• Mitch Keamy Photo Mitch Keamy is an anesthesiologist in Las Vegas Nevada Andy Kofke Photo Andy Kofke is a Professor of Neuro-anesthesiology and Critical Care at the University of Pennslvania Mike O'Connor Mike O'Connor is Professor of Anesthesiology and Critical Care at the University of Chicago Rob Dean Photo Rob Dean is a cardiac anesthesiologist in Grand Rapids Michigan, with extensive experience in O.R. administration.

« Good Anesthesia Matters! | Main | I Use The BIS Monitor For A Lot More Than Just Preventing Awareness! »


Dr. Val

Very interesting! And thanks for the compliment to physiatrists. :)


*Very* interesting.


I was the director of a large urban MICU for 25 years. I venture I saw as much anoxic damage as anyone in that time. It always amazed me how sure everyone was there was no awareness in those patients. I mean we had no way to confirm the extent of damage, no way to measure its change, in some cases no way to verify the diagnosis.
We took it on faith these people could not respond because the things we did didn't make them respond. Every once in a while a family member or nurse would note somethng which we usually disregarded, especially after experiences with families that clearly, out of hope, saw things that weren't there.
But we really never knew. And the pronouncements of the neurologists just seemed to confirm what we wanted to believe without objective evidence.
Even in the Schiavo case, granted some of the family claims and those of some of the politicians were "out there" but the confidence of some of the other side was just as discomfiting.
There is a lot to learn in this area and humility is the proper approach.

Account Deleted

I agree because of my personal experience with my PVS son Jawad Pasha who is now fully aware without motor function.Now I have come to know about another Persistent Vegetative State in Pakistan. His name is Muhammad Hussain. He is just 16 years old. He is located at somewhere in Pasheen near Quetta Pakistan. He has pressure sore(bed sore). Contracrure has developrd in his arms and feet are becomimg state due to unawareness.Still I am only on telephonic contact with the family but I talked with rhe patient and the famuly and gave them the hope. Now I have sent one peramedical to his home who is well aware due to working with my PVS son for many years. He told that the boy has started responding by blinking eyes and trying to speak.

andrew kofke

many neurologists think that these patients with pvs and who have awareness were probably misdiagnosed. I am not sure I totally believe that. However, it is also likely that there is also a percentage of PVS patients who really are unconscious and do not have awareness. anyway this work has opened our eyes to this possibility and I certainly consider it when i am around a patient with pvs.

thanks for your observations


Account Deleted

I have given my comments some six months ago and I am happy to write here that the boy (Muhammad Hussain of Pishin) has improved very much. He has started smiling even laughing on jokes sometimes, His health is now good and he is now without any bedsores. He is moving a little bit without any contolled movement and started a little eating and drinking. In my view he is too without motor function yet.

The comments to this entry are closed.

Blog powered by Typepad