Who Awakes from Coma – Is Survivor a Different Person?
Mary Ann, a survivor of coma had this to say about who awakes from coma:
“I have gone through the grieving process. I buried myself sometime last year.”
One of the most controversial issues relative to survival after brain injury is the issue of who it is that awakes. Many caregivers will firmly assert that their loved one died from the brain injury and that the person who awoke was a different person.
I cannot accept this view who awakes from coma or Mary Ann’s view of her self-burial.
People change throughout their lives. Each significant event, tragedy or success, each trauma has molded who we are. Likewise, our parent’s teaching us about politeness, manners, proper behavior has molded us.
The change from brain injury is a function of what part of the brain was damaged by the trauma. The critical issue in assessing who awakes from coma, is not the severity of the pathology, the length of the coma, but the part of the brain that was injured. Mild pathology to certain parts of the brain can be more serious than severe pathology to other parts.
I believe that most survivors are still the person they were before the injury. Each person before a brain injury, had a balance of personality that was the result of a lifetime of work by parents, friends and self. I believe that after a severe brain injury, the combination of traits that gave them their premorbid personality, has been thrown out of balance when they awake from coma. Throwing a survivor’s personality out of balance often results in an amplification of negative traits, magnified by the frustration, by the sense of loss felt by the survivor. If Mary Ann had not survived her injury, the sense of loss and mourning she feels for herself would not exist.
The goal of brain injury rehabilitation is not to create a whole new person, but to bring those personality traits back into balance as close of a balance as possible. The second role of brain injury rehab is to the degree their are and finding ways to compensate for new deficits.
Finally, if we want to make sure that who awakes from coma is has a chance to be who they were before, don’t return the survivor home too early, especially to a spouse. Too early of discharge not only cuts off the severe brain injury rehabilitation process before it should, it risks the marriage relationship. Retuning the balance, in face of the frustration and anger felt by the survivor, is harder than molding the healthy mind the first time. While it won’t take another lifetime to reset that balance, if the pace of the retuning is miscalculated, the consequences to the marriage and ultimately to the survivor, can be catastrophic. Once a marriage fails after a severe brain injury, any good chance for a lifetime of recovery for who awakes from coma, is diminished. The personal commitment, the reintegration into the outside world with a guiding hand, can only come from a spouse, or perhaps a parent. If we want who awakes from coma to be as close to the person they were, we must preserve the social structure of the survivor.
Click here for My Nightmare. One spouse’s account of coma and the return home.
My interviews at TBI Voices, Brain Injury Stories also deal with this issue in almost every story. In particular, Craig Sicilia, one of the nations leading TBI Advocates addresses this in depth in his story at http://tbilaw.com/tbivoices/craig-part-one-out-of-coma-emerges-leading-tbi-advocate/