Leap of Faith
With less than a ten per cent chance of survival, Verna Marzo agreed to extreme medical measures that were her only hope of beating the odds
What was supposed to be a straightforward operation left Verna Marzo on the brink of death.
On March 18, 2017, Verna Marzo awoke at 4am in her apartment with crushing abdominal pain. Her roommates took her to the nearest emergency department. The 44 year old from Calgary, Canada, had been living for a year with a cyst that doctors had discovered pressed up against an ovary. It was likely benign and would shrink on its own, she was told. But at the hospital, tests revealed that the cyst had grown to the size of a grapefruit. Worse, Verna’s pain and fever suggested it might have ruptured. Knowing she would need emergency surgery, doctors ordered her to be transferred to the Foothills Medical Centre by ambulance.
The chief doctor on call that night recommended a full hysterectomy. Verna, who wanted the ordeal to end, consented.
But by morning, with the surgery completed, something was still wrong. Verna had a raging fever and her abdomen was distended. When ICU doctor Dr Paul McBeth arrived for his shift at 8am, he scrutinised her file. Taking out a cyst is a fairly straightforward operation, he surmised, but she was clearly in shock.
“We’re missing something,” he told his residents.
Verna’s sister Debie gasped when she parted the curtain to visit that morning. Verna had ballooned overnight due to fluid leaking from her blood vessels.
Meanwhile, Verna’s blood pressure had crashed, her tissues were oxygen-starved and she was breathing with the help of a ventilator. Doctors put her into a coma so her body wouldn’t have to work so hard, and gave her high doses of broad-spectrum antibiotics to combat infection.
Verna’s body was in shock, but there are many different kinds of shock. The doctors went into detective mode. Dr McBeth peppered Debie with questions. Had her sister
“I’m afraid it’s hour-to-hour now,” Dr McBeth told Verna's family and friends
been travelling? Did she have any allergies? Could she have overdosed? What was the family history?
VERNA HAD NEVER BEEN LESS than a storm surge of energy. As a young girl in the Philippines, she had loved sport – running and surfing especially – and her playful high jinks were contagious. She is the second-oldest among four siblings in a fun-loving family.
At 28, Verna decided to leave a marketing job in the Philippines and seek employment abroad. That quest
led her to Calgary in 2001, where she worked as a nanny and then started her own cleaning and interior-design business.
Verna found a church community full of kindred spirits, one that her sisters Debie and Luela joined when they followed her to Calgary several years later. Things went smoothly in her new home – until they didn’t.
Some 18 hours after Verna arrived at Foothills Hospital, Dr McBeth’s initial fears were confirmed: Verna had sepsis, a massive inflammation that was triggered by E. coli in her bloodstream. Exactly how the bacteria got into her system – whether from inside the hospital or elsewhere – will never be known.
Septic shock can overwhelm a body in 12 hours. Only about half of those who contract it survive.
The doctors had a near-impossible balancing act on their hands. One symptom of the condition is runaway blood clotting, so blood thinners were issued. But those can trigger internal bleeding and lower a patient’s blood pressure. The drugs used to counteract that effect starve the tissues of oxygen. Meanwhile, Verna needed to be kept in a coma, but sedation could drive her blood pressure even lower. Cardiac arrest was a real threat.
Sure enough, she flatlined – twice within a couple of hours. Dr McBeth and a colleague took turns resuscitating Verna with intravenous doses of epinephrine.
“We need to be prepared for the worst,” Dr McBeth told Debie and some close friends who had gathered in the waiting room. Verna’s kidneys had shut down. There were blood clots in her lungs and capillaries. Dr McBeth hardly left her bedside the entire night.
In the morning, Dr McBeth met again with Verna’s circle of support. “The likelihood of survival in the next hour is very, very low,” he told them. When pressed, he guessed Verna had less than a ten per cent chance of survival.
Debie texted loved ones asking
for their prayers. In the
Phi l ippines, Verna’s mother applied for an emergency travel visa.
If a person’s odds of surviving are linked at all to their passion for this world, then the doctors had underestimated Verna’s chances.
At age six, she experienced her first great thrill, jumping from a bridge into the local river. Thirteen years after arriving in Canada, she took a much bigger jump – this time tethered to a skydiving instructor.
Then, one day five years ago, Verna found a companion for such exploits: Leah Escabillas, a young woman who showed up at Verna’s church. Leah had emigrated from Saudi Arabia. In Leah, Verna sensed a fellow traveller, someone whose hunger for adventure matched her own.
The two started planning trips together, which grew into a series of ongoing experiments in endurance and adrenaline. They went on snowshoeing and hiking expeditions. They cage-dived with great white sharks off Cape Town in South Africa.
Then, in 2016 they decided to bungee jump from Victoria Falls Bridge, on the border of Zimbabwe and Zambia. As Verna stood more than 100 metres above the Zambezi River, with Leah close behind, it was clear that she’d found someone to share her mission to live on the edge.
“Five, four, three, two, one, bungee!”
Verna didn’t die the day after her emergency surgery, or the one after that. But on day five, her family received more bad news. Her arms and legs were ischaemic: oxygen-starved. The resulting dead tissue could spark a release of toxins throughout her body that would kill her unless something radical was done.
She was eased off her cocktail of sedatives, paralytic medications and anti-anxiety drugs, and quickly surfaced from the coma. The next day, Dr McBeth laid out her options.
“Your best chance of survival is with amputations,” he said.
It was her call, he emphasised, but if she opted to go ahead, there was no time to waste. In every limb, the ischaemia was quickly spreading
towards the joint, so any delay meant potentially losing a chance at prosthetics.
If ever a moment called for Verna to be decisive, this was it. She was on life support, with a breathing tube, but she could still nod and shake her head. Five, four, three, two, one.
She gave the doctor the go-ahead.
ON APRIL 4, ONE DAY AFTER two rounds of amputations, Verna slowly came to. Alone in her hospital room, she looked down and saw her bandaged and shorter right arm. No left arm. Lower down, there was the disorienting outline of her diminished legs under a cream-coloured blanket. For the first time she felt a darkness engulfing her. As a person of faith who has always found guidance in prayer, she made a request to God: I’m sure there is another person here in this hospital who is not long for this world but wants desperately to live, Verna said. I’m asking you to let them live and take me instead.
But as the days passed, it occurred to Verna that perhaps she had found a new life purpose: to not give up. she thought,
A name was coined for the growing group of frontline support gathered in her corner: Team Verna. Beyond her close friends, including Leah, and family, it also included a physiotherapist and a social worker. Someone was always around to sing to Verna, tell a joke or gently lay a hand on her in prayer. Anchoring Team Verna was her mother, who had arrived at her daughter’s bedside on April 1.
Leah and others had adorned the walls of Verna’s hospital room with photographs of her dangling over some precipice or free-falling from the sky. They were for her caregivers. “When they come to treat this person, they see her as a survivor, a thriver – not someone who elicits pity,” says friend and psychologist, Charles Coleman.
Little by little, Verna’s body started repairing itself. She’d lost her hair and eyelashes; they grew back. Blood clots had riddled her body and her brain; they dissolved. “She probably has some element of permanent kidney damage, but her kidneys function. Her liver functions,” says Dr McBeth.
When performing an amputation a surgeon will try to save as much of a limb as possible. Sometimes they will leave it a little long, then go back, if necessary, and take more. “We need to salvage enough tissue to ensure we can close the wound site to provide
“When caregivers come to treat Verna, they see her as a thriver – not someone to pity”
a functional limb,” Dr McBeth says.
Discouragingly, Dr Rick Buckley, the orthopaedic surgeon who performed the amputations, had to operate four more times during the second week of that May – ultimately reducing Verna’s left arm to no more than a stub and, devastatingly, cleaving off the right leg above the knee.
To live and function in her new body, Verna had to relearn how to eat, go to the bathroom and even sleep. “It’s like being a baby all over again,” she says.
Around that time, Verna’s prosthetic legs arrived at the hospital. Walking on them required her full concentration – and it took training. “There’s a lot to think about just to stand,” she says.
She was the most ferociously committed rehab patient her physiotherapist, Erin McDiarmid, has ever seen. “Verna out-planks everyone,” she says. “And out-crunches the trainers.” Determined to be ready for hiking by the summer, Verna insisted on practising over uneven ground.
In August, Verna’s fibreglass right arm was ready; it fit to her stump by suction. Impulses from forearm-muscle contractions are conveyed to hydraulics in the five-fingered hand so that she can signal it to open or close simply by thinking those words.
“I can eat!” she proclaimed the first time she tried it. “I can brush my teeth!”
And then, after that: “I can rob a bank! No fingerprints!”
ON DECEMBER 7, 2017, after 263 days in hospital, Verna was transferred to a long-term-care facility. Here are the
amputees, she thought.
Verna found the mood inside sombre. Ambitions were banked, and most of the patients were relying on the aides for everything.
There was a gym in the facility, but few went. As Verna performed her exercises with focus and dedication, her effort became an inspiration. Other residents started showing up, and before long, the gym was full and, among residents, workout time became known as ‘happy hour’.
At the end of March 2018, Verna decided to enter a five-kilometre race taking place in Calgary that summer. But the day before the event, she received a new prosthesis for her right leg, and, no matter how Debie attached it, the pain was unbearable. Verna was incandescent with frustration. “I can’t do this,” she told Debie. “I’m pulling out of the race.”
“OK,” Debie replied. “But why don’t you just go anyway? We’ll bring your
“I can rob a bank,” said Verna, when she tried her rightarm prothesis. “No fingerprints!”
chair. I can always push you.” Verna let a long silence hang in the air after her sister’s offer. Then she asked: “Where are you planning on eating after?”
ON JULY 21, VERNA didn’t need the wheelchair. She walked the entire five kilometres and approached the finish line to cheers and the promise of a victory burger and milkshake as Debie’s treat. After she crossed the line, Leah enveloped her in her arms – and planted a tantalising idea. The Honolulu Marathon takes place the second Sunday in December each year. “Let’s do it together,” she said.
In the ensuing months, Verna spent as much time as she could on the treadmill to build up her aerobic base. Periodically, she landed back in hospital with bowel obstructions – fallout from the scar tissue – but after each complication, she focused again on her goal.
Then fate dealt yet another blow. On August 18, 2018, Verna learned that Leah had been hiking on a high ridge in Banff, when she slipped and fell. She was pronounced dead on arrival at hospital.
For Verna, the news was devastating. Leah had never given up on their adventures, even arriving one day to go snowshoeing, carrying a sled on which to pull her friend. Now she was gone.
In the days that followed, Verna realised she didn’t want their Honolulu dream to die. She now aims to do it in December 2020. If running a marathon is a feat more of heart than head, more of soul than body, then it will be no problem. And Leah will be right there with her still. They’ll do it together.
“Team Leah,” says Verna, raising her right arm in salute.
A decision will be made in November whether the marathon is cancelled due to the COVID-19 pandemic.