Lessons From Natasha’s Fall
What can we learn from actress Natasha Richardson’s awful skiing accident this week? Dr. Steven Flanagan, director of Rusk Institute of Rehabilitation Medicine at NYU Langone Medical Center where I work, rightly characterized Richardson’s sudden loss of consciousness after seeming fine at first as possibly “talk and die syndrome.” He was quoted right here on FoxNews.com as describing the likely buildup of blood in the head that may have overwhelmed her consciousness and caused her to blackout after first seeming to be okay.
What else can we learn? That a person can be alive and thriving one minute and have her life snuffed out the next? Who among us doesn’t know that skiing is a dangerous sport? It has been several years since a blow to my knee convinced me not to take any more chances with my livelihood and health. Unfortunately, not everyone sees it that way.
Not knowing the details, I can’t say whether she was taking chances, whether this terrible accident could have been avoided. I can’t say whether she had a hidden aneurysm in her brain that predisposed her to a bleed, or even whether prompt medical intervention, drainage and anti-inflammatory medications and life support can still bring her back. We are all hoping to find out that she is back awake and speaking with visitors tomorrow.
As is usual with celebrities, the media reports so far have been shrouded in mystery and contradiction, ranging from minor injury to looming death. As these are sorted out over the next few days, it is worth reminding readers just how often we learn incorrect facts about medicine from the sudden illnesses of those we admire.
Whatever actually happened to Natasha Richardson, and whatever happens from here, there are a few important conclusions we can already draw. 1. Skiing is a dangerous sport which can injure more than your legs. 2. The brain is a closed compartment with no outlet for blood or swelling until the swelling subsides and the blood is reabsorbed. 3. If the brain itself is not damaged, but only swollen or compressed by blood, then there is still hope for her survival.
The latest reports say that she has been flown from Quebec to New York City, and I can attest to the fact that there are medical centers here with the ability to bring people back from a deep coma.
Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News medical contributor and writes a health column for LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel is the author of “False Alarm: The Truth About the Epidemic of Fear
Tags: accident, celebrities, Natasha Richardson, New York City, Quebec, skiing, talk and die syndrome
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Remember Congressman Sonny Bono, of Sonny & Cher fame? He died of a head injury while skiing.
These are reminders to be grateful for what we’ve got, and love the people in our lives when we have a chance. For we know not what tomorrow brings.
-Steve
The details are not known but this presentation is classic for an epidural hematoma. I assume she had an emergency CT scan but why she didn’t undergo an immediate craniotomy is unclear. With immediate surgery she would have a had a good prognosis. Perhaps neurosurgical capability was not available or the family requested that she be flown to the states delaying the surgery. Even a burr hole may have saved her life. So sad.
Of course sking is a “dangerous” activity. So is, driving, bicycling walking across the street and getting out of bed in the morning. Sking is also an exhilerating experince in a beautiful environment. This type of “risk” taking is what makes life worth living.
I would rather have lived and enjoyed life as an active person, then die at 110 as a slug afraid of his shadow and never having left the house.
Dear Dr. Siegel,
Did you know that relatively (= considering the number of people engaged in these pleasurable activities) and, of course, absolutely, skiing is associated with substantially less fatalities than, for example, biking or swimming? Did a scratched knee in a biking accident or unwillingly getting some water into your mouth when swimming also convince you “not to take any more chances with your livelihood”?
By the way, I believe that Dr. Widergren is absolutely right. First, considering the development of her symptoms, it is hard to imagine anything but an epidural hematoma causing her death. Second, a very simple surgical procedure (drilling a hole through her skull that would prevent the fatal brain compression) without any delay would have almost certainly saved her life. It appears that somebody screwed up badly…
So Sad. I agree that she probably could have been saved if a hole had been drilled to relief the pressure. I have read plenty of real drama stories, one little boy hit his head on the coffee table while rough housing and he went downhill quickly with 12 hours, they did a dramatic surgery of drilling a hole in his head. He lived and is normal today. Too bad. Sounds like the right person wasn’t there to save her.
Perhaps more should be known about the treatment to this poor women. I’m sure all the physicians in the US would want to know if the hospital she was brought to had CT Scan, if a neurosurgeon was called, if they had done Burr holes. Burr holes was basic training when I was a resident and some were done without the CT Scan results by ER docs and surgical residents. Of course, now in this letiginous enviornment, I don’t think I would feel very comfortable doing that with out the results of a CT Scan.
What I think should be jumped on with this current health care crisis, is, if she was not treated the way anyone in the US would have been because of an access problem. We are heading toward this with the buy-in of universal health care coverage. This may be your best case for lives lost and sitting around singing kumbia instead of good medical treatment.
Let Fox News find out the facts and I am sure you can have your pick of US physicians commenting on what could have been done. If she or her family refused the treatment its a done deal, but if it wasn’t offered, the doors open.
The lesson is: if you are sick or injured in Canada, walk, run or crawl to the closest U.S. hospital. Socialised medicine will kill you. She was three hours (by car) from a trauma center because helicopter ambulances are too expensive for Health Canada. Add the additional two or three hours waiting at the local hospital which had no ER, and you have a recipe for tragedy.
Natasha’s passing is a shock indeed; it’s a reminder that we should live everyday like it’s our last