If you have to be the victim of a subarachnoid hemorrhage of the right vertebral artery — an “often fatal, but usually debilitating, event” — it’s good to be Yitzchak Francus.
The Squirrel Hill resident and member of Shaare Torah Congregation published a piece in The Atlantic magazine last month describing the convergence of events that saved his life in March 2014, when his “head exploded, splattering toxic blood” into his brain.
Yet, despite a full recovery more than eight months ago, he explained, he nonetheless remains faced with the aftereffect of well-meaning friends and relatives who continue to be suspicious that his brain trauma has left him fundamentally changed.
“I’m fortunate,” Francus said. “Some people actually recover from this,” although those odds are low.
“The mortality rate is 40 to 50 percent,” he explained. “And 90 percent of those who survive are left with some deficit.”
Fortunately, Francus is among the 10 percent who return to pre-trauma functioning.
The incident triggering his brain trauma occurred last year on the Shabbat before Purim, Francus recalled, and began with a pain in his lower back on Friday night. By Saturday afternoon he was in so much pain he decided to walk to the home of his physician, Barry Segal, who immediately advised him to go to the emergency room.
When Francus arrived at UPMC Shadyside Hospital, he was diagnosed with a kidney stone. He was given painkillers to which he had a bad reaction, causing him to shake his head back and forth.
It was that motion that probably caused his aneurysm, which was previously undiagnosed, to hemorrhage, he said.
Francus was taken into surgery for the kidney stone, at which time he began to complain of a headache.
It was Segal who insisted on a CT scan to check on Francus’ brain.
“That basically saved my life,” Francus said. “If I hadn’t had the hemorrhage in the hospital, and if Barry Segal hadn’t caught it …”
Segal soon conferred with Joel Weinberg, another local physician, who advised him to move Francus to UPMC Presbyterian Hospital, where there is a renowned neurology department.
“When they took me up for the MRI, I didn’t know how serious it was,” Francus said.
Luckily, the doctors were able to correct the trauma by installing a coil in Francus’ head. He remained in UPMC Presbyterian for about two weeks following the procedure, and though he had a bad headache, he could walk and talk immediately afterward. His headache only lasted a couple weeks.
After just two months, he was back to work at the law firm where he was a practicing attorney and back to his daily routine.
But, Francus discovered, recovering from a brain trauma is different than recovering from any other type of illness.
“No one thinks that a broken leg or a kidney stone or pneumonia fundamentally changes the essence of who you are,” he wrote in his Atlantic piece. “But when you’ve had a brain injury, people don’t believe that you are quite the same, although no one will actually say so.”
Friends continue to ask how he is feeling, rather than greeting him with a simple “hello.” If he stumbles over a seam in a rug, colleagues will ask him for days if he is OK. If he forgets something his wife said a bit earlier, she will wonder if it is the fallout of the trauma rather than run-of-the-mill inattentiveness.
But Francus knows all the questions of his friends and family stem from a genuine concern for his well-being.
“People are just being thoughtful,” he recognized. “They just want to know how you are. They are concerned about you.”
After observing the reaction of his family, friends and co-workers to his trauma, Francus decided to write an essay about his experiences and submit it to The Atlantic, although he had never published anything there before.
“I had this reaction from people, and it occurred to me that this might happen to other people as well,” he said.
After publication of the piece, Francus did in fact hear from others who had experienced similar reactions following their own brain traumas. Most of the comments were supportive, he said. But while many people thanked him for writing the piece, others charged that there is no way for one to experience such an incident and to completely recover.
“I’m extraordinarily lucky,” Francus acknowledged. “It was an unusual outcome for what I had.”
Although “the odds were beaten,” he observed, he does not take credit for beating those odds.
“I was just lucky,” he said.
Toby Tabachnick can be reached at firstname.lastname@example.org.