(Jim, surrounded by his sisters)

When I heard about the tragic circumstances of Natasha Richardson’s brain injury, I immediately flashed on the stages of grief, and the incredible amount of denial that my family endured when my brother Jim fell off of his horse and hit his head so hard, that there would be no hope for a meaningful recovery---and he would eventually die as a result of this accident.

 In 1999, I lost my brother to a traumatic brain injury. He really died the day of his accident; the fact that his body carried on for 7 more months was just a matter of physical resilience. He was 41-years-old when he finally succumbed to the multitude of complications that are inevitable when you’re in a severe vegetative state. We removed him from life support after months of a less than marginal quality of life. I wished that he had died the night of his injury. That would have been an act of kindness toward my brother and our family. 

Jim was injured while riding his horse at his ranch. He was a team rodeo roper, which was something that I never really understood thoroughly. I just couldn’t see the pleasure to be gained by throwing a rope around a frantic and nervous calf, and pinning it to the ground. In fact, I always saw my brother as a sensitive, almost fragile kind of person, even though he was 6’1” and 200 pounds, and enjoyed a list of “manly” activities like watching boxing matches, imbibing heavy quantities of Crown Royale whiskey, and chewing tobacco.   

The depth of my brother’s injury wasn’t something that hit us all at once. He was in a coma for the first 10 days, and there was a constant vigil at his bedside. All of us were looking for some sign that he was coming back; a twitch, a hand movement, anything that might give us a little hope. The fact that he shifted from a coma to a vegetative state without much fanfare went unnoticed by everyone but the medical staff. There was no dramatic awakening, there was no real eye contact or recognition. He just lay there with his eyes half open, moving his arms in an eerie series of fits and starts.  

After about 2 weeks in the hospital, we met with his doctors in a small, windowless, and stuffy room where they spoke in vague terms about his prognosis and recovery. They couldn’t give us anything to hang on to or to hope for. They just didn’t know for sure, but frankly, I could tell that they were not holding out much hope themselves that he would ever be himself again.

They recommended that he be moved to a rehabilitation hospital, more commonly known as a skilled nursing facility, where he could receive “therapy”, and the full care that he would require for the next 7 months. They never said the words “persistent vegetative state”, http://healthlink.mcw.edu/article/921394859.html but that was what we were facing.  

While at the rehab center, he was given an assortment of therapies that would end up having no effect. He couldn’t walk, talk, or feed himself. Things were tried, to be sure, to try to elicit some kind of reaction from him. They even brought his horse, Sonny, to the facility to see if he would react. Nothing. Nada. Zip. 

Actually, he did react one time when I was visiting, just once, and the image will be forever etched in my mind, just like the time that he pulled down his pants when he was 8 years old and took a big crap in our neighbor’s barn. 

 I was standing next to his bed at the rehab hospital. I had been talking to him, telling him about the new home that I had bought, when he slowly and deliberately turned his head toward me (which was no easy task for him), and stared at me, tears rolling down his cheeks. There was a pained look on his face, but it was no use; I would never be able to reach inside of him and release him from this life sentence. 

Now, the doctors had said that this was an autonomic reflex or something---they didn’t want to allow me to believe that my “dead” brother was communicating with me. Naturally I chose to see it differently. I chose to believe that he had been trying to tell me something, and whatever he might be trying to say is left up to my imagination. That’s the nice part. I can imagine that he was trying to say, “I love you”, or “get me outta this body!” or “remember that time that I crapped in the barn?”  

Over those 7 months, the spirit and cognitive functioning that made Jim a vital person were stripped from him. From the day of his injury, he was either lying in a bed or slumped over in a wheelchair. He never spoke again. He was tube fed because he couldn’t swallow without aspirating, and he had to be changed and sponged off and turned in bed so he wouldn’t develop pressure ulcers. 

Deep in my bones I understand what Natasha Richardson’s family is facing, along with the countless other victims of this kind of tragedy. Though it may sound insensitive, I hope that if Miranda can’t recover from this and have a meaningful life, that she is able to flee this mortal coil with dignity. To have to suffer the grief, despair, and the shock of this total kind of loss, to have to face a shell of a loved one, to not be able to release them from this physical prison, is most cruel indeed.