The Damaged Brain

During a preseason workout by the University of Denver's hockey squad in mid-November, a player was hit with a hard body check, went somersaulting through the air. As he came down, the protruding back end of his skate, two inches long, caught Defenseman George Congrave on the head. It gouged a jagged hole about the size of a silver dollar in the left side of his skull, above and forward of the ear, and tore out a piece of his brain. In an emergency operation, Neurosurgeon William Lipscomb could do little more than cut away the surrounding damaged brain--so that Congrave lost a total of about ten teaspoonfuls of grey matter--and tie off the severed arteries.

The outlook for Congrave was poor. He would probably live, but the skate blade had slashed through the areas that control speech and the movement of the right side of the body. It had also cut some of the white fibers leading from the retinas of both eyes to the visual center in the back of the brain, and other fibers leading from the frontal cortex (associated with intellectual and reasoning functions) to other parts of the brain. George Congrave, 21, a chemical engineering student from Edson, Alberta, seemed likely to spend the rest of his life more like a vegetable than a man.

Back to Infancy. But the human brain, especially in the young, has considerable powers of readjustment and a further capacity for retraining which medicine is now beginning to exploit. After a few days spent mostly in coma. Congrave perked up. His temperature dropped as the inflammation in the brain around the wound subsided. At the end of two weeks he could grunt a response to questions, and he was using his good left hand to help raise a glass to his lips. In another week, told to wiggle the fingers of his left hand, he could both understand the order and carry it out. The doctors decided to move Congrave from St. Luke's Hospital to Craig Colony, a nearby rehabilitation center. There a battery of therapists went to work on him, trying to retrain him, starting almost at the infant level, in speech, feeding and self-care.

Last week, despite a setback from a bout of pneumonia, George Congrave was able to feed himself with a special knife-and-fork combination that enabled him both to cut and pick up meat with his left hand. He was using that hand to print simple messages--his name and address, the word "mother" ("stepfather" was too much for him) and a comment on the hospital: "Here it is nice." His spoken vocabulary was limited to "Yes," "No," "Hi Mom" and "Thanks," but the speech therapist was confident that it would soon grow.

Toward the Acid Test. The doctors concluded that by this time Congrave's reasoning ability had recovered far beyond his ability to articulate. This might be dangerously frustrating, but so far the patient has shown no sign of it beyond scratching his head when puzzling out how to express something which he obviously had formulated clearly in his mind.

There was little hope that Congrave would ever regain the use of the right side of his body. How severe and lasting the impairment of his vision would be could not yet be told, or the extent to which other fibers to the frontal and temporal areas of the cortex would take over the functions of those destroyed. The acid test of Congrave's recovery would be months hence, when a member of the chemical engineering faculty brings down his textbooks to see how much he has retained, how much more he can learn.

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