The diagnosis, "acute respiratory distress syndrome" (ARDS), the medical disorder that forms the backbone of this book, did not exist before the advent of new, life supporting medical technologies just a few years ago.

ARDS is an acute lung injury of such severity that mechanical ventilation is required to prevent imminent death from respiratory failure. For reasons that are still not well understood, many severe but otherwise seemingly unrelated conditions, including major trauma, pneumonia, complications of surgery and sepsis, sometimes lead down a common, final pathway to acute respiratory distress. Before the development of mechanical ventilators for long-term life support in the mid-1960s, everyone who developed respiratory failure from any of these conditions simply suffocated and died. Imagine the experience of the first doctors and nurses who discovered that some patients could recover from acute respiratory failure if ventilation and other vital bodily functions are supported by intensive medical care until healing can occur.

Over the past several decades since the first bold experiments with prolonged mechanical ventilation for respiratory failure, survival for victims of ARDS has improved dramatically. Today, more that 60% of adults afflicted by this devastating disorder recover and leave the hospital alive. Some require life support for only a few days and are able to return home in as little as 10 to 14 days. Others remain entirely dependent for survival on mechanical ventilation, intravenous medications, tube feedings and continuous nursing care for 2 to 3 months or longer. Most remember little or nothing of their experience in the hospital until rehabilitation is well underway. However, family members and close friends remember their crisis well. Survivors and family members alike remember the long, challenging struggle to regain physical and emotional independence after the acute phase of ARDS is over.

Stephen R. Yarnall, M.D., the author of Beyond Medicine, is a practicing cardiologist and is himself a survivor of severe, prolonged ARDS. Dr. Yarnall describes his own experience and that of others who survived ARDS, and some who did not survive. Several moving stories are told in the first person. From the perspective of patients and family members, Dr. Yarnall reveals the sources of strength that ordinary people can draw upon when faced with a catastrophic illness.

Beyond Medicine is for people who wonder what lessons can be learned from personal adversity and for all those who have survived and persevered after ARDS or other life-threatening illness. Families and friends of survivors and of the many who expire will also find information and comfort in Beyond Medicine.

• Preface
  • The answers keep changing
  • What is ARDS?
  • What are Medical Miracles?
  • What will I get from this book?
  
  
  
  • I ARDS My Near-Death Experience with ARDS
  
  
  
  • Beating the Odds in Reno - Days 1-34
  • Returning Home to Seattle - Days 35 - 55
  • Rehabilitation - "No Pain - No Gain" - Days 56-92
  • Home Care
  • Christmas Reflections 2000 - by Robert Yarnall
  
  
  
  • II Six Elements of Healing
  
  
  
  • Love - A Healing Force
  • Prayer - A Proven Element for Health and Healing
  • Touch - Without Which Life Ceases
  • Humor - How Humor Heals
  • Music - A Magical Medical Force
  • Pets - The Perfect Providers for Health and Healing
• III ARDS from different perspectives
  
  
• My Miracle Story by Meg Tapucol-Provo
  Addendum - Two Years Later
• From Crisis to Creation by Eileen Rubin Zacharias
  Addendum - Humor In Everything
• From ARDS to Lung Transplant List by Carrie Walker Bookless
  Addendum - Carrie's Views on God and Religion



• IV Inspiring Stories: We Live by the Stories We Tell



• Eric Gebelein - Pets and Wilderness as Healer
• Sheridan Alonzo - Memorial: Cherish Your Children
• Kathy Larson - Little Known Killer Can Strike Anyone
• Jeff Nicholson - Quadraplegic
• David Ross - "Diving Under The Wave"
• Dee Storey - Music, Touch, and Humor
• Katherine Blaydes - A "Three Month Nap"
• Christiane Solbach - ARDS Is An International Disease
• Sheri Martin - Do You Believe In Angels?
• Jack Yonts - Wisconsin Pastor Is A Living Miracle
• Jeanie Knecht - Dogs Defeat Death
• Shannon Kalisher - The Magic Of Music - And Brothers
• Michael Weglin - Suicide, ARDS, and New Life
• Sue Hart - For Everything There Is A Season
• Heather Favale - Triathlete In Spite of ARDS
• Courtney Ann Shelstad - Our Gift From God
• Gregory Fleckenstein - Music Man Survives ARDS 4 times



• V Conclusions and Implications for Health Care and YOU



• VI References

The Answers Keep Changing

Since antiquity, models of medicine have been evolving along a number of pathways. Each new stage is born from knowledge that was one step beyond the current medicine of the day. What is beyond medicine today may be more accepted as part of tomorrow's medicine. ARDS (Acute Respiratory Distress Syndrome) and other critical diseases may be affected by elements of healing often not accepted as part of current medical practice.

As a physician with ARDS I experienced healing forces often considered beyond medicine.



What is ARDS?

ARDS is a mysterious and devastating disease, formerly considered an "Adult" malady, but it affects children also. ARDS has a mortality rate of 30-50% and affects over 150,000 Americans each year. ARDS kills about 75,000 U.S. citizens yearly. About the same number of people die in automobile accidents each year and about the same number of women die from breast cancer each year, yet ARDS is largely unknown to most people and possibly to many doctors.

Prior to my illness, I knew ARDS as "Stiff lung disease" or "White-out of the lung" (based on the fluid in the lung making it opaque - white - on the Chest X-ray). As a practicing physician, I knew enough to call a Lung Specialist, and I knew that these patients usually died. As you will see, ARDS is more than a "Respiratory" disease. As indicated by the word "Syndrome," ARDS is several problems put together. I experienced almost all of those problems with ARDS, following a 30-foot fall from a ski lift on January 28, 2000. My survival against overwhelming odds was termed a "miracle".

So many people have called me a "Miracle Man" that I have finally come to understand what they mean: It is a miracle that I am alive and back in the practice of medicine. A miracle is an event that is extremely unlikely in a given circumstance.

What are "Medical Miracles?"

Since miracles are unpredictable outcomes, miracles are outside the scope of "Evidence-based medicine". Yet, careful observations and analysis of individual cases may lead to treatment guidelines for future patients and may generate testable hypotheses. If a miracle contradicts our understanding of natural laws we are challenged to examine and extend these "laws" - not to reject the miracle.

Where the doctors feel there is little or no chance of recovery, this may be due to lack of physician knowledge or lack of data. But when a patient has a good outcome after being given a "no chance" diagnosis, we may comfortably call this a miracle. Bernie Siegel, M.D. has written about exceptional cancer patients who have outcomes far better than predicted. It appears that miracles can happen in cancer, ARDS, or any disease. Perhaps the elements of healing beyond medicine are the same in all critical disease processes.

Miracles do not refute the laws of science but call us to look for new explanations beyond our current range of knowledge. Paradigm shifts in medicine start with awareness of observations that do not fit existing models.

More attention and studies should be directed at Love, Prayer, Touch, Humor, Music and Pets as separate but interacting elements of healing, which may, in some cases, lead to miracles.

I do not give myself credit for producing miracles, but, rather, see myself as the beneficiary of miracles. It is in that sense that I am a "Miracle Man."

What Will I Get From This Book?

BEYOND MEDICINE is relevant, interesting and meant to be read - not just filed for reference.

As a physician I must note that there are times when life is over for the brain-body as it has been, and a time comes for that person to move on. Hope at that point can be directed towards that Great Unknown which follows.

While recognizing that you may die prematurely in spite of the best medical care, BEYOND MEDICINE offers hopefulness not helplessness. This is NOT a book about the medical details of how to treat ARDS. It is a book about how families and friends can take action on behalf of their loved ones with ARDS or any life-threatening disease - heart, cancer, stroke or other. BEYOND MEDICINE is a book about helping miracles happen.

Through my experiences and those of others, you will learn methods and tools beyond medicine to help yourself and others in dealing with a medical crisis wherever you may encounter it.

BEYOND MEDICINE is meant to be as much fun for you to read as it was for me to write. I believe in the "Play Theory of Learning" - which believes changes in thinking, feeling and doing occur most effectively when the mind is in a playful mode. Just as children and pets learn from play, so do adults. I hope you enjoy experiences of "Ah Ha!" and "Ha Ha!" as well as "Ho Ho!" along with a few "Oh Oh's", examining your own life in relation to the stories. We learn and are motivated more from stories than from statistics.

Beyond the excellent Medical care I received, six elements of healing stand out in my ARDS experience: Love, Prayer, Humor, Touch, Music and Pets. There may be other elements for you and your family and friends when you encounter a crisis, as you surely will at some time in your life. These true stories give hope to all who are facing high odds against recovery. It has been said, "There are no hopeless situations - only situations where people give up hope."

Stephen R. Yarnall, M.D. Edmonds, Washington June 26,2002