''Why don't you just tell me the medications?" Ahmed recalls one woman demanding. ''You just tell me the name of the medications, and I'm not going to be calling you again."
Ahmed, who has been asked by Herbert's family not to identify the drugs, has returned a few phone calls, explaining his medication strategy in general terms and warning, ''There is no guarantee."
Ahmed was treading in largely untested waters when he put Herbert, now 44, on a combination of drugs usually used to treat Parkinson's disease, depression, and attention deficit hyperactivity disorder.
He said he had seen such drugs help his other brain-injury patients at Erie County Medical Center regain focus, memory, and powers of concentration, and become less agitated or irritable. He had even seen such drugs bring people out of comas -- the eyes-closed state of complete unawareness -- and other kinds of impaired consciousness, although not after nearly 10 years as in Herbert's case.
So when he heard that Herbert had improved, ''I was not surprised," Ahmed, a genial rehabilitation specialist, said the other day. ''I was expecting from the beginning he should make a change."
In the days since, Herbert has continued to have sporadic conversations and has even played with a soccer ball.
In a discussion about Herbert's case, Ahmed waved off a question about Terri Schiavo, the brain-damaged Florida woman in a persistent vegetative state who died in March after her feeding tube was removed. He had not examined her and so could say nothing, he said.
But he emphasized that family and doctors should not give up on trying to help brain-damaged patients.
''I'm confident that if we try the same way on other people who are in a coma [or other states of impaired consciousness], there could be a difference," he said. ''There could be a lot of people who could wake up."
''God will not help you unless you try something," said Ahmed, a Muslim who grew up in Karachi, where he attended college and medical school.
