‘Peter was a nineteen-year-old student who had been brutally assaulted with a truncheon by strangers at the station one night. He arrived at the hospital in a deep coma. We operated on him successfully that night, and several more times afterwards. His prospects were grim, but we did all we could to keep him alive. And we succeeded: for months he lay in intensive care, and a year later he’d recovered enough to go home. He was so grateful, in fact, that he built a special website to tell others about his experience.
Peter returned to his home in Zeeland near the Dutch coast, where his parents lived, and I heard nothing more from him after that. I operate on dozens of patients a year with trauma-induced brain damage, often as the result of accident. I had never really looked into just how many are able to lead a fulfilling life afterwards. If patients left the hospital alive, that was the last I ever saw of them. They went back home, and if things didn’t work out there, they were moved on to a rehabilitation centre or a nursing home. But I never saw the insides of those places.
Until four years ago, when I visited a rehabilitation centre for the first time and met people who might easily have been our own former patients. It was quite a confronting experience: I met people who were so severely disabled, who were capable of so very little, I wondered whether I would want that kind of life for myself. It got me thinking: what was, for me, the essence of humanity and happiness? Life becomes so fragile once the brain is damaged. I’d never considered whether we in the hospital were even doing the right thing. Should we always be doing all that we can, just because we can?
After that, the wheels in my head started turning. One of my students wanted to research whether patients who leave the hospital after brain surgery are able to lead happy and fulfilling lives, so we decided to go and interview our former patients from previous years. That’s how we ended up in Zeeland, and I saw Peter again. We all assumed he was doing fine, as that was how we’d bid him farewell four years earlier. But he was now suffering frequent epileptic fits, his IQ had never returned to its former level and he was having memory problems. He had tried to study multiple times, but without success. And he was without a partner.
We were in serious shock, and for a full half-hour in the car on the way home we didn’t utter a word. Thankfully we ended up in a traffic jam, which gave us the opportunity to talk things over calmly. We were so convinced that we’d given Peter a miracle, but right there under our noses, our miracle had turned into a mirage.
Through Peter, I now see the importance of the research we are doing now, in collaboration with other hospitals. How far should we really go when offering treatment? Should we always operate on every patient? Although our studies are far from over, by interviewing patients and their families we hope one day to offer well-founded answers to questions like these. That way, we can give better advice and information, perhaps even predict which patients will end up with a net positive (and which may not) and hopefully improve our decision-making processes.
My confrontation with Peter was life-changing. Not only has it helped to steer my professional decisions since, but it also altered my whole outlook on life. I realised I had become untouchable at work: I was invulnerable, impenetrable, and had been hiding my pesky emotions away where they couldn’t bother me. For a long time, I had been working with a heart of stone – now, thanks to Peter, I have far more empathy to offer.’