European Stars and Stripes (Newspaper) - January 7, 1991, Darmstadt, Hesse                                But what really happens to those Hollywood brawlers a blow to the Chin May leave a person in a a persistent vegetative state a Here a scene from the film Quot Miami blues with Alec Baldwin right and Tony  David Jacobson the Hartford Conn courant what would happen if people really got hit the Way they appear to get hit in All those a a a violent movies and television shows. A. Doctors who Deal with the bloody aftermath of shootings and assaults with damaged a nerves and arteries with shaken brains and shattered faces know that Hollywood vastly Underlays the medical Impact of the violence it portrays. ,. When punches and bullets Fly they say heroes and bad Guys alike can end up with impairments ranging from. Changes in personality and in to partial losses  vision use of their limbs even their sense of smell. Standard Hollywood scenario our hero gets in a fight. He gets knocked out. By a fist to the Chin Ora bottle vase or chair Over the head. Later he wakes winces shakes it off jumps in a sports car resumes chasing bad Guys. What s wrong with this picture. A a person knocked unconscious even momentarily has experienced an injury to his reticular activating system an upper portion of the brain Stem that regulates consciousness explains or. Richard Simon director of the neurosurgical training program at the University of. V Connecticut school of Medicine and Hartford Hospital think of the brain in the Skull As a Ball at the end of a rope the rope being the brain Stem. When the head turns violently in response to a blow the brain rotates inside twisting its tether so that this weave of nerve connections known As axons is stretched or broken. Sometimes a person comes around just Tine Hollywood heroes Bear the Luck of Angels. For others enough connections in the reticular activating system can be damaged to leave them in a Quot persistent vegetative. . A those who do Wake up won t be off on the run. Given that the brain Stem also regulates blood flow to the brain head injured patients typically suffer a debilitating Hung Over feeling that lasts several Days to a week Simon says. Amnesia often temporarily shadows the mildly head injured. Quot if he the hero could operate a car he d get the key in and wonder where was i going again a says or Marc Palter director of the neurosurgical intensive care unit at Hartford Hospital. Knockout scenario variation hero wakes up in a _ Hospital. Quot you be had a Nasty bump on the head Quot doctor says hero sneaks out jumps in sports car Etc. Anyone bolting Hospital observation after being knocked unconscious would truly need to have his head examined that initial injury can be followed by leg Fly life threatening complications Simon says. Blows to the head can break or lacerate blood vessels in the cortex or outer. Brain he says. As blood collects inside the Skull pressure builds a thus a Quot classic situation Quot Simon says. A person. Comes to from a knockout from the injury to the reticular activating system and feels of but later he lapses into unconsciousness again. This is the other injury a blood clot pressure and swelling shutting Down the brain s switches. In a Hospital doctors closely Monitor such brain t swelling partly by a rays partly by peppering patients with questions what Day is it whore Are you who a the president Etc., that reveal Levels of consciousness. Palter is particularly disdainful of those  to. Hospital scenes that Lack a nurse or doctor hovering a ,. Constantly Over a head injured patient. If conditions Worsen doctors May intervene with surgery to remove clots close Down bleeding vessels and relieve pressure inside the Skull. O. Even blows that Only stagger our hero could in some real life cases affect brain function enough to change his nature. A a a. -. A a a a a a a a a e a a v damage to brain tissue too Small to show up on most tests can yield impulse disorders that cause people to act out fits of anger getting them in trouble with police or fired from their jobs says or. Alan Russakov chief of the department of physical Medicine and rehabilitation at mount Sinai Hospital in Hartford. Quot most people think of the brain As an Initiator. In fact. A the cerebrum upper brain is an inhibitor that keeps you in Bounds Quot he explains. V. Russakov cites slight drops in in from even add head injury. _ Simon also notes Subtle  from head injuries a problems with attention Span and. Concentration problems keeping track of numbers and phone Calls. But he says Only rare cases Don t Clear up after several weeks or months. In movies and to a hero gets blows to the head not just once but often week after week or in scene after scene yet unlike in nervous system connections elsewhere in the body Bram axons Don t regenerate so damage adds. Up. A a so called punch drunk syndrome a slurred speech impaired concentration and slowed thought processes a is Well documented. But the exact degree and location of brain tissue damage that brings it on is not known. Adds f Mac Buckley hah Ford lawyer Veteran boxing Trainer and president of the Connecticut Amateur boxing federation Quot Mike Hammer would be off the air in about six shows if he took All those blows to the  in a Hollywood fistfight combatants sock each other in the head tumbling Over furniture. One Guy keeps wobbling Back to his feet for More punishment a a. Quot the Guy who a doing All that  going to break his hand Quot says Buckley a former  a nightclub bouncer. A. The Guy on the receiving end7 it lies struck hard. Enough on the Bridge of the nose its not uncommon for a set of Bones to to driven backward shoaling his olfactory nerve and depriving him of his sense of smelt says or Rob ii Walker president of the hairier ican Traur Ria society and a Dallas based Oral and Maxill facial surgeon. A. The 11 Bones of the face act As a bumper,.shattering and playing to absorb blows and protect the brain and Skull behind them he says. But those Bones also act As anchors for tendons and Muscles that align and operate the eyes making precise reconstruction important not Only Lor anti cubist cosmetic reasons but to keep vision aligned. In movies and to shows the Good Guys Are forever. Getting winged by bullets or receiving Quot Only a flesh . A at the very worst they get shot in the leg Arm or shoulder. By the denouement heroes boar a Sling or Crutch in the next episode or sequel they re fully functional. Flesh wounds  that  skin subcutaneous fat or muscle a actually do exist and Are quite common says or. Lenworth Jacobs director of the trauma program at Hartford Hospital. In a big target like the thigh Quot you have a tremendous Chance to hit muscle and very Small Chance to hit major nerves or arteries Quot he says. But unlike in to scripts Quot you can t really choose whore that Bullet goes a he warns. A for example Quot a Bullet in the Arm has a much greater likelihood of hitting a major artery or nerve Quot compared. To the thigh. Jacobs says. A. The cartoonish extremes of movie arid to. Violence a makes its equivalent real life consequences hard oven for. Doctors to figure Quot it s so unreal its really hard to relate to m any sense of real  Are going to have to endure from it Quot says Russakov. Quot no  to How tie Coyote is going to do after Quot he Falls -3,000 feet Well this is the same thing ivs jus that they re using real people Quot. Monday january 7, 1991 the stars and stripes a a Page 13