You likely will not (and should not) ever encounter a physician who tells you that there’s a 100% chance or a Zero % chance of a specific outcome when someone you love is admitted to an ICU.
There are rare exceptions, but generally, no matter how catastrophic the injury that brings your father to an ICU, no doctor can ever say that no one in your dad’s situation has ever survived. Nor can we say that he will have a 100% chance of survival. Because, simply, no one has EVER been in your dad’s exact situation. Each human body and brain is totally unique in its response to disease, injury and treatment. Biology is truly too variable for irrefutable predictions.
It reminds me of the “Black Swan” effect, the result of the centuries-old European belief that all swans were white. That changed in 1697 when Dutch explorers encountered black swans in Australia. In medicine, every one of us who works in an ICU has cared for the “outlier,” the son with the gunshot wound to the head or the mother with a massive hemorrhagic stroke, who despite what seems scientifically to be an irreversibly fatal event, rebounds before our eyes, and lives to walk back into our ICU six months later, to thank the nurses and doctors and medical students who cared for them, despite no real memory of their weeks with us.
A prime example of the fallacy of neurological prediction is the ICH Score (Intracranial Hemorrhage Score), published in 2001, and still the most widely used grading system to estimate death at 30 days after a hemorrhagic stroke. The worst scores, 4 or 5, predict a 97% to 100% mortality. But these numbers reflect a “self-fulfilling prophecy.” Patients with the largest hemorrhages, and the poorest clinical exams upon arrival, are more likely to have life-sustaining treatment withheld, by family or friends, and thus die earlier, therefore skewing the numbers toward higher mortality.
