Florida spear gun accident: Stories of brain injury survivors

The Florida teen whose brain was impaled by a fishing spear survived because the spear, which entered his skull above the right eye and exited the back of his skull, missed the main blood vessels in his brain, news reports said Tuesday.

Though one might not imagine the brain could take such abuse and survive — and the extent of recovery of 16-year-old Yasser Lopez is still to be determined — there are remarkable stories of those who survive horrendous injuries like these.

The brain, for all its delicacy, is a highly plastic organ, and if one part is damaged, often another brain region can pick up the slack and take on new duties, be they for touch, or smell or some other function.

The most famous such case in medical history is that of Phineas Gage, a 19^th century railroad worker whose head was impaled by a tamping iron after a worksite explosion. As L.A. Times writer Melissa Healy described the famous incident, “the pole, more than an inch thick, rocketed through his skull with such force that it landed 30 yards away” and yet, “minutes after the accident, Gage was conscious and walking. After battling infections, he was reported to have recovered completely.”

His recovery was not complete, however. Though essential functions were preserved, more subtle damages persisted. Gage’s personality was forever altered.

The precise injuries a person sustains — to personality, vision, ability to walk, etc. — depends on which part of the brain has been damaged, not surprisingly. The degree of recovery is greatly influenced too by the resources available to the injured people: their access to rehabilitation, the extent to which they’re surrounded by loved ones who help and encourage them and even their own resolve to recover as best they can.

These points are well illustrated in a package of stories Healy wrote last year in the weeks after Rep. Gabrielle Giffords was shot in the head. The following survivor profiles show how varied the post-injury experience can be:

Jackie Nink Pflug, shot during a 1985 airplane hijacking, “needed to learn to tell time again, to recognize and count money, to hold more than a single thing in her memory at a time.” She painstakingly trained herself to move her eyes from left to right so she could learn to read again. She went on to write a book about her life and to become a motivational speaker.

Danny Rodriguez, shot by a gang member in 2009, was discharged from the hospital still unable to sit in a wheelchair and was sent home after five weeks at Rancho Los Amigos National Rehabilitation Center in Downey. Experts in the article describe his case as what can happen when a life is saved but inadequate resources are offered to help a victim regain function and live an independent, productive life.

Matthew Gross, shot on the observation deck of the Empire State Building in 1997, “doesn’t drink or go to clubs anymore because he’s on seizure medications,” the article said. “He finds dating difficult, since he still fights the urge — not always successfully — to say things that would be better left unsaid in such circumstances.” He has worked to create a new, very different life for himself.

Leonard Rugh, shot in Vietnam, “came home after 26 months in a Veterans Administration hospital, deaf in his left ear, largely paralyzed on his left side and still slow to retrieve his words.” His wife, Luanna Rugh, refused to let him hide away indoors and became his rehab champion through the decades that followed.

Most people do die from such terrible injuries. If the brain stem is damaged from bullet, spear or other piercing object, death is almost certain. This region is responsible for life-or-death functions such as breathing. But should the frontal lobe be damaged, there is a much greater chance of survival, although pretty much everybody sustains some impairment and change.

And yet, said neurosurgeon Ian Armstrong of Culver City, in one of the articles, “I have seen every foreign body in the world pass through the brain, and I never cease to be amazed that some [patients] seem to survive and do amazingly well.”