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     Volume 5 Issue 116 | October 13, 2006 |

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Straight Talk

Do You Believe in Miracles?

Sometimes I think that the human race is becoming more and more cynical and world weary. We are inadvertently finding ourselves desensitised to the pain and suffering around us possibly because we are constantly reading or hearing about violent crimes, natural disasters, wars etc. the whole time. But every now and then we do come across something that reawakens a little bit of optimism in humanity or allows us to believe that there is hope for us yet as miracles can really happen. Reading an article in the newspaper the other day about a number of people who have come out of their coma despite doctors thinking that the chances of them ever regaining consciousness were almost non existent, made me realise that even when we feel that things have reached rock bottom, there is always hope. And the strange thing is that the cause of the patients coming out of their comas was nothing more than a simple sleeping tablet!

It reminded me of a film I had watched more than ten years ago called Awakenings. It starred Robin Williams and Robert De Niro and it managed to make a huge impression on me. It portrays the story of neurologist Malcolm Sayer who takes a job in a psychiatric hospital in New York in 1969. He is in charge of a group of patients who have been in a catatonic state for decades. Soon Sayers finds that the patients respond to certain stimuli and decides to try the efficacy of a newly developed drug called L-Dopa. This brings about an almost miraculous recovery by the patients, Robert De Niro being one of them. However, the effects of the medication turn out to be short lived and soon the patients return to their catatonic state. I recall feeling genuine anguish and trying to check the flood of tears that were cascading down my cheeks when the patients stop responding and revert to their original state. This was probably mostly due to the fact that it was based on the true story of neurologist Dr. Oliver Sacks who really did use the drug L-Dopa to awaken a group of catatonic patients. These patients had survived the 1917-1928 epidemic of the so called "sleeping disease", known as encephalitis lethargica. In the film we get to witness the joy that Dr. Sacks feels at the amazing progress his patients make and then his total desolation when the drug stops working and the patients stop responding to it.

The story I read in the Guardian Newspaper was about a young man Louis Vilijoen who was in a road accident in 1994 that left him with severe brain injuries and ultimately sent him into a coma. The doctors did not believe he had any hope of regaining consciousness or even surviving. For five years his mother would visit him regularly in the hospital but saw no signs of recovery. It was a sister in the ward Louis was in who felt that Louis might be in some pain or discomfort as there were sudden spasms in his left arm. The observations by the sister led to Louis being prescribed a sedative by his GP Dr. Wally Nel, called zolpidem to try and ease his pain. This was in 1999, five years after he had the accident. His mother crushed it up and mixed with a soft drink spoon fed it to him even though he was unable to swallow. Within half an hour Louis had not only regained consciousness but had managed to say “Hello mummy”! Not only that, there were examples of other patients in similar vegetative conditions who had miraculously come of their coma thanks to the help of a straightforward sleeping tablet. Reading something like this was truly wonderful. It gave me a sense that miracles do still happen. There were no miracle drugs, it was not something scientists had been working on for years, and it was literally just a fluke. In fact even the doctors prescribing the tablets were mystified by the results of zolpidem.

It seems that people are not exactly sure how the drug is working especially when the patients in question were considered brain dead. When a scan was done on Louis brain, the finding showed that areas of the brain that had previously been black and inactive were now showing signs of being active. Dr. Nel and Dr. Raulf Clauss have a come up with a hypothesis. According to them, “After the brain has suffered severe trauma, a chemical known as Gaba (gamma amino butyric acid) closes down brain functions in order to conserve energy and help cells survive. However, in such a long-term dormant state, the receptors in the brain cells that respond to Gaba become hypersensitive, and as Gaba is a depressant, it causes a persistent vegetative state. It is thought that during this process the receptors are in some way changed or deformed so that they respond to zolpidem differently from normal receptors, thus breaking the hold of Gaba. This could mean that instead of sending patients to sleep as usual, it makes dormant areas of the brain function again and some comatose patients wake up.” (Guardian)

I can only imagine the joy of the families of all the people who have had this miracle happen to their loved ones. To get back a son or daughter or relative from a place where death was the only certainty is probably something that most of people in similar situations can only dream of. Unlike the sad ending in the film Awakenings and the real life patients on whom the story was based on, the effects of zolpidem still seem to be working on the patients who are now taking it on a daily basis. Although most of them are living with disabilities caused by their brain injuries, such as blindness and speech impairment in the case of Louis, they seem to have maintained their recovery. How long this will last no one can tell but one can only hope that patients like Louis will steadily improve and show us that miracles can happen.



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