George

George

I have posted earlier about Tommy, who had hydrocephalus from his meningomyelocoel and whose family was so horrified about his appearance that they essentially disowned him.

And I have posted earlier about the so called “vegetative state”, which is over diagnosed in almost half of the cases, and the diagnosis is used as a cover up that these people are still alive, but in the opinion of many PC bioethicists, better off dead, so like sophists they have elaborate arguments on how to justify making them dead.

In my long years of medicine, I have seen many severely brain damaged patients, but few who were completely unresponsive except in the obviously dying. As I explain in earlier posts, if they have that much brain damage, they usually die within six months of aspiration pneumonia, even with a feeding tube…

But when I worked with the retarde, we had another patient with severe hydrocephalus, who was indeed the client who was closest to what one would call a “vegetative state”…

George was very spastic, and had a huge head. A CT scan showed an empty skull, except for a small line of cortex that was probably only 1 cm thin. (The cortex is the thinking part of the brain). George mainly lay there like a lump. He was blind, and did not respond to sound, unlike most of the patients…No brain, most would say. A vegetable.

Well, not quite.

Massive hydrocephalus is not something we see nowadays but in the past when they didn’t fix hydrocephalus, such cases were seen…and in the book “Intern” by Dr. X, he relates the story of a college student who was having headaches, and when they did a pneumocenphalogram they found her cortex was only about 1 cm.

Now, George was spastic, and barely responsive, but he had enough cortex to have seizures…and he had enough cortex to feed him with a spoon.

You see, two years before I started working at that institution, George developed a huge bedsore on his back. Theoretically this was due to neglect—you prevent bedsores by changing the position of the body frequently, and by special mattresses that don’t put pressure on the bony areas. But a bedsore can develop in 1 to two hours in high-risk patients, and high-risk patients include those with poor nutrition.

So to heal the sore, they assigned George his own feeder. It took one hour to feed George, and he was fed four times a day.

And he probably had a good swallowing reflex, because in the four years I worked there, he only had one episode of pneumonia.

But my opinion of George changed one day, when I went into the ward and heard a melodious voice coming from the bathroom. I originally thought it was Vincent, or one of the other “high functioning” patients, but when I wandered in there, I was amazed to find George, who was being bathed, singing a tune. Not just moaning or vocalizing, but on key…in a patient who never responded to noise.

“Oh, he sings all the time” the aides assured me, “He likes his bath”.

So much for vegetable George.

But there is another story about George.

As laws changed we needed to find his family. Many families had little contact after their children were sent to institutions, since back then doctors said their children would never do anything, so they should forget about them. We assumed this was true about George, but needing family directives about living wills etc. we searched out his family and found a sad story.

George’s mother was blind, and his father had limited sight.

When she had the baby, the staff notified social service to take him away from her, and she was not told where he was sent. They assumed that since she was blind, she could not care for him—which was probably correct, given his severe handicaps.

But it might have been because in those days blind people weren’t supposed to be able to be independent and care for their own children.

Anyway, George’s mother had another child, who she managed to keep and raise successfully. But her heart always wondered about George…and when she was contacted, she eagerly came to see him.

And the picture stays in my mind: a blind mother, stroking her child with love, and George humming quietly in response…