Locked in syndrome
'Locked-in syndrome': A stroke of genius BY PATTON HOWELL James Hall became a victim of 'locked-in syndrome', unable to talk or move. He found an extraordinary way to tell the doctors he wanted to live, reports The Sunday Times James Hall didn't wake his wife to say goodbye. In fact, he hardly noticed her. Looking through his wardrobe, he picked a designer suit and co-ordinated tie. Leaving his house in fashionable north Dallas, he drove his Jaguar to his psychiatric offices. There he called the manager of his ranch, saying he would be out in a few days to oversee the year's branding of cattle. Later, he was on the LBJ freeway to the airport, bound for Akron, Ohio. During the flight, he sensed that something was wrong. He had just made it to the lavatory when he vomited. Things got worse: in his rental car, the gearshift seemed awkward; he felt disoriented. He knew he had to find a hospital. Where was he? Lost. A truck stop loomed ahead. He parked the car somehow and dashed through the rain. It was late at night. He asked the girl behind the counter for directions. She seemed frightened. Did he look as if he were going to rob her? "I'm just lost," he tried to explain, and his words became a jumble. She looked at him with alarm. He couldn't even understand himself; he stumbled off and drove into the night. There was a loud ringing in his ears that got louder; he eased the car across the highway and stopped in front of what looked like an official building. His head was full of sharp knives tearing his brain. He turned off the motor. His body fell onto the horn. Then a blur. The wheels of a metal stretcher: click, click, click. Casualty. So this was how death came. Susy, James's wife, answered the phone at 5am the next day. Dr Hall had had a serious, possibly fatal, stroke, she was told. At the hospital in Akron, she was greeted by a visibly embarrassed doctor, who told her that another woman was already there taking care of James. Aware of his womanising, Susy said: "Then, in that case, she can have him." Later the other woman left the hospital; Susy stayed. A few days later, she brought her husband back to Dallas in a private plane. Back home, Susy called me for help both as a friend and because, as a forensic psychophysiologist, I had worked with James. The staff of the Dallas teaching hospital had assigned James his own suite. Inside, it was like breaking into a sepulchre. His body was like a laid-out corpse. I reached over and pushed the skin on James's face. Nothing. I pushed the flesh of his shoulder. It was like pushing a shoulder of beef. My hand darted out to the carotid artery in James's neck. Yes, his body was alive. Problems of the brain and mind were my special field. I paced the room, waiting for Bill Moore, a colleague and friend of ours, to arrive. Bill was known to be a mountain of strength in crises such as this, but even he was pale.