Two

Recently, I finished a profound book, "The Year of Magical Thinking," by Joan Didion. The book is Joan's memoirs. Her life has been full of undeserved pain and suffering. In some ways it was difficult to read because her daughter and Rachel experienced similar health issues. Chapter 8 was especially difficult because she retells a story in graphic detail that conjured up all sorts of emotion. Her daughter (like Rachel) went into emergency life saving surgery due to swelling and trauma in the brain. She had a mid-line brain shift (like Rachel) and her pupils were fixed (like Rachel's).

The fact that Rachel's pupils were fixed is the reason why the neurosurgeon decided to perform the emergency surgery. I was standing by Rachel's side trying to get her to respond to the doctors and nurses and when the neurosurgeon held the flashlight in Rachel's eyes and there was no response...he panicked.

The following is an exert from "The Year of Magical Thinking," when I read this I instantly became emotional because I was not aware of these statistics.

The following is what I learned when I read about "fixed and dilated pupils." I found that they are called FDP's. I read the abstract of a study done by researchers in the Department of Neurosurgery at the University Clinic in Bonn. The study followed ninety-nine patients who had either presented with or developed one or two FDP's. The overall mortality rate was 75 percent. Of the 25 percent who were still alive twenty-four months later, 15 percent had what the Glasgow Outcome Scale defined as an "unfavorable outcome" and 10 percent a "favorable outcome." I translated the percentages: of the ninety-nine patients, seventy four died. Of the surviving twenty-five, at the end of two years, five were vegetative, ten were severely disabled, eight were independent, and two had made a full recovery.

Rachel seems to be fully recovered...Two