Miracles and Tragedies

by Attorney Gordon S. Johnson, Jr.

For what it is worth, here are my thoughts on the "miracles in severe cases" and the "tragedies in so called mild cases."

In many severe cases, there is severe damage to a localized part of the brain, but if the neurosurgeons intervene to reduce the swelling or bleeding, the secondary damage to the balance of the brain can be significantly reduced. Thus, even though there is neurosurgery and significant coma, the injury may be sufficiently localized that the brain has the ability to compensate for the injury.

In contrast, when there is no coma, the medical community does not intervene, and two of many types of pathology could explain the severity of permanent damage:

First, swelling may be occurring, but no one is there to document it. While this may not be life threatening like it is in the severe cases, it could be sufficient to cause widespread cell damage or cell death.

Second, there may be diffuse axonal injury, insufficient to cause coma. While the secondary injury caused by pressure may not be occurring here, the damage is so widespread that the brain cannot find alternative pathways to compensate for the damage. While total function may not be impaired, nothing works as it should.

Diffuse Axonal Injury

In evaluating acute interventions, one must always remember that the overwhelming priority in the medical community has always been to prevent death. The Glasgow Coma Scale was devised as a predictor of when death would occur, not the prospects for a full recovery.

Some of what I speak of is medical science, some of what I speak of is conjecture from someone who thinks about this more than our scientists do.

Hopefully, our next generation of emergency interventions will not only gives us answers, but miracles for those who "because of the lack of medical emergency" didn't appear to need them.

Non-coma Brain Injury

Understanding Subtle Brain Injury

The concussions that disable, are almost always more symptomatic at 24 hours, than at the 2-4 hour time frame when injured persons are evaluated in the emergency room. Brain injury symptoms escalate over the first 24 hours, because brain injury involves a cascade of events. It is critical that if you are still symptomatic the day after your injury, go back to the same Emergency Room, don’t wait for a doctors appointment. It is critical that the Emergency Room personnel see that the symptoms still persist or have gotten worse.

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