“I appreciate your time and your concern, Doctor, but I have a strong faith in God and I believe He will see me through this.” This is what Maru Johnson said as I attempted to persuade him to follow the cardiologist’s recommendation to have coronary artery bypass surgery (CABG or ‘cabbage’). Just a few days prior he had a major heart attack that landed him in the ICU. The cardiac catheterization had shown that all three of the major blood vessels feeding his heart muscle were severely narrowed and without surgery he was at very high risk of another heart attack.
I waffle between believing there must be a Higher Power connecting us all and giving meaning to all this and believing that the Bible is a book of fables written by men seeking to bend people to their own wills. Between calling “Lord Jesus, God Almighty please help this stupid baby, Lord!” like an old Southern Big Mama and trying not to picture the stringy-brown haired, pale-skinned Jesus image I was raised with when I pray. So maybe this is why it bothers me when patients use their belief in God to shun medical advice. As if no one before them believed enough to be spared.
It especially bothered me coming from Mr. Johnson. Because he had done it before—with kidney failure 2 years prior.
Like many patients approaching end-stage kidney disease, he was among those who believed in God’s Will. Either God would provide a miracle and save him from the doctors’ promise of dialysis, or he would simply accept that it was his time to die. And like pretty much all of them, when the symptoms of kidney failure arose and the time to die was imminent, dialysis was suddenly part of God’s plan.
I reminded him of this. How many patients said the same thing about kidney failure. He nodded, remembering. He smiled at me, believing that I was finally understanding where he was coming from. But he didn’t understand the point I was making—that they all, himself included, ended up on dialysis because prayer could not spare them the certainty of death from kidney failure without a replacement through dialysis or transplant.
The same applied here.
Just weeks earlier when I made my weekly rounds in the dialysis unit, Mr. Johnson was usually too sleepy and too uninterested to talk to me. Systolic blood pressures above 200 didn’t faze him. He could lose the equivalent of a teenaged girl and still be overweight. He didn’t know his medications and rarely bothered to take them.
But the heart attack scared him straight like a wayward teenager forced to spend a week in prison with hardened criminals. He vowed to start taking his medications as prescribed. He would follow the recommended diet. He would even stop smoking. His wife, five months pregnant with their fifth child, would make sure he did.
I was happy to hear that he was finally ready to start taking care of himself, but even if he had been for the last two years he had been on dialysis, the heart attack would not have been a surprise. Like diabetes, advanced chronic kidney disease by itself places a person at the same risk of a heart attack as someone who already had a heart attack. I was worried that his newfound determination was too little, too late. And that adding prayer wasn’t enough to get him over the hump of the inevitable.
Not to say the surgery would have guaranteed his longevity. Sure, he could die on the operating table. But surgery was his only chance at the possibility of longevity. This problem would not go away.
“The same way God gave us dialysis, He gave the surgeons the ability to bypass clogged blood vessels,” I tried to persuade him. His smile faded. He didn’t see his action as part of God’s Will.
“Again, Doctor, I appreciate your time and your concern, but I have discussed this with my family. And we believe He will see us through this,” he said. And the conversation was over.
His belief in God eased his fear in this horribly frightening situation. That was a good thing that I was all for. But to use that belief as an excuse for not having to deal with the reality at all saddened me. It didn’t have to go this way.
He left the hospital the next day, only to return to the ER a month later complaining of chest pain for three days. Still, he remained steadfast in his decision to forego surgery, not seeing this as God’s Warning.
A month later he died of a massive heart attack. Just shy of his fortieth birthday.