Trauma: Everything Was Not Enough

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Later, after a six-hour autopsy, Los Angeles Medical Examiner Thomas T. Noguchi told reporters of the massive damage done to the right portions of Kennedy's brain. The fragments were so tiny and so numerous, he said, "it was remarkable that the neurosurgeons were able to maintain the Senator's condition until the last minute." Only after several weeks of intensive microscopic examination of the brain, the vital organs, and an "exhaustive review with members of the medical team," he said, would a complete report be released.

The regions of Kennedy's brain that were either destroyed by bullet and bone fragments or damaged by being deprived of blood and oxygen spell the difference between living and existing and, as it turned out, between life and death. The cerebellum, located to the rear of the underside of the brain, controls motor coordination. The occipital lobe, that part of the cerebrum directly above and extending past the rear of the cerebellum, affects vision. Other lobes of the cerebrum house seats of personality, intellect, speech, memory and sensory-motor activity. The midbrain area, directly beneath the juncture of the cerebellar hemispheres, is related to eye reflexes and both eye and body movements. It also serves as a pathway for nerve tracts running to and from the cerebellum and other parts of the brain. A bit lower and most vital is the brain stem, the "old brain," which man has shared with other creatures since the earliest stages of evolution. A passageway for nerve impulses, it monitors breathing, heartbeat, blood pressure, digestion and muscle reflexes, mediates emotions.

Last Hours. While Kennedy lay dying, neurosurgeons recalled cases in which less extensive damage to a combination of these vital areas had not prevented partial or full recovery—even after weeks of coma. Since Kennedy was righthanded, the undamaged left side of his brain was more critical to his body control. In some cases, therapy has helped brain-injured patients to train the less dominant side of the brain to take over. Such cases are rare, and for Robert Kennedy, the damage had been too extensive even for survival. Twelve hours after the operation, the recordable brain waves ceased. For seven more hours, his heartbeat and breathing continued. Then these last two life signs faltered and stopped.

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