Random thoughts on a variety of subjects
By Sam Redman
An excellent article appeared in New York Magazine describing the need for honest reporting concerning the prospects for recovery for Gabrielle Giffords. You can read the essay by clicking here.
I’ve been looking for this sort of perspective to be published for some time. While we all wish any victim of a traumatic accident such as she experienced the very best, it should be realized from the nature and wording of the very guarded “optimistic” physician statements that the true prospects for a recovery to a normal state are actually quite grim (or certainly unknown). But, for most television viewers and readers of daily newspapers in print and online, anything other than a complete and rapid restoration of her faculties would be totally unexpected. However, it seems apparent, after the initial “squeezing” of hands in response to a verbal request that there has been nothing further which would confirm she was ever able to use this squeezing (or later improved hand dexterity) to signal answers to questions, such as one squeeze or one tap or one extended finger for “yes,” two for “no,” three for “repeat the question” or similar primitive response coding, used for other patients who can’t speak or see (even in comatose situations), but who can at the least move their fingers. And while that current state may not mean that communicative capacities are not going to be realized during her rehabilitation, it is actually quite irresponsible for various media reports to convey her situation as different than what it is.
Information from neurologists, unrelated to her case, but commenting concerning the bullet path, seems to indicate that while many brain functions (such as motor capacities) are at least partially operating, the area controlling speech (and that which enables thought processing and reasoning) is where most damage likely occurred. Sometimes that damage is repairable, but other times not. Many victims do achieve various levels of recovery and there is real hope that she could have again the ability to speak and move well enough to enjoy a life in many ways similar to what she knew prior to the accident. But, the key word here is “hope” and that is the perspective which needs to mollify the reports of her progress and prognosis.
Instead of the happy assumptions which many news bulletins seem to convey, really we can only conclude that her motions, such as giving a neck rub (which might have been just a repetitive rote low level motor memory), moving her hand across Ipad gallery images, and being fascinated with rings, are similar to those that an infant would do at various stages of early development. Babies, who can’t yet speak or walk, will smile and recognize objects and they will focus on and play with round items (like rings), as well as touch screen gallery pics (six to nine month olds will swipe across smart phone gallery images once they see it done or discover it from their own experimentation). From what some doctors have stated, especially in articles which were published long before this incident, rehab in such traumatic brain injuries can sometimes be much like teaching a baby to speak and move and walk.
It all (evidently) depends on the extent of the bullet’s damage… most press never considers the possibility that she may only reach a stage of limited functionality (simple bathroom tasks such as brushing teeth and limited bathing and other personal hygiene routines). That’s the situation in literally thousands of head trauma victims even where the very best rehabilitation techniques have been employed.
That superb article in New York Magazine is the first I’ve seen to consider any other possibilities than those which describe a “miraculous” recovery (including some which talked about her going home in week and being back in Congress shortly thereafter).
Similar (in reverse) to reporting about the oil spill, where the media wanted no good news to surface, here many reporters only seem to want to describe this situation from a Pollyanna viewpoint… that she will be, “good as new in no time.” Truth in reporting is often a rarity today. Very sadly, if the prognosis for Giffords is as bleak as it might be (or even anything less than a fully functional recovery), there will be unnecessary psychological injury to millions of people who simply won’t be prepared for what is most likely the realistic outcome.
Of course, I , like so many others, will be watching and waiting with every hope that her case is going to be one of those “miracle” recoveries and that she can return to full capacity as a Congress person or even a more lofty role (as some are already predicting). But, like the article in New York Magazine presents, I believe that our hopes should be tempered with factual status reports which give everyone the vantage of realistic expectations.
Added note: In the past few days I have seen more articles which are detailing the realism of the prospects for her recovery and the arduous nature of such a rehabilitation even when most successful. Here are two very good articles which are actually quite encouraging, while being realistic about what might be more dire scenarios. One is an article compliled from Associated Press reports on the Google news service which talks about the details of the rehab which she might experience.
A second article from the New York Times describes the recovery path of a young man, now a college student (who is also mentioned in that first article). He suffered a very similar gunshot wound to the brain as Gabrielle Giffords and his progress and current capacities certainly give hope concerning her outcome while realistically explaining his limitations and permanent handicaps as well as the difficulties he endured in achieving the level of functionality which he has accomplished.
Both of those articles seem (along with the New York Magazine piece) to signal an encouraging and welcome trend toward letting the public gain an understanding of what are realistic hopes for Gabrielle’s recovery.