Rupture: A Matter of Life OR Death

WHOOSHING:

ELECTRIC CRACKLING

SHRILL BEEPING:

I'm not quite conscious that I nearly died.

And yet I'm pursued by, um...

..this fear of violent death happening again.

I had a subarachnoid aneurysm,

and nobody was around to witness my attack.

I had it in the most banal way. I was exercising on a StairMaster at a friend's,

and it was quite comedic, actually, because when I fell off the machine,

I crawled to the main house of the friends we were staying with.

Well, I was just sort of having, like, shotguns in my head,

these kind of convulsions, and I was just...

I felt like my whole head was going to explode.

For three days...

..I had this haemorrhage in my head.

And I was SO lucky that the blood did not go into the brain, cos I would have died straightaway.

I followed an instinct on day three, as I was getting worse,

and I was misdiagnosed with a viral encephalitis or viral meningitis.

And on day three, I suddenly... An instinct in me told me,

"I don't think I'll survive the weekend."

And I was vomiting and the headaches were just atrocious.

I managed to get to emergency, to ER at Cedars hospital.

You were developing signs of brainstem dysfunction.

You were unable to be aroused, you were not responsive,

and you were beginning to have trouble breathing, for example.

These are the signs telling us that there were really some

structures that were in jeopardy if we did not operate.

I'm on a drip.

It's midnight.

I'm crying.

My headaches are relentless.

I NEED morphine.

I'm in and out of tubes.

It's dawn...

and I'm having a lumbar puncture.

The nurse holds me close to her as they draw the fluid from my spine.

There's blood in the liquid.

The disease is declaring itself. LIGHT BULBS BUZZING

A relief.

Then the fear takes over.

Am I dying?

I remember just being on my own and hearing all the hospital noises

and thinking, "OK, I'm ready to go.

"I'm OK now, I'm ready to go. I don't want this pain any more."

'They're going to operate.

'The surgeon radiates hope.

MACHINE BEEPS 'And, when I'm gone,

'he opens my head to fix the machinery.'

CUTTING UTENSIL GRINDS AND SCREECHES

HEART MONITOR BEEPS

Consciousness.

My brain restores the basic order of things.

Who am I?

Where am I?

I need to pee but I'm too weak to move.

Shifting my limbs is like moving an iron mannequin.

I slump to the toilet seat, exhausted. Bones jutting.

And, there in the mirror, is someone else staring back at me.

Sunken eyes, bruises on her shaven head and an ugly scar.

What HAPPENED to me?

'We are all close to the brink of being someone else.

'The rupture of an artery wall or a lapse of concentration at the wheel of a car

'is all it takes to cause a mind-shattering brain injury.'

'My glimpse of death has left me with so many questions about life.'

'What are we, Maryam,

'and what are we to make of our brief time in the world?'

'And what traces do we leave behind?'

'The body can be dismantled and displayed in cabinets,

'but mostly, we leave no more than our bones behind.'

'And the mind?'

'Fragments of mind can live on through ideas and through trails of memory

'in other people's minds.'

'But what about the soul?'

'Ah, the ghost in the machine.

'And here's the machine - the brain.

'All worlds real and imagined are contained within its folds and convolutions.

'Trees and stars, words and thoughts, and ghosts like us.'

Everything?

'The universe...and more.'

But yet, it's so fragile.

Your brain is very greedy.

It's the greediest organ in your body for oxygen and glucose,

more than any other part of your body at rest.

And the way the oxygen gets to the brain is through blood,

and that's through lots and lots of blood vessels - little tiny bifurcating

branch-like processes leading off from your arteries and your veins

that ensure your brain tissue gets a really constant supply of oxygen.

If something goes wrong, then the brain tissue will die.

And the ways it can go wrong is, for example, with something called an aneurysm,

and that's from the Greek, "to dilate".

So, an aneurysm is a kind of ballooning of a vessel.

And you can imagine if you're stretching and stretching a balloon,

and what happens with a balloon if you put too much inside it? It will eventually burst.

So, an aneurysm is a sign that something may be about to burst,

and if it does, that causes what's called a haemorrhage,

which means that the blood leaks out into the brain and not to the places it's supposed to be.

Well, my view is that aneurysms form very quickly.

May even be in a few minutes, or instantly.

The tear in the artery causes a blow out,

and then they either just sit there doing nothing

or it bursts there and then and the patient presents with a subarachnoid haemorrhage.

The most difficult aneurysms are those which have already ruptured,

cos they're in a very unstable situation.

Even those who reach the neurosurgical unit and have the aneurysm treated,

probably only 30 to 40% at the most get back to their premorbid state -

ie, what they were before the brain haemorrhage -

and are able to function normally again.

TRAFFIC NOISE:

You were not to know that your head contained a time bomb.

Many people go about their lives quite unaware

of the potentially fatal defects their brains are harbouring.

Blood-filled bulges known as aneurysms - little time bombs.

If an aneurysm bursts, a form of stroke,

the results are often catastrophic.

Sudden death in about one third of cases,

death within a month for another third,

and severe disability for many of the third who survive.

Aneurysms occur on the blood vessels on the surface of the brain,

so they aren't actually within the brain substance.

In contrast to other sorts of vascular problems like

arteriovenous malformations which exist in the brain.

The risk of having a stroke,

including subarachnoid haemorrhage, increases dramatically with age.

Nine out of ten people affected are over the age of 55,

but anyone of any age can fall victim.

Goang-Jong Shu was scarcely out of her teens.

I graduated sophomore year with flying colours.

I had the highest grade in my classes.

And I was really involved

in Key Club and community services.

And so, you know, I got my permit, my driving permit,

so I was on the top of the hill, and then this happened, so...

You know, my first reaction was, you know, "Why me?"

You know, "Why did this happen?" I was doing fine.

My wife and I have come to a conclusion that it must be

she got too...

..too much pressure from herself.

She was just striving for everything to be perfect.

So the aneurysm in the brain kept growing from one head,

and it kept growing into the three heads,

so it doesn't matter what time it ruptured.

And once it ruptured,

then the result is either...

either...

she will be dying or go in a coma.

- Become a vegetarian. - A

vegetable. - Vegetable. - Vegetable.

LAUGHS:
Vegetarian!

The artery from which the aneurysm arises is so damaged by the aneurysm

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