When Does Death Start?
By DARSHAK SANGHAVI
NYT
Robin Beaulieu was telling me about her daughter’s bike accident. It was an event that would force Beaulieu not only to confront the death of her child but also to embrace a new way of dying. We were sitting last spring in the kitchen of her small apartment in Manchester, N.H. Beaulieu took a drag on a Marlboro, poured a cup of coffee and told me that her daughter, Amanda Panzini, had been a rambunctious, bighearted teenager. She loved animals, even “flea-ridden, mangy dogs,” Beaulieu said, and was a fiercely loyal friend. When confronted by the possibility of donating her brain-injured daughter’s organs after the accident, Beaulieu never doubted that Amanda would have wanted them to go to someone who needed them. But Amanda first had to be declared dead, and in her case, the only way that could happen was if her parents chose a precisely choreographed death — one conducted by medical personnel in a hospital procedure meant to allow Amanda to die while preserving her organs. From this, the doctors and Beaulieu hoped, would come new life.
The last time Beaulieu talked to her daughter was on the morning of June 21, 2008, a Saturday. Amanda attended an eighth-grade dance the night before; she told her mother that she had her first kiss there. After Beaulieu left for work at a nearby minimart, Amanda decided to ride her bike a few blocks to her friend Kate’s house. She didn’t take her helmet. At the crossing of Taylor and Young Streets, a Ford F-150 pickup truck slammed into Amanda and threw her into the street. When the paramedics arrived, Amanda wasn’t breathing. They inserted a tube into her windpipe and rushed her to Elliot Hospital nearby. Beaulieu received an emergency call at the minimart; the paramedics had identified Amanda by the name engraved on her iPod.
The rest of the afternoon passed in a harrowing blur. Beaulieu remembers a concerned doctor trying to prepare her to see Amanda. She remembers seeing her child’s swollen face in the emergency room and then being loaded with her onto a trauma helicopter for transport to Children’s Hospital in Boston. Though the lighted monitors showed stable vital signs, Beaulieu sensed, as she hovered in the sky, that her child had died. Doctors in Boston performed emergency neurosurgery to decompress her skull, but it was not successful. Amanda was then admitted to an intensive-care unit and put on life support. Monica Kleinman, the clinical director of the unit, examined Amanda the next morning. The girl’s cerebral cortex — the part of the brain where desires, fears and hopes are created — was irreversibly damaged. In her 20 years of practice (I worked with her as a pediatrics resident years ago), Kleinman has treated dozens of similar injuries. Few of these patients ever left the hospital; those who did were in vegetative or otherwise neurologically devastated states.
(More here.)
NYT
Robin Beaulieu was telling me about her daughter’s bike accident. It was an event that would force Beaulieu not only to confront the death of her child but also to embrace a new way of dying. We were sitting last spring in the kitchen of her small apartment in Manchester, N.H. Beaulieu took a drag on a Marlboro, poured a cup of coffee and told me that her daughter, Amanda Panzini, had been a rambunctious, bighearted teenager. She loved animals, even “flea-ridden, mangy dogs,” Beaulieu said, and was a fiercely loyal friend. When confronted by the possibility of donating her brain-injured daughter’s organs after the accident, Beaulieu never doubted that Amanda would have wanted them to go to someone who needed them. But Amanda first had to be declared dead, and in her case, the only way that could happen was if her parents chose a precisely choreographed death — one conducted by medical personnel in a hospital procedure meant to allow Amanda to die while preserving her organs. From this, the doctors and Beaulieu hoped, would come new life.
The last time Beaulieu talked to her daughter was on the morning of June 21, 2008, a Saturday. Amanda attended an eighth-grade dance the night before; she told her mother that she had her first kiss there. After Beaulieu left for work at a nearby minimart, Amanda decided to ride her bike a few blocks to her friend Kate’s house. She didn’t take her helmet. At the crossing of Taylor and Young Streets, a Ford F-150 pickup truck slammed into Amanda and threw her into the street. When the paramedics arrived, Amanda wasn’t breathing. They inserted a tube into her windpipe and rushed her to Elliot Hospital nearby. Beaulieu received an emergency call at the minimart; the paramedics had identified Amanda by the name engraved on her iPod.
The rest of the afternoon passed in a harrowing blur. Beaulieu remembers a concerned doctor trying to prepare her to see Amanda. She remembers seeing her child’s swollen face in the emergency room and then being loaded with her onto a trauma helicopter for transport to Children’s Hospital in Boston. Though the lighted monitors showed stable vital signs, Beaulieu sensed, as she hovered in the sky, that her child had died. Doctors in Boston performed emergency neurosurgery to decompress her skull, but it was not successful. Amanda was then admitted to an intensive-care unit and put on life support. Monica Kleinman, the clinical director of the unit, examined Amanda the next morning. The girl’s cerebral cortex — the part of the brain where desires, fears and hopes are created — was irreversibly damaged. In her 20 years of practice (I worked with her as a pediatrics resident years ago), Kleinman has treated dozens of similar injuries. Few of these patients ever left the hospital; those who did were in vegetative or otherwise neurologically devastated states.
(More here.)
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