What's the difference between falling off a bicycle east or west of the Shannon?
Pam and Sammy Fleming both know the answer to that from their own horrendous experience.
It was August 1997 - the month of Princess Diana's car crash - when Sammy, then aged 20, sustained severe head injuries in a fall from his bike. He was put on life-support, he was anointed and lay in hospital in a coma for several weeks.
He regained consciousness and spent several months in University College Hospital, Galway, before being admitted to the National Rehabilitation Centre in Dún Laoghaire, Co Dublin.
After his discharge in June 1998, the battle really began to obtain regular physiotherapy, speech and occupational therapy and to ensure that Sammy was not consigned to a psychiatric hospital or nursing home. Pam Fleming knows that provision of neurosurgery services in the west won't help Sammy now, but is still bitterly disappointed at Comhairle's report, which she describes as "an insult to my son and the people of the west".
She has put years into the Western Neurosurgery Campaign along with several very committed medical professionals. It is supported by Irish-American Pat O'Dwyer, who has promised to raise funds for the unit, and US surgeon Prof Patrick Kelly at New York University who promised to give $4 million of vital equipment.
It is "truly sad" to see people in the west of Ireland who pay the same taxes being denied equality, O'Dwyer says. "Everyone knows about the importance of that vital golden hour."