What I Learned When I Almost Died - Chris Licht [14]
Twenty-two years earlier, when he was forty-five, Biden had suffered not one but two aneurysms that had to be corrected with surgery, which somehow the politician in Joe Scarborough had remembered as he stood at my bedside in the emergency room. After describing my problem to one of Biden’s aides, Mika had been put through instantly and, fighting through tears, had asked for help.
Biden did not hesitate. He would find the right guy.
The guy turned out to be Vivek Deshmukh, who had finished second in a class of 120 at the University of Florida College of Medicine and done his neurosurgical training at the Barrow Neurological Institute in Arizona, one of the world’s best. That morning, he was director of cerebrovascular and endovascular neurosurgery at George Washington. As I would come to know, he is unflappable and skilled at reducing complexity to easily understood terms in a soft, reassuring voice.
Dr. Deshmukh told Biden he would, of course, help and, after hanging up, turned to the hospital’s computer system to find my CAT scan.
It was ugly. He had seen a thousand like it. But it was ugly. There was a lot of blood loose in my head.
A brain has three linings, and my renegade blood was between the middle and the inner, the space where the brain’s arteries and veins live. The middle lining is the arachnoid, because it looks like a spider’s web, and any bleeding beneath it is thus a “subarachnoid hemorrhage.”
The most common reason for blood to be loose there is blunt-force trauma, the sort of thing that happens in a traffic accident. That wasn’t my problem, obviously. Another common reason is a rupture in an abnormal collection of blood vessels some people are born with. Dr. Deshmukh had in mind something else, the same thing I had raised with Dr. Mayersak. An aneurysm.
Cerebral aneurysms are balloonlike bulges in the walls of arteries, which are the high-pressure freeways that deliver blood from the heart throughout the body, as opposed to veins, which return blood to the heart at lower pressure. Where arteries fork, there’s turbulence in the blood, which can lead to weakness in arterial walls, which can lead to the ballooning. An aneurysm can be as small as an eighth of an inch, as big as an inch and a quarter.
Statistics vary, but several million people have an aneurysm at this moment and do not know it. Most will probably live on in blissful ignorance, because their aneurysm will not cause symptoms or burst.
But each year in the United States, something like twenty-seven thousand aneurysms do rupture. That’s seventy-four a day, three an hour. From looking at my CAT scan, Dr. Deshmukh was pretty certain that today had been Licht rupture day, which, if true, meant my life had moved closer to the abyss’s edge.
If an aneurysm ruptures, there’s no room for the blood that escapes. The skull is not an expandable place. Pressure builds. The blood can irritate tissue. Other arteries can spasm and constrict, blocking themselves, which can lead to a stroke. Tissue can get squeezed against bone. The whole brain might shift. It’s a potential cascade of malfunction.
About 15 percent of those whose aneurysms burst die before reaching a hospital. About 25 percent more die later. Of those who survive, most are permanently disabled by the invasion of blood into places it should not go. In the end, only about a fifth of those Americans whose aneurysms rupture live through the experience undamaged.
None of this did I know. It would be days before I did, not until I got home and surfed the Web and talked with Dad.
Examining my scan, Dr. Deshmukh could not tell how much damage had been done, because no scan can pick up the physical side effects of an aneurysm, like immobility or scrambled speech or blurred vision. He needed to see me in person to get a sense of those things, and he also needed a more detailed look at my brain. He called the neurologist on duty in the emergency room and ordered up a second CAT