Dr. Francis Collins
I really enjoyed working with Dr. Francis Collins on his story for my book, Sixty Seconds: One Moment Changes Everything. He was very down to earth and authentic. Considering his pedigree and position, I was impressed by his casual assumption in his very first e-mail to me that we should be on a first-name basis. Here is his bio and an abridged excerpt from his story about his work at a small mission hospital in Nigeria.
Dr. Collins, one of the country’s leading geneticists, is the author of the New York Times bestseller, The Language of God: A Scientist Presents Evidence for Belief. From 1993 to 2008, he headed up the Human Genome Project as director of the National Human Genome Research Institute. Prior to that, Dr. Collins helped to discover the genetic misspellings that cause cystic fibrosis, neurofibromatosis, and Huntington’s disease. Working on the cutting edge of the study of DNA, the code of life, he has personally discovered some of the scientific evidence for the common descent of all living creatures. For more information, visit www.genome.gov.
Four or five days went by. I took care of a myriad of problems, helping some patients, not knowing what to do with others, but generally having the sense that whatever I did was only putting a finger in the dike of what ultimately would be a disaster for most of these people. It was discouraging, knowing that many of them would go back to the same environment that had been the cause of their illness, only to be stricken by something else.
Then a young farmer came to the clinic, brought by his family, with a very puzzling illness. In the previous couple of weeks, his legs had gradually swollen to twice their normal size. He was weak, almost unable to stand, and appeared very seriously ill. In examining him, I took his pulse, and a startling revelation was immediately apparent. His pulse, while palpable when he was breathing out, disappeared entirely when he took a breath in.
Though I had never observed this classic physical sign so dramatically demonstrated, I recalled that years before, as part of my medical training, I was taught that if someone’s blood pressure goes down significantly when they take a breath in, that’s something important to pay attention to. It’s called a “paradoxical pulse.” And I recalled, although I had to remind myself by quickly looking this up in my old medical manual, that this was usually an indication of fluid in the pericardial sac around the heart. That’s a very dangerous condition, because if that fluid builds up to a large extent, it keeps the heart from being able to relax as it needs to do between each heartbeat so that it can receive blood from the veins and then pump it out again. This all began to make sense, because that would be a very good reason why this young man’s legs would be so grossly swollen—the blood was pooling in his legs because his heart couldn’t expand to receive it.
I really felt in a terribly difficult spot. I wasn’t absolutely sure of the diagnosis, and could tell that this young man was severely ill and likely to go downhill quickly if nothing was done, yet I had never done this procedure myself. And I knew that the procedure had to be done under the most careful kind of guidance, because a misplacement of the needle, and the nicking of the heart muscle itself, could be immediately fatal.
This was a scary procedure. To be explicit, you place a large bore needle directly under the sternum, aim for the left shoulder and advance the needle slowly, hoping that what you will draw off is the fluid around the heart and not the heart’s blood, in which case you know you’ve gone too far and you may have just killed your patient. In the developed world, such a procedure would be done only by a highly trained interventional cardiologist, guided by an ultrasound machine.
The young man understood what I was doing and was remarkably peaceful about it. He knew the procedure was risky, but urged me to proceed. And so, with my heart in my throat and a prayer on my lips, I inserted the needle just under his sternum and began advancing it. To my great distress, I saw the syringe fill with dark, red fluid. I was immediately concerned that I had gone too far, that my diagnosis was wrong, that I had essentially impaled this young man’s heart.
But he seemed to be all right. I remembered that one of the conditions that would be most likely to cause his problem, namely tuberculosis, was capable of causing not just fluid around the heart, but bloody fluid. So I squirted the fluid from the syringe into a pan and waited to see if it would clot. It did not. That meant it wasn’t blood. Relieved, I continued to drain almost a quart of this fluid.
I removed the needle. Over the course of the next few hours I watched my patient carefully, hoping that I had not induced some bad outcome. In fact, his improvement was dramatic. His paradoxical pulse disappeared almost at once, and over the next twenty-four hours, the swelling of his legs rapidly improved.
So finally, after many days of feeling gloomy and disappointed in myself and in the whole Nigerian experience, I felt at least briefly exhilarated that something had happened here that was providing some benefit. But that feeling was short-lived. The next morning I woke up, again surrounded by the intensely needy environment of this hospital, feeling the oppressive equatorial heat, knowing there would be hundreds of patients for me to take care of that day.
With the same old weight of discouragement settling in on me again, I went about my daily rounds. After an hour or so, I came to the bedside of the young farmer. He was sitting up, looking surprisingly well, and reading his Bible. He spoke English quite well, as many in Nigeria do. I asked him how he was doing, and he described his situation in positive terms.
Then he looked at me quizzically and said, “I get the feeling that you’re new around here.” I was surprised by that. Maybe I should have explained to him previously just how new I was, and that I basically had done a risky procedure on him that I really was not trained to do. I had not told him that, but he seemed to have figured it out anyway. That actually irritated me a little bit; I had wanted to come across as a very experienced, knowledgeable physician, and I didn’t think it was so obvious that I wasn’t. So, yes, I admitted that I had only been there a few days.
But he didn’t stop there. He said, “You know, I get the sense that you are wondering why you came here.” That really took me aback. How did he know? And then the words came out of his mouth that will stay with me for the rest of my life. He said, “I have an answer for you. You came here for one reason. You came here for me.”
I was speechless. The tears welled up in my eyes. I had the sense that, while this was a young Nigerian farmer speaking to me, about as different from me in culture, experience, and ancestry as any two humans could be, it was really God speaking to me, reminding me that what life is all about is one person at a time trying to reach out and help somebody who needs it. I had plunged a needle close to his heart; his words directly impaled mine.
ABOUT PHIL BOLSTA
Phil is the author of Sixty Seconds: One Moment Changes Everything, a collection of 45 inspiring, life-changing stories from prominent people he interviewed, including Joan Borysenko, Deepak Chopra, geneticist Dr. Francis Collins, acclaimed sportswriter Frank Deford, Dr. Larry Dossey, Wayne Dyer, Dan Millman, Caroline Myss, Dr. Christiane Northrup, Dr. Dean Ornish, Dr. Rachel Naomi Remen, Dr. Bernie Siegel, James Van Praagh, singer Billy Vera, Doreen Virtue, Neale Donald Walsch, and bassist Victor Wooten.
Here is a three-minute video that introduces you to Phil and his book. Click here to buy Sixty Seconds. Click here to ask Phil to add you to his e-mail list for updates on his blog and books.
Reading this book is like spending a few minutes face to face with each of the contributors and listening to their personal stories. Click here to read unsolicited testimonials from readers. Learn more by visiting the official Sixty Seconds website.
Sixty Seconds was one of three finalists in the General Interest/How-To category at the 12th annual Visionary Awards presented by COVR (Coalition of Visionary Resources) in Denver on June 27, 2009.
Tags: Francis Collins, Human Genome Project, Nigeria, spiritual
