“No, Sir.  He’s not dead.  He’s breathing without the respirator and has a strong pulse,” I said, and showed him the chart of vital signs.

    “A vegetable then - nothing but a vegetable!” he said with frustration in his voice. He frowned then looked away from the films and pushed the medical records toward me across the desk.

   “What do you want us to do now?” I asked, equally frustrated with the situation.

   “Send him home.  Get him out of here.  There’s nothing anyone can do.  He ought to be dead.”  The doctor turned and walked away.

   Just four weeks earlier, John Jackson, my patient (not his real name), had been a hard-working rancher, who despite his seventy-two years, rode horseback, cut cedar, mended fences, and herded cattle.

    His wife, Helen, often rode beside him over their beautiful ranch land in the Hill Country north of San Antonio.  Sometimes, their grandchildren from the city rode with them out on the range to see how  “real cowboys” work and live.

   Thin and wiry, John weighed not more than a hundred and thirty pounds.  His face, deeply suntanned and heavily wrinkled contrasted sharply with his soft blue-eyes under bushy, gray eyebrows.  Helen was thin and graying with a Texas rancher’s leathery skin.  The similarities in their appearance made them look more like brother and sister than husband and wife.

   John’s medical problems began with a headache.

 “I don’t want to be a sissy, doc; but this ain’t no regular headache,” he told his family doctor at a church social. 

   “Come to the office tomorrow, John, and we’ll check it out,” the country doctor advised.

   Practicing medicine among the rugged settlers of the Texas Hill country taught this doctor that by the time any mention was made of a problem or pain, these stoic, independent people had already suffered much and tried many of the “old time cures.”

   After his exam, the doctor said to Mr. Jackson, “You’re right, John.  This is no ordinary headache.  You’ve got to go into San Antonio and see the specialist at the medical center.”

 At the University Medical Center the neurosurgeon diagnosed a brain tumor and scheduled immediate surgery.

   Just before the anesthetist wheeled him into the operating room, John took Helen’s hand and said, “We don’t know how this will to turn out.   Please pray that God will be glorified and that He will somehow use this to bring our son, Joe, back to the fold.  No matter what happens to me.”

   These were the last words Helen would hear him say.

   Their forty-eight-year marriage gave them three adult children, two daughters and a son.  They brought up their children in church, but when their son went to college, he turned from the ways of God and was drawn into the world.  John and Helen grieved over Joe’s “lost way of life.”

   The surgery was successful.  The tumor was removed. But complications from post-operative hemorrhage and edema (swelling) left John “brain dead.”

   He remained completely unresponsive.  The brain stem which controlled his heartbeat and respiration continued to function well, but the frontal lobes no longer enabled him to respond to those around him.  He couldn’t voice his needs or communicate his thoughts (if indeed, he had any thoughts- as some people questioned.)

   Helen brought him home to their comfortable old ranch house.  Her family, friends, and local doctor helped her set up homecare for him.  They provided a hospital bed, special sheets, and liquid feedings.  Helen became a skilled nurse and care-giver.  The daughters, neighbors, and church folk took turns “helping out.” 

  There were no home health care services or hospice programs to serve remote ranches in rural Texas.

   Helen said to me, “I don’t want to put him in a nursing home in the city with strangers.  He wouldn’t like that.  He would want to live and die here at home on the ranch.”

   For over a year, he lay there with blank, unseeing eyes, brain dead, unresponsive to any stimuli, limp muscles slipping into atrophy, nothing, “nobody home,” a vegetable.

   The family doctor and I, his nurse practitioner, made regular visits.  We provided routine care, information, and some emotional support for Helen.

   God  taught us to practice care of the whole person - spirit, soul, and body.  The care plans I wrote included goals for the spirit, mind, will, emotions, and body, and included opportunities for interaction with other people.

   I tried to make a care plan for John.  Of course, physical needs, goals and procedures were obvious, many, and easy to assess and describe.   His nutritional needs were difficult to meet. He had all the physical problems associated with a helpless bed-ridden patient.  But what about his psychological and spiritual needs? 

Were there any?

   For most patients confined to bed, I set up plans for music, social interaction, time and opportunity for emotional expression and visits from other people.  For spiritual needs, we arranged pastoral visits, mass or communion, prayer, Bible or sacred readings, and fellowship with members of the patient’s own religious faith.

   But what to do for John?  Was there any point, any use, any good? 

   I prayed, “Dear God, why on earth would you leave John like this?  Why don’t you just let him die?  Take him home!
He’s no use to himself or anyone else.”

   On my visits I was concerned for Helen. She worked long hard hours to care for John and keep their working ranch alive.  Their son, Joe, moved back home to help with the business side of ranching.  Just seeing him again boosted Helen’s morale. 

   He helped his mother with  homecare, worked cattle,  lifted and turned his helpless father, teased and joked with his mother and turned his heart back to his Heavenly Father.

   He said, “Mother, it’s wonderful to be home again -  in more ways than one.” He hugged her tiny frame and lifted her off the floor. 

   Joe became an able healthcare attendant.  He asked me about procedures of care for his dad.   Helen shared that she remembered John’s last words before his surgery and was comforted in her heart by the restoration of their son to the family and to the faith.

   On one of my regular visits to John and Helen, I checked John’s physical condition, vital signs, skin, and muscle tone.  Then I visited a bit with Helen.  I grieved that I had no more to offer.  I asked, “Would you like for us to pray together before I go?”

   Helen said, “Oh, yes!  Let’s hold hands.  I usually hold John’s hand when I pray for him.”

   I stood on one side of the raised hospital bed.  Helen stood on the opposite side.  We reached across the bed to hold hands with each other and with John.

   I prayed - I heard myself saying - “Dear God, we know that you are Lord of all and that you love us.  John’s body doesn’t work well anymore, and his mind is mostly gone, but his spirit is still here.  You have shown us that important things are happening in the spirit world.”

   When I said, “..important things are happening in the spirit world,” John squeezed my hand, opened his eyes, looked at Helen and me, smiled, and nodded vigorously.

   My spirit leapt within me! Incredible!  I looked at Helen.  She hugged John.  We hugged each other.  We laughed. We cried and laughed again.  A deep, eternal bond  formed among the three of us in that moment.  My understanding of the power of God in our present lives and circumstances grew.  I left the room that day changed in spirit, heart, and mind.

   Later, when I told the neurosurgeon that John responded to those words, the surgeon said, “You must have imagined it.  It is medically impossible for that man to respond to anything at all.”

   John, Helen, God, and I *know* that many important things happened in the spirit world and that God allowed John to confirm it for Helen and me.  We will never doubt it again. “With God nothing is impossible.”

   I will not call a human being a vegetable again.  Now, I know that just as there is the unseen world of the microscopic, the unseen worlds of chemistry and electricity, the unseen worlds of sub-atomic particles, DNA, and molecular activity, there is the unseen world of the Spirit.  Important things are still happening in the spirit when the physical, mental and psychological functions may be destroyed or inactive.

   “Quality of life” cannot be properly assessed without the acknowledgment of the spiritual life and spiritual functions in the spiritual world.

   John’s spirit no longer clings to the useless earth-suit of his body.  His spirit has returned to God and his body has returned to dust. But he lingered long enough to deal with important spiritual matters, bring home his son, and teach me a great principle of life.