In the back of John's mind was his older son, Grant, who had
gone for a walk nearby minutes earlier.
He gestured to an emergency medical technician to ask what
happened.
"I called him over and I said, 'My son was walking over
this way,' and he said, 'Describe him,'" said John. "I said, 'Well,
he's 6 feet tall and has hair color just like mine,' and then he pointed at
Bryce and said, '...and looks just like him.'"
John looked down at the area that had been cordoned-off --
the pavement covered with blood -- and his heart sank.
"At that point you realize your worst fear," he
said. "I knew it was grave."
Minutes earlier, the 16-year-old had been airlifted to a
nearby trauma center after being struck by a hit-and-run driver. He had a long
list of injuries: a torn aorta, a traumatic brain injury -- including skull
fractures and bleeding throughout his brain -- compound bone fractures and
spinal fractures. Seemingly endless bits of broken glass and gravel were
embedded in his skin.
John and Bryce Virgin rushed home to break the news to
Grant's mother, JJ. Then the family hurried to the hospital, hoping to find him
still alive.
When they arrived, they were met by grim-faced doctors who
offered the slimmest odds that Grant Virgin would live through the night.
Instead of shrugging their shoulders in acceptance, his
parents were indignant.
"It's like, how dare you not fight for my son's
life?" said JJ Virgin. "It really took us ... getting very aggressive
and assertive to save our son's life, because they weren't going to do it.
"They told us not to. They told us to let him go."
From that moment forward -- time and time again -- they
would go against doctor's orders. That included trying unconventional, untested
therapies -- anything that might help Grant. One in particular involved giving
him high doses of omega-3 fatty acids (found in fish oil).
Fish oil is what the Virgin family believes ultimately --
dramatically -- altered his life course, and healed his brain.
Weeks before fish oil was even considered, Grant Virgin
underwent multiple surgeries, and spent considerable time on a ventilator.
Eventually, his body was stable, but his brain was still
riddled with damage. He was in a coma, and his doctors urged his family to
"wait and see" while his brain healed.
"The doctor told me, 'OK, now we wait.' and I go, 'We
wait?' 'Yes, we wait,'" said JJ Virgin, who questioned that course of
action -- "'Surely there's something we can do?'"
The doctor's response, according to her: "'Nope,
there's nothing we can do. We just wait. The brain's got its own time
schedule.'"
Around the same time, she was receiving a flurry of advice
from friends. One suggested trying progesterone to heal her son's brain.
In early studies, progesterone has been associated with
reduced inflammation in the brain and improved neurological outcomes after
traumatic brain injury. But the data in this area, although promising, are very
early.
Despite that, beginning about two weeks after the accident,
his mother and father began intermittently rubbing a cream containing
progesterone on him. (A leading expert questioned the efficacy of administering
progesterone in this way, noting that in studies, it is administered
intravenously.)
His family says very soon afterward, Grant Virgin emerged
from his coma, and began to speak.
It was mostly a few words and phrases -- "Let's
go" or "I love you" -- uttered in endless cycles, but his family
was heartened by his progress.
"When your kid is in a coma, and then coming out of a
coma, you watch every nuance," said JJ Virgin. "If his eyelash
fluttered, 'Oh, his eyelash fluttered!'
"You're holding on to anything that you can see and
monitoring everything, every single day. And so it was very clear when the
acceleration happened. Really clear."
Another, more dramatic, acceleration occurred several weeks
later -- about nine weeks after the accident.
JJ Virgin got more advice, this time from friends who had
seen a CNN report about high-dose fish oil used in cases of severe traumatic
brain injury.
Fish oil, they thought, might heal Grant Virgin's brain.
"If someone said to me, you know what, you can give him
fish oil, you can give him better nutrition, you'll get maybe 5% (improvement),
I'll take that," she said.
She got in touch with one of the foremost omega-3 experts,
Dr. Barry Sears, who had consulted on the first-ever case of high-dose fish oil
for traumatic brain injury in 2006.
It involved a miner, Randal McCloy, who was involved in a
deadly explosion in West Virginia. His brain had been badly damaged by carbon
monoxide, and his team of doctors was trying desperately to keep him alive.
McCloy's neurosurgeon at the time, Dr. Julian Bailes,
describes considering high-dose fish oil in this case, as akin to
"throw(ing) the kitchen sink at him."
"There is no known solution, there's no known drug,
there's nothing that we have really to offer these sorts of patients,"
said Bailes, co-director of NorthShore Neurological Institute in Evanston,
Illinois, during a previous interview with CNN.
The theory behind fish oil as a therapeutic intervention for
traumatic brain injury is at once simple and complex.
Simply stated, the brain's cell wall is, in part, composed
of omega-3 fatty acids.
"If you have a brick wall and it gets damaged, wouldn't
you want to use bricks to repair it?" said Dr. Michael Lewis, founder of
the Brain Health Education and Research Institute. "By supplementing using
(omega-3 fatty acids) in substantial doses, you provide the foundation for the
brain to repair itself."
More complicated is how omega-3 fatty acids might control
inflammation -- or damage -- in the brain. Sears likens it to quelling a
metaphorical fire in the brain.
That "fire" begins when the brain is traumatized
-- as with a profound injury like Grant Virgin's, or milder insults like
concussions suffered on a soccer field. Neurons snap, setting off a wave of
inflammation in the brain that can smolder for long periods of time --
sometimes weeks or months after the injury has occurred.
"That (inflammation) will continue over and over unless
there's a second response that turns it off," said Sears, president of the
Inflammation Research Foundation.
The fatty acid that Sears says can effectively "turn
off" that inflammatory fire is a metabolite (what remains after the body
breaks something down) of eicosapentaenoic acid, or EPA, called resolvin.
EPA is found in fish oil.
"What we think is happening is, high levels of EPA
coursing in the brain metabolize into resolvins, turning down and turning off
inflammatory process," said Sears.
Considering that, according to the Centers for Disease
Control and Prevention, 1.7 million traumatic brain injuries occur in the
United States each year, any intervention -- especially a cheap one like fish
oil -- is an exciting prospect.
But fish oil as a viable and well-studied intervention is
still a ways off; for now it dwells in the realm of the anecdote or case study.
There is McCloy, who recovered only a few months after his
mining accident.
And a case similar to Grant Virgin's: a teenager named Bobby
Ghassemi who nearly died in a car accident before getting a large infusion of
fish oil. A few months later, he attended his high school graduation.
There was the case of an 8-year-old girl who nearly drowned
after her stroller rolled into a canal. Her head and face were under water for
more than five minutes.
Eighty-two days after her accident, according to a case
study published last year in the journal PharmaNutrition, she was given high
doses of omega-3 fatty acids, after which, "...the patient exhibited very
gradual but steady progress in terms of her tolerance for stimulation and
activity."
There are seven such cases in the medical literature,
according to Sears.
"Maybe the work with Randy (McCloy) was just a lucky
break," said Sears, "But we've now done it seven times. So, so far
we're 7-for-7 in severe brain trauma."
But there are other cases -- likely many more than have been
successful -- when fish oil was tried and did not work.
It could be that fish oil was administered outside the
optimal therapeutic window. Or perhaps younger brains are more receptive to the
intervention (most of the successful case studies are among young people).
And there is a concern among doctors that high doses of fish
oil could cause excessive bleeding.
Those caveats, well known to Grant Virgin's family, did not
deter them.
Nine weeks after the accident, as Grant was being
transferred from an acute care to a rehabilitation hospital, the Virgin family
told doctors at the new facility that he was already on a 20-gram-per-day
regimen of fish oil.
In reality, his parents had been sneaking a few grams of
fish oil into his feeding tube for weeks, but nothing resembling that high
dosage.
Two days after he began at this more aggressive dosage, JJ
Virgin got a phone call late one night.
"I get this call like midnight, and I'm asleep, and I
wake up the next morning and go, 'Did Grant call me and did we have this whole
conversation?'" she said. "I just remember waking up the next morning
going, 'I must have dreamed that, that couldn't have possibly happened."
When she arrived to the hospital the next morning, a nurse
told her that, in fact, it had not been a dream.
Forty-eight hours after receiving high-dose fish oil, Grant
Virgin asked a nurse for a cell phone to call his mother, and proceeded to have
a conversation with her.
"Unbelievable," she said.
"Unbelievable."
Unbelievable, especially considering that was only two
months after Grant Virgin's parents had been told to "let him go."
"We had been told he'd never be able to recognize
anybody, he will never be able to focus his eyes, all the grim stuff,"
said John Virgin. "(They said) the diffuse damage to his brain is so much
that he's never going to be Grant again."
Today, 16 months after the accident, none of that is true.
In fact, his parents say he is even better than he was when he made that call
to his mother.
"We're not expecting Grant to get close to where he was
before, he's going to be better than he was before," said his father.
"And he's progressing every day."
The Virgin family says that progress would not be happening
if they had merely accepted what conventional medicine told them.
"I think one of the saddest things is to get to a place
and have someone tell you, 'You should just let your son die,' and you don't
have the information to make the right decision," said JJ Virgin.
"There is such hopelessness about brain injury and
there shouldn't be."
That rampant hopelessness when it comes to traumatic brain
injury is fueling a push by Bailes and Sears to do further studies about
omega-3. (Bailes receives research money from fish oil companies, and Sears has
his own EPA-rich formulation of fish oil).
They are on the cusp of beginning a broader study to find
out if omega-3 can be a useful intervention for some people after traumatic
brain injury.
The Virgin family, based on their own dramatic experience,
is sure that omega-3 will do for others what it did for their son.
"OK, what if it didn't do anything?" said John
Virgin. "It certainly couldn't hurt, but what if you have this kind of
result?"
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