Wednesday, November 20, 2013

NaNo 2013: Day 20

Today's excerpt is an interesting one for me as a medical student. On one hand, I have to go with the plot. On the other, I feel that by writing this, I am furthering a misconception about the concept of brain death. As such, this excerpt will be followed at the end of the post with some information pertaining to said topic.

"And on today's broadcast, we bring you the unusual story that seems to have caught everyone attention. A local man, previously declared brain dead, is now sitting up and talking to his family. This is the latest in the string of incidents that many are calling miracles at St. Christopher's hospital downtown," the anchor reported.

Sophia raised her eyebrow and focused on the story as the picture changed to a scene in front of the hospital.

"The doctors told us he was dead, that his body was only functioning because of the tube down his throat. They took out the tube, and he stopped breathing, for a full five minutes. Then, all of a sudden, he's gasping and sitting up in bed," a younger woman explained, clutching a tissue in her hand.


NaNo Stats:
Days: 20
Words Today: 1721
Total Words: 24,175
Words Remaining: 25,825
Average Words/Day: 1209

Educational Information:

There are two ways in which physicians can declare someone dead. The first is the traditional cardiac death, when the heart stops beating. After all, if the heart isn't beating, blood isn't flowing through the body, and thus your tissues die. Technically speaking, the heart needs to have stopped for a certain period of time before death can be called, as people's hearts stop quite often and this can be reversed, either naturally (someone passes out because their heart stops for 2-3 seconds, then restarts), or by us (CPR, or a pacemaker/defibrillator).

However, the second way in which physicians can declare someone dead is by declaring them brain dead. It's actually a fairly involved process to declare someone brain dead, and requires several tests to be performed by two separate physicians. It is not something that is taken lightly. Basically, the person does not have any signs of consciousness (withdrawing from pain, for instance, or eyes that follow a target), nor can they have some basic reflexes, including the drive to breathe. The final test for someone who is brain dead is removing them from the ventilator that is by definition keeping their body functioning, and, ultimately, their heart stops beating. These people can have bodies that are kept alive by the ventilator and medications, but are dead. They are most often put back on the ventilator after 5 or so minutes, and donate their organs. These organs are generally the most likely to survive being transplanted, and are considered better than organs given by those who die from cardiac death.

Bottom line, brain death = death. It is not possible to recover from it, and people do not make miraculous recoveries from it. It is not akin to a coma, where someone is unresponsive, but still dead.

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