Opinion | Medical Miracles: When Patients Defy the Odds

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To the Editor:

Re “When Doctors Experience a Miracle,” by Daniela J. Lamas (Sunday Review, July 4):

For those of us who perhaps didn’t wait long enough for that so desired miracle to occur, reading Dr. Lamas’s piece reaffirmed what we always feared or wondered about. What if we had waited one more day, or one more hour or one more iota of a second? Would that miracle have happened?

Ultimately those left behind are often filled with the guilt and grief of always wondering: What if? And yet, for years I have had a life-affirming sticker on my desk that reads “Expect a Miracle.” And that’s not a bad idea.

Carrie Klein
Chapel Hill, N.C.

To the Editor:

While it is difficult to argue with Dr. Daniela Lamas being “more willing to push forward” in pursuit of the “one in a million” cure after the recovery of a catastrophically ill Covid patient, we cannot ignore the critical role of patient choice in medical practice.

As a hospice physician, I care for the other 999,999 patients — those devastated by non-beneficial I.C.U. care, and families horrified by the suffering of their loved ones. The right of patients and families to decide what their doctors should do based on facts delivered clearly and with compassion rightly drives the decision to “push forward” — or to end suffering despite a minuscule chance of survival — not doctors hoping for miracles.

Joseph Sacco
Branford, Conn.
The writer is chief medical officer at The Connecticut Hospice.

To the Editor:

Dr. Daniela Lamas discusses the unfortunately too rare occurrence when patients overcome the long odds of a deadly disease and find that their own health improves beyond a physician’s expectation. She calls this a miracle, although she insists that she is “not invoking the spiritual or supernatural.” Then why use the term miracle at all and not something more appropriate like an unexpected outcome?

I am not playing a game of semantics. Rather, I think that employing fantastical language illustrates the fact that many doctors forget that they are practitioners of incomplete knowledge that is given to them. Science has provided physicians many insights into the amazing complexity of the human body, but like any science, it is incomplete and always evolving. When things happen outside their level of understanding, physicians only mislead patients by invoking magical language to cover for these gaps in their knowledge.

David J. Mogul
Chicago
The writer is a professor of biomedical engineering at the Illinois Institute of Technology.

To the Editor:

Dr. Daniela Lamas is quick to discount metaphysical intervention in a seemingly miraculous cure. Yet faith does play a role for the patient, family members and the medical profession. Over these Covid months I have visited I.C.U.s numerous times. My collaboration with staff in dealing with the critically ill has brought comfort and peace to many. Yes, we prayed for miracles, and there were a few medically unexplainable cures. God? I’d like to think so!

The aid of religion in guiding correct ethical choices for the sick person is invaluable. When a decision is made to end futile care, there is a moment when trust unites all involved, recognizing that the outcome is out of our hands.

(Rev.) Michael P. Orsi
Naples, Fla.

To the Editor:

Dr. Daniela Lamas writes with much openness about the possibility of miracles. She asks how we deal with the “the one-in-a-million outcomes, the patients who surprise and humble us.”

As a pediatrician caring for children with special needs, I am a firm believer in miracles that come my way. And how do I deal with it? Always with surprise, awe and then much humility and gratitude when I realize what has happened.

Do my patients with autism or intellectual disability suddenly wake up one morning and find themselves free of the condition? Hardly. The miracle occurs when parents of the children I am caring for, who are burdened with years of grief, broken hopes and dreams for their child, one day, finally, come to accept and embrace their child for who they are. A precious and beloved child with infinite possibilities of finding hope, meaning and purpose in their lives.

Jennifer Kiing
Singapore
The writer is clinical director of the Child Development Unit at the National University Hospital in Singapore.

A National Code for High-Rise Buildings

To the Editor:

We need a national high-rise maintenance code.

The head scratching about the collapse of the Surfside high-rise building will go on for a long time. What cannot wait is adequate maintenance of the many thousands of aging high-rise structures in this country. From what we know so far about why this collapse happened, there were major problems with the structural soundness of the building due to age and perhaps a flawed design.

Condo boards are often ill equipped and even unwilling to make necessary decisions on the substance and financing of repairs. Issues such as soil conditions, wind gusts, potential earthquakes and salty humidity play a crucial role.

A national code is necessary to enforce minimum standards of maintenance and financing. It is more important than ever because many of these structures are financed and owned fully or in part by people and companies that are not local and may not be fully aware of the conditions on the site.

We have a nationwide issue that affects all of us when buildings are unsound and precious resources of public disaster relief are required to take care of essentially private obligations.

Kurt Brandle
Ann Arbor, Mich.
The writer is professor emeritus of architecture at the University of Michigan.

How the 1967 March on the Pentagon Wasn’t Like the Capitol Riot

To the Editor:

Re “Inside the Capitol Riot: An Exclusive Video Investigation” (nytimes.com, June 30):

Thank you for the altogether scary video of the Jan. 6 insurrection. As one who was part of a contingent interested in breaking into the Pentagon in 1967, I could not help but compare.

We aimed at the seat of war, not of democratic government. We did not call for hanging Lyndon B. Johnson or Robert McNamara but for stopping the American attacks on Vietnam. We (mostly) were not interested in fighting the cops; in fact, when we were blocked, we sat down and did a lot of singing through the night and talking to the soldiers.

And we were not naïve like the Jan. 6 bullies in thinking that armed violence would push Liar Trump back into office. We spoke our truth to power, even if it took many years and deaths to be heard.

Paul Lauter
Leonia, N.J.
The writer is the author of “Our Sixties: An Activist’s History.”

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