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Progress for Man Who Spoke After 10-Year Coma

Doctor Says Brain-Injured Firefighter Is Responsive but His Condition May Fluctuate
WebMD Health News

May 4, 2005 -- Buffalo, N.Y., firefighter Donald Herbert is all over the news, having uttered his first words in a decade after suffering a severe brain injury while fighting a fire in 1995.

Herbert's doctor, Jamil Ahmed, MD of the University at Buffalo, tells WebMD that Herbert is medically stable and "much better than before. He is definitely out of the coma. He's responsive, answering in 'no' or 'yes' with me, and moving all the extremities and shaking the hand."

Ahmed says Herbert's family says Herbert has been more communicative with them, asking his wife, "How are you doing?" and asking about his condition.

The change came about three months after Ahmed prescribed medications targeting chemicals in the brain, including norepinephrine, dopamine, and serotonin. The names of the medications were not disclosed, in keeping with the wishes of the Herbert family. Ahmed says the drugs are "mostly given to people who have attention problems, cognitive problems, Parkinson's disease, and mood disorders."

Ahmed also told WebMD that Herbert's condition may fluctuate. "He is not continuously answering questions and talking. It's never happened before -- a big change for him. We are hoping he should progress more."

On Saturday Herbert spoke his first words in a decade. According to media reports, he asked for his wife and was able to have conversations with his family.

In December 1995, Herbert reportedly went without oxygen for several minutes after being trapped under a collapsed roof while fighting a house fire. The father of four is now in his 40s.

Speaking after such a long silence imposed by brain injury is "rare," says neurologist Nancy Childs, MD, of Texas NeuroRehab Center in Austin. But "recovery" might not be the right word for it, she says.

"What we're really talking about with this patient and a couple of the others that have been in the news is recovery of speech for a period of time," Childs tells WebMD, emphasizing that she does not know the particulars of Herbert's case.

"As far as disability status and what they can do -- moving and walking and transferring from a bed to a wheelchair or standing -- as far was we know those sorts of functions have not changed in these people," says Childs.

"They remain in the severe disability category. That doesn't detract from the fact that something really unusual has happened when they start talking," she says.

States of Consciousness

Ahmed says that before Herbert started talking, he was diagnosed as being in a persistent vegetative state. Ahmed says he'd heard that Herbert may have moved, understood more, and may have been more responsive -- which could indicate that he was actually in a minimally conscious state, not a coma -- but Ahmed says he himself never saw that happen.

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