong is wrong is a good thing. Judgment that agrees with God's wisdom, his revealed word, and the principles of His law, is a very good thing. I even think this is closely tied in with the two fears the New Testament says we should have: a fear of God, and a fear of Sin (those are the only two, by the way). When there is no judgment, there is no fear of either. But the fear of the LORD is the beginning of Wisdom. And certainly here, in this story, we see Jesus clearly judging the woman's adultery as sin.

But, at the same time, He did not condemn her. This is what the mercy of God is about. It still honors the Law, and fully recognizes the vile ugliness of sin for what it is: evil rebellion against God. But it grants us what we do not deserve: a clean slate and an extension of our life, along with the command to stop sinning. If you follow this through the rest of the New Testament, I think you'll find the same thing continues to be elucidated and expounded upon. Jesus' willing death was in substitution for our deserved punishment so that the requirements of the Law could be satisfied while still granting us mercy and the opportunity for reconciliation and friendship with God. Jesus could allow the woman to go uncondemned because Jesus Himself would pay the penalty of death as the condemnation for her sin. And not just hers. Also my sin. And yours.

It is a horrible mistake for us to think that Jesus' way of mercy is one that says "your sin doesn't matter". If it didn't matter, then there would have been no need for him to volunteer to suffer the passion of his torturous execution on our behalf. Our sin is still sinful! Every sin still cries out toward God, screaming "DAMN ME TO HELL!" But Jesus stands in the way and says to the Father "Penalty already paid, in full".

And then He says to us, "Go and sin no more."

If your understanding of Christ's mercy over our sin has missed this point, then I dare say you are not alone, but among many who have been deceived by the father of lies into having no fear of sin, or of God. This is not the faith of the bible. May God have mercy on us, still.