Emergency Brain

The first time my daughter Karuna had a major, sudden medical emergency, I was unprepared for the onset of what I like to call Emergency Brain: the complete inability to remember all the important details about your child and his or her medical condition. Karuna suddenly spiked a high fever that continued to escalate, a rapid heart rate, and was clearly in distress. Since she had a central line, I knew the symptoms of septic shock, and knew she needed to get to the hospital as soon as possible.

When we got there, I could remember basic things like her name and her general medical condition. But things I usually rattled off the top of my head—her medications, her surgical history, her central line protocol, or her sepsis emergency plan—I could not remember at all.

Luckily, I had her medication list with me, and everything else was able to be filled in later once I calmed down. We only had one minor mishap with her central line protocol, which is about as good as it gets, anyway.

It turns out that Emergency Brain is an actual physiological process that happens to your brain and body. When something stressful and frightening occurs, your body naturally enters survival mode, also known colloquially as fight or flight. Your body releases epinephrine and produces cortisol, leading to the common physical symptoms of stress. But more relevant are the accompanying cognitive changes. Your brain enters a state that enhances your ability to react to danger. Some parts of the brain, like the amygdala, become more active, while those responsible for critical thinking, learning, and certain types of memory, are less engaged.

These brain changes would be perfect if a lion was chasing you. But when the stress is panic over your child’s medical condition, you may find yourself having trouble thinking, retrieving medical information from your memory, or processing, all of which are skills you definitely need in a medical emergency.

So, what should you do?

First of all, make sure you have everything written down in some sort of care book or manual about your child. A 1-2 page emergency form summarizing the most pertinent details, like this one recommended by ER doctors, can be another great tool. Then, even if you cannot recall the necessary information, you can hand a written copy of it to the medical staff.

You can also practice handling emergencies in advance, running through the exact steps in the process so they become second nature. This is critically important when you need to perform actual emergency procedures on your child, such as giving Diastat to stop a seizure, giving an Epipen for an allergic reaction, or changing out a clogged trach.

Finally, you can learn to calm yourself down in a stressful situation. A few deep breaths or other simple relaxation exercises may help ground you enough.

Over time, I learned to calm myself during these types of emergencies, hyperfocusing on the task at hand. Being prepared by having everything written down and practicing in advance increased my confidence, which in many cases prevented my body from going into a stress response entirely. But even if Emergency Brain does affect you, the simple fact of understanding what it is may be enough to pull you out of your body’s survival mode.