Michael Schumacher in critical condition

Here (dutch only, sorry) it says that they have stopped trying to awaken him.

It says that Michael Schumacher was in an induced coma for 58 days and that the doctors have been trying to awaken him since the end of january. That proces they now seem to have stopped.
 
At this point we just need to hope that it's not a pure brainstem injury and that he's not locked in.

The article about Massa visiting him gave me the willies over that. I can't imagine anything worse for any human to have to endure - especially if nobody recognizes it. I've got specific instructions in my advance directive exactly for that possibility.
 
Cool Hand Luke said:
At this point we just need to hope that it's not a pure brainstem injury and that he's not locked in.
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I have seen this once before - clinically - after a small but devastating pontine infarct in an elderly patient. We withdrew care after a difficult conversation with the patient and the patient's family.

Gut wrenching stuff. So, I hope you're right. We just haven't had that much level of clinical detail from Schumacher's caregivers.

~Dr. Imago
 
Dr. Imago said:
I have seen this once before - clinically - after a small but devastating pontine infarct in an elderly patient. We withdrew care after a difficult conversation with the patient and the patient's family.

Gut wrenching stuff. So, I hope you're right. We just haven't had that much level of clinical detail from Schumacher's caregivers.

~Dr. Imago
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I get the feeling (and it's no more than that) that if Schumacher were making any significant progress, his management would be making it readily known. I also have the feeling that his management are (perhaps understandably) engaging in a campaign of false optimism across pretty much every area related to the accident and its ramifications.

So I feel that the fact that there's really no significant reported uplift in Schumacher's condition can reasonably be considered as tentative evidence that the prognosis is now very bad indeed. At least it appears that by and large, the mass media have stopped writing ludicrously speculative reports swaying sharply one way and the other - "He's getting better!" "He's never going to wake up." - in favour of sticking to reporting what Schumacher's people choose to release.
 
Dr. Imago said:
I have seen this once before - clinically - after a small but devastating pontine infarct in an elderly patient.
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My first exposure was a late stage progressive supranuclear palsy I saw at grand rounds. There was only minor dementia evident during the decline so you knew there was still something left in there. You just wanted to look away. I couldn't even imagine what that's like for somebody.

I'm really hoping that they continue to make progress with the fMRI and other functional communication tests for these syndromes. I'm terrified at the notion of patients carrying a vegetative Dx who may actually have awareness.
 
Cool Hand Luke said:
I'm really hoping that they continue to make progress with the fMRI and other functional communication tests for these syndromes. I'm terrified at the notion of patients carrying a vegetative Dx who may actually have awareness.
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ALS victims eventually "lock-in", but it's slow and progressive. It's like a nightmare thinking of sudden catastrophic events that cause this and you may not realize the patient is completely cognizant of everything you are saying.

One of the first things I learned in medical school during an ER sub-internship was to never assume that an unconscious patient can't hear everything you are saying. Good advice.

~Dr. Imago
 
LondonJohn said:
I get the feeling (and it's no more than that) that if Schumacher were making any significant progress, his management would be making it readily known.
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Yeah, you're probably right. Hard to know exactly the motivations why there aren't a lot more reports - positive or negative, but I just agree with you that no good news is probably no good news.

~Dr. Imago
 
Cool Hand Luke said:
.
My first exposure was a late stage progressive supranuclear palsy I saw at grand rounds. There was only minor dementia evident during the decline so you knew there was still something left in there. You just wanted to look away. I couldn't even imagine what that's like for somebody.

I'm really hoping that they continue to make progress with the fMRI and other functional communication tests for these syndromes. I'm terrified at the notion of patients carrying a vegetative Dx who may actually have awareness.
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Uf.
That's about as bad as it gets for a physician, isn't it?
 
This is from the 25th Feb:

http://www.independent.co.uk/news/p...-world-champion-have-been-halted-9151445.html

Michael Schumacher’s manager has dismissed claims by a German magazine that doctors have stopped the “waking up process” as he continues to be slowly brought out of the medically-induced coma he has been in for nearly two months.
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Note, he is being "slowly brought out" of the coma.

I'm not expecting him to suddenly wake up and start talking any time soon.

I still find this reassuring.
 
Orphia Nay said:
This is from the 25th Feb:

http://www.independent.co.uk/news/p...-world-champion-have-been-halted-9151445.html



Note, he is being "slowly brought out" of the coma.

I'm not expecting him to suddenly wake up and start talking any time soon.

I still find this reassuring.
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And this is from today:

http://www.bbc.co.uk/sport/0/formula1/26479162


Same "still in wake-up phase" stuff. Ugh. I'm afraid his manager is beginning to sound a little like Baghdad Bob: "Everything's fine! They're just waking him up really really slowly on purpose! No need for alarm!".

I realise that his manager has a job to do, and I also guess that she is being bombarded by the media with requests for updates and statements constantly. But I don't think she's being honest or doing her client any real favours. I think it was apparent from the very start that she had one overriding agenda: protect Schumacher and his reputation, at almost any costs.

I think it's reasonable to assume from today's statement that Schumacher is essentially still totally unresponsive as of today, 7th March. And since the accident happened over two months ago, and since (apparently) the medical team have been actively trying to bring him out of coma for over a month now, medical history and precedent suggest that the prognosis for Schumacher is very bad indeed. I wish therefore that his manager would simply issue no comment rather than continue with the "he's still waking up" stuff.

I think at this point you'd be very hard-pressed to find any medical professional qualified in this area to argue that Schumacher is ever going to wake up at all, in any normal sense of the term. All very sad, but that's the harsh reality of the situation.
 
LondonJohn said:
I realise that his manager has a job to do, and I also guess that she is being bombarded by the media with requests for updates and statements constantly. But I don't think she's being honest or doing her client any real favours. I think it was apparent from the very start that she had one overriding agenda: protect Schumacher and his reputation, at almost any costs.

... I wish therefore that his manager would simply issue no comment rather than continue with the "he's still waking up" stuff.
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Well, that is his job, as you said. And maybe the family isn't ready to receive death condolences or address memorial plans while any hope of recovery still remains.

Can't see how whether or not the man comes out of coma will affect his reputation one way or the other. It's not like he'd been previously criticized for being coma-prone.
 
Myriad said:
Well, that is his job, as you said. And maybe the family isn't ready to receive death condolences or address memorial plans while any hope of recovery still remains.

Can't see how whether or not the man comes out of coma will affect his reputation one way or the other. It's not like he'd been previously criticized for being coma-prone.
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The reputational protection part was more in regard to the nature of the accident itself. His manager (female, BTW) was very keen to place stories about him veering off-piste to help a struggling child or something.......

And I'm not talking about death condolences or memorials. I'm talking about the strange spectacle of his spokeswoman continuing to claim that he is still in the "waking-up phase", as if this is a dynamic process in progress. It's not. If you read what I wrote, I said that in my opinion the best thing for his spokeswoman/manager to do right now would be to issue no comment on his condition. But if she was inclined to talk about his condition, I would judge that it would be more appropriate, more accurate and more sensible to say something along the lines of: "He remains unresponsive. We are all concerned, but continue to hold the hope that his condition will improve."
 
LondonJohn said:
The reputational protection part was more in regard to the nature of the accident itself. His manager (female, BTW) was very keen to place stories about him veering off-piste to help a struggling child or something.......
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Did she really? Sounds ludicrous to me to need any excuse for his accident.

While I had been waiting to see either of the helmet cams' footage (his and one other on the hill), I have looked at the photos of the site and I'm surprised at the dread connotations "off piste" seems to conjure up in this case.

It was nothing but the un-groomed crud between two trails and not even trees to avoid. I've skied in, and fallen on, far, far worse. He caught the truly unfortunate end of statistics but I don't fault him. The only reason I probably would not have taken that little route is, from the pics, it's not steep enough and that heavy chunky crap looks TOO SLOW.

To be honest, I'd have been on the smooth trails, either GSing because it's not steep or dicking around doing ballet down it (yes, I used to do Javelin 360s and Leg Breakers even on my 185cm GS pairs not just my ballet skis and I'm only 5'7". I was old school freestyle from the 70's :p ).

And I was just 14 when I began, and immediately fell in doing the crazy crap, with the truly insane, at Squaw, so I'm not upset he had his boy with him either.
 
Jim_MDP said:
While I had been waiting to see either of the helmet cams' footage (his and one other on the hill), I have looked at the photos of the site and I'm surprised at the dread connotations "off piste" seems to conjure up in this case.

It was nothing but the un-groomed crud between two trails and not even trees to avoid. I've skied in, and fallen on, far, far worse. He caught the truly unfortunate end of statistics but I don't fault him. The only reason I probably would not have taken that little route is, from the pics, it's not steep enough and that heavy chunky crap looks TOO SLOW.
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I've skied in Meribel since the Schumacher crash and seen the site of it with my own eyes.

It's basically a boulder field with a light covering of snow. Admittedly there was less snow when I saw it than when Schumacher crashed. Instructors for other members of my group said Schumacher was an idiot for trying to ski it.
 
jeremyp said:
I've skied in Meribel since the Schumacher crash and seen the site of it with my own eyes.

It's basically a boulder field with a light covering of snow. Admittedly there was less snow when I saw it than when Schumacher crashed. Instructors for other members of my group said Schumacher was an idiot for trying to ski it.
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I take your point and it is too easy to second guess.

That said... I've skied worse rock fields and basically got tired of rebuilding my bases and even replacing an edge section or three (I worked in a shop for a few years). I just looked again at the site pics and I just wouldn't have bothered with that chunky crap, there isn't even any air to be had at the bottom of the field... not steep or firm enough.

Or maybe it was idiotic, I'm just trying to not be too hard on him. Years and hundreds and hundreds of days (uninjured) didn't bring me wisdom, it brought me caution... broken limbs are no fun. :D

Strange we were less concerned for our melons. Nobody even wore lids for inverteds. Go figure.
 
jeremyp said:
I've skied in Meribel since the Schumacher crash and seen the site of it with my own eyes.

It's basically a boulder field with a light covering of snow. Admittedly there was less snow when I saw it than when Schumacher crashed. Instructors for other members of my group said Schumacher was an idiot for trying to ski it.
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Yep, and the boulders were still highly visible above the snowline on the day of Schumacher's accident. From the contemporaneous photos of the boulder field, anyone trying to ski through it at any speed would be lucky not to hit a boulder.

My personal belief is that Schumacher was possibly testing himself and deliberately introducing risk so as to experience the exhilaration of the payoff. I think he very possibly was skiing at some considerable speed (faster than 20mph, say), and misjudged the terrain with disastrous consequences.

And if that is anywhere close to what actually happened, then I don't find Schumacher at fault or guilty of negligence or anything like that: it was up to him how much risk he took when skiing, provided that he placed nobody else at risk in the process (although in that respect, I still have a nagging doubt about whether he led his son into that boulder field as well, but that's a different matter). I think he wanted to place himself in a modicum of jeopardy. He might have even needed to do so, given his obvious appetite for risk and personal danger. Had he ended up in the same brain-injured situation after (say) driving his sports car too fast and losing control, or (say) free-climbing up a 200-foot rock face, it would be easier to make the explicit connection between his desire for risk and the consequences of taking such risks.
 
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