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
XFood, Mood and Altitude 