"First they asked us to let them pull the plug," Judy recalled one recent afternoon, as we sat in the living room of the Coxes' house in a Memphis suburb. "Then they tried getting us to sign a do-not-resuscitate order." Without one, the doctor explained, hospital staff would be forced to revive Chris each time he started slipping away, which could mean cracking his ribs and shocking him with electricity. Even if they managed to keep his body alive, what was left of his brain would surely die in the days ahead.Wayne and Judy refused to sign. "This is not some dog we're talking about putting down," Wayne shouted. "This is our son."
Some recent reports have suggested that the prescription sleep aids Ambien and zolpidem can suddently awaken people who have spent years in a vegetative state. The trick to pursuing an avenue with a patient like Chris Cox is figuring out which responses -- whether physical or merely detectable via electrical brain activity -- constitute consciousness and which are merely concidence. Also complicated and painful for families and caregivers is when to decide that the patient has recovered all he or she can:
"Once a patient progresses to minimal consciousness, we can't predict what's going to happen," says Dr. Joseph J. Fins, chief of medical ethics at Weill Cornell Medical College and author of a coming book, "Rights Come to Mind: Brain Injury, Ethics and the Struggle for Consciousness." Some patients have recovered full consciousness, but many more remain stuck in limbo. The only way to know the outcome is to give the patient time.