THE PATIENT

SEPTEMBER 2011ASHLAND CITY HOSPITAL, ASHLAND CITY, TENNESSEE

He was an eighty-two-year-old, proud Alabama boy, lying in theintensive care unit, and while I didn't yet know his time of death, Ialready knew the cause.

For more than a year, he had been struggling with myelodysplasticsyndrome—his bone marrow had stopped producing the bloodcells needed to fight off infection. He was immunocompromisedand had developed a severe staph infection that was almost impossibleto treat. His body had become septic, and the inflammationwas devastating his organs. I knew his days were numbered, but Icouldn't stand the thought of his passing.

I had known him all my life. He was a teacher and a farmer—intelligentand determined, proud and stubborn. He was also aman of great faith. He didn't see any reason to prolong his life onearth past the purpose God had for him. Like many of my elderlypatients, he believed that he had an appointment with heaven andthat Jesus was waiting for him on the other side.

As a doctor, I've seen what happens to the patient whose lovedones hang on too long. They desperately cling to their familymember, demanding that doctors use extraordinary means to keepthat person here when, really, the dying believer just wants toslip gently to the other side. Sometimes doctors can postpone apatient's death for weeks or months, but it often involves drasticmeasures with the person being kept alive by machines and feedingtubes. The patient's quality of life isn't what relatives expectwhen they initially make the decision, and it's rarely what a patientdesires.

Whenever God called him home, he was ready.

I didn't want this patient kept alive by machines, and he didn'twant it either. But I had good reasons to lengthen his life. He had aclose, extended family, some of whom lived out of town and wanteda chance to say goodbye. With intensive medical intervention, Icould postpone his death long enough to allow them the opportunityto see him one last time. His family wasn't ready to let him go,and I understood that in the most intimate way possible. I wasn'tready for him to be gone either.

I thought of other deaths I had witnessed—includingan unforgettable experience that happened while I was a medical resident.

* * *

Throughout medical school I had taken care of dying patients, butthis was the first time that I, as the senior resident, would be theone in charge when a patient died. I didn't know what to expect.

"Dr. Anderson," the elderly woman began, her voice starting tofade. "Will you hold my hand? I'm going to see Jesus, and I need anescort."

That night, I experienced the veil parting—the veil that separatesthis life from the next. As I held the dying woman's hands, I felt thewarmth of her soul pass by my cheek when it left her body, sweptup by an inexplicably cool breeze in an otherwise stagnant room.I smelled the familiar fragrance of lilac and citrus, and I knew theveil was parting to allow her soul to pass through.

Since that first patient, I've walked with countless others to thedoorstep of heaven and watched them enter paradise. On many occasions,as I held hands with the dying, God allowed me to peer intoheaven's entryway where I watched each patient slip into the nextworld.

I've sensed Jesus on the other side, standing in heaven's foyer, welcomingthe dead who are made whole again. I've glimpsed surrealcolors and sights and heard sounds more intense than anything I'veever experienced in this ordinary world. I've inhaled the scents oflilac, citrus, freshly carved cedar, and baking bread—more fragrantthan I ever thought possible.

Sometimes I've even witnessed patients leave this world and comeback. As they've shared their stories with me, I've often rememberedthe time early in my life when God allowed me to step into heaven'sfoyer, even though I no longer believed he was real.

The one thing these experiences have in common is the intensityof the sights, sounds, fragrances, and feelings that I sensed. Heavenis more real than anything we experience here, and the sense ofpeace, joy, and overwhelming love is beyond description.

* * *

Memories of other dying patients, as well as my personal glimpsesinto heaven, drifted through my mind as I sat at my patient's bedsidein the ICU that day. I had every confidence that what awaitedhim would be more joyous than anything he'd ever experienced.But, selfishly, I wasn't ready to see him disappear through the opening.As the attending physician, the family looked to me for guidance.I could recommend a blood transfusion that would prolonghis life for a few more days; with several transfusions, maybe I couldextend it a week or more.

Or I could let him go.

Either way, I knew that he and his family would listen to me anddo what I suggested.

I had a difficult decision to make, and my medical decisions werecomplicated by what my patients and I had experienced on heaven'sside of the veil. But my struggle was even greater because of who I was.

I wasn't just the patient's physician—I was also his son.