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Brain-Injured Fireman's Recovery Takes Science Into a Murky Area
NY Times ^ | May 4, 2005 | ANAHAD O'CONNOR

Posted on 05/04/2005 6:23:04 PM PDT by neverdem

When Donald Herbert broke 10 years of virtual silence on Saturday and announced that he wanted to speak to his wife, his family and doctors were astonished and bewildered.

Mr. Herbert, 44, a Buffalo firefighter who suffered severe brain damage after being struck by debris in a burning building in 1995, had mustered only "yes" and "no" answers sporadically throughout the years, passing his days in front of a television that he could barely see because his vision was so badly blurred.

Neurologists said yesterday that such remarkable recoveries for people with severe brain damage are rare - but perhaps not as rare as the medical literature suggests.

"This is a phenomenon that is being frequently reported," said Dr. Joseph Fins, chief of the medical ethics division at NewYork-Presbyterian/Weill Cornell hospital and an expert on the subject. "It may be just the tip of the iceberg, and the question is how deep is it, what is the extent, and what are the predictors of this kind of reclaiming of consciousness."

Mr. Herbert, a member of a fire rescue squad in Buffalo, was buried under debris after rushing into a burning building on Dec. 29, 1995. He was knocked unconscious and slipped into a coma, but two and a half months later entered a state of faint consciousness that left him mostly unresponsive, according to family members.

After his abrupt awakening on Saturday, family members said, he was resting and slowly reconnecting with friends and relatives. Some friends said he was unable to see them, but could recognize them by their voices.

Although recoveries like Mr. Herbert's are widely publicized and romanticized in movies, the number of well-documented cases is rare. Most patients who regain consciousness do so within a few years, and those whose injuries, like Mr. Herbert's, are believed to have resulted from a prolonged loss of oxygen to the brain are usually given the worst prognosis.

Neurologists said yesterday that there was no way to know the true frequency of outcomes like Mr. Herbert's because people in his state have never been followed in long-term epidemiological studies.

Before his awakening, Mr. Herbert was nearly blind and virtually silent. Family members said he had not recognized them for years. Details of his recovery are murky, but neurologists said yesterday that his symptoms suggested that he had suffered damage to multiple areas of his brain because of a lack of oxygen for several minutes at the time of the accident.

"He has classic signs of hypoxic damage," said Dr. Alan C. Carver, an assistant professor of neurology at the Mount Sinai School of Medicine. "It's not hard to understand what happened to his brain in 1995. What is remarkable is to think that after 10 years of being like this the brain should show evidence of regeneration, because when cells don't get oxygen for a prolonged period of time they die."

In limited studies, researchers have found that about 15 percent of people who suffer brain damage caused by oxygen deprivation recover some awareness in the first few months, and that about 50 percent of those who suffer traumatic brain injuries, like a blow to the head, recover in the first year. Few people in either group recover after two years.

Little is known about people like Mr. Herbert, who enter a state of subdued awareness and then abruptly awaken a decade or more later. But Dr. Fins of NewYork-Presbyterian/Weill Cornell said their stories are strikingly similar, and suggest that recovery from years of minimal consciousness follows a steplike progression.

"There appears to be a window of time to move into this minimally conscious state, and from that there is a chance of recovering at distant time frames," he said.

The case with perhaps the most parallels to Mr. Herbert's may be that of Terry Wallis, a mechanic in Arkansas who slipped into a coma and then minimal consciousness at the age of 19 after a car accident. He was largely unresponsive, but could track objects with his eyes and even respond to some commands periodically. His family was told that he was unlikely to ever recover. But in 2003, after more than 18 years of virtual silence, he suddenly perked up and began speaking.

"These are cases that we're only finding out about sporadically," Dr. Fins said. "It really calls for an epidemiological study that can find out how many other patients like this are out there lingering in nursing homes."


TOPICS: Culture/Society; Extended News; News/Current Events; US: New York
KEYWORDS: brain; coma
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To: neverdem

Would you ping me, please.


21 posted on 05/04/2005 8:12:50 PM PDT by MoochPooch (A righteous person worries about his or her behavior, an extremist about everyone else's.)
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To: Calpernia

I'm just fine, but this story is chilling in light of the recent events here in Florida. Truly chilling.

Hope you are well, too. I'm dashing off to bed! 'Night!


22 posted on 05/04/2005 8:12:59 PM PDT by GatorGirl (God Bless Pope Benedict XVI)
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To: GatorGirl

Have a great night!

And yes, chilling indeed.


23 posted on 05/04/2005 8:13:31 PM PDT by Calpernia (Breederville.com)
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To: neverdem

I can't believe they aren't even studying this, or even keeping track it seems.

Maybe some enterprising med student (or somesuch, guess it wouldn't be a med student, exactly) can start the research in the archives of "Lifenews".

Beats toenail fungus, I venture. No insult intended to any toenail fungus sufferers or curers out there.


24 posted on 05/04/2005 8:21:49 PM PDT by jocon307 (Irish grandmother rolls in grave, yet again.)
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Comment #25 Removed by Moderator

To: bethelgrad

"And why do you care?"

I'm tired of clicking on stories that look like they might be interesting only to find a bunch of religious nonsense.

And my main point holds - you don't immediately go to a supernatural explanation for something just because we don't have a naturalistic explanation. That sort of thinking belongs in the middle ages.

I don't follow any religions. There is a whole forum area for religion I don't visit because I have nothing to contribute. When religion ends up in forums I do read, I take that opportunity to give my two cents if I feel like it. I found the statement to which I responded a particularly agregious piece of reasoning even for the invisible-man-in-the-sky-crowd.


26 posted on 05/04/2005 9:11:43 PM PDT by New Orleans Slim
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To: potlatch

From the New York Times
Interesting scientific discussion.
Wonder what his MRI looked like.
Terri should have had stimulation and therapy all those years.


27 posted on 05/04/2005 10:14:58 PM PDT by ntnychik
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To: ntnychik

This is an amazing story. I hope people start paying more attention to cases like this from now on, especially judges!


28 posted on 05/04/2005 10:21:26 PM PDT by potlatch (Does a clean house indicate that there is a broken computer in it?)
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To: neverdem
I read somewhere that he spent much of his time sitting in front of a TV for the past several years. I think THIS is what is responsible for his recovery. The constant stimulation of the TV served as a modeling device for his brain. It literally grew dendrites as his brain responded to the stimulation. He had a lot of damage to his brain, which is why it took so long for it to repair itself.
29 posted on 05/04/2005 11:00:30 PM PDT by my_pointy_head_is_sharp
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To: gridlock
It is a shame he is to be denied the euphoric experience of being starved to death. If only he received the proper care! He could be so much more peaceful and radiant!

LOL! I bet he's wishing right now he were married to Michael Schiavo.

30 posted on 05/05/2005 12:02:43 AM PDT by Tabi Katz
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To: djreece

marking


31 posted on 05/05/2005 1:05:05 AM PDT by djreece ("... Until He leads justice to victory." Matt. 12:20c)
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To: neverdem

bttt


32 posted on 05/05/2005 1:57:32 AM PDT by lainde
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To: neverdem
Crosslinked:

-Useless Eaters vs The Death Cult--

33 posted on 05/05/2005 2:03:59 AM PDT by backhoe (-30-)
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To: my_pointy_head_is_sharp
I think THIS is what is responsible for his recovery. The constant stimulation of the TV served as a modeling device for his brain. It literally grew dendrites as his brain responded to the stimulation.

That constant stimulation of the TV might put me in a coma, unless there was a good selection provided. I'm familiar with Wallerian degeneration. Do you have any links for dendritic proliferation?

34 posted on 05/05/2005 2:25:22 AM PDT by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
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To: dr huer; Calpernia; tutstar; russesjunjee; wildandcrazyrussian; T'wit
I think it's underway, the murder investigation.

The face of Florida's GOP

35 posted on 05/05/2005 6:21:02 AM PDT by floriduh voter (Terri's not the first victim or the last Visit www.terrisfight.org (e-newsletter).)
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To: Tabi Katz

I noticed that his first words weren't "Get me Attorney Felos."


36 posted on 05/05/2005 6:22:20 AM PDT by floriduh voter (Terri's not the first victim or the last Visit www.terrisfight.org (e-newsletter).)
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To: EternalVigilance; Republic; dandelion; Ohioan from Florida; MeekOneGOP; AnimalLover

ping


37 posted on 05/05/2005 6:23:39 AM PDT by floriduh voter (Terri's not the first victim or the last Visit www.terrisfight.org (e-newsletter).)
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To: neverdem

Saw his Doc. this morning on FOX. He said that about 3 months ago they started adding a med that was reported to stimulate nerve activity.


38 posted on 05/05/2005 6:46:33 AM PDT by helper
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To: neverdem
Do you have any links for dendritic proliferation?

No, sorry. It's just a supposition as to what I think happened.

39 posted on 05/05/2005 11:30:02 AM PDT by my_pointy_head_is_sharp
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To: mlc9852
> I wonder what Judge Greer thinks.

He doesn't. He can't. He's a kudzu. He has no moral cortex left. His soul is 90% liquid and 10% woody substance. Don't confuse his occasional grunts and twitches with actual "thought." Neurologists tell us that these seemingly real gestures -- so eagerly noted by his admirers -- are merely reflexes from his stem.

40 posted on 05/05/2005 5:01:32 PM PDT by T'wit (Anything the liberals call "fair" is guaranteed to be unfair, deceitful and larcenous.)
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