PussyStapler

Not OP, but generally locked in syndrome has sleep-wake cycles. It's one of the ways you can differentiate it from coma or persistent vegetative state on EEG.

Great recovery, and best wishes for a continued recovery!

Locked in syndrome can be hard to diagnose, but brain death has specific criteria that are often not met with locked in syndrome. I can see a misdiagnosis of coma or persistent vegetative state, but I'm having trouble grasping how doctors could have pronounced you brain dead. Your pupils would still react to light. An EEG would show sleep-wake patterns. Cerebral perfusion studies and carotid Doppler would show you still had blood-flow to the brain.

Additional, if you were pronounced brain dead, you would be legally dead, and they would either harvest organs or withdraw support. No hospital or nursing home would care for a dead patient.

So I'm wondering if you are conflating brain death with PVS or some other diagnosis.

Can you elaborate on how the doctors misdiagnosed brain death?

EDIT: Sorry I asked this, as I guess it doesn't really matter and this question just generated unnecessary controversy. OP was cared for at MGH. That hospital does formal testing for brain death, which means this was likely a miscommunication issue. Either a trainee or physician said something stupid off the cuff, or the family misunderstood severe brain damage for brain death. A conversation might go something like this:

"so, doc, is he brain dead?"

"Practically speaking, there isn't much difference. He's so profoundly damaged, he will likely never wake up and have any meaningful interaction."

--you can imagine in a stressful situation, it's hard to pick up on that nuance, and it could have been explained better.

Either way, this doesn't detract from the fact that your recovery is impressive. Way to go, OP, and keep working with rehab!

I interviewed for a job once where the corporate office was built above a downtown shopping mall. I went to Nordstrom's, bought off the rack, interviewed, and returned it 2 hours later. The salesperson knew exactly what I did.

I wouldn't have done that with and altered/tailored suit though.

I realized after I asked it, that he can't really answer what the docs were thinking, and it's probably outside the scope of the AMA, which deals with his personal experience of locked-in syndrome.

I'm curious if you were involved in the case of Anthony Garcia, a doctor who murdered his division chief and the family of his program director because they failed/fired him as a resident for unprofessional behavior.

Giving a trainee a failing grade usually has repercussions for the educator. They often have to spend extra time writing letters justifying the failure, or they have to spend an extra year working with an incompetent resident, or they get subpoena'd in a lawsuit. There is no incentive to self-police, and then these problem doctors are unleashed to the public. Anthony Garcia is an extreme case, but I do think about the possibility of retaliation when considering failing a resident or student.

Why do you think physicians don't self-police?