Then Came Heaven

By Gilda Arruda

Then Came Heaven: A memoir, is a source of inspiration and guidance; it serves as a loving example of what it means to live no matter where the truth may lead you or how difficult it may be. It is also a lesson on the patience of change. Each page is the embodiment of hope, trust, knowledge, and self-acceptance to develop a sense of worth within ourselves.

Judy’s odyssey to find peace led her through many stages of not only seeing but sharing her vision of Divinity, adding color to our own vision of God. Her story allows us to pause and reflect on our thoughts to find a new perspective on the anger and pain that can reach the deepest part of our soul. Through the lessons of Judy’s experiences we can ask for forgiveness and to be forgiven in order to find our own peace.

• Language: English
• Publisher: Write Words Inc.
• Release date: Jun 6, 2015
• ISBN: 9781613863237

Gilda Arruda

Gilda Arruda is an author, inspirational speaker, and free-lance writer. She has written five books, including A Boy and his Music, a children’s book based on the life of Joseph Raposo, composer and cofounder of Sesame Street; Amor Proibido-Forbidden Love, a Portuguese historical romance; and Dr. Irving Fradkin-Words to Ignite The American Dream, a book based on the work of Dr.Irving Fradkin and Dollars for Scholars/ScholarshipAmerica.She has also written for Sibyl magazine as well asmany local and regional newspapers and is a member of VOWW (Voices of Women Worldwide).

Book preview

Then Came Heaven

by Gilda Arruda

© 2015 Gilda Arruda. All Rights Reserved

First Electronic Edition, June, 2015

Published at Smashwords by Write Words, Inc.

ISBN 978-1-61386-323-7

Dedication

With a loving heart I dedicate this book to my sister, Judith Almeida. Judy revealed her spirit of unconditional love. While overcoming her own personal struggles of faith and fate she gained a depth of insight and built levels of courage and trust to share with others.

Chapter 1

Symptoms

Judith Almeida, my older sister by three years, had been fighting an apparent cold for three weeks. I was becoming concerned that her symptoms, pronounced pallor, general weakness, and a persistent, painful cough, had not improved, but were worsening. I had been attempting without success to convince her to go to a doctor. Because of her asthma, we had been down this road before. Judy’s next action would start us down a new road, one on which her choice of paths would prove to be increasingly limited.

Judy coughed into a tissue, glanced at it, and attempted to discard it. Prompted by a combination of long years of instinct, and a sudden conviction that there was something furtive about Judy’s manner, I intercepted it. Upon examination, the tissue proved to contain greenish, blood-tinged sputum.

Deeply alarmed, I brandished the tissue at her and said, My god, Judy! How long have you known about this?

Defeated, Judy slumped wearily down into the couch and said, A few days. The dismissive hand gesture with which she accompanied these words was not enough to disguise the fear in her voice when she then whispered, I think I have tuberculosis.

Because one of our uncles, who had lived with us, had tuberculosis it was entirely logical that Judy would come to this conclusion.

My first thought was that Judy had a bad pneumonia, although, looking back, it is likely that we thought of tuberculosis or pneumonia to avoid other, darker thoughts. Now that some of Judy’s fears were out in the open, she finally agreed to let me schedule an appointment with the doctor. As a medical assistant for a group of doctors, I arranged for Judy to be seen by one of the doctors I worked for. I was relieved that my sister was going to get the medical treatment that she needed.

On a cold November day, I saw Judy in my professional capacity for the first time. Despite the worsening of her symptoms, Judy refused my offer of a ride, instead insisting on driving herself to the doctor’s office. Her independence proved to be costly: By the time she arrived at the office she was so worn down and out of breath that she was unable to even answer the standard questions posed by the receptionist.

Having overheard her arrival, I interrupted my routine to provide the necessary information and to get her settled into an exam room. Judy, even in her distressed look, still managed to look beautiful. Her long, silky black hair shimmered under the overhead light. Her soft brown eyes spoke for her when her voice, interrupted by cough, failed her. 

Getting her settled proved to require more effort than expected, even with her petite frame, as Judy’s pain, weakness, and constant coughing made it impossible for her to undress herself. I dressed her in a gown myself, and was about to return to my routine when Dr. Primo entered.

After dispensing with formalities and standard questions, onset, nature, duration, and severity of symptoms, he listened to Judy’s lungs and asked her to take several deep breaths. At that time Judy found deep respiration so intensely painful that Dr. Primo was unable to adequately complete his examination.

Noticing her discomfort, the doctor abruptly terminated the examination, turned to me, and said, I’m going to send her for a chest X-ray with a wet reading. As he was leaving the room he told me that I could take her myself, and said that he would like Judy to be transported in a wheelchair.

This was how the first phase of Judy’s first appointment ended. The doctor left to tend to his other patients, while I remained in the room to dress my sister.

As it turned out I was not the one to transport Judy after all. By the time I had gotten Judy ready to go, and begged her, despite her objections, to accept the wheelchair transport, I had accumulated too great a patient backlog to allow me to go with her, so one of my coworkers transported Judy.

I processed several patients more briskly than usual for me, because my mind was elsewhere. To be specific, my mind was across the street at the hospital where Judy was being X-rayed.

I had progressed from worry to actual fear. Although the doctor had said little, some of his instructions were sufficiently unusual to warrant grave concern. First, the doctor had stipulated that the X-ray was to be a wet reading.

By wet reading, the doctor meant that the X-ray was to be read immediately upon development by a radiologist, whereas other X-rays are often read at the close of the business day on which they were taken. Because the X-ray facilities within our building were staffed by an X-ray technician, but not a radiologist, the hospital trip was mandatory.

Second, his preference that Judy be transported by wheelchair meant that he was skeptical of her ability to even make the trip across one street under her own power. This combination of insistence on an immediate reading, with such a dismal assessment of my sister’s physical capacity, brought to my conscious mind thoughts that had been either absent, or mercifully subconscious. Suddenly, the dark thing that waited was many steps closer. In a short time, we would see its face and know its name.

I was so preoccupied with these thoughts and fears that Judy had come back to the office and been settled into one of the exam rooms before I even knew she had left the hospital. Immediately after this realization, I noticed another unexpected fact. The doctor was already on the phone with the radiologist. Understanding that the diagnosis was imminent, I hurried to Judy’s room to be there for her when it came. It was fortunate that I decided to hurry. I entered the room seconds ahead of the doctor.

Upon entering, I quickly stepped aside to allow Dr. Primo’s imposing form to enter the room. Shaking his head with a sorrowful look, he leaned on his desk and began to speak directly to Judy.

The radiologist’s interpretation is an infiltrate of the right upper lobe. I have to be honest with you—I have some doubts. Usually pneumonia is much lower in the lobe, but I will treat you with an antibiotic and cough suppressant. If there is no improvement or your symptoms become worse, we will have to consider a bronchoscopy. With a family history of exposure to TB, we will have to rule it out, as well as cancer of the lung.

I felt as though Dr. Primo had just set off a bomb in the room. The diagnosis itself was cause for concern, but his doubts, and the alternate diagnosis he was trying to avoid discussing, were absolutely terrifying. He had mentioned cancer almost in passing, but I could see that we shared the same private thoughts. Reacting to the seriousness of the implications, I was forced to use a wall for support.

The dark thing had been named, and was standing in the room with us. At this point, however, I was still the only one who could see it clearly. It would take far too long for everyone else to see it as it truly was.

While I was struggling to absorb this information, the doctor crossed the distance between his desk and the door in two quick, uninterrupted steps. Once he reached the door, his head snapped abruptly around to focus his gaze on me.

Taking a deep breath and fighting for control of his facial muscles, he spoke with forced casualness, Because of the hematosis, she may need a bronchoscopy. Returning his attention to the door, he made his escape.

The events of the past few minutes had left me speechless. Because of this, I had not asked any of the many questions that had occurred to me as he was speaking. Dr. Primo had taken advantage of this temporary condition to avoid being placed in an awkward position. I had no doubt that the radiologist’s reading was incorrect.

Furthermore, I was convinced that Dr. Primo knew it, too. Knowing that when I did speak, my first priority would be to question a diagnosis that neither of us believed, he was forced to flee or choose between two equally undesirable alternatives. He would have to either confirm the diagnosis, which, given his doubts, amounted to lying to his employee, or contradict the radiologist’s finding, thereby breaking the first unwritten rule of the medical profession, Doctors Do Not Contradict Each Other.

Since he managed to exit the room while I was still speechless, however, the confrontation would have to wait until later. I had Judy to consider.

Turning back to my sister, I saw that her eyes were overflowing with unshed tears.

In a hushed, barely-controlled whisper she said, D-did he just say ‘Cancer?’

I immediately responded, It has to be TB.

At that moment, I felt that reassuring Judy was more important than telling the absolute truth. I had seen my sister scared before, but had never seen her so emotionally overwrought. Ironically, TB had become the comforting option.

I immediately began to help Judy dress, mostly to forestall any further conversation. Once she was fully dressed, I helped her down from the exam table and handed over her coat and handbag. Leading the way, I opened the door to find the doctor standing at the doorway. He tore loose the two prescriptions he had just written and handed them to Judy. As he did this he emphasized to her that, although the painkiller could be filled later, she was to start the antibiotic immediately. In fact, he insisted upon administering a dose of it before she left. I then offered Judy a ride home but, despite her illness and the visible impact of the last hour on her emotional state, she once again refused to be transported. My sister would return the way she had come, driving herself. After Judy left, I scheduled the follow-up appointment for ten days later, as Dr. Primo mandated. Somehow, I made it through the rest of the day.

Chapter 2

First Appointment

Judy did not keep the follow-up appointment that I had made. After only a few days had passed, her still-worsening symptoms forced her to seek relief.

Since the appointment was not a scheduled one, we were unable to see Dr. Primo. We had to make due with Dr. Dapper, who was Dr. Primo’s partner. Although we would have preferred to see her physician, recent developments in her condition had made it clearly inadvisable to delay until he was available.

By this time, Judy was seven days into her ten day course of PCE, the strongest antibiotic for the treatment of respiratory infections at that time, in the doctor’s opinion. While it was true that she had stopped coughing up blood, her pain had increased enough that it was unresponsive to Tylenol with codeine. In addition, the pain that had been confined to the right side of her chest at the time of the first appointment had begun to radiate to her back.

All this, despite a week of antibiotics! In desperation, Judy had begun taking Percocet. The relief that they provided her was minimal and, prompted by fears of addiction, she soon discontinued them entirely.

Once again, Judy insisted on driving herself to the appointment. I was so busy preparing the several flu vaccines that I anticipated administering before lunch that I was not even aware that Judy had arrived at the office. My friend and coworker Muriel processed Judy and settled her into an exam room. Then she tracked me down to let me know that Judy had arrived.

After I finished preparing the flu vaccines, I hurried to join Judy in the exam room. Sitting there listening to her labored breathing, I found myself increasingly impatient for the doctor’s entrance. Because I had spoken to him earlier in the day and impressed