Coma

I was born into a Roman Catholic family. We went to mass on religious holidays, had weddings and funerals officiated by priests, and prayed before meals at family gatherings. Like most of the other kids I knew, I was baptized, attended Catholic school from K-12, and celebrated my First Holy Communion, Confirmation, and Confession. I read the Bible, completed the mandatory Religious Studies in each grade, and memorized the Lord’s Prayer and the Hail Mary. In my child’s mind, God was a mysterious and powerful figure who watched over me (which was simultaneously comforting and frightening), Heaven was an ethereal idea of the wonderful place waiting for me when I die, and Hell was the terrifying end I would experience if I had been a bad person. In my teens, I learned about other religions of the world, and my perspectives on spirituality expanded and evolved. While I did not doubt the existence of a Higher Power and the possibility of life after the death of my physical body, I began to question the contradictions and circular logic within the religion I had grown up in. As a result, I abandoned Catholicism, and became Agnostic for many years. In my late 20s, I discovered Paganism. This earth-based faith, with its triple aspect female deity and her male consort, supported the values and ideals I had developed over the years, and I embraced its practices and celebrated its holidays with enthusiasm throughout the following decade. But a few months after my 38th birthday, my life took an unexpected turn, and my attitude about spirituality did an about-face. After a series of vaccines, I developed a rare neurological autoimmune illness that hospitalized me for 18 months. As a result, my spiritual peace of mind came to an abrupt end, and I have been living (perhaps even struggling) with its absence for the last 12 years. The illness and rehabilitation process was the most terrifying, depressing, traumatizing chapter of my life, and not once did I experience the support of a higher power or any indication of an existence beyond the physical realm. Did I pray? You bet I did! I prayed in earnest. I begged. I raged. I tearfully pleaded for relief from the pain, fear, and loneliness I was enduring. When I didn’t receive a response from the Goddess of my Pagan faith, I reached out to the God of my childhood. Sometimes I prayed for healing, sometimes for guidance, sometimes even for death. I received no reply. Twice, while I was in the six-week coma, I teetered on the brink of death, but I was completely unaware of it. There was no tunnel, no white light, no passed loved ones coming to greet me, and certainly no godly entity welcoming me to an eternally peaceful plane of existence. There was nothing. Just a blank space where time continued to march on without me. I was certain that such a sudden and traumatic event should elicit some sort of spiritual experience or divine intervention. When it didn’t, I felt disillusioned and slightly betrayed. I had spent so many years having faith in a higher power, but when I needed them the most, they were nowhere to be found. I came to the conclusion that it must be because no such entity exists, and there is no realm beyond death; when we die, we simply cease to exist. I have shared my feelings and conclusions with many different people, and it has been met with a variety of reactions, from sorrow for my “loss” to outright judgment of my “attitude.” I have been given advice on how to find God again, and heard all the vague explanations and platitudes: “Everything happens for a reason.” “God only gives you what you’re strong enough to handle.” “Maybe there is a lesson in this that you’re supposed to learn.” “God works in mysterious ways.” “God always has a plan.” But none of these have been helpful to me in coming to terms with my experiences versus my expectations. In fact, many times, they have only created more questions. My husband once said, “You can pray as much as you want, but sometimes the answer is ‘no.’” My response to this was, “But why?” Why would a benevolent, loving, compassionate god not want to help if it’s within their power to do so? Why would they stand aside and allow such intense suffering to continue? And if there is some divine purpose for it, why wouldn’t they at least offer a guiding hand? It made no sense to me. The alternative was much more logical. It was even somewhat comforting to imagine that death was like falling into a dreamless sleep, where all my pain and worry would simply wink out of existence. So I’ve spent the last 12 years denying the need for spiritual practice, and viewing life and death in much more “realistic” scientific terms. Recently, however, I have found myself revisiting the possibility of a higher power and life after death. My husband passed away from liver cancer two months ago. He had a lifelong faith in God and Christ, and was always curious (even sometimes excited) about what his existence would be like after his death. He loved astronomy and absorbed every bit of new information about space and the latest scientific discoveries. He often said that he hoped, when he died, that God would let him fly around and explore the universe. I miss him terribly, and often talk to him, hoping he is listening. The possibility that he no longer exists is deeply disturbing to me. I cannot stand the thought that he might not have gotten his wish for his afterlife. And the idea that I will never see him again fills me with a profound sadness. The dichotomy of believing there is no existence beyond death and hoping my husband still exists somewhere created an eddy of uncertainty that has sparked a whole new conversation with myself. So, once again, I am allowing myself to explore the possibility that there is more to life and death than science can explain. I am only human, after all, with knowledge and perspectives limited to my existence on this plane, in this reality, in this physical vessel. Absence of evidence is not evidence of absence. Who am I to say what other possibilities and realities exist? I have no idea where this new openness will carry me, but I must admit that releasing my anger at god(s) and resistance to spirituality has calmed a simmering tension, and created a budding sense of calm. Most importantly, it has reminded me that spirituality is deeply personal, and is impacted by our experiences and circumstances. No one has all the answers, and no one alive knows what exists beyond this physical realm. There is no “right” answer, no step-by-step guide to attaining enlightenment. Every journey is valid, regardless of what you believe and where you are on that journey. If, like me, you have struggled with spirituality, be gentle with yourself. Allow your thoughts and feelings to evolve in whatever way feels right to you, and don’t let anyone convince you that you’re wrong. You don’t have all the answers, and neither do they.

When my sister and I were children, my mother would put fluoride in our milk every morning, made sure we brushed our teeth twice a day, and took us for regular dental checkups and cleaning. Throughout my teens and adulthood, I remained diligent about my dental health, and aside from rebuilding a broken front tooth and two years of braces, had no dental work whatsoever. Not a single cavity in 40 years (which, apparently, is very unusual). But that all drastically changed in my 40s. In 2009, as a result of a rare neurological autoimmune illness, I was hospitalized and mostly bed-confined for 18 months. During my hospitalization, I received no oral health care that I can remember. When my mouth was dry, I was allowed to suck on a small, moistened sponge on a stick. Much later, I was permitted to chew ice chips, and suck the resulting water from my mouth with my suction wand. Near the end, after I had the tracheostomy removed, I relearned how to swallow and was finally able to eat and drink by mouth again. Never once, in the year and a half I was hospitalized, was my mouth cleaned or my teeth brushed. My oral health was completely overlooked. Under the circumstances, I imagine it was probably the last thing anyone was thinking about, including myself. But I wish it had been included in my daily care. It would have saved me a whole lot of discomfort, time, and money in the future. Some time after I left the hospital, I was finally able to see a dentist for a cleaning and check-up. The cleaning took an extraordinarily long time, and I grew more uncomfortable with each passing minute. I struggled to hold my mouth open and body still as the hygienist scraped and polished away years of plaque and tartar build-up. Afterward, the dentist looked at the x-rays and examined my teeth, then delivered the news: I required five fillings, and was going to need a root canal in one of my molars. For someone who had never had a cavity, this was quite a shock. I went ahead and booked the appointments to have the work done, and began following all the dentist’s recommendations to prevent further dental issues. Little did I know that this was only the first of many more issues to come. As the years marched on, despite my best efforts to maintain excellent oral hygiene, my teeth continued to deteriorate. I spent several years returning again and again to the dentist’s chair, wading through the red tape of funding, and often draining my already meager bank account. Today, I have 15 fillings, five root canals, five crowns, one implant, and I’m still waiting for funding approval for two more crowns. My husband’s dental insurance is pretty good, and the Ministry covers up to a certain amount per year. However, dental work is expensive, and many procedures (like crowns) are not fully covered, and some are not covered at all (like implants). So why did this happen? Tooth decay isn’t often noticeable right away. It can take some time before it is identified, and an improvement in oral care can prevent further decay, but does not reverse the damage that has begun. This is why I kept returning to the dentist for years after I left the hospital. There are many reasons for dental health issues, but the three main reasons people who have been hospitalized for an extended time develop tooth decay are dry mouth, inadequate cleaning, and medications. Dry mouth: The number one reason why long-term hospital patients develop dental issues is dry mouth. There are multiple reasons why a patient develops dry mouth, including ventilation, open-mouth breathing, brain injury, and disease. Saliva is an important component of oral health. Saliva provides a natural defense against acid erosion by neutralizing acids within the mouth, washing away food debris, and restoring minerals to the teeth. Decreased saliva production often leads to tooth decay and gum disease. Inadequate cleaning: When a patient is in the ICU and medical staff are fighting to keep them alive, oral health care is the lowest concern on the priority list. Issues such as lack of consciousness, intubation, ventilation, seizures, etc. prevent oral care from being performed. But even when the patient stabilizes and begins to recover, oral care is often overlooked. It is simply not included in the procedure that nurses and hospital aides follow in caring for patients. It wasn’t until I left the hospital and entered rehab that dental hygiene became part of my daily routine again. Medication: Some medications may have a direct impact on dental health by causing inflammation, infection, enamel erosion, or bone problems. Many medications, however, impact dental health indirectly through the side effect of dry mouth which, as I explained earlier, is a common cause of tooth decay. The fact that dental care is separate from health care is a mystery to me. Our mouths are a part of our body, and our oral health can impact our physical health. Gum disease is linked to a host of illnesses including heart disease, diabetes, respiratory disease, osteoporosis, and rheumatoid arthritis. Here in Canada, the importance of dental health and its link to overall wellness is becoming recognized, and there is a push for universal dental care. Until that happens, if you have a loved one in medical care, make sure oral hygiene is a part of their regular routine. They (and their wallets) will thank you!