Dr. Mikayel Grigoryan: There's a quote from the Sopranos: "More is lost by indecision than by wrong decision." That is absolutely true in our case, because if you do nothing, you're going to lose 100%.
Rev. Michael Lehman: Never having had a serious medical issue in my life, I couldn't imagine at the time that there was anything actually wrong.
Dr. Mikayel Grigoryan: Michael, I can do one of two things. I can give you blood thinners but if you walk out of here and you pass out again, next time you may not be able to drive yourself to the hospital.
Rev. Michael Lehman: It actually started in February 2021. I was on the hike in Santa Barbara and included some boulder scrambling, rock climbing. I did experience a couple minor falls, but I didn't hit my head or neck or anything and completed the hike and felt totally fine. I woke up one morning and after my shower, as I was drying off, realized, "I'm going to black out." I sat down on my couch and then just passed out for a few seconds and I remember being down and then coming back to and thinking, "I just worked a lot the day before. Didn't really get a good dinner that night. I'm just fatigued."
So, I just drove myself 10 minutes down the road. That's how I got to the hospital.
Dr. Mikayel Grigoryan: We all have two vessels running in the neck towards the back of the brain, they're called vertebral arteries. They converge together and they supply blood to basal artery which is the downtown of the brain. Every tiny little ... There, I have a tattoo of it. In Michael's case, right vertebral artery was completely shut off. His left vertebral artery was hanging literally by here. And it free floats like a flap. As a result of that, blood gets under that flap and forms a blood clot. It was a trace of an emergency shoulder going through, and there was traffic going through, a little bit.
When he would stand up, he would pass out. These are exits, sort of the exits of downtown. You block these exits, you end up being locked in. Which is like, you're conscious but you're within a coffin because there's not a single muscle in your body that moves.
Rev. Michael Lehman: When I was laying there on the table after my MRI and they were explaining what was going on, and knowing I was about to face surgery and that I'd heard the phrase, "You could stroke at any minute, you need to get into surgery now," I was not afraid. I was not afraid for myself. Where my thoughts did go were to my family, especially my parents. Oh my God, they're going to have to go through this loss if I don't make it.
Dr. Mikayel Grigoryan: We took him for a test called angiogram. The picture looked very scary, and his case is not a case where you have guidelines or recommendations, because you don't have randomized trials for catastrophes. Ultimately, it's one of two categories: You either need to say, "Hey this looks very bad. I can leave you medications and kiss you on the forehead and let you go home," or we felt that if we don't reopen at least one of these vessels in the neck, then we can have a much bigger problem, because a much bigger blood clot can form and, God forbid, he ends up being locked in.
It's on a case-to-case basis, but that's the beauty of job. When your work doesn't give you adrenaline, doesn't give you the goosebumps, you don't come home happy from work, why are you working? That's why I do what I do, because it's sudden and spontaneous, and you help people in very unorthodox situations. This is like jazz music, because you have the theme and yet you can improvise on the theme and go wherever you want and then you come back to the theme and you finish your jazz piece and then you're done.
In his case, a catheter, a hole of maybe a fraction of a millimeter goes through the arm and then up from the neck. Actually the most difficult thing is to get there, not to fix it. You get to climb the mountain, and then after that you can take a picture on the mountain, and that would be you taking the clot out but you got to climb it.
So we went ahead and stent-reconstructed the left vertebral artery, the one that wasn't completely blocked and the right one we decided to leave alone. He recovered very well, and the other vessel actually healed itself, and his balance improved to the point where he plays marimba. He sent us a video of him playing marimba in church. Yeah, we stay in touch because I need to keep a close eye on him. I'm responsible for him after everything that happened.
Rev. Michael Lehman: Shortly after that experience, when people had learned what had happened, and the potential of what could have happened but didn't, the word "miracle" was tossed out a lot which, as a minister, I'm theologically suspicious of. I've reflected on that a lot in the last year and a half and what that means and when I reflect back on that time, particularly the experience in the hospital with that team, where everyone there through their education, their time, their dedication in their lives to preserving life and giving people another chance, helping them heal and restore to full health -- that in itself to me is a miracle. That's how I look back on that time, because I also say whenever we tap into loving one another, to healing and helping one another, that's where the spirit of God is. So in that sense, the whole experience to me was a miracle.