The Road Back

After a hard day on the set playing the part of a missionary doctor in Director John Ford's Seven Women, Patricia Neal, 39, went home to Pacific Palisades. She was helping her daughter Tessa, almost 8, with her bath when she collapsed with a blinding, disabling pain in her head. Her husband, British Short Story Writer Roald Dahl, knew that this was no ordinary headache. Ever since a 1960 Manhattan taxicab accident left their only son* Theo, 41, with hydrocephalus (water on the brain), Dahl had been working with neurosurgeons on an improved valve to drain water from the boy's head. He had picked up enough medical knowledge to suspect that Pat might have had a stroke, and he knew just the kind of doctor to call.

Lead Apron. Within a half-hour, Neurosurgeon Charles Carton met the Dahls in the emergency room of the U.C.L.A. Hospital. There, though Pat was awake and aware on arrival, something worse happened. The 1963 Oscar winner (for her role in Hud) became speechless and paralyzed; then she shipped into unconsciousness. A spinal tap revealed blood in the fluid, showing that she had had a hemorrhagic stroke. To locate the site of the trouble, Pat was taken to the X-ray room, where six doctors went to work. She was pregnant, so a lead apron was placed over her abdomen to protect her unborn child from radiation.

As the surgeons were threading a catheter (a thin plastic tube) into her brain arteries through a needle in her neck, Pat had a third and more massive stroke. Only immediate surgery could save the actress, if anything could. Residents shaved Pat's skull, and Surgeon Carton sawed loose a trapdoor, 4 by 6 in., over the left temple. Guided by the X rays, Dr. Carton began removing the clots that had formed after the hemorrhages. The original break had been in the left carotid artery, where an aneurysm had ballooned out from a weak spot in the artery wall (evidently the result of an unexplainable weakness present since birth).

Dr. Carton removed the clot between the brain and its parchmentlike covering, the dura mater. Next he boldly cut into the left temporal lobe to remove another clot. In a righthanded person such as Pat, the left side of the brain controls not only movement on the right side of the body but also the speech center. Finally Surgeon Carton carefully lifted the temporal lobe, put metal clips on the aneurysm and sprayed on a plastic coating to reinforce the artery wall.

Tentative Caress. Pat Dahl remained in a coma for ten days, while Husband Roald kept a bedside vigil, gently squeezing her limp hand and repeating endlessly "Pat, this is Roald." It was more than a week before he got the merest squeeze of recognition in return. Pat was kept on a cortisone drug to minimize swelling in the brain, on another drug to help keep water from her brain tissues, and on antibiotics and anticonvulsants. She had to be fed intravenously and by stomach tube. It was still touch and go.

Three weeks ago Pat came out of the coma, and hope came out of its corner. The air tube that led into her windpipe through a cut in her neck was removed, and retraining experts soon went to work. Speech therapists helped her in the difficult task of finding and forming words. Physiotherapists gently but determinedly raised and bent her right arm and leg.

Last week Pat finally went home. She could manage a few words and she could feed herself with her left hand. With her right she tried the first tentative caressing movements when baby Ophelia, ten months old, was put in her bed. She was already trying to learn to walk again. Her obstetrician thought there was a good chance that she would even fulfill her ambition of enlarging her family by carrying to term the baby which she intends to have delivered in England. At week's end though her speech was still limited, Pat Dahl was able to tell her husband proudly: "I can feel the baby moving."

* Eldest child Olivia died of measles two years ago.

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