1 in 5 vegetative patients is conscious. This neuroscientist finds them. | Big Think x Freethink

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What if vegetative patients are conscious? Neuroscientist Adrian Owen, author of Into The Gray Zone and a professor at Western University in Canada, is using fMRI technology to try to reach the people who may still be aware of their surroundings.

Consciousness has traditionally been assessed by asking patients to respond to verbal commands. Through brain imaging, Dr Owen and his team were able to prove that these tests are inadequate, and it's estimated that 20 percent of vegetative patients are conscious but are physically incapable of communicating it.

"Communication is the thing that really makes us human," says Dr. Owen. "If we can give these patients back the ability to make decisions, I think we can give them back a little piece of their humanity."
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DR ADRIAN OWEN:

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TRANSCRIPT:

DR. ADRIAN OWEN: Imagine this scenario. You've unfortunately had a terrible accident. You're lying in a hospital bed and you're aware—you're aware but you're unable to respond, but the doctors and your relatives don't know that. You have to lie there, listening to them deciding whether to let you live or die. I can think of nothing more terrifying.

I'm Dr. Adrian Owen. I'm the author of ‘Into the Gray Zone’, a neuroscientist explores the border between life and death.

Communication is at the very heart of what makes us human. It's the basis of everything. What we're doing is we're returning the ability to communicate to some patients who seem to have lost that forever. The vegetative state is often referred to as a state of wakefulness without awareness. Patients open their eyes, they'll just gaze around the room. They'll have sleeping and waking cycles, but they never show any evidence of having any awareness.

So, typically, the way that we assess consciousness is through command following. We ask somebody to do something, say, squeeze our hand, and if they do it, you know that they’re conscious. The problem in the vegetative state is that these patients by definition can produce no movements. And the question I asked is, well, could somebody command follow with their brain? It was that idea that pushed us into a new realm of understanding this patient population. When a part of your brain is involved in generating a thought or performing an action, it burns energy in the form of glucose, and it's replenished through blood flow. As blood flows to that part of the brain, we're able to see that with the fMRI scanner.

I think one of the key insights was the realization that we could simply get somebody to lie in the scanner and imagine something and, based on the pattern of brain activity, we will be able to work out what it is they were thinking. We had to find something that produces really a quite distinct pattern of activity that was more or less the same for everybody. So, we came up with two tasks. One task, imagine playing tennis, produces activity in the premotor cortex in almost every healthy person we tried this in. A different task, thinking about moving from room to room in your house, produces an entirely different pattern of brain activity; particularly, it involves a part of the brain known as the parahippocampal gyrus. And again, it's very consistent across different people.

So, we realized that we could use this as a simple mechanism for asking yes or no questions. We could say, well, I'm going to ask you a question. If the answer is yes, imagine playing tennis. If the answer is no, imagine thinking about moving through the rooms of your home. I can still remember exactly what it felt like the first time we saw a patient that we thought was in a vegetative state activate their brain...

[bigthink]

What other scientific breakthroughs have given you hope lately?

[patrickhurley]

God bless this man. God bless the scientists that use their hearts and minds to help humanity.

[heavenandearthhealing]

This happened to me when I was 13 years old. In 1995 I was diagnosed with acute lymphocytic leukemia. I underwent massive chemotherapy treatments one of which was intrathecal methotrexate. The methotrexate eventually started to attack my brain and threw me into a vegetative state. I was aware but trapped in my body. I would just sit there crying and crying because of how scary it was to not be able to communicate.I started to slip deeper and deeper into a coma and my doctors have lost all hope at that point. I went to a dark peaceful void that was filled with love and warmth. When I woke I saw my entire family standing around my bed saying goodbye to me. At this point the doctor said I was either going to die or never wake up. I even had my last rites. Upon waking up I could feel how scared everybody was. I kept saying to everybody (in my head bc I couldn’t speak) “it’s OK guys I’m gonna be OK”…Sure enough I pulled out of it and made a full recovery which stunned doctors. I am now a pediatric reiki nurse and a mother of a beautiful 4 1/2 year old. I always looked at how lucky I was to survive some thing that nobody thought I would. God had other plans for me. Life truly is beautiful to me because I truly did get a major second chance…Live each day like it’s your last because it could be.♥️

[ya.ghostie]

My grandmother is in a vegetative state. We talk to her and sometimes her eyes tear up. The doctor told us that she hasn’t responded to any of the tests, and to make a decision regarding her life, but its only been 3 days. We don’t want to keep her if she’s suffering, but if there’s a chance she can recover, we are praying for it.

[bredixon]

My brother went in for a gastric sleeve surgery and has been in the hospital for almost 4 months due to their mistake. He got moved to a facility that could help him and he had respiratory distress and his heart stopped twice. No one can tell us how long he went without oxygen. The drs just told us he is 90% in a vegetative state. They did 1 ct, 1 eeg and assessments like see if he feels pain. They want us to make the decision after a few days to end his life? Seeing and hearing stories like this gives us hope.

[marinabarrett]

I was overcome with emotion on this. Thank you for helping these people. Recognising they are awake.

[QueenetBowie]

I’ve had sleep paralysis, and that alone gives me anxiety, I can’t imagine going through that for day, months or even years...

[alteredbananawithrice]

My mother had a cardiac arrest just 2weeks after her she was in recovery from her 3rd stroke. Her neurologist confirmed after 2 EEG tests that she is in pvs and will be fully be dependent on machines just to be able to live, so we came to the decision to stop her life support. After extubating her, she was surprisingly still breathing on her own (even at a better rate than when she was under a vent). It’s been 5 days since and her breath and stats are still miraculously stable despite what the doctor said. These are times I could just cry and wish this kind of study is available here in the Philippines just so I could be at peace and confirm that she really heard me, and that it really was her own tears that fell when after I told her that I love her so much when were about to remove her support back then

[deedee]

my dad passed away in 2014, before he passed away he was in a coma or vegetative states for 20~21 days, if his state allowed him to heard us back then, its kinda makes me happy and relieved, because he would knew how we (my family) loves him so much and will always loves him in our lifetime.

[khristinaa.]

Absolutely terrifying. I was talking to a person at work who said he was in a coma for 12 days. He told me he remembered hearing things happening around him and hallucinating nightmares. This brought me to tears. We are so fortunate to live in a time were science can address this.

[MelissaMayGB]

This is so comforting. My grandad had a fall a few days ago and cracked his skull, he's alive but in a vegetative state. It's so good to know that when we talk to him, comfort him and tell him we're here for him, he might be able to hear us...

[deborahm]

I was in a vegetative coma when I was 19. My parents were told I would never come out of it. They were told to take me off machines, which I wanted. But they wouldn’t agree. I was looking down on everything happening to me, and listening very clearly to everything being said, from the ceiling. I just wanted to be let go to the peace just beyond my reach, and leave the pain of my body behind. I remember hearing people adjusting equipment. One said what a waste of time and money I was. “She’s just a pin cushion. Nobody home.”

[YiannisANO]

During my masters i participated in a study that was working on something similar. It was stunning. The student doing the experiment told me in her previous internship they actually solved some issues a family had by communicating with the father who was in a coma. I cant even imagine what we’ll have in the future

[Soooooooooooonicable]

If you ever start feeling shitty about your life, just be grateful that you're not experiencing this kind of hell.

[Picasso_Picante]

Did he just say 20% are still aware of their surroundings? HOLY SH*T! This is horrible!

[raresmircea]

I remember hearing the nightmarish accounts of a person who recovered, saying how gruesome it was to be fed hot soup by ignorant nurses, to be manipulated without any care for the joints, to be absolutely confined, to hear his mother talk out loud begging for him to die so that everyone’s struggle and suffering ends. I’m so sorry!

[knosp]

I'm a Respiratory Therapist and I work in long term care and most of my patients are vegetative. This is very fascinating. Thanks.

[not_today_satan_]

Wow that's really amazing my brother was in a pvs for 7 1/2 years. When I would walk into his hospital room and say hi brian he would open his eyes. He never looked at me could not track. Was in a diaper and feeding tube. He never spoke a word but I think he knew I was there. I miss him

[ShaySails]

Beautiful. This gives me hope my father could hear me when I spoke from my heart at his deathbed.

[canalperegrino]

My dad has been like this for 3 years, sometimes I see tears running from his eyes, ... he cries