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As Bob lost complete consciousness, the young surgeon screamed, “He’s going down, he’s going down!” and then he yelled to me, “I hate blood on the brain.”

The surgeon instantly started a brain puncture (with a drill) to release the powerful buildup of blood putting pressure on the brain. During the procedure, Bob aspirated and in addition to the traumatic brain injury, he was later diagnosed with acute respiratory distress syndrome (ARDS), a very serious problem that happens when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs.

Do you remember actress Natasha Richardson, 45, married to Liam Neeson, laughing and chatting with friends soon after a skiing accident at a Canadian ski resort? Hours later at her hotel, her head began to throb and she was rushed to a hospital where she most likely died of an epidural hemorrhage caused by blunt force trauma to the head. There were no outward signs of any traumatic brain injury. This condition is often referred to as “talk and die” syndrome as the patient declines so fast. Doctors say patients with this type of brain injury can appear totally normal like Bob when they actually have a catastrophic brain bleed. As pressure builds in the brain, they will have symptoms of a traumatic brain injury. Blood gets trapped between the skull and the hard layer of the skin between the bone and brain (dura mater). As the blood flows from the ruptured artery, the fluid builds up and punctures the dura. At this point, all of the pressure is pushed on the brain, causing it to swell. As the pressure continues, it reduces blood flow to the brain and the patient begins to have obvious symptoms and usually succumbs to the bleed.

That night, my son Rob and I huddled together in the recently renovated family room next to Bob’s ICU bed. I called our two daughters and Bob’s family and anxiously listened to the drill puncturing Bob’s skull. We both covered our ears as the loud, whirling, grinding sound went on forever until sunrise when it stopped. As a Christian, I had ultimate faith in God and the brilliant neurosurgeon but still peppered the young doctor with questions: Where did you study? What board certifications do you have? How many brain surgeries have you performed? Has anyone died during your surgery?

In the midst of the most horrific catastrophe imaginable, I needed some comforting words and strong assurance that this surgeon was indeed the very best. I needed him to say, “It’s OK. Bob bumped his head. It will be fine.”

Instead, the young surgeon looked at me with tears in his eyes and said, “You are the most courageous woman I have ever seen.”

I didn’t feel so courageous the next morning when a burst of white coats–doctors, surgeons and ICU nurses–rushed into Bob’s room with pages of legal documents for me to sign—for emergency brain surgery, to put in a Central Line (a catheter that’s inserted in the chest through the skin into a large vein), to insert a feeding tube and to do a tracheostomy, an opening surgically created through the neck into the trachea (windpipe) to allow direct access to the tube that’s connected to life support. With each legal release I read and signed, I mentally noted the first line on the release forms stated, “Death is the likely outcome.”

And I was unprepared for what followed.

Deb Bruce
Deb Bruce
Debra Fulghum Bruce, PhD, is a well-known author, senior medical writer and health literary expert. Deb works hard and plays hard! An avid wordsmith and health communications professional, Deb loves boating, fishing and catching blue crabs at her bay front condominium in South Tampa Florida.

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