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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

States of Consciousness continued...

In a minimally conscious state, "there's inconsistent but definite behavioral evidence that the patient has an awareness [that] may be better or worse at some times," says Childs, who has worked for 18 years with patients with catastrophic brain injuries and disorders of consciousness.

In a vegetative state, "there is no awareness of yourself or the environment," she explains.

Childs says Terri Schiavo, who was recently at the center of a high-profile case regarding removal of her feeding tube, was in a persistent vegetative state.

Asked what scientists know about what's going on in the brain in cases like Herbert's, Child says, "practically nothing."

"Some of the basic science and basic questions about what happens with the neurophysiology of the brain as patients move through levels of consciousness are just beginning to be explored," she says. "We have very little science about the huge majority of patients, let alone what happens with this handful of patients who do the unusual."

"I think it's true that the rare cases that have been reported have been younger. We do know [of] studies of traumatic brain injuries that as a whole, younger [patients] do better."

Patients who reach minimal consciousness within the first few months do better than those who are vegetative," says Childs. But "nobody knows" what predictors or factors might explain cases like Herbert's, she says.

'Slow Process'

"Brain injury recovery is a very slow process," says Paulette Demato, program director of the Coma Recovery Association.

"People may proceed to a certain level and then reach a plateau, and nothing else may happen for years after that," she tells WebMD.

Herbert's case "kind of gives hope to all the families out there who are waiting for that miracle. These things do happen," says Demato.

"Several months ago, there was a woman in Kansas who began to speak after 20 years. It doesn't mean that they're 'waking up' after that period of time. It means certain things are beginning."

The woman in Kansas that Demato referred to is Sarah Scantlin. Her brother, Jim Scantlin, shared her story with WebMD.

In September 1984, Sarah Scantlin was a pedestrian crossing a street when a drunk driver hit her. She lingered in a coma for five or six weeks, then entered a minimally conscious state, says Jim Scantlin of Fayetteville, Ark. Unlike Herbert, Sarah Scantlin did not suffer from oxygen deprivation to her brain.

"We never knew if she knew it was us [in the room with her] or not," says Jim Scantlin.

In January of this year, Sarah Scantlin started talking, he says. For a few weeks, she declined to talk to her parents, probably because she wanted to practice talking first, says Jim Scantlin.

Then, on Feb. 4, she talked by phone to her mother and father. The staff at Golden Plains Health Care Center -- a nursing home in Hutchinson, Kan. -- put her on speaker phone. "She can't hold a phone," says Jim Scantlin.

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