Natasha, you will be missed

Stuyvesant High School

In 2008 I witnessed Vanessa Redgrave’s performance in The Year of Magical Thinking, the Joan Didion play based on her book of the same name. It is an account of the year following the death of her husband while her daughter struggled with her own health. Ms. Didion’s daughter, Quintana, died after publication of the book but her death was included in the play.  

year-of-magical-thinking

 “Life changes fast.  Life changes in the instant.  You sit down to dinner and life as you know it ends.” 

This line, repeated throughout the book like a montra, haunted me.

vanessa-redgrave

This past month when Natasha Richardson died, I couldn’t help but associate Vanessa Redgrave’s peformance as a forshadowing of events to come. I had been a fan of Natasha’s for many years beginning with her performance as Mary Shelley in Ken Russell’s Gothic. I followed her career ever since then and even felt an unexplainable comfort like most fans do when their starlets find love and get married. In this case it was to Liam Neeson.  Whenever a newspaper or magazine posted a photo of the happy couple, I read the accompanying article with joy. When she triumphed on the New York stage, I applauded vigorously when she won the Tony Award for Caberet and then earned another nomination for Closer. Her career was destined for the same greatness as her mother’s.

That’s why when she died tragically due to injuries suffered during a skiing lesson, I was shocked and confounded. How did his happen?

My deduction is that she suffered a  subdural bleed. Trauma to the head causes a contra coup injury as the brain hits the opposite side of the skull to where the impact occurs.  This can disrupt the bridging veins, causing a slow progressive bleed. That would explain why Natasha was lucid initially. Then as blood collects in the small confines of the skull, the victim becomes sleepy, complains of headaches,  and finally gets more and more obtunded until eventually they die if untreated. 

 “Life changes fast.  Life changes in the instant.  You sit down to dinner and life as you know it ends.” 

If only Natasha had been brought to a trauma hospital. She would have recieved a CT Scan of the head. Burr holes would have been drilled into her skull, evacuating the blood and saving her life.  

I worked in a trauma ER for nearly two years. It was a living hell. Some head traumas have distinctive signs to look out for:

raccoon-eyes

– Raccoon Eyes consistent with a periorbital fracture

battle-sign

– Battle Sign consistent with basilar skull fracture

And one that I will never forget because it saved a woman’s life – blood behind the tympanic membrane. 

As a doctor, we try to learn from our mistakes. Hindsite is 20/20. If anything it’s important to remember that Natasha should have been wearing a helmut during her lesson and after the accident, she should have gone directly to the emergency room.

Farewell Natasha. You will be missed.

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