COMING OUT OF COMA (Published 1982) (2024)

On the afternoon of Dec. 13, 1979, Sgt. David Mack and eight other members of the Minneapolis Police Department smashed through the door of a rented house in search of stolen property. When the man inside started shooting, Mack was struck in the abdomen and the neck; he stopped breathing, lapsing into a coma. ''Sergeant Mack will never regain cognitive, sapient functioning,'' said Dr. Ronald E. Cranford, an associate professor of neurology at the University of Minnesota Medical School, six months later. ''He will never be aware of his condition nor resume any degree of meaningful voluntary conscious interaction with his family or friends.''

On Oct. 22, 1981, doctors discovered that Mack was awake. Severely paralyzed, unable to speak, Mack returned to consciousness with his intellect intact. Though his recovery hardly resembled the brighteyed, rosy-cheeked version seen on soap operas, Mack was able to communicate clearly through a system of eye movements. Dr. Cranford comments: ''The lay press is filled with articles about miraculous cures, and usually they don't pan out. But the fact that Mack awoke calls into question the way we assess these cases. ... It introduces an element of uncertainty into a situation that was very difficult to begin with.''

The case of Sergeant Mack occurs at a time of a growing debate in the medical world over what can and cannot - indeed, what should and should not -be done for those whose brains have been injured severely enough to put them into coma. The conventional wisdom has been that either a brain got better after a certain period of time or it wasn't going to, and the medical community does not normally devote substantial resources to keeping ''hopeless'' cases alive. Today, an increasing number of experts are challenging those assumptions.

Debate has arisen over some very basic medical facts, as basic as whether a particular brain-damaged patient is dead or alive. Thirtyone states and the District of Columbia have legally endorsed the concept that human life is at an end when the brain is dead, a concept recommended by a Presidential commission. But similar moves have been stalled in such states as New York by those who see the definition as a first step to legalized euthanasia. Some critics ask whether the medical establishment, given the instances of unexpected recovery from coma, really know enough about the brain to make such judgments.