Email to a friend , 17th July 2009, two weeks after the attack that left my son in a coma:

I  had words with the nurse by his bed ( there is one with him 24/7) . Unfortunately, I had to get the patronising one, who told me that when they say stable that’s what it means and I needn’t concern myself… and when I said I had asked to be informed of any major changes, ‘Oh, so you want me to call you at 2 am to tell you he’s had a pooh?’ This with a saccharine–sweet smile. Grrrr….She also said that she is a mother and knows exactly what I’m going through… somehow, I don’t think so, or there would be a little more compassion.

Unfortunately, the other person at his bedside with me was the police family liaison officer… and she, bless her, was not impressed. I saw a doctor, away from the bedside, within minutes.

So, a rather more accurate update…

Brain pressures are finally stable enough, within acceptable parameters, even when the drain is clamped. CO2 levels are high, but he’s tolerating the added blood to the brain. Vital signs are ok, though most are machine regulated. He has now been completely removed from the cooling machine and is running a slight temperature (as of 5am this morning 38.6) so has been given paracetamol to control it. He doesn’t necessarily have a chest infection… though they are testing for one as there is a heavy build up of fluid on the lungs, more than there should be for someone in a coma and unable to cough and move to ease it. They are running a full body infection screen to check for other infections as his white cell count is up. The broad spectrum antibiotic was a dual purpose thing to combat possible infection and to stimulate the gut, as he is still not absorbing much nutrition, even though the tube has now been inserted directly into the duodenum instead of the stomach.

There is reflex movement in his eyelids… just a strong twitch… but in both of them. Considering the severity of the damage to the left hemisphere, I am pleased and surprised to see any movement on the right hand side of his body. He coughs when they aspirate his lungs. He is being given adrenalin for his heart and insulin.

They have removed the paralysing agent altogether! And began last night to marginally drop the dosage of the morphine. That will take several days, depending on how he reacts. I am told the withdrawal from such massive doses will affect him and he may become agitated and distressed… frankly, though that may be awful to see, if he can control his limbs enough to clutch at tubes and things, I’ll take that as a positive sign. They will give him tranquillisers rather than sedatives, to calm him if this happens.

However.. and there had to be one, didn’t there, as this is such a roller-coaster…

I finally got some answers on the damage itself. Probably as much as they can tell me at this stage and more than they may perhaps have wished to say.

During the initial brain surgery to clean the wound as best they could and remove the shards of bone from the brain, they said the weapon had left a 2 inch track into the left hemisphere from the temple. However, recent scans show that the initial damage was far more severe, with the screwdriver penetrating far deeper into the brain, coming very close to the brain stem itself. Along with the swelling, bleeding and bruising surrounding the wound, it seems the brain stem may have been compromised. Add this to the instant coma, the depressed fracture and bone splinters, massive subarachnoid haemorrhage, the intracranial pressures being so high, the oxygen deprivation and blood loss… and the coma score of 3 right from the start (3 is the minimum score for just being alive, 15 is ‘normal’) and the prognosis looks appalling.

My son is currently unlikely to die from the actual wound itself… enough time has passed for a degree of healing to occur. Swelling, further bleeding and infection may still kill him. However, it is my reading of what I have been told that they are removing the sedation so quickly now, following the scans, in order to give Nick a chance to die. The brain stem, amongst other functions, I understand, plays a large part in the involuntary movements which regulate the workings of the lungs and the ability of the heart to beat. They will not restart his heart should it stop.

Should he survive physically, it seems now even more likely that he will remain in a coma, or be left in a vegetative state of wakefulness without awareness or ability. We know that the areas of the brain that deal with memory, personality, language, understanding, learning, and many motor skills have been damaged (and that’s the short list, without adding the possibilities of damage to the brain stem itself). How well the brain can recover from these injuries varies from one person to another, but the physical damage appears so severe there is little left to hope for.

My son always said he would not want to be left alive like this, should he have a car accident, yet the doctors, ethically, must try and save his life. A very large part of me wishes they would stop now.

The pain of this is indescribable. Yesterday I stood and watched my son’s eyes flicker, grinning like an idiot,  KNOWING this was ‘nothing’, just reflex, not Nick… yet I could not help the flare of hope and joy at seeing any sign of ‘life’… even if I knew it wasn’t really. Hope springs from the deepest level of love and knows no logic. Yet at an even deeper level, I am praying that he can go now, in peace, to be healed by the Light, held close in our love for him forever.