“Moments of consciousness and awakening”!!!

Well today is a superb day.

Sabine has told us two incredibly important things, things that not only inform us as to where we are, but open up rather more optimistic possibilities than some of the darker options we’ve considered until now, based on not knowing.

I want to repeat, because it’s important to fully understand what will follow, that while “wakefulness” and “consciousness” usually are pretty much one and the same, after the brain is injured, the two can be dissociated. What do I mean?

Assuming that the terms are being used and translated correctly (and Sabine is a consummate professional and wouldn’t get this wrong), awakening refers to (at least) the appearance of . . . being awake. Basically that means eyes open. And as I mentioned before, this eye opening can even be cyclic, following what looks just like a sleep-wake cycle (even if not synchronised to real day-night hours).

Wakefulness WITHOUT consciousness is the definition of a vegetative state. The eyes are open, but there’s no interaction with the environment. If Sabine had “only” said that Michael was showing wakefulness, it would mean that he is not comatose. That in itself is a damned sight “better” than persistent coma, not just in terms of life expectancy, but in terms of the chances of neurologic improvement.

But Sabine has also told us that Michael is showing signs of consciousness. My lord, the brain is an amazing organ. And Michael a remarkable man. What does this consciousness probably look like? It consists of episodes of clear, purposeful interaction with the environment, and/or clear signs of awareness of self, even if these signs are not constantly present. For example, if Michael smiles when a member of his entourage talks to him – reproducibly and consistently on at least a few occasions. Or following people with his eyes. Or trying to communicate, or obeying simple commands. Any of this constitutes objective signs of contact between the “outside” and the “inside”. This then would be a minimally conscious state. And that is about the best news we could possibly get right now.

Why? Because of what it means for everyone – Michael himself, his loved ones, and his fans. It means that Michael may well see, hear, and feel the love that’s around him. That he is, in some very real way, HERE. It means his life expectancy has now improved VERY significantly. And last, but perhaps most important, it opens up a very real chance for further improvement. This would mean spending more time “in touch” with his surroundings, and also improvement in the quality of the interaction. How incredibly positive!

This means rehab, lots of rehab. Michael is used to working hard. Getting that brain to learn new ways of doing things, stimulating it, forcing it to handle data, and all the while working hard to build him up again physically. All very exciting. And very good.

Don’t get me wrong – this is a very important step, but we don’t want Michael to stay like this. But this is a very very very big step.

We all need to thank the team taking care of Michael as well as the people around him, for their devotion and patience. Everyone is going to need to be patient – for weeks, months, maybe years.

But if you’re even the slightest bit spiritual, it’s time cast a look upwards and mouth the words “thank you”.

229 thoughts on ““Moments of consciousness and awakening”!!!

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  2. I’m not sure if this is actually another update from Sabine, but it appears to be:

    “There are moments when he is awake and moments when he is conscious.

    “Of course I am not a doctor, but medically, there is a distinction between being awake and being conscious, the latter meaning there is an ability to interact with his surroundings.

    “I don’t want to disclose details out of respect for the family, but we have no doubt at all in the abilities of the doctors treating Michael, they are experts in their field.”

    http://www.independent.co.uk/news/people/news/michael-schumacher-latest-schumacher-showing-small-signs-of-progress-as-sabine-kehm-gives-positive-report-9258613.html

  3. Why don’t some of you grow up!!!!! You act like little children who have just had their favorite toy hijacked! Boo hoo, not everyone agrees with me. LOL! You guys make me laugh! Get a life you stuffy ole foogies.

    • Berating others and telling them to grow up, yet you yourself respond with immaturity? Comments such as yours are not only an insult to the purpose of this blog, but also to Dr Hartstein who has generously taken the time to provide people with insight and understanding of a very complex situation. Surely he deserves better than this, and so do those who post here without lowering themselves to such a lack of civility.

    • My goodness Jussi, you ARE pedantic. I am sorry, I should have written “posts above”, in which you mention my name 3 times, yes, count them 1, 2, 3. ………. By all means correct me if I’m wrong but calculus doesn’t equate to simple math such as adding single digit numbers, does it ???? I, in fact, did not take calculus in school. Not My Thing. ( its a figure of speech )

      However, now that you have appointed yourself the ” Quality Control of Comments Police ” I promise to only post intellectual, well thought through comments, AND I will submit them to you first for scrutiny & acceptance, okay? ……. When Pigs Fly ( another figure of speech )

      One other thing I ponder; do you think maybe ALL your girlfriends/spouses (plural) have possibly moved on because they WERE, as you put it, smarter than you ????? Can you say Foot in Mouth ( yet another figure of speech)

      • Liza, you are one funny person and commentator.

        “I promise to only post intellectual, well thought through comments,”, you write.
        We shall see about that. I do truly hope that you will keep your promise.

        I did not state that my former girl friends or spouses were smarter than I am. I just stated, that in general they were more intelligent – not the same as being smart. An anecdote: an intelligent person finds a way out of a difficult situation into which a smart person would never get in the first place.

        PS Please do not use capital letters when just writing simple statement. Capital letters are interpreted as SHOUTING in social media!

        Just a wild quess, you Liza are about 10-12 years of age – assessing on the quality of your comments. Or, then you must be an American, which fact you deny. Either one must be true.

      • Okay Jussi ……. lets assume you are correct. I am 11 years old, American, obviously uneducated, incapable of making intelligent comments. Explain me this; who is more sagacious ? A person who is intelligent or a person who is smart.

      • To Jussi: ……… BTW, the correct spelling of “guess” is with a g, not q. I know they look the same but they are in fact very different letters of the English alphabet, regrettably not interchangeable. It is however obvious that you get extremely excited while composing yet another insult directed at me. May I suggest you proof read your future comments for errors before you post them, if not, you might seriously jeopardize your relentless pursuit of proving your academically superior verba(liza)tion ………… Yes, pun intended 🙂

        Aside: (if I may borrow your favorite word, Jason) To Everyone Else: please don’t get your panties in a bunch. I really don’t care about spelling or diction in posts. I consider this merely friendly banter between Jussi & I while we all wait for more information about Michael. I honestly hope you find this amusing as opposed to getting angry. Sincerely, thanks.

    • Who are you targeting Mimi? What has got you so upset?
      I was really impressed when you didn’t go off the rails after Jussi posted ” It is of course in every way better than reading non-intellectual/teenage-like comments by Liza or Mimi et al.” …… And then you posted ” thank you! Jussi, your post/message was absolutely brilliant!!!! I have basically been saying the same thing since the accident but only not as eloquently. You two are two very smart, intelligent ladies. Jussi, I’m assuming you are a lady. If not please accept my apology.”
      I’m confused but bemused that you let his insult fly.

      • Well, it is possible that Mimi has some brain cells still functioning and she (or he, who knows these days) is able to learn, absorb and comprehend new information, opposite to some of the more stubborn, unintellectual commentators. Who knows. Take care – with regard to your own intellectual ability – of yourselves. Have a nice day!

  4. My goodness Liza and a couple of others, I have disagreed with some of the stuff you’ve put up, but you are so right with the remarks about the comments on this blog.
    These few people have only succeeded in chasing away so many of the people who originally came here for a balanced and sensible exchange of views, with their extraordinary, insensitive and rambling posts, in some cases barely coherent… with the ‘pillow smothering’ remark really taking the biscuit in gratuitously offensive insults and one I would have though has no place on a forum such as this.
    I may make myself unpopular for saying so but I would urge our leader to take a more robust stance with some of these comments … they are no longer ‘amusing’ … in my humble opinion they detract massively from the gravitas of his blog.

    • Jan please don’t go …… even though this blog has been temporarily hijacked, I have faith that Dr. Hartstein can & will prevail ……. hopefully sooner then later.
      Also to Peter; I am sorry, I would have very much liked to continue our discussion but I’ve had a change of heart. I’ve no desire to continually open myself up to the verbal firing squad of the recent posse every time I post a comment. Furthermore, qualifying my opinions by divulging personal information pertaining as to how I met & know Michael Schumacher, Sabine Kehm etc. is no longer something I wish to share in what has become a hostile environment. I will however be lurking in the background, waiting patiently for the good doctor to take the reins back. As always, I wish my dear Michael a full recovery ……… Thanks Doc, for everything.

      Prepare For The Worst, Hope For The Best

  5. MartineF – It is been really nice to read your comments. Actually, when the words are flying to and fro, yours are calming, centering. What a wonderful contributions. Thanks.

  6. Well Jason, I’m certainly not of the ‘pillow-smothering’ school of thought, that is for certain! I think the initial optimism has been tempered with a dose of realism in some respects as I think people were automatically thinking that this was a first step, with others to follow, which is by no means any kind of certainty. No one knows what is going to happen in the future but I hope, and continue to hope, for the very best outcome for MS and his family.

    I do find it a little baffling that some posters seem to think that, just because MS may not be the MS he was before his accident, this should mean that he would have no quality of life and therefore would not wish to be here. We may ‘know’ MS as the former F1 driver but we don’t know the man, the father, the husband, the son. We don’t know what he would want. His family are the ones who know the private MS, not us. What some may think is of absolutely no consequence to the family.

    As for the medical team looking after MS – they are the ones who know what is going on so I would think that they are the ones guiding the family. As the Doc had alluded to in a previous blog, the medical team wouldn’t give false hope. MS is showing small signs of some sort of improvement, and it is this I would rather focus on. I would rather have ‘unrealistic optimism’ any day of the week than negativity.

  7. Sarah and Jussi….thank you! Jussi, your post/message was absolutely brilliant!!!! Sarah, as was yours. I have basically been saying the same thing since the accident but only not as eloquently. You two are two very smart, intelligent ladies. Jussi, I’m assuming you are a lady. If not please accept my apology.
    Keep staying in the moment and not in a fantasy world.

  8. Martine F, I have to disagree with your assertion that it’s human nature to want our loved ones with us, no matter what their condition or prognosis. I don’t believe in life at any cost, I really don’t. It strikes me as cruel and self-serving.

    I found a study a few weeks back (alas saved on my old laptop that has since died) carried out in the UK about relatives views/perceptions about their loved ones prognosis whilst in a coma/pvs/mcs. Really interesting. It seemed to suggest that there was a period of time when decisions could be made not to support life further before there came a point at which the person had made enough ‘progress’ where the opportunity to withdraw support had passed.

    I appreciate my views are abhorrent to some. It’s an easier position to take where someone has had a long and happy life. When something so dreadful happens to a younger person there’s a future, just possibly, still to lose. Perhaps naturally, the light of hope burns brighter for a recovery. I understand for some people hope is always enough. I’m just not sure that it would be enough for me.

    Some of us respond emotionally, some of us respond pragmatically. We all need each other to level out the extremes I guess. We all do what we think is best and right at the time. It’s just different for different people.

    • Hi SarahFi,

      Thank you for your comment. I think the point I was trying to make is that sometimes it takes someone who isn’t immediately involved to help and guide in such a situation. The family is dealing with everything emotionally, in shock, and it does need a cool, level head to help at that time.

      It’s interesting you mention about reaching that period of time where a decision to stop treatment can be given but how long does that period last before the time is lost? When is it too early, too late or the right time? This is where the help and professionalism of the medical team should come in to its own.

      It is different for everyone in such a situation. I was in a similar situation (not a coma) with my first husband and I took the pragmatic approach I suppose. Some may have decided differently but I was the person in that situation at that time, no one else. It’s easy for us to take a stand in a hypothetical situation but real life is very, very different. Even after almost 20 years, the decision still haunts me along with the guilt, even though I know (when thinking with head and not heart) that it was the right decision. As you say, some respond emotionally, some pragmatically – would I do the same thing again? I honestly don’t know and I would never want to be tested to find out.

      • It is purely speculation at the moment as to whether the family of MS are current deliberating whether or not to pull the plug or whether or not to use a pillow as many appear now to be recommending.

        It is all rather strange, given Gary’s blog was so optimistic, commenting on MS family’s latest statement of “moments of consciousness” … Gary even suggested that we direct our gaze upwards and say “thank you”. Compared to previous blog pieces this piece was far more optimistic.

        The first few comments to the blog were happy and joyous. I may even myself have got a little carried away in my optimism but Gary did intervene to put some balance into the comments.

        However a sombre mood seems to have now taken hold where some are asserting in effect that MS plug should be pulled because in their opinion it is best for them – so they don’t have to keep reading this blog and making comments about other peoples “unrealistic optimism”.

    • SarahFi
      Personally, I agree with you about “life at any cost.” I guess each of us need to define exactly what that would be for ourselves, communicate to those we love and then make sure that the legal instruction and documents for our choices are clear and free from the possibility of misunderstanding. In the US, these “choices” must be drawn up as a legal document and filed with ones doctor and ones local hospital. There is quite an effort here, not sure yet if completed, that would allow that info shared with another doctor/s or other hospital/s no matter where one is.

      Frankly, when I began to think about my own mortality, I was uncomfortable. Wisdom and maturity won out; my choices and wishes are clearly defined with regard to what I would find acceptable as “life”. I also chose an individual who felt as I did and I knew That he would be able to speak or fight for me…just in case.

      It is hard for me to imagine that Michael Schumacher would have not made those decisions and then took the steps to have them solidified considering what he loved to do – go fast, take thoughtful risks and enjoy his life doing such things. Then again, it is possible that he did not do that simply because he was young, (I wasn’t able to get to the task until I passed fifty five).
      Oh well… The family has kept this and other information close to their chest, that we might find informative, which is completely understandable. I do not know if anyone who is commenting knows Michael personally and if so how well. I do not. That does not prevent me from wanting to support his opportunity for recovery and, even though I am impatient with regards to updates, I wait in peace.

      Thanks for the comments that you have made too on Gary’s blog.
      KC

  9. Even though I will most likely be criticized by certain commentators, I will take the risk and provide some more information regarding the topic; TBI and MCS since I believe there are at least a few ardent readers and commentators, who are keen to learn more on the subject. Therefore, Liza, please stop reading this comment of mine any further right here.

    I hope that I have brought some realism to this commentary section and your feet again back on to the ground regarding prospects for possible outcomes from a very severe traumatic brain injury (TBI). It would be a miracle (or an act of God, if you are a religious person) if Michael is able to eat, dress/undress, defecate and urinate, walk, talk and somehow be independent in the future. Roughly speaking, if the patient survives the first two weeks (maybe 50% chance), then afterwards 1/3 of the patients die; 1/3 of the patients stay in coma, vegetative or in minimally conscious state and 1/3 recover to a better state, but virtually none will become the same person they used to be – they ALL will be severely disabled with 99.99% certainty. Statistically, prospects for a good recovery will deteriorate after the age of 40. Michael is 45.

    First, let us study the human brain a bit. There are significant differences between male and female brains. Before we can continue defining possible damages, please take a look at male and female brains and see how they differ from each other http://2.bp.blogspot.com/-yyMWE9H0LhY/TqchCBoZc_I/AAAAAAAABUM/E-Tw8LQLPO4/s1600/male-female-brain-2.jpg. I think that the smallest areas/glands in Michael´s case have ceased to exist/respond completely but the larger areas in the middle have stayed more or less intact, which is good.

    Now that you got the basics, you may continue reading. Yes, I know it is not the first of April today. Thanks for noticing, but humo(u)r helps dealing with difficult issues. I will give links to some educative videos regarding TBI and recovery stories after TBI that are to be found in YouTube. I noted the length of each video (in brackets).

    FIRSTLY – ABOUT THE BRAIN AND TRAUMATIC BRAIN INJURY
    -Anatomy of the Brain (4:29) http://www.youtube.com/watch?v=WCOU9lgpd5c
    -Understanding traumatic brain injury (14:28) http://www.youtube.com/watch?v=9Wl4-nNOGJ0
    I highly recommend to watch this video – it is a must!

    SECONDLY – SOME GOOD RECOVERY STORIES. Warning of emotional content – you may need Kleenex, paper tissues or a handkerchief.
    -Katrina 3 years after her brain injury http://www.youtube.com/watch?v=Ls30v3ykjO8
    She is at the level of a 6 month old baby.

    -Adam´s story (1:56) http://www.youtube.com/watch?v=KTyplX9q4lk
    -My Brother’s Journey Through A Tramatic Brain Injury – A Survivor (5:32) http://www.youtube.com/watch?v=BLoAIzSpXWg
    -Holly´s road to recovery – a TBI survivor (31:24) http://www.youtube.com/watch?v=FhegboT-FO8
    You might want to skip the first six minutes because it only shows how energetic, sporty and healthy young woman she was before the accident. Holly made a remarkable recovery in very short time period. Now she is studying. This film is good in showing the various stages of recovery process after TBI and of rehabilitation process.

    -Corey´s story (15:51) http://www.youtube.com/watch?v=rqq9680IV5A
    -The Micah Jones case http://www.youtube.com/watch?v=_DaWtcB9rUE

    RECOMMENDED VIDEOS FOR FURTHER UNDERSTANDING:
    -Traumatic Brain Injuries: Effects of damage to different lobes of the brain (8:20) http://www.youtube.com/watch?v=wlYiDxNcMdc
    -Overview of Traumatic Brain Injury (TBI) (7:42) http://www.youtube.com/watch?v=T0WBMM7WKL4

    Commenting other commentators hinting of Michael´s wishing or not wishing to live in a state like MCS or giving fish oil as treatment and recent news:
    -Active euthanasia is possible in Switzerland. This would require concent of the patient, though. Michael made his will before joining Mercedes team in 2010. It is possible that he has also undersigned his living will i.e. medical treatment wish/testament for the case of no hope of recovery from Coma/VS/MCS etc. as well.
    -Fish oil experimenting could happen maybe 2 years from now. Maybe rabbit, snake, chicken or cockroach oil would do the same thing. At least, most probably they will not harm the patient.
    -L´Equipe reported that Michael had opened his eyes in about middle of March.
    -Please do not believe any of the news regarding Michael Schumacher reported by Daily Mail, The Sun, Daily Mirror, Bild etc.

    Well, there you have something to digest. Have a nice day.

    PS
    -lulumoretti, it is not possible to receive a score of zero (0) on Glasgow Coma Scale since the lowest possible score is three (3) and maximum 15.
    -Liza, I take that you are an American. Just took a wild guess.

    PPS I have mentioned the study by Luauté et al. (2010). Here are the results of that study from another source (I just read the abstract):
    They followed 12 patients in VS and 39 in MCS:
    • None of the patients in VS improved during the follow-up period: 1 was lost to follow-up, 9 died, and 2 remained in VS.
    • Among the 39 patients in MCS, 3 were lost to follow-up.
    • Five years after coma onset, the outcomes of the other 36 patients were as follows:
    – 13 severe disabilities (33.3%)
    – 9 MCS (23.1%)
    – 14 deaths (35.9%).
    • Of those who emerged from MCS, 8 (61%) had emerged by 2 years, and a further 4 by 4 years. Only 1 more had emerged by the fifth year of follow-up. http://www.rcplondon.ac.uk/sites/default/files/annex_1b_literature_on_prognosis_for_recovery.pdf

    So, the prospects for a good recovery are rather bleak.

    Take care of yourselves! Wear helmets and safety belts!
    At the same time, stay out of your own home, since statistically, most deaths occur at home!

    • Hi Jussi
      Another for your list is a full documentary film about a young American Superpipe Snowborder Kevin Pearce – “The Crash Reel” – who was training for the 2010 Winter Olympics in Vancover, Canada. His recovery, still in process, took four years. I do not know comparatively how severe his injury was to Michaels; my guess, not as. I have not yet seen the whole film albeit I have watched interviews with Kevin and the filmmaker Lucy Walker. There are many opportunities to meet this amazing young man on YouTube. Kevin has even started a Be aware of your brain program to inform and educate. What courage, GUTS, these folks have. I ofter wonder now if I could dig that deep…
      Thought it might be OK with you to tag “The Crash Reel” onto your list.
      Thanks for sharing your findings too.
      KC

      • Thanks for your comment KC.

        It is virtually not possible that you have watched all the videos I recommended/suggested for watching.

        Why did you not give link to “The Crash Reel” video yourself?

        Anyhow, thanks for your basically supporting/positive feedback. It is of course in every way better than reading non-intellectual/teenage-like comments by Liza or Mimi et al.

      • Jussi: I think you may have misinterpreted KC’s comment. She was referring to having not seen fully the “The Crash Reel” rather than your list of recommended viewing.

        Although I may not agree with some of your interpretations and the tone of some of your comments – I do greatly appreciate the effort you have put in to research the issue and to provide links to relevant information.

      • Hi Jessi – The Crash Reel is a film which is available for purchase on iTunes for $12.99. Trailers and interviews are available on YouTube. Sorry for not being more clear. I have not seen the film as of yet, however the reviews are five starts, (the highest), for what it’s worth.
        KC

    • Oh Jussi ! …. you mentioned me THREE times in your post …… Does Jussi have a little crush on Liza ??? ….. you make me blush, you naughty boy. I do love an intelligent man albeit not the self indulgent blowfish type.

      PS. Sorry love, I’m not American ….. but I have enjoyed vacations in Florida, Arizona & of course Austin,Texas for the GP races.

      • Liza, I mentioned you twice – not three times in my comment. You probably skipped the calculus lessons/classes at elementary school.

        OK. You are not American. What is your excuse then for low-quality comments? Being an american would have been somewhat understandable.

        Naughty or not, intelligent or not, having a crush or not … Decide for yourself. All my girl friends/spouses (with one exception) have been straight A students and intelligent – more intelligent than I am.

        Take care & please improve on the quality of your comments. Thanks in advance.

  10. Martine F, you are absolutely right. I was in a similarish position a year ago with my dad and I didn’t want to let go no matter what. I’m still finding it so very very hard even now. It was what I was alluding to earlier when I referred to viewing things from the family’s perspective. We must give them space and allow them to deal with this in whatever way they feel most comfortable, if there could ever be any ‘comfortable’ way. It’s difficult for us as we all feel so close, Schumi having been such a massive part of F1 for so many years but the best we can do is keep praying and keep letting the family know that we’re totally behind them & patiently hoping for the best possible outcome.

  11. A near relative of mine got a very severe stroke. We got no information of “states”, except that it was a very grave damage. This relative, an elderly man, was very fond of life and had a strong love of life.

    We kept asking him for a sign, a word, anything, that showed he was aware. We thought we got signs, but maybe we did not.The doctor did not want to give him food artificially. We, the relatives, protested and therefore he was given nutrition artificially. He lived for almost a year.

    When about seven months had elapsed, a strange thing happened. We, the relatives, were in the room trying to make our relative answer us. A nurse came into the room and was there for a while. We, the relatives, continued to urge our relative to speak. Then the nurse said to him: “I do not think you want to do that”. Then our relative said in a strong, clear voice, just normal: ” No, what would be the point?”

    This story has made me think. These matters are filled with problems.

    Also, there are two Ginas on this blog. Think I was the first one.

    • Hi Gina, thanks for your comment. I assume you meant that it was the infirm relative that replied to the Nurse? Did he say anything else or did he lapse straight back into incommunication?

      Would this have been a case of “sleep talking”?

      • Hi Jason, Yes, my relative answered the nurse. He only uttered that sentence. It was his normal voice, he spoke with emphasis. He never showed signs of awareness before or after, did not speak.

        Cannot have been sleep-talking, because he answered normally, at once.

      • My relative, (in a MCS?), (see some posts above) suddenly spoke normally for a short while and during that time
        communicated that he did not want to speak, because it had no meaning.

        We on the blog are well alive and it is, as Martine says, natural for us to want our relatives to live. But we know very little about how some people in MCS think about that. At least, in some way or sometimes, some of them think,
        But I think my relative’s and Michael Schumacher’s situations are very different. We must and want to hope for the best for Michael, a life that has a quality.

  12. I think it’s human nature to want our loved ones with us, regardless of what their medical situation or prognosis may be. We always hope that they will come back to us and things will be, if not ‘normal’ then bearable as we don’t want to say good bye, we don’t want to let go. It doesn’t make us selfish or uncaring, more a case of not wanting to deal with the unthinkable of continuing to live our lives without that person around us. There will always be something that we wish we could have said or done, something that we have left unsaid that we wish our loved ones knew.

    This is where the medical profession hopefully steps in and guides the loved ones to the best of their ability and their knowledge. It’s easy to make some sort of statement with regards to what we would do in such a situation but until it happens to us, we cannot possibly say how we would react, given the same circumstances. The ‘burden’ if you will, is always with the families, as they are the ones who are witnessing what is happening. They are living in that moment and cannot comprehend anything else at that time. The future to them is something that may be only a minute or an hour away…thinking weeks, months or years ahead is an abstract thought, something that cannot be dealt with at that moment in time. Every tiny improvement gives renewed hope and we do hope as it’s the human condition.

    We should all be thankful that we are not in a similar situation.

  13. My brother-in-law had a heart attack in Mexico and it was 20 minutes before he could be gotten to a hospital. We family members hovered around his bed for over two months where, at first, he was frozen with his arms raised as though he were reaching for something. Though he was not intubated, I thought he was about a zero on the Glascow Coma Scale.

    At first some wanted to believe he was trying to say something, but then as days turned to weeks, then months, our only thought was putting him in a home setting. His attending physician urged us to treat him with respect, as we would a favorite plant, and see he gets some sunlight everyday. He was in his home with 24 hour care for another two months when he died. It was a fruitless exercise, all of it, as my husband and I could see his brain was severely damaged from lack of oxygen throughout the initial transit time.

    I’ve read some comments to me suggesting (more than suggesting) that I am a negative voice. I’m not, just a voice that has seen what coma is.

      • Liza and Mimi,

        Essentially I know nothing of Schumacher’s condition, but I know what it is to have a dear relative whose mind is gone but his body remains lying there on the bed day after day. He needs to be turned frequently to prevent bed sores and his blood settling. It’s difficult to turn an inert 180 pound man and takes two or three strong orderlies to do it. He must be washed. The bag needs to be changed. The liquids administered. And for what?

        At first we were numb with shock and thought perhaps he could be revived somehow. But seeing him day after day we realized this was it. He was gone, only not quite. The smart, witty man was gone, but his body remained, and what to do with it? It was merely a sorry souvenir. What were the options? Keep the body in the hospital. Put it in a ‘home’. Bring it back to his house. His wife wanted the latter so it was done and after that all the decisions were left to her and the two adult daughters. It was too much for them, too devastating to have the body lying in a bedroom day after day with strangers in the house and too much emotional exhaustion. It was like the first horrible days in the hospital over and over again.

        I believe it was three months from his heart attack that his body gave way to infections and his heart, the culprit, stopped. It’s been 14 years and I have forgotten almost all the medical details, remembering only the emotions of those months. We have spoken, quietly, about how much better it would have been if the body had not been resuscitated, if it could have left with his mind.

        I do remember that the very worst were the cheery folks telling us they were praying for him, or knew that God was taking care of him, or some such silliness. His mind was gone, his body decaying, and that was what it was.

  14. I just watched the clip from CBS. Sorry, but to to me that is not living. Do you really think MS would want to live like that? Do you think he would want to go out in public? If that is going to be as good as it gets….my heart just breaks for the family and him. He will need constant care…24 hours. What’s the answer? I guess it’s best to have a loved one in a MCS then not to have them at all.

    • Hi Mimi
      I don’t believe that any of us would knowingly choose that life. At some time we need to make choices that we never thought we would have to, or need to; truth is that there are those who do or must.

      Unrelated: one of my favorite question is: Would war end if the dead could return?

      KC

      • Jason, I am not proposing anything. Just stating an opinion. If I had a proposal that I thought would work I would not be sitting here typing this to you.

        And LULU, thank you for being one who is not afraid to face reality.

    • You are so right Mimi, QUALITY OF LIFE …. So many of you take simple things like walking etc. for granted. I believe, and may I remind you ALL that I am entitled to my opinion. The Michael Schumacher that I knew & loved would rather be dead than live like that.
      And another thing, you guys; YOU KNOW who I’m directing this at, do the rest of us lay people a favor & cut back your long winded yap, yap, yap. If Dr. Hartstein can explain things to us in simple terms, certainly your incessant need to prove your status of brainiak ( I don’t care that its not a real word !!!!) ……………….. PUUULEEASE find another blog to converse among yourselves. I am SOOOO sick of reading ENDLESS long drawn out posts between 2 or 3 people. You are monopolizing this blog. If you insist on continuing, at least cut it back. Please & Thank You.

      • Liza, I don’t think you speak for ‘so many of us’ assuming others take simple things for granted..I also don’t think you speak for Michael Schumacher..I think those who actually do know and love him would know what his thoughts would be on his own quality of life. The remainder of your post had me thinking I was reading something a petulant teenager would be writing. I am actually tired of coming to this blog and seeing posts such as yours, however, I am not so self righteous that I will dictate to others what or how they post, nor would I suggest they go elsewhere. It is a public forum that certainly is being monopolized by certain individuals who are taking away from what this forum should be about. That is a real shame. I am glad that you feel entitled to your own opinion and do hope you will give the same consideration to others who are equally entitled to share theirs.

      • Liza “The Michael Schumacher that I knew & loved would rather be dead than live like that”.

        And what exactly are you proposing with this comment? It was to you and other such posts that my previous comment that you failed to understand was directed.

      • “… may I remind you ALL that I am entitled to my opinion”.
        “… find another blog to converse among yourselves”.

        Hilarious 🙂

        Additionally:
        “Don’t stop putting these people in their place.”
        “What an asinine comment Jason.”
        “Peter, grow up, you are just adding to the problem here.”

        The quality of comments, tolerance and respect for others is constantly improving!

      • Lisa – just for fun….
        On this topic “Moments……..awakening” out of 191 posts:

        In the lead: Jusssi 20 comments – what stands out is mostly informative, understanding
        Second: Jason 19 comments – what stands out is mostly questioning, defending himself
        Tied for Second: Lisa: 19 comments – what stands out mostly critical, tiny sympathy

        The above is my only my OPINION! Take or leave it and remember the door swings in and out. Many of us have asked, almost begged for the tone to remain on topic. Most of us have asked, almost begged for the criticism of other’s opinion to stop. Apparently, that request goes unheard or ignored. PLEASE…. We ALL have good words to contribute. PLEASE!!!

        Or take your best shot. In spite of what you may say, I will continue to read what you write and give what you say the attention it deserves. May The Force Be With You.

      • My goodness Liza, I have disagreed with some of the stuff you’ve put up, but you are so right with that remark.
        These people have chased away so many of the people who originally came here for a balanced and sensible exchange of views, with some of the most extraordinary, insensitive and absurd comments I think I have ever seen on the internet … the ‘pillow smothering’ remark really taking the biscuit in offensive insults.
        I may make myself unpopular for saying so but I would urge our leader to take a more robust stance with some of these comments … they are no longer ‘amusing’ … in my humble opinion they detract massively from the gravitas of his blog.

  15. Jussi

    WOW!!! WOW!!! WOW!!!
    I just finished watching the Anderson Cooper segment that you hyperlinked. WOW!!! That is the extent on my vocabulary at the moment. Ambien no less. It seems to me that some TBI’s do not have not much to loose by having a family, or a family member, who are/is willing to… Dare I say experiment…?

    Several weeks ago there was a piece that CNN did about the utilization of fish oil for TBI. I put the information out and even sent it to a couple of publications. At the time, there wasn’t much interest. I am not a doctor, not even close, however, I do think we human beings can easily get stuck in the familiar, the predictable bank account. Sorry for being crass.

    Sometimes lives can be saved by stepping outside the box. Sometimes a new and magnificant miracle path makes itself known. Years ago, when homeopathic medicine first knocked at the AMA door; at first there was a lot of yelling and screaming, swearing, my uncle included. Today, that is not the case. Maybe some changes require time. I willingly admit my impatience.

    For those who have not watched this video, “Awakening: The Returns”, that Jussi gave us, please do. I do not believe that you will regret taking the time.

    KC

  16. Thank you for providing this, I watched it and was in tears to see those two men and what their families went through. The thought of Michael being like this is heartbreaking, I just hope that the docs at Grenoble try everything, and that somehow Michael can beat the odds and have some sort of quality of life.

  17. OK, I will give the link to CBS 60 Minutes´ story about patients who recovered from Vegetative or Minimally Conscious State. I think it will give an impression of what the best case scenario for Michael is. I recommend to watch it (duration 11:40).

    There are two cases: Don Herbert and George Melendez. Herbert got out of VS/MCS possibly because of Parkinson disease drug was given to him and Melendez because common pain killer Ambien was given to him.

    CNN:s reporter Anderson Cooper made the story in 2007. The neurologist interviewed is Steven Laureys´ research fellow Nicholas Schiff.

    Here is the link: http://www.cbsnews.com/news/awakenings-return-to-life/

  18. Let’s not get carried away here.

    By far the most statistically likely outcome for a patient in a MCS is . . . to remain in a MCS. You must avoid giving the impression that this is a process which, once started, will inevitably continue. While that is certainly possible (and fervently desired by all of us), it is, in a very real statistical sense, improbable.

    I think Sabine’s statement was a response to the rumours of construction at Michael’s home, as well as to other “pressure” from various quarters (including perhaps incredibly this blog, which is just . . . crazy). I see no reason it should in any way be construed as a change in comms policy.

    Jussi, I am not an expert in the arcana of persistent disorders of consciousness, and I think that a better source of widely applied and applicable knowledge, guidelines and standards would be review articles and consensus statements, rather than cutting edge stuff. So while I work frequently with Steve Laureys (I manage these patients when they come for their MRIs), I’m unable to answer your more detailed questions.

    • Thanks Gary,
      yes, I am aware that the most likely outcome is to remain in MCS and that from Coma to functional state is not a continuing process – recovery can stop at any stage.

      Luauté et al. followed 39 patients in MCS for five years after one year of TBI occurrence. Of these patients 14 (36%) died, 13 (33%) remained the same and 9 (23%) improved. What happened to 3 (8%) patients is unknown, maybe they just lost track of them – this was not mentioned in the abstract.

      I did not want to deprive readers of their optimism, for which reason I did not mention deaths nor patients remaining in the same state. Additionally, I gave some search terms for those who are interested in MCS (did not mention what their recovery was). CBS News´ story of Don Herbert is worth watching (duration some 11-12 minutes). I feel that this would be the best possible outcome for Michael except for the almost 10 year VS/MCS state.

      Do you know of any more recent studies regarding MCS patients than that of Luauté et al. from 2010?

      Thanks anyhow for your answer.

    • Without feedback I can get a little carried away from my armchair – so thanks for the balancing comment. I do have a sense of optimism though that he will wake up – from the fact that he is still being kept at Grenoble and a sense that the family are holding back a little to announce only “significant” and certain progress. Bit I have zero experience in this area.

  19. It seems to me that with the “Moments of consciousness and awakening” statement the next statement will be “MS has now woken” – so it’s just a question of how long to wait. Of course once woken then the “real work” of recuperation begins.

    The family through Sabine Kehm had said previously that MS was in the “awakening phase” and intimated there would be no further comment until that status had changed.

    The “moments of consciousness & awakening” statement hence seems to be a change in policy in that an intermediary stage in the awakening phase has been announced.

    Considering the chronology of events it seems to me that the announcement was in response to media speculation occurring at that time (regarding million dollar facilities and bleak outlooks for MS prospects).

    • I would suspect on the basis of what I have read, that Michael is now in MCS- i.e. in Minimally Conscious State Minus meaning that he has a definite sleep/wake cycle, he opens his eyes, reacts somehow to pain and can smile or cry. Reactions are not inconsistent and not long lasting. Next state would be MCS+.

      “MCS+ describes high level behavioural responses (i.e., command following, intelligible verbalizations or non-functional communication) and MCS- describes low-level behavioural responses (i.e., visual pursuit, localization of noxious stimulation or contingent behaviour such as appropriate smiling or crying to emotional stimuli).”
      Source: Vanhaudenhuyse et al., 2011.

      Yes, it is possible that there is a change in policy.

      • thanks for that Jussi – I need to digest all the new terms.

        I would also imagine that they would be very careful to announce “MS has woken” because there would be absolute pandemonium in the media and off the scale excitement in the public. So I think they would leave the “MS has woken” announcement until MS was well into the “woken stage” – with some form of verbal communication going (e.g. squeeze my hand if you can hear me etc).

  20. As promised, this comment is about MCS (Minimally Conscious State).

    I have a few questions to Gary.

    I read the abstract of the study by Luauté et al., published in Neurology in 2010. They found that one third of MCS-diagnosed patients improved after more than a year. Do you have any knowledge what the status of these 9 patients was at the end of the study and what happened to three patients of the original 39 patients they followed (14+13+9=36)?

    Researchers at the University of Liège, Coma Science Group (Bruno, Thibault, Vanhaudenhuise, Moonen, Laureys) suggested in 2011 to define MCS into MCS- and MCS+. Has this topic been discussed amongst neurosurgeons and how was this proposition welcomed? I presume you do know some of the researchers, since Liège is where you work.

    Do you have any anticipation or knowledge when the new revised version of WHO:s International Classification of Diseases 2011ICD9CM codes will be revised and maybe MCS will be added? Has this been debated amongst colleaques?

    Suggested google searches and watching/reading for those who are interested in MCS: “Don Herbert CBS News”, “Terri Schiavo”, “Nancy Cruzan”, “Karen Quinlan”.

    Does anyone have any information regarding recovery process of the British speedway driver Ricky Ashworth, who was in coma for 91 days (august-november 2013)? He was able to speak when he woke up.

    • One more related question.

      I have encoutered with the term Confusional State. Is this term to be interpreted as MCS+ and the existing term Minimal Conscious State would be reserved for MCS- ?

      • I found the answer myself. The cronological order is: Coma -> Vegetative State -> MCS- -> MCS+ -> Confusional State -> Recovery of normative cognitive function OR Locked-in state OR Functional LIS. Source: Laureys & Schiff, 2011.

        Therefore, can you explain the difference between MCS+ and Confusional State. Additionally, what does “Functional LIS” mean?

        Thanks.

  21. I know there was a discussion with regards to whether the nose caused the flip but it was said that it was front tyre on rear tyre due to the angle of contact My heart was in my mouth when I watched the accident and, as always, I’m constantly amazed that there wasn’t a serious injury. It has to be said that, regardless of what others may be thinking of the new regulations, the construction of the monocoque is a thing of beauty when a driver can be flipped like that and walk away.

    • Of recent years I remember the Valencia 2010 grand prix where Mark Webber’s car went airborne and the Belgium 2012 grand prix where Grosjean drove his car over Alonso’s car. Both incidents seemed like terrifying “near misses” but everyone walked away injury free. The key as you mentioned seems to be the shape of the monocoque and presumably the suspension around the driver.


      • I remember when Damon Hill landed upside down. He’d said that his greatest fear in F1 was landing upside down and being consumed by fire. There he was, in the kitty litter, for what seemed to this viewer as far far too long. But no fire. And no damage to the excellent Mr. Hill.

        Hooray for the designers of the modern F1 cars and to Mr. Gutierrez as well. I must say, rewatching the incident convinces me that Maldonado had nowhere to go. Esteban misjudged the corner and any driver coming around it would have no time to avoid a collision. Bad call.

  22. Pingback: F1 Bahrain Grand Prix: Dial “SC” For Excitement | The Lowdown Blog

  23. Hi Gary! I just read your “illustrative Anecdote” and it brought another safety issue in motorsport to my mind: the lowered (and very ugly) noses in F1. Originally they were designed to prevent cars from taking off in a rear impact and to improve driver safety in a t-bone crash. But there are people (for example Adrian Newey) who think that the lowered noses could go under a car so that “you end up with a rear crash structure in your face”. If you look at the Massa/Kobayashi Crash in Melbourne (http://sports.ndtv.com/images/stories/massa-crash-640.jpg) I think A. Newey really has a point there. What is your Opinion about the lowered noses? It would be great to hear your opinion about this problem. best wishes from germany, Martin

    • I may be wrong but I think main causes of fatalities are going air-borne, having a wheel hit you, and fire. Ultimately a “balance” will need to be obtained that globally minimises the risk given the governing rules of the sport and the technologies available.

  24. Aside: I was looking at the Gutierrez flip at the Schumacher corner in Bahrain, & it seems that the collision was a function of the track design with the pit exit appearing close to a right angled bend – Guttierrez didn’t appear to see Maldonado exiting the pit, and Maldonado had no where to go when Guttierrez turned in on him. It’s amazing that no injury occurred:
    http://www.bbc.co.uk/sport/0/formula1/26914125

    • the Gutierrez flip at the Schumacher corner in Bahrain, & it seems that the collision was a function of the track design with the pit exit appearing close to a right angled bend – Guttierrez didn’t appear to see Maldonado exiting the pit, and Maldonado had no where to go when Guttierrez turned in on him.

      omg, i can’t believe it – a reasoned comment re. Maldonado vs. Gutierrez.

      What a treat to encounter this. lol. cheers!

  25. Jussi
    I am an American and what you have said is, sadly, accurate. “Free Speech” is so often, in my opinion, misused, oftentimes to cause harm, oftentimes to carry untruths, oftentimes to intentionally mislead. Unfortunately, there are many that choose to follow the Judas goat because they are either too lazy, too apathetic to do much of anything else; to do their own research or homework, to educate themselves.

    I have been so disappointed to read some comments that I feel, or that I interpret, as rude, as insensitive. There are others that are simply off the charts – direct attacks. Fortunately, the majority are interesting, thoughtful, honest, sincere, informtive and I believe that you would agree with me, making that statement.

    In a perfect world, we would be perfect. It is not,we are not. My personal choice is to be part of a larger concept, to be a member of the human race who occupies my two feet of space, given to me, to the best of my ability and conscience. It is my choice and intention to make a contribution that make things a bit better; to make that effort, that contribution in a thoughtful way. Sometimes I succeed. Sometimes I do not. Sometimes I celebrate. Sometimes I don’t.

    I have learned a lot from Gary. His commentary has stimulated me to study, to learn more about TBI. I know that his words have stimulated others. That is a great thing to be a teacher.
    It is my hope that we can become better students.

    KC

  26. Hopefully finally some good news about Michael! I think I have recently started to “detach” somewhat, to the extent that I now only check for updates every other day or so. At first i was waiting up for the news conferences out of Grenoble which were at 2am my time (pacific). That doesnt mean i care any less, I just accept that any news, good or bad, will be made available if and when the family decides. I always come to this blog, i agree with the vast majority here that this is an extremely educational blog and that it is based on experience and opinion, not fact.

    What does the community as a whole including Dr Hartstein think about completely ignoring those people who come here to stir up emotions and conflict? I think that is their only goal. Hiding behind nick names and saying things they would never (i hope) say to the person’s face. I think that is the case with any comment section on any blog or news site in the world.. People try to get a rise out of another person, using insults and mockery…imagine getting a sharp response from Dr Hartstein himself, that has to be the ultimate satisfaction. What if we deprive them of that satisfaction? I am not suggesting we suppress discussion or differences of opinion, but I think we all know who the people are that most of us wish wouldnt be here. Lets ignore them when they post here and their post is clearly aimed at starting conflict. I think blocking them they would just show up under another name.

    Full disclosure; Sasha is a nick name too, I use it for privacy reasons and wouldnt post my full name or city on any public site. But i am here to learn and not to cause trouble.

    • Yes I’ve been thinking about this. I’ll no longer respond to this kind of stuff, unless there are potential issues with factual misrepresentation. I’ll only delete the most unacceptable. I’ll leave most up for our general amusement. Thanks for making a good suggestion and a good point.

      • It’s your blog doc….you have the freedom to pick and choose. Please don’t let a few influence your good judgement.
        Thank you for everything you have told us and have explained to us. You have presented a much clearer picture then we could have ever imagined. ;)))))))

      • PLEASE Dr. Hartstein, don’t stop adding some levity to what has been such a somber subject. Your zingers make me literally LOL. Don’t stop putting these people in their place.

    • Sasha, why can’t you just respect what others have to say and then maybe they will respect what you have to say. I find that works. It is not very adult like when one can not tolerate an opinion that differs from their own.
      And the fact that one would ask the good doctor to eliminate those with opinions who may not agree with those of the masses here is simply ridiculous. Here in America we are very proud of the first amendment.

      • Where are you people getting all of this? And why now are you starting to respect what other people are thinking while just a few days ago you didn’t.
        Amazing.

        Quoted your earlier comment to me.

        Regarding the first amendment you are so proud of, some quotes from Wikipedia:
        “The freedom of speech is not absolute; the Supreme Court of the United States has recognized several categories of speech that are excluded from the freedom, and it has recognized that governments may enact reasonable time, place, or manner restrictions on speech.”

        “Currently the United States is ranked 57th out of 181 countries in the annual Worldwide Press Freedom Index by Reporters Without Borders.”

        The US is right before Haiti and Niger in Press Freedom Index. At the top of the list are Finland, the Netherlands and Norway. All 16 top countries are in Europe.

        xxxxx
        In order to comment your earlier remark adressed to me, I want to say that in Europe people are civilized, informed and literate, they can read and write fluently and comprehend, whereas in the US this is not true. Therefore the quality of newspapers and other media in the US is so poor, trashy as you stated – targeted to the audience. For example in PISA scores, almost all of the European countries outperform the United States (Finland being the best worldwide as a country). Also, in the United Status, apart from European countries, socioeconomic status of the family is a significant factor explaining student´s performance. Also, the US spends twice as much money on education per student as Slovenia, but the results are the same.

        Well, anyhow, it is nice that you are so proud of your country and starting to be tolerant toward opinions that you do not share (we shall see).

        PS One of the founding fathers was of Finnish descent (both parents were Finns), namely John Morton, whose signature was of crucial importance in creating the new nation.

      • Quote from Jussi “Where are you people getting all of this?”

        Please be more specific when using the general attribute “you people”. It seems you mean “Mimi” when referring to “you people” but it is not 100% clear as otherwise you would (should) have used the label “Mimi”

        Now in this comment I would like to express my general disappointment that such issues between commentators that have the appearance of personal bickering can’t be taken out from this blog to another private space where the matter can be resolved between the two (Mimi and Jussi in this case) … as posting such personal differences on here is detracting from the topic of BTI & MS and may be discouraging others from contributing relevant posts.

        🙂

      • Jason, yes, my comment was a reply to Mimi. It is clearly evident from the content and from the horizontal position of my comment with relation to other comments. My comment was right to Mimi´s original posting.

        Yes, I know that it was off-topic but I just could not resist the temptation – Mimi started it.
        Recent comments by Mimi:

        To Jan: “LOL! Here is Jan saying there is really no need for that sort of nastiness when she is the mother of all nastiness.”
        To me: “Where are you people getting all of this? And why now are you believing what you are reading while just a few short weeks ago you didn’t. Amazing.”

        So, it was kind of hilarious to read Mimi´s commenting respectfulness and tolerance. As well I had to comment on the first amendment (freedom of speech and press) of the US, that she so much praised.

        The only lists the United States is on the top are the likes of military expenditure, military aggression towards other countries, espionage (on countries, businesses and individuals), federal debt, environmental pollution incl. carbon dioxide emissions, inequality, inaccessibility of higher education, inaccessibility of medical care, homelessness, obesity etc.

        European (and some Asian) countries are on top of the positive lists. For example Finland is first on the following lists: best country in the world (Newsweek), least successful state, best country for mothers, least corrupt state, most liveable major city (Helsinki), most honest city (Helsinki), developer of best mobile games, PISA scores (=education), most avid readers (=loans from public library per capita), freedom of press etc. Finland is second on following lists: most happy country in the world, best workers, gender equality, income distribution (=Gini index), best credit rating (=AAA, one of several countries) etc. Usually, the top countries on previous, positive lists are in general European, mostly Scandinavian (Denmark, Finland, Norway, Sweden), or then Switzerland or the Netherlands is on top.

        By the way, civilized European countries do not have the habit of organizing false flag operations by the government in order to start a war (for oil and world supremacy/dominance) killing thousands of their own countrymen in the attack.
        Sorry for detracting from the topic. In the future, I will try to stay on topic (unless I am being provoked).

        My next comment will deal with Minimally Conscious State (MCS). That`s a promise. I have been studying this subject.

        Have a nice day.

        PS KC Thanks for agreeing with my statements.

      • Jason,
        you wrote “… is detracting from the topic of BTI & MS”.

        As far as I have understood, the topic here is not “Binding Tariff Information” nor “Business Tax and Information” nor “Big Taco Inhaler” nor any of the possible other meanings of the abbrevitation “BTI”.

        I think (correct if I am wrong) that the subject is Traumatic Brain Injury (TBI) in general and Michael Schumacher specifically.
        🙂 Have a nice day!

    • What does the community as a whole including Dr Hartstein think about completely ignoring those people who come here to stir up emotions and conflict?

      Well, we can really only respond as individuals, Sasha, right? That said, I would be very happy if a genuine consensus as a “community” to not “feed the trolls” emerges…

      Everyone is entitled to their own thoughts and opinions, but I think Dr. Hartstein has been incredibly tolerant of some bad apples who engage in almost antisocial behavior! It’s his blog, after all, and we can’t wield the moderator’s hammer on abusive comments in his place, but you’re right – we can ignore them, which is usually the best generic approach…

      Gary’s time is too valuable to waste trying to engage rationally with irrational folks in an emotionally-charged environment and so I’m glad to hear that he’s on-guard against being sucked-in by the drama queens.

      At the same time, who isn’t tempted to bop a troll (or a boor) on the head and scold them for misbehaving? The trick is not to get sucked into long, pointless exchanges, as even one response starts to legitimize, somewhat, their attack.

      When all this started, I told Doc via Twitter that I thought his commentary and insights were incredibly valuable and encouraged him to continue, and not be deterred. I feel the same now, and nothing he’s written or said w/r/t Schumacher or TBI or medicine in general could be described as unprofessional, insensitive or inappropriate (imo). We’re lucky that “A FORMER F1 DOC WRITES” online, and privileged to have such ready access to a public personality as significant in (our sport of) Formula 1 as Dr. Gary Hartstein.

      But yes, you’re right – we can all do our part by encouraging civility and not demeaning this site by engaging in – or condoning – histrionics.

      • Joe,
        I agree.
        Dr. Hartstein’s blog is the voice of reason in the emotionally charged atmosphere surrounding this unfortunate situation. He has laid out the facts as he knows them based on his experience in the field. He is cool, calm, and logical. I admire his courage in the face of what appeared[s] to be a campaign of disinformation.

        Some of us appreciate facts and others prefer faith/hope/wishes/dreams. That’s fine. What surprises me is the level of venom that some are pleased to unleash against a fellow participant when his/her opinion doesn’t coincide with his/hers. I don’t get it. We F1 folk who care enough to offer our thoughts are a small tribe. A little respect goes a long way.
        Best,
        lm

  27. Just want to say a huge thank you to Doctor Hartstein for metaphorically holding our hands as we watch, wait and hope for Michael’s re-emergence. It is incredibly helpful to those of us not in the medical profession to be able to understand exactly what the tabloids are twisting around for dramatic effect! So, thank you, Sir. And I certainly did thank the “Man Upstairs” when I read this news! Not to push my beliefs on anyone else, but there were and are many, many fans of Michael who are praying a lot for him.

    ~yes, it is sadly my real name~

  28. Please dear contributors of comments to Gary’s blog can we have an amnesty and stop haranguing fellow commentators and Gary etc – your points have been noted. There is no need for repetition.

    Please can we focus from now on – on MS, his family, the medical care, the medical science, TBI and reliability of the reporting. There have been some contributions including some from people that have had TBI themselves that is being lost in this bickering. Please also don’t criticise people for taking an optimistic view. Whatever will happen will happen no matter if people are optimistic or doubtful of the current reports (moments of consciousness). Can we please get back to a learning and forward looking and respectful interaction. Best wishes to all.

    • Jason
      You are so right and your thoughts so well written. Bless you for you wisdom. Maybe it will make a difference and maybe it won’t, however you have my support and vote of confidence. Thank you!
      KC

    • Yes, I second that and I missed out the point about learning.
      There is so much dross on here now from people trying to score cheap points over each other, making wild statements that really have to coherence to the topic, often in very bad English, or comments that are just plain bonkers that you have to wade through, that one can miss comments and contributions that are serious in their intent and make an interesting contribution to the general subject.
      Maybe Gary should wield his chopper a bit more …! 😉

      • Here’s a thought Peter ……. proof read your post BEFORE you smack the Post Comment button 😉
        By the way, you really made quite a few assumptions while attempting to answer the question I posed you, so, I feel that I must qualify myself since making such bold statements concerning the ” trained monkey”. Did I misquote you again?
        I apologise for the delayed reply as I’ve been away for several days dealing with a personal matter. I have just arrived home late this evening but will do so (qualify) hopefully in the next 24 hours. It will be my intention to shed some light regarding my strong opinionated comments.

    • Hi Jason
      Here is a very informative website that might be of interest to you – and maybe others. It is very informative and easy to read and understand while at the same time being somewhat very medically oriented. Again, thank you so much for speaking to what has been in the column of unfortunate commentaries. Life is too damn short for the pettiness.

      http://www.scholarpedia.org/article/Vegetative_state

      KC

    • Jason, you are a hypocrite. You make this plea for amnesty ” lets not criticize ” , yet you blatantly have insulted my intelligence & been condescending. I think you owe me an apology.

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