Sunday, March 10, 2002

Sunday Afternoon There are of course, few sights as heartbreaking as seeing one whom you love inert on a gurney blinking, beeping, wheezing, bubbling, and dripping in ICU. But the mechanical devices necessary to facillitate Duncan's existence at this momnet, are in stark contrast to the warm and human care provided by nurses attending him. Both Dr. Bidawalla (A neurosugeon) and Dr. Matt Shane (the physician taking stock of Duncan below the neck), took a long time today to discuss the extent of Duncan's injuries. The impact from the car resulted in Diffuse Axonal Injury (DAI). "If the brain is the head of a mop", they said, "if you swing it rapidly back and forth, the little strands will flick at the end of each arc. In the brain, this results in the tearing of of the ends of the nerves, (axons)". More CATscans have revealed that Duncan's frontal lobe is bruised. There is also some bleeding into the ventricles of the brain. The treatment for this type of injury is primarilly supportive. The brain swells, and the skull's design as an inflexible protective helmet from injury, works against the patient. So Duncan's support team is monitoring his intracranial pressure and doing their best to keep it down. Duncan remains unresponsive to anything other than painful stimuli, which is not a good sign. 4:33:37 PM     comment [] The First Night Duncan's injuries were described by his physician as "the neurologic insult and change". The force of the impact was so great (that the seat belt(?)) broke a rib and punctured a lung, bruised his heart and fractured some spinous processes of his verterbrae. (see Spinous process.) However it was Duncan's "unresponsiveness to any stimulation other than pain" that is the principal concern to his caregivers. Although an intial CATscan revealed no overt signs of injury a subsequent scan found that he had some bruising on the front of his brain and some bleeding around the ventricles in the back of his brain. Duncan's EKG indicated he might be suffering a heart attack but this turned out to be an erroneous finding, perhaps affected by the bruising of his heart or his neurologic problems. His other injuries attended to, Duncan was sent to the Intensive Care Unit (ICU) for further treatment. 10:48:12 AM     comment [] The Accident At 6:19 pm on Friday March 8, 2002, Duncan's Nissan Sentra pulled out onto Leestown Road not a mile from his home and was struck on the driver side quarter panel by another car. ( Map). Duncan was wearing his seat belt and was apparently able to leave the vehicle immediately after the wreck. He walked across the road then collapsed. Winter Maley, who was going to the same meeting with Duncan, was following a few minutes behind, and by the time he arrived Duncan was already unconcious. A helicopter arrived soon after and flew Duncan to the University Of Kentucky Medical Center, the trauma center in central Kentucky. 10:21:08 AM     comment []

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