The Heart Speaks Softly
by Mike Litrel, M.D.

memory. I told her about myself, too, and we became friends.

The Cardiology team was a wonder. Emory University is a cardiology powerhouse, the birthplace of Balloon Catheter Angioplasty. The foremost experts in the world work and train there, performing this marvelous technique. I watched the Cardiology Chief operate on patient after patient, improving life, and holding death at bay - my faith in the life-saving power of technology grew.

Mrs. Strickland did not share this faith. She still refused the procedure. "I think I'm going to die if I have this done," she told me. When I shared her fears with the Cardiology Chief, he became exasperated: "She'd die sooner without it." So I redoubled my efforts to convince her. And after another week, she reluctantly agreed.

I was happy when I wheeled her down to the lab the next morning. At last we could help her. She smiled at me, and I held her hand as she was sedated.

She died on the table a few minutes later.

We had no warning. The procedure had barely begun. Even the Cardiology Chief didn't seem to know what was going on. There was confusion in his voice - and fear. He raced to get her heart beating again. But nothing worked, and the resuscitation became desperate.

Then just as unexpectedly, her heart began to beat again.

Remarkably, the next morning, she was back to her old self. Ashamed that I had so readily dismissed her fears, I had trouble meeting her smile. I began to explain what had happened.

Her next statement stopped me cold.

"I was there, too, you know. I remember everything."

She told me that when her heart had stopped she could see her body lying on the table, with the cardiology team frantically trying to bring her back. She saw me looking very frightened, standing out of the way. But it was peaceful, she remembered, and as she was floating above the room she wondered to herself if maybe it was a good time to die.

"But you've been so nice to me, and I knew it would upset you if I died," she said, holding my hand. "So I decided I wouldn't die just yet."

Dumbfounded, I could only stare at her in amazement.

Two mornings later we sent her home. "Let's get her out of here before we kill her," the chagrined Cardiology Chief told me. And modern medicine beat a confused but grateful retreat.

I'll always remember Mrs. Strickland and the wonderful gift of her return to life. She was the first patient to teach me humility and show me something the medical literature never could: she taught me to listen, listen carefully, to the heart. It's a mistake to place all of your faith in technology or in the surgeon. The gift of healing is a miracle, like the gift of birth, and the physician is only a witness to this miracle, not the source.

So I finished telling my patient's angry husband about Mrs. Strickland, and again I offered my hand. This time he shook it, and thus we successfully avoided a fistfight. Weeks later, I performed his wife's surgery when she finally felt ready. And, thank God, she was healed.

Dr. Litrel is a surgeon in private practice with Cherokee Women's Health Specialists in Canton and Towne Lake. He is a Clinical Professor at Emory Medical School and the Medical College of Georgia. Dr. Litrel lives in Woodstock with his wife Ann and their two sons, Tyler and Joseph. E-mail: mikelitrel@comcast.net.

The following is an excerpt from Dr. Litrel's new book, The Eyes Don't See What the Mind Don't Know: A Physician's Journey to Faith, available this October.

My patient was unusually apprehensive before her surgery. The operation would be a simple laparoscopy. Through a small incision under her belly button, I wanted to look inside to diagnose and treat the cause of her increasing pain. The day before, she had been comfortable with our plans for surgery. But that morning, she was very frightened and nothing I did could put her at ease. At first she was too embarrassed to tell me why. But finally she admitted she was upset because of a bad dream. She dreamed she was going to die during the operation.

Although the medical literature doesn't support the decision, we postponed her surgery. Her face flooded with relief and gratitude, and I knew it was the right thing to do.

But her husband was angry. The surgery had been planned for a month. He had taken off work and gotten her to the hospital at six that morning. He rolled his eyes in disgust when I told him why I'd cancelled her surgery. Because of a dream? Where did I get my medical degree? Voodoo School? He seemed less interested in my explanation and more interested in taking me outside to settle the issue. I became angry and defensive as the insults kept coming, and I started wondering if maybe a fistfight wasn't such a bad idea.

Instead, I told him about Mrs. Strickland.

I met her as a third year medical school student. The Cardiology Chief had told Mrs. Strickland she needed a catheter placed in her heart. But she was frightened and refused the procedure. He considered her too ill to leave the hospital and refused her wishes to be discharged. She had been in the hospital for a week when I met her.

Mrs. Strickland was a pleasant elderly woman, and I was happy with the assignment the Cardiology Chief gave me. "Spend time with her and convince her to get the cath." It was my first year out of the classroom, and like other third year students, I was mostly useless to my medical team. The cardiologists were so busy they didn't have the time to spend with Mrs. Strickland. So I welcomed the opportunity to contribute.

I looked forward to our meals together. I could tell our conversations helped her feel better. She had grown up on a farm in Marietta, but didn't have much family left. She spoke slowly and laughed softly when she shared a pleasant