madge This is another one of those exam questions where the right answer comes to you in the middle of the next night. along with a paradigm stretching realization.  Keeping in mind that Patient Rights is the one competency I got an unsatisfactory result on my pre exam.  The question is, you have a younger person who has emerged from a car accident on ventilation with no detectable brain waves.  What do you tell the family?

Well, strictly speaking, I haven’t done any dedicated coursework in neuroscience, so I’m not really qualified to say.  But if the issue is patient rights, they have a right to know the truth, which is apparently not “I’ll tell you more when I know more.”

What is interesting about this is the idea that if your brain waves collapse, the party is over.  It’s as if your brain has a pulse.  I’ve reflected on this before.  I used to think that neurons were like switchboards, only active when you actually had a thought or some stimulus.  But it turns out they are firing constantly, even during dreamless sleep.  So your consciousness is not like a spider or even a millipede trekking along a canyon but a kayak on top of white water, stirring its path above tons of roiling, crushing chaos.

“Is this making any sense?”

“No, but that’s very common after a head injury.  Here’s your things.”

“Oh, my shoes!”

Image:  While you were sleeping 1995 Hollywood Pictures & Caravan Pictures

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