In a Stroke Patient, Doctor Sees Power Of Brain to Recover

WSJ (two week free trial subscription available) ^ | November 23, 2005 | THOMAS M. BURTON Staff Reporter of WSJ

[baseball_fan]

'Neurointensive' Care Gains Adherents, Despite Risk Of Raising False Hopes 'Too Often, People Give Up'

Devastating strokes on both sides of his head drove 31-year-old Mark Ragucci into a deep coma. As seizures swept through his brain like silent electrical storms, his gaze froze. His arms were paralyzed at his sides in a syndrome neurologists call man-in-the-barrel, signaling serious brain damage.

The most likely fate for the patient was death or survival in a state of near-total disability, concluded Stephan A. Mayer, director of neurointensive care at Columbia University's medical center. "I really thought there was no hope" of a meaningful recovery, recalls Dr. Mayer.

But the family of Dr. Ragucci, who had just started a career as a doctor before his stroke, wanted every possible effort made to spare his life. So Dr. Mayer and his colleagues aggressively treated Dr. Ragucci's pneumonia, septic infections and roller-coaster blood pressure. They also dramatically cooled his body and brain to protect brain tissue.

A month after his stroke, Dr. Ragucci had recovered somewhat physically, but not mentally. He was still officially in a vegetative state. Six weeks after the stroke his family transferred him to a rehabilitation facility, and that was the last Stephan Mayer saw of Mark Ragucci.

The last, that is, until the day nearly a year later, in late 2002, when Dr. Ragucci walked into Dr. Mayer's Columbia office and introduced himself. The former patient spoke in a monotone and his fingers were tightened into claws, but that was the extent of his disability. "When he walked in, I almost fell over," Dr. Mayer recalls. "It was at that point I realized that we knew absolutely nothing about the recuperative power of the brain."

[baseball_fan]

[Dr. Ragucci, who is now at 35 back to practicing rehabilitation medicine, says he was somewhat conscious even when his doctors perceived no brain activity, and it bothered him to hear nurses and doctors referring to him in the past tense. "Somebody has to realize that you're in there," he says. "Just because you can't move doesn't mean there's not somebody in there."]

and

[The treatment may raise unrealistic hopes in family members. Even if it saves patients from death, they may survive only in a state of severe disability or remain in a vegetative state, burdening family members for months or years. Many people eager to avoid being kept alive in such a condition have drafted documents designed to stop medical intervention as soon as a doctor decides brain recovery isn't possible.

Yet some neurointensive-care specialists now believe that many doctors are too quick to reach that conclusion and encourage families to abandon hope. "The fatalistic attitude toward treating brain disease is very prevalent -- and untrue. All too often, people give up," says Owen B. Samuels, chief of neurointensive care at Emory University. "We've all been humbled by the brain's ability to recover."]

- see full article using trial subscription

[Professional Engineer]

The brain is amazing indeed. Pat Rummerfeld was a quadrapelegic at 22. At 43 he set the Land Speed Record in an electric car at 248+ mph.

Driver

Pat Rummerfield, driver of DWRA's first car, "White Lightning", is a success story in his own right.  Struggling back from a crippling accident that left him a quadriplegic two decades ago, the 43 year-old driver has overcome the odds of never walking again to pilot "White Lightning" in its world record speed run.

After years of painful therapy, Rummerfield not only drives a race car, but competed in, and finished the prestigious Ironman Triathlon in 1992.  The ultradistance race consists of a 4.2 mile swim, 110-mile bicycle ride and 26.2 mile run.  He has also completed the Antarctic Marathon, perhaps one of the toughest races ever organized, and the Los Angeles Marathon in March of 2000.

A graduate of University of California Medical School, Rummerfield works as a performance assessment coordinator for the Injury Prevention Program at Washington University's School of Medicine.

Rummerfield is also Co-Founder of The NextSteps Foundation, a non-profit organization created to help in the prevention, treatment and cure of paralysis.

Rummerfield drove "White Lightning" to a one-way speed of 254.229 mph at the Bonneville Salt Flats in October of 1999.

Rummerfield has been the recipient of numerous awards, including ESPN's prestigious ARETE award for courage and excellence in sports.  Past recipients include Hank Aron, Mario Andretti and Muhammad Ali, just to name a few.

Rummerfield and DWRA are planning their return to Bonneville to establish a new world record in an electric vehicle.

 

 

Rummerfield prepares for Bonneville practice run.