Post 1 — When the Body Doesn't Follow the Textbook
When Complexity Meets the Standardized Box An educational series about individualized care, medical complexity, system design, and the human life at the center. Post 1 — When the Body Doesn't Follow the Textbook CLINICAL EDUCATION · AUTONOMIC INSTABILITY When the body doesn’t follow the textbook, don’t force the textbook onto the body. My son Alex sustained catastrophic injuries involving the cervicomedullary junction, upper cervical spinal cord, and brainstem. One of the most extraordinary consequences has been the way his autonomic nervous system responds. Consider heart rate and blood pressure. In many familiar medical situations, when blood pressure falls, the body attempts to compensate by increasing heart rate. But Alex can experience something very different. His heart rate and blood pressure can fall together, dramatically, within seconds. We have witnessed his heart rate drop from the 70s or 80s into the 30s, accompanied by profound blood-pressure changes. Now imagine ...