Losses: In Search of an Honest PrognosisMarch 19, 2012
Several years ago I took care of a lady who’d suffered a small cerebral hemorrhage after falling and hitting her head. She was in the ICU for several days. Her husband stayed at her side constantly, and he became a part of a never-ending loop in which she would wake up startled to be in a hospital, and then notice her husband and ask him where she was and what had happened. He’d hold her hand and gently relay the events of her injury, after which she’d react with mild surprise, every single time. Then she’d close her eyes and doze until she woke up to reinitiate the same conversation.
Her husband, after days of patiently playing his role in this repetitive scene, was clearly wearing down. He waited anxiously for the neurosurgeon, expecting explanations and hoping for reassurance.
When the neurosurgeon rounded later that day I heard him speak at great length about the details of her injury and the treatment plan. He ultimately advised that, although he thought she’d recover well, only time would tell.
Her husband wanted more than that, though. He pressed for specifics, firing one question after another in his quest for clarity and absolutes, until the neurosurgeon paused and wiped his brow with a sigh.
I expected him to remain equivocal, but instead he said, in quite possibly the most soothing voice I’ve ever heard, “I can’t say for sure, but it’s possible, given the exact location of your wife’s injury . . . it’s possible there could be long-term effects on her diction and cadence of speech. And rhythm . . . in music. But I can’t say, for sure.”
Her husband nodded, a look of acceptance on his face, as if there were no arguments to mount against those sacrifices, as long as he knew what they were.
I don’t know what about that conversation held such significance that I still recall it so clearly. Maybe it has to do with neuroscience and the image I hold of a detailed map of the brain. Maybe it struck me to see a neurosurgeon, when confronted and pressed by a strained and frazzled husband, pause and offer a stab at specificity. Perhaps it was watching a husband appear to measure cadence, diction, and rhythm against the essence of his wife, and in doing so, consider which parts of her could be lived without.
But I think what really got me is how the tones of that conversation illuminated how devastating those losses would really be, and the notion that, given the option, the loss of short-term memory might possibly be the lesser evil.