Mayor Nobby Clark’s brain fade comments ‘plausible’

Thursday, 20 June 2024

A cardiac expert says Invercargill mayor Nobby Clark could well have suffered from cognitive dysfunction for up to three months after his open-heart surgery.

Clark has cited “brain fade” caused by being on a heart-lung machine during his double heart bypass surgery in January as the reason behind offensive behaviour that led to a complaint from the United Fire Brigades’ Association.

When Clark spoke at a prize-giving dinner after an association event on March 16, it was his first public speaking engagement since the surgery, he said. He reportedly mocked, degraded and offended firefighters and embarrassed guests.

Experts say cognitive dysfunction in the part of the brain that controls inhibition is plausible for about three months after surgery, but it’s not all that common.

In an apology letter to the association, Clark said: “The cardiac specialist I consulted advised me, after I approached them after your event, that I suffer from what is commonly referred to as ‘brain fade’ – a condition resulting from being on a heart-lung machine during the surgery (at the time, I did advise my colleagues of this impact).

“The advice: The condition means that the brain wanders and doesn’t also keep to a normal pattern – by joining and mixing thoughts.”

Clark was hospitalised for a heart attack on December 27 and underwent double heart bypass surgery on January 3.

He returned to work on March 6.

Professor Harvey White, a cardiologist and director of the Green Lane Cardiovascular Research Unit in Auckland, said about 20% to 50% of cardiac surgery patients experienced postoperative cognitive dysfunction that typically lasted up to six weeks after surgery.

Most patients reported impaired attention, concentration and memory, which included brain fade or brain fog, he said.

Postoperative cognitive dysfunction is primarily caused by blood clots, platelets or air travelling to the brain, inflammation, or changes to blood flow, White said.

Symptoms could last six weeks to three months, depending on the patient, he said.

Professor Simon Mitchell, the University of Auckland’s head of anaesthesiology, has spent time researching how changes in gas levels affect the brain.

There were well-quantified incidents of cognitive dysfunction after heart surgery, he said, mostly in the week following surgery with the prevalence decreasing over time.

This dysfunction could take many forms, Mitchell said.

“Any part of the brain can be affected, including parts that would inhibit you from doing things you would otherwise think were unwise.”

While the usual complaints were that people felt slow or had memory trouble, Mitchell confirmed that behaving rudely or without inhibition could occur as a result of brain fade.

“Have I seen this? Yes. It’s certainly possible,” he said.