A Rage to Live

The patient, who had been injured in a collision between his light car and a heavy truck, was deaf, blind and speechless; he had no reflexes at all, and he did not show any pain reactions. The full medical diagnosis, reported in the magazine Medical World News, reads like a lengthening catalogue of doom:

Fracture of the base of the skull, with laceration of the fornix cerebri (white fibers connecting the brain's hemispheres); contusion of the frontal and temporal lobes; severe shock; fracture of nine ribs; pneumothorax (air in the pleural space around the lungs); hemothorax (blood in the same space); rupture of the pubic bone junction; fractures of the pubic, hip and haunch bones, and of the head of the left thigh bone; severe contusions of abdominal organs; rupture of the urinary bladder; paralysis of both arms and both legs; gradual failing of circulation, and gradual failing of breathing, apparently from brain damage.

Technical Death. The man in Moscow Hospital No. 50 that day last January was Lev Davidovich Landau, 54, one of the world's greatest physicists. "Dau" was no ordinary patient, and he got no ordinary care. His friends unabashedly called for help from the free world. Canada's famed retired Neurosurgeon Wilder Penfield flew from Montreal at a few hours' notice. The Moscow doctors had already opened Landau's skull, but could not be sure whether the major threat to his brain was a large blood mass or a multiplicity of hemorrhages. Should they operate further on Landau's brain? Even while they conferred, Landau showed a faint sign of improvement; he seemed to recognize a friend. With Penfield concurring, further surgery was ruled unnecessary.

Though Landau was kept on round-the-clock artificial respiration, four times within a week his pulse disappeared and arterial blood pressure dropped to zero. Technically, he was dead. Each time, injections of adrenaline and strophanthin, and blood transfused directly into an artery, brought him back to a semblance of life. Landau spent seven weeks on artificial respiration; it was another seven weeks before he began to show signs of returning brain function.

Compelled to Reconsider. Soviet physicians are justifiably proud that they brought Landau, the year's Nobel laureate in physics (TIME, Nov. 9), back to life. Landau's brain had been starved of blood and oxygen for more than 100 days. "It was held previously," says Director Boris Yegorov of Moscow's Institute of Neurosurgery, "that oxygen deficiency of the brain cells inevitably led to their destruction. The Landau case compels us to reconsider the whole of accumulated medical experience. It has overthrown all existing theories." Neurologists outside Russia would not go as far as that. What the Landau case did, they conceded, was to undermine such arguments as the one propounded in last week's London medical journal Lancet, that doctors should not seek to prolong the lives of braindamaged patients in "irrevocable comas." By previously accepted standards, Landau had been in such a coma for months.

Yet now, Landau has recovered most of his memory. Childhood recollections returned first, then those of more recent events. He is even beginning to get back to work, once more thinking the abstruse thoughts of the theoretical physicist.

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