A Voice In The Dark

A seemingly unresponsive patient creates some career-changing questions for Dr Max

- Dr Max

IN MY FIRST year as a junior doctor I worked on a stroke ward. It was a dynamic, cutting-edge unit with close links to universities and actively involved in research. A stroke is usually caused by a blood clot in one of the blood vessels in the brain—similar to how a heart attack is caused by a blood clot in the blood vessels supplying the heart. The parts of the brain downstream from the clot don’t get enough fresh, oxygenated blood because of the blockage and start to die. The unit pioneered the idea that if someone was treated quick enough with clot-busting drugs, then the damage from the stroke could be limited. This is now widely accepted with rapid-response stroke treatment units in many hospitals, but at the time, this was quite a novel and revolutionary idea. People were given intense treatment with drugs and physiotherapy in an attempt to minimise disability.