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A Piece of My Mind |


Herb Lee, MD1
[+] Author Affiliations
1Department of Anesthesiology, JFK Medical Center, Edison, New Jersey
JAMA. 2014;311(16):1613-1614. doi:10.1001/jama.2014.3069.
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It’s the same routine every time. I hesitate a moment before I enter my son’s room to go over his homework. By now, Richard has had his afternoon nap and should be rested. I remind myself I must be patient, that what happened was not his fault and that I must help him any way I can. This is the aftermath of a traumatic brain injury sustained a brief 3 years earlier, when Richard was 10.

The traumatic brain injury was actually a spontaneous rupture of an arteriovenous malformation (AVM) deep in the brain, in the thalamus, a region with connections to virtually all parts of the cerebral cortex. Nothing in the events of that Sunday could have predicted the wrenching consequences that followed. We had returned home from a relaxing buffet dinner. We even had time to purchase a mattress from Sleepy’s on the way back. We watched television; we went over spelling words. Richard was already in bed when it happened. While I was brushing the teeth of my youngest in the upstairs bathroom, I hear Richard’s voice downstairs, loud, uncharacteristically defiant, complaining of a headache. His mother gave him an icepack to reassure him. His response was a shattering, unrecognizably loud declaration of his headache pain. He stomped back upstairs to his bedroom. I left the baby in the bathroom and followed Richard. I looked desperately at Richard as he lay on his bed, wishing for some miracle to be able to see if he was bleeding inside his head. The last thing Richard said to me was, “Dad, you’re a doctor. Please do something.”


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