Awakenings

In the story ‘Rip Van Winkle’ (1820) Rip is a loveable layabout, a hen-pecked husband who loves nothing more than getting out of the house and taking to the Catskills Mountains with his gun and his dog, Wolf.

It begins on a July evening around 1776 when Rip is out walking in the mountains and a strange bearded fellow, carrying a keg of liquor, calls out to him. Rip falls in with him and meets a number of dwarves who are playing ninepins, helps them drink their drink and falls asleep under a tree.

When he wakes up with a sore head they are all gone so he goes back to his village only to find that he knows no one. There are more people than ever and they are all dressed in a different fashion from that to which he is accustomed. When he scratches his chin he realises that his beard is white and a foot long! He blames the demon drink and heads to his house but it is lying in decay. He goes to his local inn but in its place is the Union Hotel and on a pole is a flag of General George Washington instead of King George. The suspicious locals challenge Rip and wonder is he a spy. He says he is looking for his friends. Who are they, he is asked.

“Nicholas Vedder.”

He is told that he has been dead eighteen years.

“Brom Dutcher.”

He had gone off to war and never returned. Rip is confused but hears a young woman speak with the tone of voice of his wife. She tells him that her father went off twenty years earlier and had been either shot or carried away by the Indians. He realises that she is his daughter and discovers that his wife is dead (she broke a blood-vessel in a fit of passion over a peddler!). Rip then reveals his identity but is doubted until an old woman recognises him. Rip then tells his amazing story and in turn learns of all the changes – a revolutionary war, American independence, his old friend Van Bummel now a Congressman – that have taken place during the twenty years that he slept.

I have always liked that story; it has a relatively happy end, though it is unsettling.  As an analogy it is not as grim as the reality for those people who have been robbed of many years of life as they lay in comas or in a persistent vegetative state only to come around at some point and discover all the changes that have occurred ‘while they were sleeping’.

Of course, such recoveries often appear to be miraculous and such accounts not only hold out hope for some but pose a major dilemma for others who have to decide whether switching off a life-support machine is the right decision. An American police officer shot in the head, lay in a coma for seven years. Everyday his mother spoke to him and played him his favourite music until she was persuaded that it was best to switch off the machine. She left the room for the machine to be unplugged but rushed back in to kiss her son one last goodbye when he suddenly opened his eyes and said that he had heard everything that was going on but was unable to communicate.

A few days ago there was a news story about Terry Wallis from Arkansas. He was left in a coma after a car crash in 1984. He was nineteen and married with a baby girl. For weeks he remained absolutely lifeless and for years there was little more than a blank stare. His mother visited him twice a week, on a fifty-mile return journey, to speak to him.

Four weeks ago he ‘woke up’, said ‘Mum’, and began slowly talking again. He knows his date of birth but not how old he is. He thinks Ronald Reagan is still the US President. He does not remember his wife, who, perhaps understandably, moved on with her own life years ago, and he finds it hard to believe he has a daughter. But his speech improves daily and he hardly stops to eat for trying to catch up on so much.

‘Awakenings’ is a 1990 film based on the work of neurologist, Oliver Sachs. A physician-researcher, Dr Sayres (Robin Williams), works in a chronic-care hospital and among his patients are inarticulate victims of an epidemic of encephalitis lethargica. Sayres makes a connection between their symptoms and Parkinson’s disease and conducts a therapeutic trial with a new anti-Parkinson drug, L-Dopa. The patients respond by ‘awakening’ after many years but gradually they have trouble adapting to the radical changes in themselves and the world and the horrifying side effects of L-Dopa appear. The drug is eventually withdrawn and the patients return to their previous state, some with a marked regression.

One reviewer noted, appositely: “The individuality of the awakened patients and their passion for real living is a sobering reminder of the ‘unthinkable’, possible conscious-but-incommunicado existence of people whose mental status is unknown.”

For thirteen years Noreen Hill sat at the bedside of her husband Ronnie, who slipped into a coma two days after a wall collapsed on him on the day the IRA bombed the Remembrance Day parade in Enniskillen. She stayed with him in hospital every night for the first four years after the bombing, before buying a nursing home in Holywood, County Down, so that she could provide round-the-clock care for her husband. While in a coma he missed the marriages of their three daughters and son and the births of their grandchildren. For a further nine years she sat by his bedside until his death – the twelfth fatality from that bomb – in 2000.

Twenty-two years ago my mother collapsed, suffered a brain haemorrhage and lost her ability to memorise, but never went into a coma. She knows about things that happened before 1981 – though about those she has become increasingly vague – but cannot sustain new memories for anything longer than perhaps twenty minutes before they vanish and she retreats into her silent world. And so she doesn’t know, and we haven’t told her, that her husband is dead, her daughter Susan is dead, her sisters May, Anna and Eileen have died and her brothers Harry and Willie. Nor of all the changes in the past twenty-two years in our lives.

Often we have prayed for a miracle, that whatever connections in her brain were severed on the day that she fell might once again reconnect and that even at 79 she would come back into full life, though knowledge of what has transpired over the years might – no, would – break her old heart.