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'Something clicked' for brain-damaged man

/ Source: The Associated Press

Day after day, Donald Herbert sat unmoving in a wheelchair, drooling and barely aware. For the once robust firefighter, 10 minutes without oxygen had turned into nearly 10 years without seeing or speaking.

His wife refused to give up. His doctor had an idea.

Certain medications had shown promise in Dr. Jamil Ahmed’s more recently brain-damaged patients, drugs normally used to treat Parkinson’s disease, attention deficit hyperactivity disorder and depression. He gave them to Herbert.

Three months later, on Saturday, something clicked in Herbert’s brain. He started talking. Not only talking, his doctor said, but talking sensibly. Even making people laugh.

Over the next 14 to 16 hours, until he fell into a 30-hour sleep early Sunday morning, Herbert chatted with his wife, Linda, his four sons and other family and friends, catching up on what he’d missed.

Miraculous?

“I think so,” said Dr. Ellen Reilly, Herbert’s attending physician at Father Baker Manor nursing home, where he has lived the past seven years.

Ahmed had told Linda Herbert to give the drugs six months. Even he was startled at their apparent effect. When Ahmed examined Herbert on Saturday, he could follow commands such as shaking his head, moving his hands and counting to 200.

“I went to see him in the nursing home and I was so amazed,” Ahmed said. “I was so surprised that not only that he was talking but he was talking very sensibly. He was remembering his past, he just didn’t realize how long he was asleep. ... He recognized people. His comments were very interesting and people were laughing.”

Since that breakthrough, Herbert, who will turn 44 Saturday, has had infrequent moments of clarity but has not matched Saturday’s progress, his wife said.

“Don has made some advances, but there is still a long way to go,” she said. “As you can imagine for us, to speak to, and to be recognized by my husband, their father, after 9½ years, was completely overwhelming.”

Fluctuating conditon

Herbert went without oxygen for 10 minutes after being trapped under a collapsed roof while fighting a house fire in December 1995. He spent 2½ months in a coma, was blind and had little, if any, memory. In the last several years, his condition had sunk to a near persistent vegetative state, Ahmed said.

Then he asked for Linda.

He was stunned that nearly a decade had passed.

“My son, Nicholas, who had just turned 4 at the time of the accident, is just thrilled to have his father call him by name, hug him and speak with him. ... My husband did not believe that it was Nick at first, because he thought Nick was still 3 years old,” Linda Herbert said.

The experience has given the family, and doctors, hope.

The drug combination, he said, was meant to stimulate neurotransmitters, which brain cells use to communicate with one another.

Dr. Ross Zafonte, chairman of the department of physical medicine and rehabilitation at the University of Pittsburgh, said such classes of drugs may help with a rerouting of brain circuitry.

While seeming to offer promise in this case, the approach is not a cure-all for brain-injured patients, he said.

“Some of these things happen overnight. ... Some individuals are non-responders and understanding who is a non-responder is important, too,” Zafonte said.

There have been a few other widely publicized examples of brain-damaged patients showing sudden improvement after a number of years, at least temporarily, but experts say they are so rare they don’t have much to study.

In 2003, an Arkansas man, Terry Wallis, returned to consciousness 19 years after he was injured in a car accident, stunning his mother by saying “Mom” and then asking for a Pepsi. His brain function has remained limited, his family said months later.

Tennessee police officer Gary Dockery, whose brain was damaged in a 1988 shooting, began speaking to his family one day in 1996, telling jokes and recounting annual winter camping trips. But after 18 hours, he never repeated the unbridled conversation of that day, though he remained more alert than he had been. He died the following year of a blood clot on his lung.