A husband stands in defense of his wife’s humanity as she, and those who love her, cope with her terminal illness.
In graphic detail, yet with a straightforward writing style, Miracles Happen … Sometimes relays the declining physical health of a terminally ill woman and the loss of hope and clarity felt by those around her. This account is Cliff Koch’s attempt to complete his wife Pam’s message about the devastation caused by bulimia.
Adding to his wife’s three short chapters, Koch communicates in stunning detail the harrowing account of Pam’s final three years, which she spent either in the hospital or in a rehab facility being treated for irreversible organ failure that ravaged her digestive tract, lungs, kidneys, and cardiovascular system. Delivered with a sense of detachment, the destruction of hope and connectedness in Koch and Pam’s family accurately depicts the toll terminal illness takes on caregivers.
Koch dramatizes the fractured links between family intermediaries and community, particularly the apathy of the institutions that finance extensive hospitalization and extended care. Alongside his ebbing emotional control, coercive paperwork overwhelms Koch’s faculties, forcing him to make necessary decisions about how to reimburse the medical community for Pam’s treatment.
Episodes are filled with specifics of the tracheotomy and ventilation machine that breathe for Pam, and of the resuscitations, dosages, and surgeries that keep her alive. While there is a sense of intensity around the medical treatment and action, there is a contrasting lack of emotional depth conveyed by the author, his wife, and their family members.
Other than one brief mention, missing from the downward spiral of Pam’s life is the recognition and acceptance, by both herself and her husband, that an eating disorder had caused her suffering and demise. After years of “ulcers,” tests of all kinds, and various medications, it was during one of many trips to the emergency room that the doctors discovered Pam’s eating disorder. She was eventually admitted to an in-patient program with follow-up therapy. Unfortunately, Pam did not continue in treatment, which Koch admits “may have been a fatal mistake in the years to come.”
The structure of a time line would add context to the fractured telling of events. Early in the book, Koch relates trips to the hospital and extended-care facilities in repetitive detail with a detached, “first this happened, then this happened” delivery, offering little indication of the emotional toll of his wife’s suffering. Later, when he begins to describe the impact stress, distraction, and repeated absences have on his job performance, readers begin to see more clearly how this journey has affected Koch.
While repetition and cliché abound, the tone suits the state of mind of a husband who invests fully in his wife’s final days and in the safekeeping and support that buoy her spirits. Ultimately, there is no “miracle” to be found, though the overall impression is of a husband standing in defense of his wife’s humanity. With some polish, Koch’s intense narrative will hold value for individuals suffering from an eating disorder and for their families.