chapter 3
72 Hours
The doctors had spoken . . . and now we waited on God.
At last a medical assistant led Beth and me to a small conference room. The doctor wanted to speak with us privately. It seemed like hours before he arrived. After we exchanged a few courtesies, he pulled out an X-ray of the injured area at the base of Alex’s skull. No medical knowledge was needed to understand the hideous truth the darkened image revealed. Something in me could not accept that this was a picture of Alex’s spine. Instinctively, I glanced at the bottom left corner of the sheet: WILLIAM ALEXANDER MALARKEY. Those three words were so final, so unambiguous. Any thoughts that the situation might not be all that bad vanished.
The doctor moved across the room to a whiteboard. He sketched a normal spinal column and next to it a picture of Alex’s spine. It was easy to see what was wrong. The first vertebra below his skull had been pulled apart from the second and stood at a forty-five-degree angle.
Turning to us, the doctor began, “I must be frank with you. Alex’s situation is extremely serious. Injuries involving this spinal alignment virtually always result in death. In point of fact, Alex is presently being kept alive by artificial means. He does have a youthful constitution in his favor, but if he survives, the nature of these injuries will lead to certain outcomes, and it’s best to be realistic about them. Given the severity and height of the injury—which is to say its proximity to the base of the brain stem and the trauma sustained by the cerebral cortex—should Alex survive, normal brain function cannot be reasonably expected. Alex will never breathe on his own, and below the neck he will not move on his own. This injury will preclude Alex from swallowing food. He is presently receiving fluids intravenously, but if he survives, we will have to install a gastronomy tube, or G-tube, so he can receive nutrition directly into his stomach. And, finally, if he does survive, he will never be able to speak. I understand these are difficult things to hear. Truly I am sorry.”
G-tube, no normal brain function, paralyzed—my eyes fell to the floor, fixed in stunned disbelief. It was all so overwhelming it would have to be sifted through piece by piece, but the doctor had spoken. We would have to deal with it. The information was so horrific and the scale of it so massive that my mind went into numbed acceptance. I’d think more coherently about the details later.
Beth’s experience, informed by Dave in the parking lot, was completely different. She wasn’t having any of it. I was still looking at the floor when she spoke. Looking directly into the doctor’s eyes, she confidently spoke three simple words: “You are wrong.”
I inhaled sharply, thoroughly embarrassed. This doctor was the head of a team of top-notch surgeons, all of whom had reviewed Alex’s case. We were under the care of one of the best children’s trauma units in the country. Who was she to question them? I placed a hand on her arm, trying to get her to stop talking. She needed to sit back and accept reality, as I was doing. Beth pulled away from my touch. She had no intention of backing down.
+ + +
Trying to take in the scope of Alex’s injury was overwhelming. Like looking over the rail at the Grand Canyon, your mind is incapable of grasping the enormity of what you see.
It wasn’t explained to us until much later why, medically speaking, it was so unlikely that Alex would survive. He had suffered an internal decapitation—his skull was detached from his spinal column. Skin, muscle, and ligaments were holding his head on his body, but his spinal cord tendon sheath was severed.
Months later we received an X-ray from a medical professional taken more than an hour after the car accident. The X-ray was of the bottom portion of Alex’s skull and the top portion of his spinal cord. The X-ray clearly reveals Alex’s vertebrae detached from his head.
Not only was there no mention of this situation to either my wife or me, but there has never been a medical procedure to reattach his skull to his spinal column.
Kevin Malarkey
+ + +
“Alex is going to be fine. His health will be fully restored, and his story is going to have a national impact, bringing hope to thousands of people.”
Okay, I told myself, she is totally losing it. I looked at the doctor, confident of what he was thinking, although I have to hand it to him—he listened to Beth with an earnest concern, nodding his head sympathetically. There was not one thought in my mind about Alex helping others. I just wanted my boy to be okay. I wanted my own guilt to dissipate. I wanted my son to regain consciousness long enough for me to ask his forgiveness—a conversation I had already played over in my mind a thousand times since the accident a few hours earlier.
But Beth was just getting started.
“I know you don’t believe me, but he is going to get better, and I mean completely healthy.”
I sat back, helpless to stop the drama. The good doctor continued to nod respectfully. I was sure I could read his mind: Another poor woman in the grips of an irrational outburst brought on by shocking news she doesn’t want to be true . . . seen it thousands of times. It’s an opportunity for me to be gracious.
But I also knew the doctor was wrong, at least about Beth. She never becomes a refugee from reality in a crisis. She’s calm and clinical under the most intense pressure. Her words to the doctor were a confident proclamation, not mindless wishful thinking. It was as if she knew something the rest of us hadn’t been told. I certainly couldn’t see whatever miraculous future she had in view. All I could see was the X-ray and the horrendous prognosis that accompanied it.
“Just wait and see. It will be a medical phenomenon. Alex’s story will touch people all across this nation. It will give hope to people who have lost all hope.”
Whatever was in her, it wasn’t in me. The doctor finished listening and politely excused himself.
+ + +
What was happening now seemed so surreal. Memories emerged from deep places. I had written a poem for Alex months before he was born, parts of which seemed strangely relevant now:
Precious Child
There is so much I yearn to
Tell you
To teach you
To experience with you
For now, let me share some of my sorrows
You will be exposed to a world
Far different than the womb . . .
Blessed child
What I long to teach you most
Is where you come from
And where you might return . . .
Beth and I trusted God and believed, even before Alex was born, that God had a special life planned for him. Now, in the hush of the hospital, I had to face the end of those plans, at least on earth.
+ + +
When we returned to the waiting room, even more people had gathered. Some were talking and others were praying. We shared the news we had received from the doctors, and then all the people in the room held hands and began to pray. Many audible prayers were brought to the throne of God in this moment.
In fact, over those first dark days, we turned to God again and again. I don’t remember my own prayers or most of the others. But there was one prayer that pierced my darkness the day after the accident.
Our minister, Pastor Brown, had waited for everyone else to pray, and then, following a few moments of silence, he lifted up his voice: “Oh Lord, we know that Alex is with You, even now. The doctors have spoken. And now, Lord, we await Your word on the matter.”
Simple and powerful. Yes, what did God have to say on the matter of Alex? Pastor Brown’s prayer was a great comfort. Of course, nothing would happen outside of God’s supervision. I needed to hang on to that truth. And I did—for a short time.
+ + +
As Beth and I waited to see Alex that first day, in my mind, I was back at the day of Alex’s birth. Another hospital, a day of joy. I was beside Beth, but shielding my eyes from the cesarean surgery—I didn’t want to pass out. And then the indescribable moment when he entered our world. . . . The nurse cut the cord, looked over to me, and said, “Would you like to hold William Alexander?”
“Is that his name?”
Beth looked up at me. “Uh, Kevin, that’s the name we chose in case we had a boy—remember?” She smiled.
“Oh yeah, that’s right,” I agreed. “William Alexander, after my dad.”
+ + +
My father, Dr. William Malarkey, an endocrinologist and director of the Clinical Research Center at Ohio State University, was off lecturing somewhere in Europe. Had anyone notified him about the accident? As I sat in the waiting room, surrounded by praying friends and family, a new set of questions came at me like daggers.
If Alex dies, will I go to jail for vehicular homicide?
Did I hurt the people in the other car?
+ + +
I was speaking at a medical conference in Europe when the accident occurred. In fact, I was taking pictures of a boy who was a quadriplegic with a respirator in a wheelchair at a park in Paris. At the same time, thousands of miles away in Ohio, unknown to me, my grandson was on a MedFlight and would face a similar outcome. Every time I see a picture of the Eiffel Tower, I am reminded that I had just looked at its lighted outline when I received the phone call about the accident.
Dr. William Malarkey, Kevin’s father
+ + +
Are we going to lose our house?
Is Beth thinking, “I knew this would happen with Kevin because of all the chances he takes. If he had listened to me, none of this would have happened”?
Is everyone here and at the accident just being kind but really thinking what a rotten person I am—what a pathetic father Alex has?
That first day, fear, doubt, and self-loathing slid in and out of my mind—reasonable, under the circumstances, but also pointless and destructive. I knew these thoughts didn’t come from God—they were directly from my adversary, the devil. But knowing the truth about these things wasn’t enough. I was almost overcome by them. I had to fight against them. I had to reject the false voice and cling to the truth. I began holding on to the only hope I had: God loves me. God loves Alex. God loves Beth and our other children. God’s peace was there, available for me, but I had to receive it by rejecting the Accuser and listening to the Voice of Truth. I will listen to the Voice of Truth.
+ + +
Another memory came to me . . . a happy one. Alex was just a few days old, and to get him off to a proper start, I held him up to see Ohio Stadium.
“Hey, buddy,” I said, holding him face out, “that’s where the Buckeyes play football!”
Yes, I had planned this initiation rite well in advance. On check-in to the birthing center, just before Alex’s delivery, I had managed to secure the hospital room that afforded the best view of the stadium. Now, sitting in the hospital waiting room, I wondered, Why am I thinking about this now?
+ + +
At last a hospital worker arrived to lead us to Alex’s room. We were about to go into a very different hospital room from the one of my memory. I had never before been in an intensive care unit. Walking down the hall, I thought how strange it was that none of the rooms had doors. Only loosely hanging, shabby-looking drapes separated us from the many families and the trauma that engulfed them. For all their plainness, those drapes wielded tremendous power to shield passersby from the pain within each room. The hollow gaze of hopeless anguish flooded through the doorways with open drapes. The children I saw looked so sick, so distressed. Alex would look much different, I assured myself, much better.
When we rounded the corner and stepped into Alex’s room, I took a sharp breath. The scene was overwhelming. It was as if we had stepped into the command center in some diabolical war. Alex lay flaccid, eyes closed, on a bed in the center of the room. He was completely surrounded by a riot of monitors, wires, tubes, and endless medical paraphernalia. A ventilator conspicuously pumped air into his lungs.
Yet other than the obvious trauma points and the tubes running in and out of his body, he looked fairly normal, at least at first glance. Garish evidence of the accident was mercifully spare, just a few small scrapes and one deep gash held together by stitches.
A moment later, though, the icy fingers of fear once again encircled my heart—he looked . . . lifeless. How do you describe what it means to be a parent and to stand, helpless, over the broken body of your child? Yet in that very moment, something deep inside me believed Alex would survive—in what condition I dared not think. But from that moment on, an assurance that he would live took root, never to be dislodged.
Please, God, help our son.
+ + +
I remembered praying with Alex as he received Jesus as his Savior a few years before. He was so young, yet so sincere. What an awesome privilege! Alex knew he wanted to go to Heaven someday, and he grasped that he could not go simply by “being a good boy.” Heaven could not be earned like other things. Alex knew he needed someone else to pay the price for his sin—the wrong things he would do in his life—so that he could accept the gift of going to Heaven and being with God.
I have to admit, I did wonder about the sincerity of his faith. What can a child understand about the depths of faith at this age? Surely kids only mindlessly repeat the words and ideas adults feed them, without really understanding the truth.
A few weeks after Alex prayed to invite Jesus into his life, I put his faith to the test.
“Alex, does Jesus live in your heart?”
“No, Daddy.”
My heart sank. There it was, I thought. His prayer had been meaningless . . . but then Alex continued, “Jesus died for my sins, but He doesn’t live in my heart—He wouldn’t fit. The Holy Spirit is in my heart now.”
So Alex did understand—Jesus had died for his sins and left the Holy Spirit as His Comforter and Counselor. I learned my lesson then and there: a young child is able to grasp the things God wants him to know.
+ + +
Suddenly my consciousness was jerked back into the present. There was my precious son, lying in front of me. I took assurance from the fact that the Holy Spirit would be with Alex forever, but would God allow me to be with Alex again in this world?
What else was there to do but to cry out to God for mercy? We didn’t know it then, but even the best doctors are quick to admit they don’t understand these situations very well. I could do nothing but beg God for help.
Oh God, please forgive me for what I have done. Please let me apologize to Alex. Please protect him. Please comfort him. Please be his heavenly Father because his earthly father is completely helpless. I give You my son. I let go of him. He is Yours. Please help him from the top of his head to the bottom of his feet. I trust You, God. In Jesus’ name, amen.
Somehow in God’s mercy, my spirit was bathed in a new sense of calm at the end of that prayer. Had some kind of spiritual transfer occurred? My theology already settled the matter of God’s being in complete control of the situation. God had already wrapped His arms around Alex, but had something fundamentally changed in Heaven because of my prayer to completely release Alex to God . . . to let go of what I couldn’t hold on to anyway? Somehow, it seemed so.
Beth and I stayed and looked on our son in silence. How long, I don’t know. In the quietness, I slipped my arm around her, probably more for my comfort than for hers. The coma took Alex someplace we couldn’t reach him. I stared, wondering as my heart ached for my broken son. Little buddy, are you lonely? Are you scared? Do you want me to hold you? How desperately I want to hold you.
+ + +
I remembered how much Alex had loved church. We belonged to a casual-dress church. For the most part, people dressed comfortably, and kids wore school clothing. Not Alex. He decided he wanted to wear a suit to church. Even with Daddy in khakis and a dress shirt, even with a pastor who almost never wore a suit, Alex wanted to wear a suit. He has never been a go-along-with-the-crowd type. He never wore a suit anywhere else. He wanted to dress up for God.
And then I thought about another side of Alex—the one that spent as much time outdoors as possible. I remembered one day how deeply satisfied he looked as he walked barefoot in the back garden, crunching autumn leaves with his toes. “Daddy,” he asked, “don’t you just love the sound of the leaves under your feet?”
+ + +
At some point during our first evening at the hospital, we were ushered into a room designated for parents whose kids were in the ICU. Our other three children had gone to stay with some of our friends, and we soon found ourselves alone in bed, staring at the ceiling in silence. What had just happened to our lives? What would tomorrow bring? Would Alex make it through the night? Where was he, really? The accident had traumatized his body. The coma had taken him far away. When would he come back? Would he come back?
Oh God, we need You now . . .
In a fit of exhaustion, we slept.
+ + +
For the first week, Beth and I never even left the hospital; we weren’t interested in being anywhere else. At the same time, support came flowing in. The first group to assemble for help was made up of friends, family, and our church family, led by Pastor Brown. But soon the exponentially growing number of men and women around Alex and our family could only be described as an army.
Our children were with us virtually the entire time, but on those occasions when they weren’t, they were warmly loved and nurtured by friends or family. For instance, a few women took turns rocking, feeding, and changing our newborn whenever Beth couldn’t be with him. Someone organized the delivery of all our meals. Someone else organized the bringing of fresh clothes and the laundering of dirty clothes, as well as providing any personal items we needed. Errands were handled by someone else. So much food began appearing that there was a buffet line in the ICU waiting room at one point. It remained for days as people removed and replaced covered dishes as necessary. Get-well cards bearing notes, prayers, and Scripture verses flowed in until every square inch of Alex’s room was papered over with them. The doctors and nurses were dumbfounded and often commented that they had never seen such an outpouring of love.
A steady stream of godly men—elders, deacons, pastors, and lay leaders—along with many godly women arrived from every corner of the state. Common were the stories of people who “felt God tugging at their hearts to come.” One pastor drove two hours just to visit Alex. Since he arrived after visiting hours and wasn’t on the prearranged schedule, the hospital denied him admittance to Alex’s room. Undaunted, he drove home, only to turn around the next morning and drive back, spending most of the day praying over Alex. During those first few critical days, many local youth groups came as well, singing praise and worship songs in Alex’s room. At any given time, there were never fewer than five people in Alex’s room during visiting hours.
Within a short time, there were so many visitors that someone organized a visiting schedule to accommodate them all. Even more important, someone organized a night-watch prayer vigil in Alex’s room. Every two hours, someone was praying over Alex throughout the night—every night, for months. Many of these saints we never met. They were there serving God in obscurity, for His glory.
The ministry to Alex and our family engendered so much activity that the hospital had to organize itself, too, in order to handle all the traffic. Hospital staff printed up stacks of “Alex” passes with his name and room number. They told us that Alex typically had more visitors than the rest of the ICU patients combined, a situation the saints soon endeavored to remedy.
The prayer/visiting/blessing ministry that started with Alex soon fanned out to the other families in the ICU. In this God reserved a special blessing for Beth and me. We had been completely absorbed with Alex and his care—understandable, yes, but when we joined those who came to minister to Alex and went from room to room in the ICU to comfort others and to pray with them, God did something in our hearts. These firsthand encounters with other families experiencing deep trials were a poignant reminder in the midst of our own sorrow that there were many other people suffering just as much as we were. It helped us gain perspective, helped us to turn outward and see in a new light the blessings God was bestowing so abundantly on us.
If you were looking for good food and good Christian fellowship during that mid-November, there was no better place than Children’s Hospital and the ministry that grew up around Alex. We could never begin to appropriately thank the thousands who blessed us with their selfless giving. If there ever was a time when the church enveloped needy souls in arms of love, we experienced it.
Oh, and one more thing. That stack of unpaid bills overflowing my bill basket back home, which I had fretted so much about prior to the accident? It disappeared. I never got the chance to tape that God Will Provide sign on the side of it. A wonderful man whom I have always held in the highest regard made a quiet trip out to our empty house during that first week we were in the hospital. He took the entire basket and paid every bill to the last penny—an immense sum. But these things have a way of getting out. Thank you, God, for Your beautiful saints.
Two by Two
On the third day following the accident, there was an unexpected development. A nurse approached me and asked, “Mr. Malarkey, may I have a word with you in private?”
“Sure.”
We walked into the hall, and she began to speak, hesitated, and began again. “Uh, Mr. Malarkey . . . I know you’ll understand—I’m sure you’ll agree—from now on, we need to limit Alex’s visitors to no more than two people in his room at a time.”
“I certainly do understand, but I hope this didn’t come about because our friends have abused our visiting privileges. If so, I would like to apologize for—”
“Oh, no, sir! That’s not it at all, I . . . I promise,” she replied in haste. “Not that the numbers haven’t been overwhelming. But everyone has been very respectful of the hospital rules.”
“Oh, that’s good to hear. But then why the rule change?”
“Well,” she hesitated, searching for words with a side-glance, “it’s not a change, really—it’s just, well, a guideline we should be following.”
I nodded, but my mind raced to understand. At that very moment, there were twenty people on the waiting list in the lobby ready to go in, five at a time, to pray for Alex—just like the previous seventy-two hours. I rarely take things at face value, and this wasn’t making sense to me. Why was this policy so important today, if not yesterday or the day before? Clearly there was something she didn’t want to tell me. Then the light went on.
“The doctors just figured out that Alex is going to live, didn’t they?”
The nurse nodded, a little sheepishly, and then leaned in, assuming a confidential tone. “I’ve worked on this unit for twelve years. I have never seen a child survive the kind of injury your child sustained—never.”
Seventy-two hours had been the time frame the medical staff had stressed. They’d been watching the clock. The unit workers had not expected Alex to cross over into this day with a beating heart.
My heart leaped for joy as I hurried back to the lobby, gathered everyone there, and issued the new rule and explained its reason. A cheer went up, and everyone praised God. The visitors list was reorganized for groups of two. Once there, they could pray for as long as they felt the need—then they had to give their place to someone else. To help accommodate the steady stream of people, we agreed there would be no conversation in the room other than with God. Alex would have two people praying beside his bed at all times.
+ + +
As I sat by Alex one day that week, another memory surfaced. Just a few months before, Alex had actually caught air when riding on a local BMX course. He and I were at the top of the biggest hill on the course when I turned my head to see where Aaron had gone. In that instant, Alex launched down the giant hill. Although my emotions were doing a bungee jump as I watched him gain enormous speed, he actually stuck the landing! He had also learned how to do a flip one day on a friend’s trampoline. A few weeks later he was at the perfect location to execute the flip he had been practicing—the side of a swimming pool! He scared us to death, but again nailed the landing. Before the accident, Alex could be socially shy and sometimes clingy with his mommy and daddy; when it came to physical activities, however, he was fearless.
Now as I sat by my boy’s bedside, I couldn’t help but wonder, What would happen to him now? Would he ever have a chance to act with such fearlessness again?
+ + +
When Alex moves again, we are going to have a bike race.
Gracie Malarkey, Alex’s sister
+ + +
From Alex
Inside the Gates
I knew you before I formed you in your mother’s womb. Before you were born I set you apart and appointed you as my prophet to the nations.
Jeremiah 1:5
Heaven is not the next world; it is now.
Heaven is not up in the sky; it is everywhere and nowhere.
Heaven is a place that is not a place. It’s eternal. All other places end.
Heaven is a time with no past, present, or future . . . it is always now.
When I was in the car, I tried to move my legs. I realized that they would not move. I went through a light and I heard music.
Then I was in the presence of God. He had a body that was like a human body, but it was a lot bigger. I could only see up to His neck because, like the Bible says, nobody is allowed to see God’s face or that person will die. He had on a white robe that was very bright. I looked down at my legs, and I could move them again.
Even right now as I tell you this, I feel in my heart just like I did when it happened.
Everything was perfect.
My daddy told me about a man who wrote about spending time in Heaven. He had a bad car accident like me, and he went to Heaven and heard incredible music and saw glorious colors—like me. But this man saw people he had met in life who had talked to him about Jesus. When I was in Heaven right after the accident, I didn’t see any people, only God, Jesus, and angels.
But when I heard the story, I told my daddy that this man was not in Heaven.
My daddy was surprised. Daddy said that this man was a pastor and that he believed him. I told Daddy that the man’s story was true; it’s just that, technically (one of my new favorite words), the man stayed outside the gates of Heaven. Then my daddy told me that’s what the man says in the book!
I asked Daddy, “He didn’t see God or any angels, did he?” Daddy said that’s what the man said in his book. I also told Daddy he wasn’t there very long. Daddy said that was true; he was there only about an hour and a half. Daddy asked me how I knew that. It’s because he didn’t get to see much of the good stuff, I told him. All of the heavenly beings are inside the gate. God must have wanted him back to earth right away.
When I went to Heaven, I arrived on the inside of the gate. I was with heavenly beings, but the other people who came to Heaven were all on the outside of the gate.
The gate is really tall, and it’s white. It is very shiny, and it looks like it has scales like a fish.
I think of the things on the outside of the gate as an outer Heaven. I was in the inner Heaven, and everything is brighter and more intense on the inside of the gate.
There is a hole in outer Heaven. That hole goes to hell.
Later, my daddy asked me to tell him about other differences between the inside and outside of the gate, but I had to tell him that I am not allowed to share some things. God told me not to. I don’t know why; it’s just what He said. I asked my daddy if he was mad about this, but he just hugged me and told me that obeying God is more important than anything.
But I can say that inside the gate is the place God has prepared for us. It is brighter and more colorful. It is impossible to describe . . . it’s glorious!
The outside of the gates is like a waiting room. Things don’t move on the outside like they do on the inside. They move, but it’s not the same. I can’t describe it.
That other man who spent time in Heaven is right: the music is beautiful. He said it was like many songs at the same time—but sounding like one song. I didn’t think it was a bunch of songs at the same time, just very intense. It’s beautiful. I really liked the harps inside the gates. The music is nothing like music here. It is perfect!
Perfect is my favorite word for describing Heaven.