After Sudden Lucidity, Firefighter Is Less Animated

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“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.” (New York Times )

As I predicted yesterday, inappropriate analogies to Terry Schiavo and allusions to his having been, in the words of his treating physician, “close to the persistent vegetative state”, are now emerging. Although I emphasize that I have no firsthand knowledge of his condition other than what I am reading, subsequent descriptions of Mr. Herbert’s condition over the last decade in the article suggest that he has always continued to show evidence of consciousness even though cognitive functions such as memory and language had been markedly damaged by the oxygen deprivation his brain suffered in his accident in 1995. This is a more crucial detail of his case than the more ‘sexy’ one the Times coverage is focusing upon, the admittedly fascinating Rip van Winkle-like drama of the information overload he will suffer, if he remains alert, in taking in all that has happened in both his personal life and the larger world over a missed decade. [Inexplicably, the Times‘ hyperbole in that sphere focuses on things like the Buffalo Bills’ performance over the intervening decade rather than, oh say, 9-11…]

According to the Times coverage, Mr. Herbert’s awakening may relate to a recent change in the cocktail of medications he has been taking.

“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.”

Realize that a psychopharmacologically based approach to altering his level of consciousness necessitates that there was a substrate of brain activity there to modify with medications! This is quite distinct from a persistent vegetative state, in which bodily functions such as respiration and circulation persist in the absence of demonstrable brain activity.