Coma Victim Regains Speach After 20 Years

[sharkman]

Terry Wallis, 42, was 19 when he suffered a brain injury that left him in a minimally conscious state in which he was awake but uncommunicative other than occasional nods and grunts for more than 19 years. "The nerve fibers from the cells were severed, but the cells themselves remained intact", said Dr. James Bernat, a neurrologist. Nerve cells that have not died can form new connections and grow about an inch a month.

Three years ago, after about 20 in this condition, Terry started speaking and moving. Doctors believe his brain was slowly forming these new connections at a glacial pace until enough were present to make a network.

The article goes on to say that most neurologists would have been willing to bet money that whatever the cause of it, if it hadn't changed in 19 years, it wasn't going to change.

How many patients today are in this state, and neurologists are advising the family that there will be no miracles and nothing will change, so the family needs to prepare themselves to say goodbye to their loved one, ala Terry Schiavo.

[FTA Lawyer]

From the article:

Terry Wallis, 42, is one of the few people known to have recovered so dramatically so long after a serious brain injury. He still needs help eating and cannot walk, but his speech continues to improve and he can count to 25 without interruption.

Wallis' sudden recovery happened three years ago at a rehabilitation center in Mountain View, Ark., but doctors said the same cannot be hoped for people in a persistent vegetative state, such as Terri Schiavo, the Florida woman who died last year after a fierce right-to- die court battle. Nor do they know how to make others with less serious damage, like Wallis, recover.

"Right now these cases are like winning the lottery," said Dr. Ross Zafonte, rehabilitation chief at the University of Pittsburgh Medical Center, who was not involved in the research. "I wouldn't want to overenthuse family members or folks who think now we have a cure for this."

Wallis has complete amnesia about the two decades he spent barely conscious, but remembers his life before the injury.

"He still thinks Ronald Reagan is president," his father, Jerry, said in a statement, adding that until recently his son insisted he was 20 years old.

The human body is indeed capable of incredible things...but we must be careful not to write about these miracle scenarios as though this man's problems are now resolved. If after 20 years of being "on leave" he is looking at another 10 to be able to reach the level of speech and mobility of a 10 year old then, in my view, it's not worth the wait.

It's bad enough to simply lose the best 2 or 3 decades of your life, (thankfully for his he has no memory of his "absence"), but what of someone who is actually aware of what is going on around them for that length of time but can't move or communicate in any way?

Recently, a highly respected Federal Crown prosecutor in Calgary passed away following a battle with ALS (Lou Gherig's Disease). To me there could be little worse than being fully functional mentally, but lose the function of your body entirely. One of the only merciful things about ALS I suppose is that it works much more quickly than in terms of decades. 20 years in that kind of condition would be the worst cruelty I could ever imagine.

Medical science is always learning...so this kind of story is important to remind us not to accept every impossibility of today as being an impossibility for tomorrow. That said, what I think is even more important about this story is that it underscores the importance of having not only a will, but a personal directive and an enduring power of attorney...so that if you are ever incapacitated in such a manner, there are clear legal parameters set out to ensure that what YOU want done with you and your assets is what happens.

(And no, I do not do wills and estates so this is not a plug for my services)

FTA

[sharkman]

The human body is indeed capable of incredible things...but we must be careful not to write about these miracle scenarios as though this man's problems are now resolved. If after 20 years of being "on leave" he is looking at another 10 to be able to reach the level of speech and mobility of a 10 year old then, in my view, it's not worth the wait.

It's bad enough to simply lose the best 2 or 3 decades of your life, (thankfully for his he has no memory of his "absence"), but what of someone who is actually aware of what is going on around them for that length of time but can't move or communicate in any way?

Recently, a highly respected Federal Crown prosecutor in Calgary passed away following a battle with ALS (Lou Gherig's Disease). To me there could be little worse than being fully functional mentally, but lose the function of your body entirely. One of the only merciful things about ALS I suppose is that it works much more quickly than in terms of decades. 20 years in that kind of condition would be the worst cruelty I could ever imagine.

Medical science is always learning...so this kind of story is important to remind us not to accept every impossibility of today as being an impossibility for tomorrow. That said, what I think is even more important about this story is that it underscores the importance of having not only a will, but a personal directive and an enduring power of attorney...so that if you are ever incapacitated in such a manner, there are clear legal parameters set out to ensure that what YOU want done with you and your assets is what happens.

(And no, I do not do wills and estates so this is not a plug for my services)

FTA

So it seems you do not have the patience of a mother. Personally, I believe this is good news for those in a similar condition. The article clearly states that if the injury to the nerves involved allows the cells themselves to remain intact, then they can survive and start regrowing, thus starting the patient on the road to higher function.

I guess my argument is how can doctors encourage death in a situation like this. I know, as you said, the patients problems are not over (I think being able to communicate after 20 years of no speech is not a 'problem', and so being able to walk), but this person is still improving and is, after all a life with loved ones who care about him.

Your story of the person with ALS is sad, but is comparing apples to oranges because he was AWARE of his rapidly worsening condition.

[FTA Lawyer]

I guess my argument is how can doctors encourage death in a situation like this. I know, as you said, the patients problems are not over (I think being able to communicate after 20 years of no speech is not a 'problem', and so being able to walk), but this person is still improving and is, after all a life with loved ones who care about him.

Your story of the person with ALS is sad, but is comparing apples to oranges because he was AWARE of his rapidly worsening condition.

I didn't mean to confuse the issue with the ALS example...all I was getting at was that there may well be valid reasons that an individual (or their spouse or family members) would not want to wait around for 20 years on the hopes that maybe he or she might regain some functions. Death can indeed be merciful.

As to the question of doctors "encouraging death", I guess my response is that this outcome / breakthrough / whatever you want to call it should simply be added to the pile of knowledge to make up valid informed consent.

That is, when the doctor is seeking instructions on whether to discontinue life support, he or she should be careful to distinguish whether the particular patient is someone who could re-generate these brain cell networks and be clear to advise the family on the relative likelihood of this happening. These situations are horrible, and are always a matter of playing the odds...and there is no way of knowing what the "other" outcome would be. How many families have (and now will) care for essentially comatose loved ones for 20 or 30 years only to have them pass away without ever regaining any function?

I simply hope that I am never put in the position that I have to make this decision on anyone's behalf...but if it does happen, I sure hope they have formalized their wishes in a personal directive beforehand so I can take some comfort in making the decision that I know they actually said they wanted for themselves.

FTA

[sharkman]

As to the question of doctors "encouraging death", I guess my response is that this outcome / breakthrough / whatever you want to call it should simply be added to the pile of knowledge to make up valid informed consent.

That is, when the doctor is seeking instructions on whether to discontinue life support, he or she should be careful to distinguish whether the particular patient is someone who could re-generate these brain cell networks and be clear to advise the family on the relative likelihood of this happening. These situations are horrible, and are always a matter of playing the odds...and there is no way of knowing what the "other" outcome would be. How many families have (and now will) care for essentially comatose loved ones for 20 or 30 years only to have them pass away without ever regaining any function?

I simply hope that I am never put in the position that I have to make this decision on anyone's behalf...but if it does happen, I sure hope they have formalized their wishes in a personal directive beforehand so I can take some comfort in making the decision that I know they actually said they wanted for themselves.

FTA

I think that's what I was getting at as well. The more info and data to make an informed decision, the better. And if the decision can be free of politicization, the family then has less to deal with on top of their grief.