So the crowd marveled as they saw the mute speaking, the crippled restored, and the lame walking, and the blind seeing; and they glorified the God of Israel
Matthew 15:31
Crystal Briggs doesn’t cry.
But she cried out of gratefulness after witnessing God’s Hand crafting a miracle in her hospital.
‘We have to try … she’s going to die if we don’t’
Dr. Yogish Kamath talked to himself while he sorted things out.
The best place to take Malori Maddox was UT Southwestern in Dallas – two hours away.
Not enough time.
They called the larger hospital in Wichita Falls, which had a better equipped trauma center.
That hospital would not take the transfer.
Blood from a nasty mess of rupturing blood vessels – a rare Arteriovenous Malformation or AVM – was pushing Malori’s brain to one side and causing swelling.
Her vomiting was caused by the brain pushing on the brain stem.
One of her pupils was dilated. If the brain continued to swell, it would compress both nerves controlling the pupil which would be a terminal event.
But Kell West Regional Hospital’s normal operating room crew was already gone early in the evening of Nov. 10, 2015.
The neurosurgeon raised his head and said “We have to try – she’s going to die if we don’t.”
Kamath showed Malori’s parents a scan of their daughter’s brain and how it had shifted seven millimeters.
He told them their daughter was nearing the point of no return in the next 15 minutes or so – she would die if they didn’t act now.
Malori’s mom Sarah was in tears and told Kamath, “Thank you for doing your best to save our daughter’s life. She’s a very special girl. We’ll be praying for you.”
Sarah also asked Crystal if she would let Kamath operate on her child.
“In a minute,” Crystal responded.
A gut feeling is accurate
Earlier, Crystal had stayed late for one patient to get out of surgery.
The patient was fine, but Kell West’s medisurg nurse manager had a gut feeling she should stay.
The charge nurse told her to go home, but Crystal said she didn’t feel right leaving yet. Shortly after that, she met Malori – and understood her gut feeling.
Malori had been taken for a CAT scan.
Crystal was not an expert in reading CAT scans, but even she knew something wasn’t right.
Kamath was changing clothes in the doctor’s lounge after five cases on his regular surgery day.
Crystal texted the doctor and told him they had an occipital bleed.
He got there in seconds, looked at the CAT scan and knew he wasn’t going home.
Nurse Susan Bailey was in a recovery room with a new employee. It was a fluke she was still there. She got a phone call asking her to get some Mannitol, used to reduce swelling of the brain.
Kell West’s pharmacy was not open, so Susan started running to ICU, where she could find some.
Most of Kell West’s regular operating room team had left, so Kamath got Briggs and Cindy Lane, emergency room nurse manager, and started with his makeshift team.
Cindy had allowed Malori’s parents to come in, lay hands on their daughter and pray. Crystal found Malori’s sister Maci in a triage room and let her join her parents. Prayers – and tears – flowed.
Makeshift team gets busy
Susan brought the Mannitol and joined the team, which now included Paula Lynn, the nurse anesthetist (CRNA).
When the brain swells, blood pressure goes haywire, the heart rate slows, breathing
For example – they couldn’t find Malori’s blood pressure.
Paula pumped six units of O negative blood into the Lubbock Christian University student athlete – there was no time to match. Later, they added two more cross-matched units.
She also inserted a breathing tube.
Susan inserted a catheter.
She put an IV into Malori’s left foot.
They needed to give her another IV but it was hard because her blood pressure was so low.
In addition to the Mannitol, they gave Malori Dopamine to help her blood pressure, steroids the stop the brain swelling and medications to prevent seizures.
The nurses also elevated her head.
The regular operating room staff had been called to come back.
But as they started working on Malori, there were very few people in the room.
Malori still had vomit on her from the frantic car ride from Midwestern State University, where her Lady Chap volleyball team had been playing.
Kamath told them how to put the bed together.
Kamath told Susan to go to specific shelves to get equipment because she didn’t work in the operating room. It was a different world to her, but she was impressed how organized it was and how Kamath knew exactly where everything was.
Crystal helped Kamath put the metal halo (Mayfield head frame) on Malori’s head to stabilize her before they opened her skull.
She had never done it before. When she was screwing bolts into Malori’s head she heard a pop and turned white. It was OK, though, and the color returned to her face.
Bit by bit, nurses and staff who normally assist in this type of procedure arrived to help.
Kamath took the skin covering Malori’s skull and folded it back. He removed one side of her skull. They needed to store it someplace safe, but if it was frozen it could get misplaced or contaminated. So Kamath cut into Malori’s abdomen and slipped it inside her abdominal wall underneath the skin for storage and retrieval at a later date.
Opening the skull kept the brain from finding its own way out of Malori’s head and relieved pressure on her brain stem.
Attacking the AVM
Once Kamath got into Malori’s head he started an hours-long process of trying to seal hundreds of the AVM’s bleeding branches – which resembled Medusa’s head from Greek mythology.
When the AVM burst, the growing pool of blood – the clot – needed to be removed first to create space in Malori’s hemorrhaging head and reduce her brain’s swelling.
As the clot grew, some of it started to coagulate to the consistency of grape jelly while some was freshly bleeding.
There was so much blood, Crystal thought it looked as if Malori’s brain was soaking in spaghetti sauce.
Kamath removed some of it with a suction catheter and the more solid pieces with a forceps.
He took it out piece by piece.
They filled a number of canisters with blood.
But he would not remove the intricate AVM – that would be another surgery.
Kamath knew removing an AVM is better when it could be planned following an angiogram which would give another doctor a road map of the vascular structures to have a better chance to remove it.
It was not optimum to do it in an emergency setting.
His job over the hours stretching past midnight into the early hours of Nov. 11 was to remove the blood, stop the swelling and shut down the AVM to keep Malori alive.
Shutting down the AVM was painstaking work.
The “branches” coming off Malori’s deadly AVM were not like regular blood vessels. They had spider-thin walls, broke easily and kept bleeding.
Kamath used an electric current, bipolar electrocautery, to seal them.
It took hours. But as Kamath attacked each of the hundreds of bleeding pieces he lost track of time.
It could have been two hours or four – he didn’t know and didn’t care.
He was focused.
And sometimes, he knew, you can’t stop the bleeding.
He knew there was a chance they may not get the volleyball player off the table alive.
As he worked, he thought Malori reminded him of his daughter, Ila, who was in junior high school. He thought if something ever happened to her he hoped someone would be there to save her life.
Tonight, though, he was churning through a laborious process of being another family’s savior – while that family waited nearby praying with all they could to their heavenly Savior.
An eerie peace
At one point, Crystal asked Kamath if it was going to be OK. He told her he hoped so.
Even though Kamath was not certain he could save Malori, his calm demeanor gave the Kell West nurses confidence.
Susan never had a doubt Malori would make it through the surgery – it was a gut feeling based on watching Kamath’s work over the years.
Cindy was used to a more chaotic scene in the ER. There was an eerie peace in the room all night – from when Kamath told the nurses how to put the bed together until they finished – as they worked on the beautiful girl with the long blonde hair asleep on the table.
Kamath was focused and in control.
At one point Cindy made a face. Kamath asked why. She told him Malori’s blood pressure had dropped, but they calmly dealt with it.
Malori was also cold, so they got blankets because a nurse’s number one priority is to keep the patient warm. Susan spent a couple of hours rubbing Malori’s feet because of all the nerve endings there, wondering if her toes hurt.
And she prayed for Malori – whose ponytail holder she now had on her wrist.
A gift for Malori’s mom
Before Kamath removed a chunk of Malori’s skull, they shaved off half of her trademark long blonde hair.
Susan thought Malori’s mom would want the hair. She put it in a baggie and gave it to Christie Hansard, a Kell West licensed social worker. She told Christie she needed to go back into the operating room, but asked the social worker to give the baggie to Sarah.
Christie took Sarah and Maci in a room and handed Sarah the baggie. Maci asked if it was for Locks of Love.
Sarah told her youngest daughter, “No – this is for me to hold my baby.”
Christie expected Sarah to lose control, but was surprised how calm she was.
Sarah then looked at Christie and said: “Her name is Malori, just pray and ask everybody you know to pray for her.”
Shortly after, Sarah took the baggie into a bathroom and started sobbing.
Bleeding stopped and hope can grow
As Kamath’s assault on the AVM went on, Christie gave the Maddoxes updates.
Again, she was surprised how calm and appreciative they were.
Diane Stewart, chief nursing officer, came to the waiting room occasionally to tell the Maddoxes that Malori was “holding her own.”
Her updates comforted Sarah, who kept watching for the door to open so they could hear Malori was still alive.
Ironically, Diane had taught a class at Midwestern State University that day on AVMs.
Sarah kept asking Crystal – who by now was in and out of the operating room – if it was going to be OK.
“I don’t know” was all the nurse could answer. She’d been in Sarah’s situation – not knowing if one of her children would get through a medical crisis.
She wanted to say something more hopeful but didn’t want to give false hope.
Malori’s dad Marray would ask questions in other ways and Sarah would talk about the future and recovery phase – but answers were not there yet.
Close to six hours after he started, Kamath’s battle against the AVM was done.
They did another CAT scan.
It looked satisfactory enough they could move her to Zale Lipshy University Hospital at the UT Southwestern Medical Center in Dallas.
Malori was moved to an ICU room at Kell West.
Kamath pulled Malori’s family in a room close to 2 a.m. and told them he’d stopped the bleeding but the next 72 hours would be critical.
Her age would help. There’s a big difference recovering from this if you’re 20 compared to 75 years old, he said, and if she could get past the next few days, she could do very well.
Kamath saw relief on the Maddox family’s faces.
Kamath told them they planned to fly Malori to Dallas in the next one to two hours.
Meanwhile, the nurses were surprised at the growing crowd in their hospital praying for Malori.
They had never seen that many people at Kell West. Even Cindy, who worked at bigger hospitals said she’d never seen anything like it.
One of those was Tyler Rogers, Lubbock Christian University basketball player and Malori’s boyfriend, who’d come from Lubbock once he got the news.
After a frantic drive, he was very upset.
Crystal approached him and asked if they could do anything for him.
Tyler explained who he was and wanted to know if he could have five minutes alone with his love. He told Crystal he had to get in there.
So they went to Malori’s room.
Tyler sat down, held Malori’s hand, prayed and read to her from his Bible. He trusted God the plans he hoped for them would still come true.
God was in control
Susan texted her family to tell them she’d be working late because a young girl came in with a brain bleed and wasn’t sure when she’d be home.
She asked them to pray.
She sent another text to women of faith at Kell West and implored “y’all start praying.”
Part of the calm that night for some was a sense the team that saved Malori was covered in an avalanche of prayer.
Crystal, who doesn’t cry, cried a lot on a night she and her colleagues felt God’s presence.
She saw people who should die and didn’t – or people who should not die and do. The only sense she could make of it was an overwhelming peace that God was in control.
It was nights like this that made it worth sometimes having to miss family things.
She’d heard about miracles and now she got to be part of one with Kell West’s “Miracle Mal.”
And, she felt, whether you were a Christian or not, you had to know a higher power was involved that night in Wichita Falls.
Pieces of the miracle
The Maddox family and many others believe they witnessed a miracle that Malori survived. Whether you believe it or not, it’s hard to ignore the things that happened. For instance:
- If Midwestern soccer coach Doug Elder had not recommended going to Kell West when the Maddoxes were putting Malori in their car, she would have not made it. The logical choice is the bigger hospital – but Kell West was the right choice.
- Kamath could have been in India and not be available to help Malori. His 76-year-old mother had fallen a day or two before and broke her hip. He debated taking the 26-hour trip to India for his mother’s surgery but figured he would not get there in time. While he was working on Malori’s AVM, his mother was also in surgery.
- If Crystal had not caught Kamath before he left, the extra 20-30 minutes it took him to return could have cost Malori her life.
- A CAT scan technician was about to go home and stayed to wait on his own in case he was needed. He was.
On to Dallas
Kamath stayed at the hospital until Malori was flown to Dallas because there could still be problems – a rebleed or other potential issues.
He slept in the doctors’ lounge.
As the clock got close to 4 a.m. on Nov. 11, Malori was taken to the plane.
Kamath saw she had started to open her eyes and nodding yes or no to questions.
It was significant improvement.
She still had the AVM in her head, but a growing army of people praying for her.
Devotional Questions
By Marray Maddox, Malori’s father
What do you do when you feel hopeless and afraid? And what does God want from us during these times? Dr. Kamath told us soon after arriving at Kell West Regional hospital with Malori that she may only have 15 minutes to live and needed immediate, emergency life-saving surgery. It was a time of horrific heart-wrenching fear and God-honoring faith. Immediately it was vital for Sarah, Maci and I and soon everyone’s heartfelt prayers for God’s healing hand while relying on and trusting in Him, His word and His awesome power to work through Dr. Kamath and his operating staff.
- Psalm 46:1 … “God is our refuge and strength, an ever-present help in time of need.”
- James 4:8 … “Come near to God and He will come near to you.”
- Psalm 62:6 … “Truly He is my rock and my salvation; He is my fortress, I will not be shaken.”
- Are we prepared for storms in our life? Having a daily relationship with God through prayer and reading His word daily gives all of us a foundation when those storms strike.
- Matthew 8:23-27 … “A furious storm came while Jesus and His disciples were in a boat on a lake. As the disciples panicked, Jesus questioned their faith and immediately calmed the storm. Jesus has the power to calm any storm in our life and He did that night in Wichita Falls and the following days and weeks.
- 2 Timothy 1:7 … “For God has not given us a spirit of fear, but of power, love and self control.”
- Matthew 19:26 … “Jesus looked at them and said, ‘With man this is impossible, but with God all things are possible.’”
- Do we look to God’s word for examples of healing, faith and trust in Him? Faith in the Lord in healing is so important as told in scripture.
- Luke 17:19 … “Jesus said to them ‘Rise and go; your faith has made you well.’”
- Matthew 17:20 … “Jesus said, ‘If you have faith as small as a mustard seed, you can say to this mountain, move and it will move. Nothing will be impossible for you.’”
- James 1:2-3 … “Consider it pure joy, my brothers and sisters, whenever you know that the testing of your faith produces perseverance.”
Prayer Recommendations
Always be thankful. … 1Thess 5:16-19 Ask God to be Spirit led every day. … James 4:8 Humble ourselves to God every day. … James 4:10 Trust and rely on the Lord every day. … Proverbs 3:5-6 Be prepared for storms in our life, know who calms the storm. … Matthew 8:23-27 Know that struggles bring us into a closer relationship with God. … Romans 8:28 Stay connected daily with God and every moment possible, spiritual nourishment everyday. … 1Peter 3:15 Stay positive, negative thoughts aren’t of God. … 2 Tim 1:7 Know that with God all things are possible. … Matthew 19:26