Albert Bierstadt Sierra Nevada paintingGeorge Stubbs Whistlejacket paintingJohannes Vermeer The Little Street painting
have been profoundly handicapped.“Even among patients in the deepest comas,” O’Brien explained, “where there’s little or no those automatic responses declined in frequency until they ceased to be observed at all. This suggested a steady loss of function in the lower brain stem.The previous morning, Dunny’s heart had stopped. Defibrillation and injections of epinephrine restarted the heart, but only briefly.“The automatic function of the circulatory system is maintained by the lower brain stem,” Dr. O’Brien said. “It was clear his heart had failed because brain-stem function failedapparent activity in the cerebrum, there is usually enough function in the brain stem to allow them to exhibit some automatic responses. They continue to breathe unaided. Once in a while they might cough, blink their eyes, even yawn.”Throughout most of his hospitalization, Dunny had breathed on his own. Three days ago, his declining automatic responses required that he be connected to a ventilator. He’d no longer been able to breathe without mechanical assistance.[348] In his early weeks at the hospital, although deeply comatose, he had at times coughed, sneezed, yawned, blinked. Occasionally he had even exhibited roving eye movements.Gradually,
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