National Geographic : 2016 Apr
52 national geographic • april 2016 people attending to Pérez actually felt. Todd Lovgren, co-leader of the medical team, knows the anguish of losing a daughter—he lost one too, the oldest of his five children, who would have been 12 years old had she lived. “It would have offended me not to treat Karla like a person,” he told me. “I saw a young woman with painted fingernails, her mom doing her hair, with warm hands and warm toes ... Whether her brain was still functional or not, I don’t think her humanity was gone.” Speaking as a parent rather than a clinician, Lovgren says he thought something of Pérez’s essence was still there in the bed—even though he knew, by the time of her second CT scan, that not only was her brain not functioning but large portions of it were dying off and peeling away. (Despite this, he hadn’t tested for the last of the three criteria of brain death, apnea, fearing that removing Pérez from the ventilator for even a few minutes might harm the fetus.) On February 18, ten days after Pérez’s stroke, it became clear that her blood wasn’t clotting normally—an indication that dead brain tissue was getting into her bloodstream, one more sign to Lovgren that “she was never going to recov- er.” By this time the fetus was 24 weeks old, so the team transferred Pérez from the main cam- pus back to Methodist Women’s, the maternity hospital. They managed to correct the clotting problem for the moment. But they were ready to do a C-section as soon as it became clear that it was time to let go, when even the semblance of a living person that their skills and instru- ments had patched together was beginning to fall apart. To Sam Parnia, death is potentially revers- ible. Cells inside our bodies don’t usually die when we die, he says; some cells and organs can remain viable for hours, maybe even days. The timing of the declaration of death is sometimes a matter of personal attitude, he says. When he was in training, he notes, people would stop CPR after just five to ten minutes, assuming that any longer would mean irreparable brain damage. But resuscitation scientists have learned ways to keep the brain and other organs from dying even after the heart stops. They know that lowering body temperature helps—which happened naturally with Gardell Martin, and which happens deliberately in some ERs that routinely chill patients before doing CPR. They know that persistence helps too, especially in hospitals that use machines to regulate chest compressions or that someday might use drugs such as iodide. Parnia compares resuscitation science to aeronautics. It never seemed possible for peo- ple to fly, yet in 1903 the Wright brothers flew. How incredible, he says, that it took only 66 years from that first, 12-second flight to a moon landing. He thinks such advances can happen in resuscitation science too. When it comes to reversing death, Parnia believes we’re still in the Kitty Hawk era. Yet doctors are already able to snatch life from death in stunning, inspiring ways. In Ne- braska that happened on April 4, 2015, the day before Easter, when a baby boy named Angel Pérez was born by C-section at Methodist Wom- en’s Hospital just before noon. Angel is alive today because doctors were able to keep his brain-dead mother’s body functioning for 54 days, long enough to let him grow into a small yet otherwise perfectly normal newborn, two pounds, 12.6 ounces, miraculous in his ordinari- ness. A baby who turned out to be the milagro his grandparents had been praying for. j At the start of this project photographer Lynn John- son connected with a friend whose mother, Phyllis, was dying. Find the family’s pow- erful story at ngm.com/more. What meaning do you hope readers find in their story? The intention of the project was to ask, How do you want to die? Because we’re all going to do it. This is how one woman and her family moved through that time. And they did so with a lot of tenderness and love, with an effort to help her be pain free and fear free.