From a clinical perspective...

[PCIntern]

the language used by the medical professionals in last night's presser was most disheartening. I myself have used such verbiage to cast the best light, for the time being, on a very bad situation. The surgeons and physicians were carefully parsing their words and were in effect saying, IMO: She's alive...she has sustained a terrible brain injury...she may recover from her wounds physically...from a brain standpoint it has yet to be determined exactly how much function she has lost...do not raise your expectations in terms of cognitive or physical function...more surgery may be necessary (that is usually really bad news).

Suffice it to say that this woman will most likely never be the same...a transverse bullet wound would have to pass through the frontal lobe for severe neurological wounding NOT to occur IMO. Someone stated that it was a back-to-front transversal which is normally very bad, and it pained me to see the faces of the doctors trying to be, in one sense upbeat, but the sadness in the eyes when describing her condition was almost unmistakable. I really really hope I'm wrong about this, but I have treated many people with much less severe brain injury whose faculties are severely impaired.

I have had to tell people that they have cancerous lesions of the posterior aspect of the tongue and/or the floor of the mouth. These lesions are VERY serious and often/usually fatal. My whole persona changes from when, say, I have to tell someone to go for a biopsy on what seems like it is probably nothing remarkable, but somewhat suspicious. It's a whole different attitude one takes...one can't help it. One lady, a very very heavy smoker and drinker looked into my eyes when I saw a nickel-sized lesion in the floor of her mouth under the lateral border of her tongue, and said to me, "I'm going to die, aren't I?" I attempted to recover, but realized that my whole visage had fallen despite my attempts to remain impassive. I saw that in their faces yesterday. Perhaps it was because of the mass of death around them...I hope so for her sake.

[phylny]

1. I am a speech-language pathologist,

and I got an order to assess a hospital patient who had an unsuccessful suicide attempt. He had a through-and-through frontal lobe injury. He talked, but rambled nonsensically, and he had no impulse control (his genitals were exposed when I walked in and he was touching his penis, with really no awareness that what he was doing was not okay). It was one of the saddest cases I had in the hospital.

[PCIntern]

2. I'm sure it was...

and believe me, I wasn't trying to insinuate that a frontal lobe wound wasn't serious, but that any other wound is orders of magnitude WORSE.

Very descriptive post on your part, BTW, I need to stop visualizing it...brain-bleach, please...

[GoCubsGo]

3. This makes me think of James Brady.

He survived similar injuries. I'm hoping for that sort of miracle, as imperfect as his was.

[malaise]

4. Dr Nancy shares your view

If she survives the next 72 hours, life will be very different.

No change so far says the mayor

http://www.justin.tv/rockinroosters12#/w/735381392/20

[PCIntern]

5. Just watched Sanjay Gupta on CNN...

the usual candy-assed BS from him...he never learned his lesson from when Michale Moore took a giant crap on him.

[MH1]

6. That's what I got too

I don't having any specific medical experience, just life experience, and I figured it would be a very lucky, maybe impossibly lucky, circumstance for that kind of injury to NOT result in permanent functional damage.

And the faces and word-parsing of the doctor really said it all.

I had originally posted the NPR story when they said she had died ... I was relieved that she was alive, but thought immediately, "what kind of life?" I hope it is such that the survivors are glad for it, but no one should think the magnitude of the tragedy, broadly speaking, is diminished because she is technically alive. And of course 6 others died as well. I am trying to put this in words and afraid I'm failing, but it's kind of like there was a huge sigh of relief 'she's alive!' but I find it hard to share in that relief. Maybe partly because my father suffered a stroke that was not adequately treated immediately, and I watched him deteriorate from that point for many years. I would not wish that on anyone. Either role.

[lapislzi]

7. PCIntern, I wish you had been my mom's doctor

She died from exactly the kind of tongue lesion you describe (heavy smoker/drinker...goes without saying). I was there when the doctor handed her the death sentence. I hung back as my father took mom out to the car. The doc just looked at me and said, "what?" in an almost confrontational tone. I had hoped for a word of comfort, anything. I mumbled "nothing," and shuffled out. I'd like to think that he was overcome, but I really believe he was just a jerk. I never spoke to him again. My mom died 6 weeks later.

Thank you for your informative post.

[Lucinda]

8. Thank you for the post.

My first thought when I heard that she had survived was about the quality of her life going forward. My hopes are that she surprises us all and does well...

[REACTIVATED IN CT]

11. My thoughts, also.

I work (in administrative capacity) in a rehab hospital that treats many pts with traumatic brain injury. Much long, hard work goes into their recovery but not all functions are always fully recoverable. I will be greatly surprised if she doesn't resign from her office.

[JohnnyLib2]

9. I suspect you are right and hope you are wrong.

sigh.....

[MuseRider]

10. The word optimistic

many times means something much different with a brain injury than it does in other situations.

I have taken care of too many brain injuries to think this will be what most were excited about yesterday after the word optimistic was used.

Of course there are always cases that amaze us, this could be one of them and I hope and pray that it is.

[REACTIVATED IN CT]

12. I hope so too n/t

[Lucinda]

13. Ran across this quote just now...

"...The Arizona Republic quoted Mark Kimble, a Giffords staff member, saying he had been informed by doctors that the congresswoman had been shot in “the best place you can be shot … It didn’t cross the centerline of the brain, which is crucial..."

http://www.politico.com/news/stories/0111/47276.html