BACK FROM THE DEAD? ( with electric pulsing )

[Guest guest]

Back From the Dead

A small but passionate group of doctors say that electricity applied

deep in the brain can jolt patients out of irreversible comas. That's

when the real problems begin.

By Gary GreenbergPage

 

For someone left for dead 12 years ago, Candice Ivey seems to be doing

pretty well. She's still got her homecoming queen looks and A-student

smarts. She has earned a college degree and holds a job as a

recreational therapist in a retirement community. She has, however,

lost her ballerina grace and now walks a bit like her feet are asleep.

She slurs her words a little, too, which sometimes leads to trouble.

" One time I got pulled over, " she says in her North Carolina twang.

" The cop looked at me and said, 'What have you been drinking?' I said,

'Nothing.' He said, 'Get out here and walk the line.' I was staggering

all over the place. He said, 'All right, blow into this.' Of course I

blew a zero, and he had to let me go. "

 

In November 1994, when Ivey was 17, a log truck T-boned her Chevy

Blazer. She remembers nothing of the next two months. But it's all

seared into the memory of her mother, Elaine, especially the part

where the doctors told her that Candice, who was in a coma and

breathing by respirator, should be pronounced dead. Her brain, they

said, was entirely and irreversibly destroyed by a week of swelling

and bleeding and being pushed up against the inside of her skull like

a ship scuttled on a reef.

 

A few days later, however, Candice proved the doctors wrong. Unhooked

from the respirator, she continued to breathe on her own – something

she couldn't have done if she were truly brain-dead. Now Elaine faced

the horrible decision of whether or not to feed her child. The doctors

warned her that Candice would probably never wake up, and if she did,

she almost certainly would be unable to live independently. In the

worst case, she would enter the permanent twilight known as a

persistent vegetative state, in which she might sleep and wake and

move her limbs, yawn and sneeze and utter sounds, but not in a way

that was purposeful. Elaine decided to keep the feeding tube in place,

which, she recalls, made the neurosurgeon furious. " He thought I was

just prolonging her agony and that I would have a vegetable on my

hands, " she says. " But when it's your child lying there, you'll do

anything. "

 

In this case, anything included letting an orthopedic surgeon named

Edwin Cooper try an experimental treatment. He approached Elaine out

of the blue soon after the accident and urged her to let him put an

electrified cuff on Candice's wrist. It sent a 20-milliampere charge –

enough to make her hand clench and her arm tremble a little – into her

median nerve, a major pathway to the brain. It might rouse her from

her coma, he said.

 

" I thought it was hokey, if you want to know the truth, " Elaine says.

She agreed nonetheless – she was, she says, " drunk as a coot " from a

combination of " nerve pills and a full glass of whisky " – and the cuff

went on. Within a week, Elaine was sure that Candice was stirring. Her

doctors doubted it. " They kept telling me it was just reflexes, but a

momma knows. " Then, just before New Year's Day, a month after the

accident, Cooper asked Candice how many little pigs there were. She

held up three fingers.

 

Now 29, Candice Ivey is thrilled to see the 64-year-old Cooper when he

shows up at her door. She gives him a big, warm hug and sits close to

him on the couch. They chat about the presentation on traumatic brain

injury that she recently gave to nurses at Cooper's hospital, and how

hearing the story of her ordeal again brought him to tears. As she

tells me of her injury and its aftermath, she comes back time and

again to her gratitude. " The wreck was my fault, " she says. " But

getting better, that was God's doing. He sent Dr. Cooper to my momma,

didn't he? "

 

Edwin Cooper has been sent, or has sent himself, to about 60 severely

brain-injured people since the mid-1980s, when he first made the

accidental discovery that electrical stimulation had effects on

arousal. He was using a neuro-stimulator to relieve spasticity in the

limbs of microcephalics, people with abnormally small skulls who often

have reduced mental capacity and poor muscle control. During the

treatment, he recalls, one patient started looking around his room and

smiling when people walked in, instead of staring blankly. Cooper had

already observed that when he placed the stimulator on one arm of a

quadriplegic patient to strengthen the muscles there, the opposite arm

also got stronger. He concluded that the electricity was making its

way to the brain, crossing to the opposite hemisphere, and stimulating

arousal centers in the process. He began to wonder about the effect

this might have on unconscious people. " I thought, if someone were

normal and able-bodied but in a coma, maybe this would make a

difference, maybe help wake them up, " Cooper says. " It was like maybe

we could reboot the brain. "

 

Cooper started testing this hypothesis in 1993. Candice Ivey was one

of his first research subjects, and her recovery remains the most

spectacular. But Cooper has gathered data on 37 other patients in two

studies (at the University of Virginia and East Carolina University).

The results indicate that people given electrical stimulation emerge

from comas sooner and then regain function more quickly than if they

are given only traditional treatment. They're more likely to leave the

hospital under their own steam, with less-severe disabilities than

would be predicted by the nature and extent of their injuries.

 

Still, Cooper knows that 38 patients is a tiny sample, especially in a

field where so little is understood and in which unexplained

spontaneous awakenings, even after long periods of unconsciousness,

are not uncommon. But despite being published in the peer-reviewed

journals Brain Injury and Neuropsychological Rehabilitation, his work

has yet to attract the attention of mainstream researchers. So, in the

meantime, he hustles for every patient. He heard about Candice while

at a friend's wake, waiting to view the body. Another mourner

mentioned that there was a girl in a coma at ECU's Pitt County

Memorial Hospital. " I got right out of that line and went to find

her, " he says. He adds that he has Google news trackers set up for

" brain stem injury " and " teenage coma. " But the patients and doctors

he contacts rarely respond, and Cooper and his stimulator remain on

the margins of medicine, frustrated. " It's so easy. Why don't people

just use it? "

 

Cooper's best hope may lie overseas in Japan, where over the last two

decades doctors have used electrical stimulation on hundreds of

patients – some of whom have been unconscious for many years. The

evidence that the Japanese doctors have amassed could confirm Cooper's

claims and bring hope to the families of patients most American

doctors consider beyond cure. But it may also undermine the hard-won

yet fragile consensus on what, neurologically speaking, makes someone

alive and when it is acceptable to pull the plug.

 

more:

 

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