This extraordinary shot captures the moment a paralysed man whose life support machine is about to be switched off signals to doctors he wants to live – by blinking.
The heart-wrenching plea for life from father-of-two Richard Rudd, 43, was filmed for a BBC documentary into patients with serious brain injuries.
‘Between Life and Death’ follows the progress of Richard and two other patients at the UK’s leading care centre at Addenbrooke’s Hospital in Cambridge.
He was seriously injured after he hit a car while riding his motorbike as the driver pulled out of a filling station on 23 October last year.
Doctors battled to save his life, but he was left completely paralysed and non-responsive after the treatment at the Neuro Critical Care Unit (NCCU) at Addenbrooke’s.
Staff at the NCCU were due to switch off Richard’s life support machine three weeks later when, incredibly, he began to show signs of communicating by moving his eyes.
And despite having told family members previously that he would not want to live in such a state, Richard answered ”yes” when asked if he wanted to live or die – with a blink.
His father, also called Richard Rudd, 60, from Kidderminster, had already given permission for doctors to withdraw treatment when Richard was unresponsive.
He said: ”We said that knowing Richard, there was no way in a million years that he would want to live with his injuries, but doctors wanted to wait a litte bit longer.
”He held open his eyelids and asked him to move his eyes if he could hear and was awake and he move his eyes around, so we knew he wasn’t brain dead.
”Now Richard can move his head slowly an inch either way and he can smile and grimace, but he’ll never come off the ventilator. Physically, he’s gone.
”I’m glad that he’s been given the chance to survive and to have a say. Him being able to communicate a little bit the way he can has taken pressure offf the family.
”The worst time was when we didn’t know. Having to make the decision of whether your child should live or die is almost impossible.
”But if you kept them alive and they regained consciousness and couldn’t cope with their injuries then the guilt would be terrible.
”It might not be the same Richard that we started out with, but at least he’s still coping because he still smiles when we talk about the past or when he sees his children.”
Richard, a former coach driver from Kidderminster, has two daughters, Bethan, 14, and Charlotte, 18.
He was thrown 20 feet into a ditch as he travelled to see his girlfriend in Spalding, Lincs., from his home in Kidderminster, Worcs., during the crash.
Richard could initially still talk and had movement in his arms, but complications emerged three days later when he was placed in an induced coma and suffered a brain injury.
He was taken to Addenbrooke’s after contracting an infection, as well as pneumonia and renal failure.
Director Nick Holt spent two months in the department before filming for a six month period and shot over 90 hours of footage to make the 50 minute programme.
He said: ”When Richard entered the unit there was very little chance of him making a meaningful recovery, but then Prof. Menon found that he could respond using eye movements.
”That led to a process of five months where the medical team and speech therapists worked to communicate with Richard.
”Professor Menon asked him three times if he wanted to continue with his treatment and he indicated that he did.
”It was a huge relief for the family, because Richard’s father said that he would never have been able to ask that question himself.”
Addenbrookes NCCU has 21 beds and caters for a population of three million admitting 1,000 people every year.
Around 40 per cent of those admitted are treated sucessfully and able to take up independent lives after leaving the unit.
Intensive-care specialist Professor David Menon, 53, set up the unit thirteen years ago and was in chargeof Richard’s care.
He said: ”He had severe injuries to his brain and we could not communicate with him. The outcome was thought to be very bleak indeed.
”In fact, Richard was in a locked in state where people have relatively normal cognitive processes in the brain but are only able to allow you to know about that by movement of the eyes or eyelids.
”When, after a period of waiting, he showed voluntary movement of his eyes, everything changed.
”We could use these eye movements to document “yes” or “no” responses, and through such communication, allow Richard to have a say in his own care.”
The documentary also followed the progress of an 18-year-old girl, Samantha, as her parents follow the difficult deterioration of her brain after a road accident.
A third patient in the documentary was Beckii(corr), 28, the mother of three young boys who was battling with neurogical injuries after a car crash.
The NCCU treats patients who have been in major accidents as well as those who have had infections causing inflammation in the brain or brain bleeds.
* The documentary ”Between Life and Death” is screened on BBC1 tonight (Tues) at 10.35pm ENDS