What We Don’t Know

After being hit by a drunk driver, Sarah Scantlin spent virtually two decades in a semi-comatose state, unable to walk or speak.

She had suffered a trauma so great that it was difficult to comprehend how she had survived it at all, let alone to believe that she would one day break through to full consciousness and communication.

Then, earlier this year, Sarah Scantlin began to speak. Before long, her story was being recounted on news outlets throughout the country.

The true tale was one of those rare instances of good news – a happy little miracle to break up the grim recounting of crimes, deaths and fights that normally constitutes the reporting of current events.

But Sarah Scantlin’s unexpected return to a world from which she had been cut off for most of her adult existence has also been good for more than just warming hearts.

It is a reminder to us of how much we don’t know about human beings. And why, when we don’t know something, we must err on the side of caution, hope and preserving a person’s life.

All of this is very simple stuff, but it’s also easy to lose sight of in an age where we have the benefits of sophisticated medical knowledge and diagnostic techniques. We can measure brain activity. We can quantify brain damage. It’s no wonder that we sometimes forget we can’t always translate those observations into an accurate pronouncement of whether the sum of all the biological parts still makes up the person who once presided over the now broken body.

Sarah Scantlin’s story has, not surprisingly, led many observers to make comparisons with the Terri Schiavo case.

The Scantlin family has tried to avoid such associations, pointing out (quite rightly) the huge differences in the levels of functioning and organic damage between the two women, even before Sarah’s dramatic recovery. (Schiavo was in a persistent vegetative state. Scantlin, by contrast, was not even in a coma – she reacted to painful stimuli and could blink her eyes. Medically speaking, their conditions were separated by a large gulf.)

But – while respecting the Scantlin family’s wish not to have their daughter’s extraordinary breakthrough co-opted by those with a political or religious mission – we would be remiss not to use Sarah’s example to inform future decisions about ending the lives of those we consider too far gone to be worth “saving.” No, Sarah Scantlin breaking twenty years of silence does not prove that a person in a persistent vegetative state like Terri Schiavo’s could ever return to consciousness. But it does prove that for all our tools and understanding, we do not know what is going through any patient’s mind or how much and what parts of that mind make up the person.

It would be a failure of our duty as fellow human beings to give up on any patient, to fail to defend his or her right to continue living. Fortunately, in Sarah Scantlin’s case, there was no talk of ending the woman’s life because she was physiologically strong enough to keep going. And though she was severely brain damaged, she was awake.

But Sarah was still unbelievably lucky to have had a nursing home staff member who thought Sarah would talk again and who worked with Sarah for 20 minutes a day for seven years to that end. There was no medical reason to think that Sarah would ever utter another word and no objective way to know that she was making any progress.

The key was a woman who was able to look into Sarah’s eyes – an apparently blank stare – and understand that Sarah was really still there, just waiting to be helped back into the loud world of speech and activity.

For every Sarah Scantlin there are no doubt thousands of brain-damaged patients who will, no matter how hard their families and therapists try, never show any outside improvement in their conditions.

Yet Sarah’s case reminds us that these patients are still people, and their lack of progress does not prove that they are not more aware and more conscious of what is happening than we have objective reason to think. If nothing else, Sarah Scantlin has reminded us how very much there is that we don’t know about what it means to be alive. And that we should defend life that much more fervently because of it.

Government paid medical care leads us to think that we should not ask who pays for this and whether it is worth it. At the same time people are screaming about the cost of health care.

It's very easy to be cinical about this issue when it's someone elses problem. Let me tell you about a case in my family. In Feb. my mother (63 yo) had a sub-arachnoid hemorhage. She was life flighted to the nuero-critical care unit in Indy. She should have (statistically) died upon onset but was a real fighter. The next day she opened her eyes and responded to our instructions. She never re-developed her speech but was able to answer questions with nods and head shaking for a little while. Eventually her body created too much cerebral spinal fluid and her ventrical swelled and she went into a coma. She died in June, we dont know the exact cause but I say all of this to let the cinics know, That burden on the insurance company, whose life seemed useless, who had no "quality of life" to the casual observer was my mother. A woman who was loved and needed. We just dont throw away people. Period.

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