In a Coma-Like State for Six Years, a Stunning Awakening
On an otherwise uneventful Sunday morning this March, Lucille Smith, a Colorado health-care administrator, rose early to wake her daughter Christa Lilly. Smith entered the room with her usual “Hi, baby. How you doin’?” But instead of answering with her customary silence and vacant gaze, Lilly opened her eyes and said, “Fine.”
“She looked at me and smiled and told me she was hungry,” says Smith, 73, as if recounting a dream. Because in a way it was: Lilly, now 49, has been in a coma-like state—fed through a tube, her body motionless and eyes unaware of the TV that plays in an effort to stimulate her—since cardiac arrest in 2000 deprived her brain of oxygen. But at her Colorado Springs nursing home on March 4, Lilly suddenly roused. For three days she spoke in a slurred but recognizable voice to her friends. She became reacquainted with her four daughters and three grandchildren—and showed a ravenous appetite. “I asked her what she wanted to eat,” recalls Grace Thomas, a longtime pal, “and she said, ‘Anything.'”
In the end it was fried catfish and hush puppies at a local restaurant. “When she comes out,” says Smith, “she tells me what she wants and what she doesn’t.” Then, just as mysteriously as Lilly’s awakening had begun, “I went in the room and said, ‘Hi, baby, how you doin’?'” recalls her mother, her voice trailing off. “She just looked at me. I knew that she had gone back in.”
That heartbreaking reversal was not the first time Lilly has roused from—and returned to—a twilight world somewhere between full consciousness and complete coma. Termed a “minimally conscious state” (see box), the classification generally applies to people who suffer traumatic brain injury but recover with some level of awareness. Eight months after sinking into her near-coma at age 43, Lilly, a former nursing assistant who is separated from her husband, showed her first sign of wakefulness. “I was at the table getting ready to fix her food,” says Smith, “and then I heard a voice.” That episode lasted barely an hour; since then, it has happened four more times, says Smith.
For years doctors doubted Smith’s claims that her daughter had intervals of lucidity. This time Smith took Lilly to see her longtime neurologist Dr. Randall Bjork. Hearing her voice for the first time, “I was flabbergasted,” he says. “I’ve never seen this cyclic kind of awakening.” Diagnosed with an abnormality in her heart’s electrical system, Lilly had suffered a cardiac arrest in 2000. “She had the paddles five times,” says Bjork, “so she was essentially dead.” Medics revived her, and, like many patients who undergo similar trauma, Lilly remained in a coma. But then, says Bjork, she began to evolve: “Think of it as a pyramid, a continuum of consciousness. Some people die, some get to be comatose, some develop into a vegetative state.” The others, even fewer, enter Lilly’s world.
Lilly herself seems to have little memory or true understanding of what is happening to her. “I told her she’d been asleep,” says Smith, “and she said, ‘Why didn’t you wake me up?'” When Lilly awakened in March, her daughter Chelcy picked up right where she left off the last time. “I felt that I could still tell her things I’ve been meaning to tell her,” says Chelcy, 12, “like how much I missed her.” For her children, says Smith, “it’s just like Christmas to hear their mother’s voice and be able to talk to her.” But everyone knows those moments with Lilly are fleeting. During a period of wakefulness last year, Lilly was at a family barbecue. “All of a sudden she began to go,” says Smith. “I just went over and took the chicken out of her hand.”
Doctors can offer the family no real prognosis or glimpse into Lilly’s future. But that does not lessen the joy her awakenings bring to her family or their faith that others will come. Chelcy, for one, believes her mother will be with her once again. Why? “Because,” she says, “I am praying that she will.”