The following letter was written to Judith Bluestone, Clinical and Educational Director of The HANDLE Institute on November 15, 1996, by a nurse who was in charge of the care of a 2 year old girl-a little girl who had been brain dead for 18 months ever since she suffered 40 minutes of anoxia in a freak accident at the age of 6 months. The child's name has been changed to provide the family confidentiality.

Dear Judith,

I hope you are able to remember me. I'm Jo P., the RN taking care of Hannah. We met in Austin last week. I will probably never forget you.

First things first. Miss Hannah is changing. On Monday her dad and I saw her yawn, 3 times, for the first time in over a year. Her eyes are more often convergent…. As of Wednesday she pretty much hated the world and a wet diaper, another new thing as Hannah has never complained before about such discomforts. She cried a lot, had more facial expressions than I have seen… and snuggled into my breast when I held her. Unusual as I normally have to place her head and extremities for her. As of today she has quit resisting the exercises. Sometimes she even tries to help as if anticipating the next move, at least with the arm games. Her stiffness is diminishing rapidly. She looks at you when you speak to her and she is making some noise, a whimpering, soft sound, which is so much better than utter silence. When her thumbs and fingers are brought to her mouth she often purses her lips lightly, as I have seen so many new borns do. A sign to me of a growing awareness. She has more awake time and sleeps like a person who is really tired. I know she must be as I am utterly exhausted at the end of the day. There is something we can't quite put our collective finger on, but it's like she is less spaced out now. We are doing our work religiously and Hannah is responding to the effort. So far she has held her head up one out of three tries in our daily routine. She relaxes, sometimes to sleep during reflexology, and looks at me like I am insane during face tapping. Her response to popcorn is one of the adorably baffled. She likes back tapping and the peacemaker. She smiles with This Little Piggy. I love her so!

Meeting you left a deep impression on me. Ever growing deeper as I observe this precious lamb responding. I am confused, but with my eyes open. I don't really know what to expect anymore…. I marched myself back up to the local university and applied to enter the masters program. Wise or not, after meeting you my deficit of knowledge is gaping and impossible to ignore. I must understand how you do what you do…. I need to become a nurse practitioner, via another degree, to open a practice and deliver care the way it should be delivered, the kind of care we know is needed. So that's where I'm at. Only this will take me years. As many as 4 -5 years before I can apprentice with you. And that apprenticeship is the goal. In need to understand it, Judith…..

I do have a couple of suggestions for you. One is to hire a bulldog of a secretary. Someone who will protect you or I fear the needy masses will inadvertently drain you dry. Then we all lose. The second is to publish. You must. Too many of us await answers to questions deemed permanently hopeless. You must preserve yourself and your knowledge as this particular fight will be going on long after you and I are gone and the weapons, your knowledge, are what we leave to continue the battle….