21 - Kate: cognitive recovery and emotional adjustment in a young woman who was unresponsive for several months

Summary

This chapter describes a young woman who was reported to be in a vegetative state for several months. She made a good cognitive recovery despite severe physical impairments but needed long-term support for emotional adjustment. This case illustrates how developing a shared understanding of Kate's strengths and difficulties with her and those around her was an important step toward re-establishing her sense of social identity. This, in turn, led to increased social participation.

Background and illness

Kate was born in 1970. She was the second daughter of a professional family living in Cambridge. She had a happy normal childhood with no serious illnesses. Her older sister trained as a medical doctor and Kate went to university to study history. After completing her degree Kate trained as a primary school teacher but because she felt her spelling was poor she chose to work at a nursery school near Peterborough. She was living with her boyfriend whom she hoped to marry and they planned to have several children. At the age of 26 years Kate developed a sore throat and a headache. Her mother described what happened.

One Sunday Kate phoned to say she had a sore throat. On Monday she went to work. I phoned on Tuesday but didn't speak to Kate, I spoke to Katey's boyfriend. He said Kate was not well and was in bed. He went to work on Wednesday and when he came home he could not wake her. He telephoned an ambulance and Kate was taken to hospital where she was said to be in a coma. […]