Hitting a Nerve

The fragile gray mass between your ears


 


He’s almost 10 years younger than me.

He’d been in the hospital for 3 weeks. The ICU room had been decorated, as many families do, with pictures of his life. His wedding. His kids. He and his wife dressed as Darth Vader and Princess Leia for a Halloween party. A few religious items.

Stockdevil/Thinkstock
He had been leading a routine life when a freak accident at work caused a serious traumatic brain injury. Now, after 3 weeks, he still wasn’t waking up.

He was off sedation. EEG didn’t show any seizures. Head CT just showed the extensive damage from his head injury. The neurosurgeons can evacuate clots and decrease intracranial pressure, but they can’t repair brain tissue.

His wife was long past the point of shock when I met with her. After 3 weeks, she understood what the new normal was and how the lives of both herself and their kids would never be the same. She held his hand at the bedside as we talked, asked me a few pointed questions, and then thanked me for coming in to see him.

For me, it was just another day on call. I walked back to the nurses station, got some coffee from the galley, and sat down to dictate a note. There are always other patients to see on the coverage list.

But it still reminds you.

The brain doesn’t weigh much, just 2-3 pounds; it’s about the size of your fists put together.

But it’s everything that we are, both as individuals and as a species. All that humanity has achieved, good and bad, came from the brain.

The rest of him was in good shape. A healthy guy in his 40s. Probably in better condition than me. But with his brain irreparably damaged, none of that meant anything.

Dr. Allan M. Block, a neurologist is Scottsdale, Ariz.

Dr. Allan M. Block

You realize that, for something with such incredible complexity, capability, and potential, it’s amazingly fragile. And sadly, sometimes only bad luck stands between it and eternity.

Even after almost 20 years of doing this work, this sort of thing still reminds me how lucky I, and most of us, are – and to be grateful for what I have.

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

Recommended Reading

New and Noteworthy Information—January 2018
MDedge Neurology
C7 nerve transfer shows promising results for spastic arm paralysis
MDedge Neurology
New and Noteworthy Information—February 2018
MDedge Neurology
Blood test approved for patients with concussions
MDedge Neurology
New and Noteworthy Information—March 2018
MDedge Neurology
Follow-up care for pediatric concussions not heeded in Ontario
MDedge Neurology
New and Noteworthy Information—April 2018
MDedge Neurology
Gluten-Free Diet May Help Patients With Neuropathic Pain
MDedge Neurology
New and Noteworthy Information—May 2018
MDedge Neurology
New and Noteworthy Information—June 2018
MDedge Neurology