Dan Cappellazzo for The New York Times
Linda Herbert yesterday spoke about her husband, who resumed speaking a decade after an injury. With her is their son Thomas.
Posted on 05/05/2005 1:21:03 PM PDT by neverdem
A brain-injured Buffalo firefighter who unexpectedly started speaking again on Saturday after almost a decade of silence has continued to have bursts of conversation since then, but he has not been as animated, his family said yesterday.
Hearing the firefighter, Donald Herbert, speak was "completely overwhelming," his wife, Linda, said yesterday. "We are still trying to cope with this incredible experience."
His doctor said the breakthrough - 14 hours that began when Mr. Herbert suddenly regained consciousness and asked for his wife - came three months after his medicine was changed. The doctor, Jamil Ahmed, said that he had figured the new drug regimen would take six months to become effective.
For the first time, Dr. Ahmed described Mr. Herbert's condition over the last couple of years as having been close to a "persistent vegetative state," a term that neurologists used to describe Terri Schiavo before she died last month in Florida. Someone in a persistent vegetative state appears to be awake but is unaware of what is going on around him.
Dr. Ahmed said he had paid close attention to Mr. Herbert's responsiveness, or lack of it, from the time he first examined him in 2002. "I was trying to understand and clarify, "Is he understanding? Is he aware of the environment?' " Dr. Ahmed said yesterday. "But there was no way to confirm that. I came to the conclusion that he was, you could say, close to the persistent vegetative state."
Dr. Ahmed, who appeared at a news conference at the Erie County Medical Center in Buffalo arranged by the family and attended by dozens of reporters, said that Mr. Herbert had spent much of the time since Saturday sleeping. Other relatives said they had been careful not to overwhelm him with information about everything he had missed since he was trapped by a collapse in a burning building in 1995.
Dr. Ahmed said Mr. Herbert thought that it had been only a couple of months since the accident, not a decade - in which a president was tried for impeachment; e-mail and cellphones became popular; and his hometown football team, the Buffalo Bills, made the playoffs four times.
Mr. Herbert found out that he had been sidelined far longer than he thought when, at his request, a staff member at the nursing home called his home on Saturday and his youngest son, Nicholas, 13, answered. Mr. Herbert could not believe it, saying of Nicholas: "He's just a baby. He can't talk."
But his doctors said he seems to be taking it all in. "He's in awe that it's been 10 years and that he's 43 years old now," said Eileen Reilly, a doctor at Father Baker Manor, the nursing home in the Buffalo suburb of Orchard Park where Mr. Herbert is a patient.
She said his awareness suggests that he has at least some short-term memory. "He knows the aides, knows the nurses in the nursing home, knows their names, says hello to them," she said. "He listens to the voice and follows where the voice is and greets them. It's amazing."
Dr. Reilly said Mr. Herbert's condition was remarkably different from what it was a month ago. "He is much more responsive and speaking clearly for the first time," she said.
But she said that Mr. Herbert was becoming tired. And Mrs. Herbert said yesterday that he had had several "infrequent" moments of clarity since Saturday but that the family had "much hope for further recovery."
Dr. Ahmed said that Mr. Herbert might "fluctuate" with time. "But the way he improved and woke up, we are hoping he will progress," he said.
Dr. Ahmed said that, on Saturday, "I was so surprised that not only was he talking but he was talking very sensibly."
"He was remembering his past. He just didn't realize how long he was asleep," Dr. Ahmed said. "He recognized people."
Some were relatives and some were fellow firefighters who rushed to the nursing home as word spread that he had regained consciousness. Dr. Ahmed said he was amazed this week, when he visited Mr. Herbert, to find him following commands to shake his head and move his hands, and counting to 200.
Mr. Herbert suffered a head injury and oxygen deprivation after he rushed into a burning apartment building in Buffalo on Dec. 29, 1995. The roof gave way, and he was knocked unconscious. Reports at the time said that he went without oxygen for six minutes before other firefighters rescued him. He was taken to Erie County Medical Center, where he was in a coma for two and a half months.
He regained consciousness for a while in 1996, but had speech and vision problems and could not eat or walk without help. His memory was all but gone, and he did not recognize relatives and friends.
Mr. Herbert's doctors said yesterday that they had tried using various combinations of drugs to revive him. Three months ago, when his condition worsened, they switched him to a cocktail of drugs that is normally used to treat depression, Parkinson's disease and attention deficit hyperactivity disorder. His doctors would not name the drugs they had administered, but a number of medications have been shown in the past to stimulate awareness in a handful of people who were minimally conscious, even after several years.
Gary Dockery, a Tennessee police officer who was left paralyzed and mute after being shot in the head in 1988, suddenly spoke up nine years later when his doctors gave him diazepam, an antianxiety medication. For about 18 hours, Mr. Dockery returned to life and started talking and recalling memories of camping trips. Just as unexpectedly, he relapsed the next day. He died about a year later from a blood clot in his lung.
Dr. Nicholas D. Schiff, an assistant professor of neurology and neuroscience at NewYork-Presbyterian/Weill Cornell hospital, said there have been cases in which people awoke from minimally conscious states after being given similar drugs, including zolpidem, another antianxiety medication.
In Mr. Herbert's case, he said, it was impossible to know for certain what his doctors might do and how he would respond. "This has not been systematically studied in a way that would allow us to recognize regularity in types of responses," he said.
David Staba, in Buffalo, and Anahad O'Connor, in New York, contributed reporting for this article.
Dan Cappellazzo for The New York Times
Linda Herbert yesterday spoke about her husband, who resumed speaking a decade after an injury. With her is their son Thomas.
Maybe the change in his drug regimen had something to do with it.
FReepmail me if you want on or off my health and science ping list.
If this would of happened a few months earlier, Terri's murder might not have taken place.
I am very happy for his family.
Frankly, I'm stunned that the Times even mentions Schiavo in this article. I'll give them two points, and take one away....because they always manage to disappoint.
I listened to the live statement yesterday by the doctor.
According to him, Mr. Herbert was not always unconcious.
In the beginning, he was awake but unresponsive to the doctors tests.
He worsened over time and became semi-conscious, similar to Terri's condition.
His explanation was that Mr. Herbert was very much 'nearly' in a Persistant Vegetative State.
Now how exactly you define 'nearly' is anyone's guess, but It may be more a matter of nuance in language than anything else.
This is reminiscent of Oliver Sack's book Awakenings (a very powerful and heartbreaking book).
I had no idea they were giving him drugs. So, yes, it's probably due to the medication.
Buffalo Fireman Regains Long-Lost Memories
"He could say yes or no, but he could not put words together or talk back if people asked him a question. Most days, he just sat silently."
bump
Leni
I am currently a battalion chief with the Buffalo fire department and up until April of 2003
I was the safety battalion chief for the Buffalo fire department. I'm very familiar with the fire that Don Herbert was severely injured in.
I can tell you that firefighter Herbert was literally buried alive with hundreds of pounds of roofing debris when the flaming roof gave away.
In addition to this, firefighter Herbert's only air supply, his self-contained breathing apparatus face piece was completely pinched off. That left him in full cardiac arrest when he was found and dug out from his would-be grave.
In the Buffalo fire department's subsequent investigation we concluded that firefighter Herbert went ten minutes without oxygen.
Now, as you know, going that long without oxygenated blood to the brain would under most circumstances leave one not only clinically dead but biologically dead.
The fact that firefighter Herbert came through this is a miracle in itself.
In the immediate days and weeks following this terrible incident firefighter Herbert's family was told that he virtually had no chance of recovery. The best they could hope for was that he would be in a permanent vegetative state due to the severe irreversible brain damage that he suffered.
Mrs. Linda Herbert was given the option of pulling her husband's feeding tube, and after much soul-searching, decided against it. The next nine and a half years proved to be extremely difficult and exhausting for the entire Herbert family.
Although most people had completely written this hero off, the Herbert family and close friends continued to pray and believe for a miracle and as we all know now this is exactly what happened this past Saturday afternoon.
Just to bring you up to date, there was a press conference held Wednesday afternoon.
Firefighter Herbert's doctors confirmed that over the past several years Don's condition had deteriorated to the point that he was in a persistent vegetative state.
Rush read this on his show this morning.
What an incredible story. I never thought this would be possible.
Thanks for the ping.
I'd say it's pretty obvious that somebody injected this fellow with levodopa or zolpidem. It'll last a while and then he'll stop responding to this treatment. After this long in a quasiconscious state he will not manufacture enough dopamine to remain conscious and alert and unfortunately medical science hasn't progressed to the point where this kind of thing can be cured. There are other drugs to be tried here but this guy probably won't stay lucid long. If he'd come out of it on his own I'd say it was likely but if it was just because of a synthetic dopamine I wouldn't think so.
I'm no expert on this by any stretch of the imagination.
oh, just read it was diazepam. Okay.
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