Paul White: Severe Brain Injury
A new millennium, spring 2000; we celebrate our 25th wedding anniversary with our daughter, Ruth, 22 and our son, Paul, 20. Saturday, a gentle horse and cart ride through Suffolk countryside and pub lunch. Sunday, church, family lunch, walk the dog and relax. Sunday evening, Paul went to see “Gladiator”, driven by a friend in his expensively “souped-up” pride and joy, a Fiat Uno of some vintage and hiding rust.
At midnight we hear the heavy knocking of a policeman and our world falls apart; never to be the same again. He announces a car crash and asks us to attend the local hospital. We go weak at the knees but gather ourselves together and drive in. The prognosis is terrible: Paul has massive brain injury and is not expected to survive. His GCS score was three, the lowest. Strangely he doesn’t look so bad; many scratches, deep glass cuts to left cheek, broken clavicle, two fingers, femur and many bruises, but the brain scan tells a worse story.
Paul is transferred to intensive care and, within hours, to the regional Neurosciences Critical Care Unit which is 6o miles away. Thankfully they have a bed and know how to give Paul the best chance. However his life hangs by a knife edge as bruising to lungs and heart and the brain create a fine balancing act of drugs, drains, blood pressure, inter-cranial pressure, oxygen count. Paul is kept in a coma until he has stabilised, but when he is allowed to come round the worst fears are confirmed and doctors talk of nerves severed from the brain stem and recommend a “Do not resuscitate” order.
Paul survives and now, over three years later, continues to progress VERY SLOWLY from that minimally responsive vegetative state. Paul still cannot walk or talk or write, so communication is very difficult and that is why Paul cannot write this story himself. But Paul can smile, show pleasure or frustration, cooperate or make things difficult. Paul can now swallow and eat and, with improving coordination of the right hand, he can do some of that for himself after prompting. He remains doubly incontinent.
After a few months in a general NHS hospital Paul had 6 months of rehabilitation therapy, an isolating 140 miles from home. He is now in a high dependency home 30 miles from us. Extra therapy, support workers and equipment are paid from interim compensation claims against the driver’s insurance. Without those significant funds, advocacy by ourselves and much effort by all involved, Paul would not have made as much progress, progress which has not been encouraged by several experts who talked of reaching plateaus and warned to “stop expecting so much”.
Paul’s girlfriend missed out on her A levels as she rushed to keep a bedside vigil and visited regularly for a whole year. Mum and Dad visit once a week but this is often arranged to coincide with meetings, equipment demonstrations, helping or learning from therapists. We bring Paul home most Saturdays and overnight once a month. There is much correspondence to handle with solicitors and case manager and many decisions to take on Paul’s behalf. Dad can only work 3 days a week if we are to cope with this regime. Paul’s sister Ruth visits him at the care home or our home. Our house has been adapted to accommodate the wheelchair and provide for Paul’s care needs.
It is no longer useful to get too stressed by the circumstances of the crash itself; we just have to cope with the consequences. However, trust and care-freeness have been destroyed. The “it won’t happen to me or mine” mentality is gone and replaced by concern over road safety, driver attitude, the injustices of the legal system. In this case the young driver, like so many, was careless of the danger of excessive speed and took a corner so fast that he caught the kerb, crossed the road, climbed a low bank and smashed the rear of the car into a tree. Paul was in the back and took the brunt of the impact as the back of the car broke in half due to the poor “professional” repair of rusted sills, which should not have passed an MOT test. The system failed us by doing nothing about the MOT pass, by bringing only a careless driving charge, by presenting the case only to a magistrate, by neglecting to tell us when the date was changed, by charging only for the offence of excess speed not for ruining Paul’s life.
There can be a very fine dividing line between death and injury. For many months we grieved over the loss of Paul who had before him all the hopes of career, marriage and children. All have gone. Fatal crashes are not dealt with fairly by the law; serious injury is just about ignored – this injustice is part of our suffering.
Prepared by Samer Ojeil- YASA Lebanon