EXPIRED: 06/11/10 – Fred Plum, 86, was never in a “persistent vegetative state,” although he is the guy who came up with the phrase.

While researching the state of consciousness and care of the comatose, Plum, coined that phrase as well as the lesser-used, and far more frightening, “locked-in syndrome.”

He also suggested we start making “living wills.”

His father, the owner of a chain of Depression Era drug stores, died when Plum was just a kid. His sister died of poliomyelitis a few years later. That’s when the Atlantic City, New Jersey native decided to pursue a career in neurology, earning an undergraduate degree from Dartmouth College in 1944 and a medical degree from the Cornell University School of Medicine in 1947.

He was smart. The University of Washington soon named Plum the head of neurology, making him, at age 29, the their youngest chief ever. While there he created a respiratory center to comotose patients who overdosed on drugs. Without the benefit of now-standard technologies like CT scans and MRI’s and ultrasounds, the medical field had only a basic understanding of brain swelling, impaired consciousness and brain death. And few doctors knew how to treat them. He penned The Diagnosis of Stupor and Coma in 1966 and then developed the Glasgow Coma Scale, a way to monitor the state of a coma patient based on eye motion, and motor and verbal responses, coining “persistent vegetative state” to describe coma patients with severe brain damage who had the appearance of being conscious without any detectable awareness.

Such was the case with Karen Ann Quinlan, in which Plum testified as an expert witness in 1975.

Plum later coined the term “locked-in syndrome” to describe the opposite condition —  in which a patient is aware and awake but can’t move or communicate due to complete paralysis except for eye movement. The thought of that just freaks me out.

Because of that “freak out” factor, Plum advocated that people like me should prepare for such a state with a “living will” just in case they’re not able to make medical care decisions after they fall ill.

Plum died in New York from progressive aphasia, a form of dementia. And yes, he had a living will.

I still don’t.



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