3 is dead

Everyone in Israel has heard of the Glasgow scale. Why? Because our former prime minister Ariel Sharon was and still is in a coma. The Glasgow scale, of course, measures the level of consciousness (or lack of). Ariel Sharon, for example, scored 6 out of 15. 8 or less is defined as a coma. 6 doesn't sound that bad, doesn't it? So why am I writing about it? What's so curious?

Recently, I heard of two people for which the Glasgow scale was any relevant. So it got me curious, and I looked for some information to see what it means. The strange thing about it is that if you're dead, you still score 3. Why would someone invent a scale for which the minimum is 3!?

The reason of course is that the Glasgow score is the sum of three components, Eye response (1 to 4), Verbal response (1 to 5) and Motor response (1 to 6). If you're dead, you cannot move your eyes nor respond verbally or motoric such that you get 1 in each category (the exception are some "dead" Palestinians who can score the full 15, at least until they fall off a stretcher). Clearly, a much more reasonable scaling would be 0 to 12 (i.e., subtract 1 from each category). Dead will be appropriately zero, and fully conscious people will get the nice round number of 12 (which is in fact nicer than 10). Sharon would be 3/12 on this modified Glasgow scale. More appropriate for his unfortunate condition. 10/12 and above on this scale would be mild brain injury. Sounds nicer, doesn't it?

So why 3 is dead? There are several possibilities one can think of for why this stupid scaling came about.
  1. The doctors who invented the scale don't know how to count from zero.
  2. The doctors who invented the scale think other doctors don't know how to count from zero.
  3. Artificially increasing the score makes its sound less severe. Getting a 3 doesn't sound as bad as getting nothing.
  4. And of course, the ultimate reason: total lack of thought.
Given that all the doctors I know are well aware for the existence of "zero", I would imagine that the doctors who invented the scale do too. So option 2 is probably not correct. If these doctors are the exception (i.e, option 1 is correct), they would still not think that other doctors cannot count from zero, because they cannot think on something they are not aware themselves....

I'd hate to think that option 3 is the reason. But after a few brushes with the medical system, I know that some doctors do have the tendency to hide information, so it could be a way to throw some chaff. From the same brushes with the system, however, I would imagine that option 4 is the real reason.

Anyway, as for the two people I know, one scored 13 or 14, and is now 100% back to normal. The other was 3 and had since died (i.e., now permanently a 3). Some of his organs, though, are still kicking as they were donated. Oh, yeah, fill your donor consents.