From Nearly Dead to Medical School Graduate

Alex Lake, MD

Disclosures

July 12, 2018

I have a vague memory of going to bed but felt normal upon waking. I had a mild headache, but I was able to eat breakfast, smile, and felt surprisingly well. "Dude, we thought you were dead for a minute last night," my friends said over and over in different ways. We laughed together. Everything felt normal until around 4 PM, 16 hours after my head hit the concrete. My headache worsened, I became nauseated, and began to vomit as the world started spinning. I grabbed onto my friend, who noticed I was walking erratically, and asked him to take me to the ED. Fortunately, it was the same ED I worked at. The triage nurse knew me and sensed that something was off. I was taken in immediately.

My vitals were stable. My mental state was not. I told them my story like I was fine and survived it without injury. But I was obviously affected and slurring my speech. The doctor noticed this right away. From what I've been told—my memory of that day is still severely limited—a doctor who was familiar with me walked into the room and heard me speak. He wasted no time and wheeled my bed out of the room and personally pulled me into the CT scan. What did the scan show?

It's just as you suspected, future doctor: a large brain bleed. An epidural hematoma and a subdural hematoma, plus a subarachnoid hemorrhage with a temporal bone fracture with, fortunately, minimal midline shift. I had experienced what you learn about regarding an epidural hematoma in medical school: the "lucid interval." My neurosurgeon told me that I was less than 2 hours away from a coma or death. He performed an emergency craniotomy and excavated the buildup of blood from the torn middle meningeal artery. The official surgical document stated, "We opened up the cranium and the middle meningeal artery was shooting profusely." The blood was drained to relieve pressure on my brain. I awoke in the neuro ICU with a shunt in my head, wondering what my life would become.

'You Will Not Make It in Medical School'

The next few days weren't easy. I remember that I couldn't stand up on day 2 and needed the help of two nurses. Not being able to do anything on my own for the first 3 days following surgery was discouraging. But I knew that if I gave up right then and there and didn't go through therapy without giving it my all, I would never be the same. By day 5, I was walking up and down the stairs with only minimal assistance. I eventually passed all of the neurologic exams. On day 6, I was discharged. I had multiple medical appointments following this injury. Most of these appointments went exceptionally well, and the physicians encouraged me to continue pursuing my dream.

I canceled the rest of my interviews. I was stuck at home with terrible headaches. Going through that with physical therapy, occupational therapy, and speech therapy was just too much to continue. I committed to Lincoln Memorial University-DeBusk College of Osteopathic Medicine (LMU-DCOM) at this time because I knew, even amidst the agonizing headaches, dizziness, and routine struggles, that I could complete medical school.

All of this testing and work aimed at ensuring that I remained the same person continued for several months. In May 2014, approximately 3 months before starting medical school, I felt that I was back to normal. I had an appointment scheduled with a neuropsychologist who was to clear me to resume normal activities. This man, with a PhD and MD in neuropsychology, didn't try to sugarcoat anything. He told me quite directly: "You will not make it in medical school. You're too slow at recalling objects, and your short-term memory is poor. You have trouble with spatial organization as well." As I left his office, I told this doctor that I was grateful for his time and appreciated his assessment. I then told him that I'd send him a copy of my diploma when I graduated from med school. And on to medical school I went.

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