From Coma to Emerging Consciousness

Sam’s Medical Status:  I had a friend email me today about Sam.  She was a little confused because I sometimes talk about him being “asleep” and “awake”.  Another order of confusion is in the Glasgow Coma Scale which says that 3 to 8 on the scale is a coma and 9 to 15 is not (Sam is now an 11).  From what I’ve read about comas and/or recovering from a coma, one doesn’t usually just “wake up” from a coma like you see in the movies or on TV.  Recovery from a coma is a slow process as we’ve seen with Sam. 

It just so happened that on Monday evening Erin called me and said the doctors at the VA hospital told her they don’t consider Sam to be in a “Coma” anymore but in a “state of emerging consciousness”.  I’m not sure if this is a clinical term or not but they did tell her this was a significant landmark in his recovery.  So, from this point, I won’t speak of Sam being in a Coma.  It will make more sense when I talk about him being “awake” and “asleep”.

Once a patient gets above an 8 on the Glasgow Coma Scale, the numbers become less and less useful.  There is another scale that is used to track the progress of patients who have previously been in a coma—it’s called the Rancho Los Amigos Scale or Rancho Scale for short.  I saw an explanation of this scale at one of the nurses stations at the VA hospital, so for now, I’m assuming they will be using the Rancho Scale to track Sam’s progress.  I’ll research the Rancho Scale a little further give you Sam’s current status. 

Tuesday afternoon I spoke to Erin and she gave me an update on the latest little miracles—My parents went to Palo Alto to drop off some cloths for my wife and also all of Sam and Erin’s Harry Potter books.  Erin said she was reading the first book to Sam yesterday morning and would stop every now and then to ask him, “if you want me to keep reading, blink your eyes”—and he blinked away.  She asked him this question a few different times as she was reading, and every time he would blink a couple of times to make her continue.   

Erin said Sam is also starting to move his arms a little.  As my parents left this morning, he waved at them and even lifted up his forearm a little bit.  Previously he was only able to move his fingers and wrist a little bit.  Erin said, this morning Sam was really becoming more and more animated with his facial expressions, so you could really tell if he was in pain or happy.  

Erin and Sam's nurse at the Bethesda NNMC Visitors to the VA Hospital to see Sam:  A few of you have emailed that you are getting excited about coming to see Sam and want more information on when you can visit.  I’m still in the process of gathering information, so please give me a little more time.  I would say by next week, I can start coordinating visits from folks.  Here are a few tips on visiting Sam (I’m sure Erin will give me more later):

  • It’s very important that Sam not receive too much stimulation at one time.
  • Visitors need to remain calm and not make any loud noises.
  • No one under the age of 16 is allowed in the room.
  • Gowns and gloves are still required at this time (mask are no longer needed).
  • Most visits will probably be scheduled with 2 to 3 people at a time.
  • The best time to visit Sam is (roughly) between the hours of 10:00 AM and noon in the morning.  Other time frames can be worked out if needed.

It will be good for Sam to receive visitors and Erin is exciting about people coming to see them.  But, as I said, it needs to be done in a way that will not create too much stimulation for Sam.  Keep in mind that even though he is now considered out of the coma, he still has a tracheotomy tube, he has two large wounds on his right calf and thigh that are normally exposed so they get fresh air (the wounds really look good by the way, but are still a little scary when you first see them), and most importantly, Sam isn’t at a point where he can recognize most people—so he’s not going to react when you come into the room.  That can be a little disconcerting and scary, so please be ready.  He does pretty good at recognizing Erin’s voice and even tracks her with his eyes when he’s really awake and fresh, but normally he stays pretty still. 

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Click on “Palo Alto VA Hospital” at the on top of this blog menu to get directions to the VA hospital.   


10 Responses to From Coma to Emerging Consciousness

  1. Doc Couhie says:

    Still keeping my eyes on Sam. It’s great to hear the progress he is making. The marines and I will be up there before you know it. Can’t wait to see him.
    Doc Couhie

  2. Bette DeCavelle says:

    Our prayers are being answered….. we have an awesome GOD! I am always excited to hear of Sam’s progress and will continue to pray. I think being closer to home will be a huge blessing for Erin….you’re a tough one girl! God bless you!

  3. Ron Thurston says:

    My son Bryan is in Kilo Battery 3/12 in Iraq. He will be returning home in October and I can’t wait to see him step off of that bus at Camp Pendleton. Bryan informed me of what happend to Sam and the others a couple of days after the incident. He was very upset. He told me about this website in August and asked if I would keep tack of Sam’s progress for him. I’ve been a daily visitor ever since and give Bryan updates everytime he calls. I am so thankful for young men like Sam who place themselves in harms way to keep the rest of us safe. I’ve been praying for Sam, Erin, and family every day. I’m amazed at how awsome God is and how he has answered the prayers of so many of us who make Sam a daily part of our lives.

  4. the Can People says:


    I represent a group of folks who’ve had the priviledge of supporting Kilo Battery 3/12 throughout their deployment. We are a team of (mostly) civilians who feel a duty to thank those who defend our nation. In our case, we do this through regular care package deliveries. We’d like Sgt Nichols, his family, friends, and fellow Marines to know that we are keeping all of you in our thoughts and prayers.

    Can People

  5. All of us need to keep praying; remember the story of Jesus and the centurion; God has honored our faith, and He will continue to.
    Matthew 8
    And when Jesus was entered into Capernaum, there came unto him a centurion, beseeching him,

    And saying, Lord, my servant lieth at home sick of the palsy, grievously tormented.

    And Jesus saith unto him, I will come and heal him.

    The centurion answered and said, Lord, I am not worthy that thou shouldest come under my roof: but speak the word only, and my servant shall be healed.

    For I am a man under authority, having soldiers under me: and I say to this man, Go, and he goeth; and to another, Come, and he cometh; and to my servant, Do this, and he doeth it.

    When Jesus heard it, he marvelled, and said to them that followed, Verily I say unto you, I have not found so great faith, no, not in Israel.

    And I say unto you, That many shall come from the east and west, and shall sit down with Abraham, and Isaac, and Jacob, in the kingdom of heaven.

    But the children of the kingdom shall be cast out into outer darkness: there shall be weeping and gnashing of teeth.

    And Jesus said unto the centurion, Go thy way; and as thou hast believed, so be it done unto thee. And his servant was healed in the selfsame hour.

  6. Please read Matthew 8:5-13 about the centurion who trusted Jesus to heal his daughter

    And Jesus said unto the centurion, Go thy way; and as thou hast believed, so be it done unto thee. And his servant was healed in the selfsame hour.

  7. Matthew 8:13
    And Jesus said unto the centurion, Go thy way; and as thou hast believed, so be it done unto thee. And his servant was healed in the selfsame hour.

  8. Kalista Kersten says:

    YEAH!!!! that is such excited news that sam is considered to not be in a coma anymore! Mr. Neria thank you for letting us know that we all might be able to see sam soon. its soo wonderful to know that our prayers are being answered and that the miracles keep coming! Erin and Sam, we will all see you soon 🙂

  9. Bobbie Toyne says:

    I’m so happy to hear of Sam’s progress…I guess our prayers are being answered as Iknew they would somehow! It has been such a long road, and even thoughyou have not seen the end of the road, your faith and our prayers will carrry you through! God Bless all who have had such an intrigal part in his recovery. God love you. Bobbie

  10. wadea william saad says:

    hi, it is always great to hear of recovery stories such as in sam the marine case , happy for her , i have similar sitution with a step son in cairo egypt . comatose from age 3 now he is 17 name is joseph , comatose on count of anesthesia overdose i beleive
    , currently not cared for by doctors , he is fed liquified food by spoon , breathes , sleeps not moving and unaware . recognizes the sounds of household people like cousins he lives with them . i wish to find organization that can examine his possibilit of at least partial recovery . i live in new jersey for 38 years with 4 kids of my own , my heart goes for joseph in egypt , they wheel him to church every sunday for communion . he can swallow . any guidance to help , how we bring him here for treatment . i will be very gratefull , many thanks in advance

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