May 29, 2024

Terry and Terri: can people recover from devastating brain injuries?

The New York Times recently ran an obituary of Terry Wallis, a 57-year-old Arkansas man who died in a rehabilitation facility on March 29. What made Mr Wallis remarkable was that he was a kind of neurological Rip Van Winkle – he woke up in 2003 after 19 years in a minimally conscious state.

In 1984, Mr Wallis, then aged 20 and married with an infant daughter, was driving a pickup with two passengers. It skidded, smashed through the railing of a bridge over a dry riverbed. One passenger died, the other escaped without serious injury, and Mr Wallis emerged from the wreck comatose and quadriplegic. He was visited regularly by his family but was always unresponsive. But suddenly, on June 11, 2003, he greeted his mother and quickly began to communicate with the people around him, including his wife and daughter, now aged 19, with a child of her own.

“Within a three-day period, from saying ‘Mom’ and ‘Pepsi,’ he had regained verbal fluency,” said Dr Nicholas Schiff, a neuroscientist at Weill Cornell Medicine in Manhattan who studied Mr. Wallis’s brain. “He was disoriented,” Dr Schiff told the NYTimes, and “he thought it was still 1984, but otherwise he knew all the people in his family and had that fluency.”

He even regained some movement in his arms and legs. After his awakening, he was cared for by his parents and his daughter. (His marriage had ended in divorce.)

“I think Terry’s legacy to neuroscience at the highest level,” Dr Schiff said, “is to instil our enduring, undiluted and deep interest in understanding how human consciousness may recover after serious brain injury.”

Mr Wallis recovered two years before Terri Schiavo, a brain-damaged Florida woman was allowed to starve to death in 2005 – a case which went to the US Supreme Court and was reported around the world. Naturally, many people asked why she wouldn’t recover as well. Some doctors insisted that it was possible; others, just as fervently, that she could not. With the benefit of hindsight, it seems that Terry Wallis was in a “minimally conscious state” — his injury was less serious and some of his brain managed to regenerate. Terri Schiavo may have been in a persistent vegetative state.

Whatever the medical facts are, both were clearly alive, even if they were not conscious. Removing hydration and nutrition from Terri Schiavo, which led to her death, was described as murder by many observers.