Tuesday, 27 December 2011

Ariz. Student Emerges From "Irreversible" Coma

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Twenty-one-year-old Sam Schmid (left) had an extra-special gift for his family, presented to them just in time for the Christmas holiday. Days after an October 19th car accident that left him in an apparently irreversible coma, and just as medical professionals were set to suggest that it might be time for his family to think about end-of-life options for him, the University of Arizona student amazed the medical staff and everyone else by responding to a simple command from his doctor. Two months later on Christmas Eve, instead of grieving for her son, Schmid’s mother was watching him take short steps with a walker, and even speak in brief, broken sentences.

Advocates for those with severe brain injuries and other life-threatening disabilities point to Schmid’s story as just the latest proof against making hasty end-of-life decisions on the suggestion of doctors and medical experts.

“Right now, I’m feeling all right,” Schmid was quoted by the Associated Press as saying. “except for the rehabilitation, I’m feeling pretty good.”

While doctors say that Schmid has a lot of work ahead of him to regain his speech, memory, and motor skills, his responses today are light years ahead of where he was when, following surgery, medical staff could see no responsive signs and began to discuss removing him from life support and talking to his mother about organ donation.

“They never approached me to say would I donate his organs,” recalled Schmid’s mother, Susan Regan. But they were “asking about Sam, his quality of life, what would Sam want if we had to come to a difficult decision,” she told the AP.

Neurosurgeon Dr. Robert Spetzler said that the five-car accident that killed two others left Schmid “with all the odds stacked against him.” Following surgery for a brain aneurism and other injuries, Schmid did not seem to be improving, causing Spetzler serious concerns about his patient’s chances for regaining consciousness. But the surgeon held off making any suggestions to Schmid’s mother, hoping for an encouraging sign. Recalled Regan to ABC News, “At some point, I knew we had to make some sort of decision, and I kept praying.”

Spetzler emphasized that there was “plenty wrong” with Schmid. “He had a hemorrhage, an aneurysm, and a stroke from the part of the aneurysm.” But there were some small positives, too, the doctor added, noting that the young man “didn’t have a blood clot in the most vital part of his brain, which we know he can’t recover from. And he didn’t have a massive stroke that would predict no chance of a useful existence.”

Even as the young man’s family began having their own doubts, Spetzler ordered an MRI, which was encouraging. Almost immediately after the test Schmid began responding to simple commands.

“It seems like we were being led down a path to plan for the worst and that things were not going to work out,” Schmid’s brother John told ABC’s Good Morning America. “The miracle, to put it bluntly, was that in a matter of seven days, we went from organ donation to rehab. What a roller coaster it was.”

Schmid’s mother said that when the future seemed hopeless, she and others kept praying, and her son eventually began to respond. “Nobody could ever give me a better Christmas present than this — ever, ever, ever,” she told Good Morning America. “I tell everyone, if they want to call it a modern-day miracle, this is a miracle. I have friends who are atheists who have called me and said, ‘I am going back to church.’”

Spetzler agreed that the word “miracle” is a good one to describe his patient’s turnaround. “I am dumbfounded with his incredible recovery in such a short time,” Spetzler told ABC. “His recovery was really remarkable considering the extent of his lethal injuries.”

As Sam Schmid faces months of intense rehabilitation, his brother John is relocating to Phoenix to help. Schmid would like to move back into college life, and has plans to finish his business degree. “I see myself leaving the house, going to school, work, basic things like that,” Schmid told AP News. “I just want my life to be what it used to be.”

Eileen Geller of True Compassion Advocates, an education and advocacy group for individuals with life-threatening illnesses and disabilities, said that Sam Schmid’s rapid turnaround in the face of what seemed a hopeless situation offers a powerful argument against “pulling the plug” on someone who is facing "irreversible" coma. Geller told The New American that, even with breakthroughs in medical technology, brain science is still a world of vast mysteries. “The truth is, there is so much we don’t know about how people respond to these types of injuries,” she said. “In fact, we don’t know what we don’t know.”

She said that there are many variables that doctors and neurosurgeons don’t understand about how individuals heal or don’t heal from the types of injuries Sam Schmid suffered. “People who have been unconscious for months, or even years, wake up, recover, and end up living productive lives,” she said.

What could have ended as an unnecessary tragedy had Schmid not responded, instead became a new chapter of hope and gratitude to God for the young man and his family. Geller said she strongly advises those in the circumstances faced by Sam Schmid’s family to err on the side of caution with regard to making irrevocable decisions with the life of a loved one. “A family should be extremely reticent to believe that any doctor really knows what’s going on with someone who has suffered such an injury,” she said. “There are just too many unknowns and variables, and there is always hope.”

Schmid’s neurosurgeon, Dr. Spetzler, is inclined to agree. “There are so many things we don’t understand about the brain and what happens at the time someone is near death,” he told Good Morning America. “The whole family was at his side during the day and at night hovering over him, then to see there was a chance after being ready to let go.”

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