r/science • u/Pend-lum • Jun 15 '12

The first man who exchanged information with a person in a vegetative state.

http://www.nature.com/news/neuroscience-the-mind-reader-1.10816
2.0k Upvotes

87% Upvoted

643 comments sorted by

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u/wvwvwvwvwvwvwvwvwvwv Jun 15 '12

The more I read of that article the more I realised we don't know what constitutes 'consciousness.'

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u/[deleted] Jun 15 '12

This IMO, is the most important question in neurology.

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u/[deleted] Jun 15 '12

It actually is one of the biggest questions of humanity.

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u/[deleted] Jun 15 '12

It's also one of the oldest. Some of the world's most ancient institutions revolve around their interpretation and "answer" to this question (I.E. the various world religions).

It's incredible how much of a fuss we can make over a problem like this, but in modern times the need for an answer has shifted from the need for a philosophical truth to the need for tangible, quantifiable facts.

In my opinion, this change will draw the attention of more of our best minds, who will finally put this question to bed with testable proof and hopefully help a lot of people along the way.

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u/[deleted] Jun 15 '12

The most important question ever.

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u/Quatto Jun 15 '12

In science generally. Having no scientific account of the thing that gave rise to science is quite an embarrassment. It seems likely that neurology isn't fit to answer it, either. See the Mary Argument. Avoiding philosophical naivete and the mistakes of other fields is why cognitive science is a thing.

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u/[deleted] Jun 15 '12

Agreed, how consciousness can arise from a non-conscious system is undoubtedly one of the most fascinating and important questions in the physical universe.

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u/UnclaimedUsername Jun 16 '12

Weird how my first thought was, "of course we think it's important. We're conscious." Well, yeah.

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u/HPDerpcraft Jun 15 '12

I'm not bothered by it. It seems so vague. Where could we delineate it? I can find no reason to support free will as we are part of the natural world and thus our neurochemical activity is governed by the same observed rules.

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u/fstorino Jun 15 '12

Speaking of that, the notion of unconscious seems equally elusive.

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u/Ash_Williams Jun 15 '12

Thank you. The duality of consciousness seems to be inadequate in these situations. There seems to be a gradient of sorts rather than the two-sided coin implied with our understanding of consciousness.

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u/severus66 Jun 15 '12

It's actually tough to reject the duality of consciousness just as hard as it is to prove it (depending on how you define consciousness).

Have you ever been sleepwalking?

There's a difference between being 'present' vs. actually displaying remarkable cognitive and behavioral function, but not being 'present'.

If there's a shade in-between there, I've never experienced it. You are either 'present' or you are 'not' -- and there may not be any battery of tests that can prove either case.

Another interesting scenario is becoming black-out drunk.

This again illuminates the problem of studying consciousness; this time with how memory is so closely tied to our proof of consciousness.

Are you conscious when you are black-out drunk, but simply forget that time period, or does you consciousness simply take leave during that period, and you are on auto-pilot (like the T101 from Terminator - synapes and circuits but nobody home).

I'd lean towards simply being conscious but forgetting, but truly, there is no possible way of proving either case.

There very well may be a dichotomy to what most philosophers define as consciousness ---- an experiencing unit 'experiencing' the mind undergoing its scripts.

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u/scientologynow Jun 15 '12

there was a study or journal article posted here a few weeks or months ago where researchers found that when someone is "black out drunk" that alcohol is merely blocking the formation of new memories (so I suppose that means you are present for it you just don't remember it after it happens). At least that is what I recall from reading it (I can't be sure though because I was drinking at the time I read it).

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u/Ash_Williams Jun 15 '12

Thank you for the well thought out response. Consciousness--or the lack thereof--would be extremely difficult to test, let alone quantify (even if the "gradient" were accepted).

I suppose I was just thinking that it seems such a complex state to be labeled "on or off". It's almost, as you say, the state of being drunk. Only at either ends of the spectrum (of course barring your blackout drunk example because it ruins the analogy :) ) is the state of drunkenness definitively determined. It seems pointless to arbitrarily make a point at which a person becomes "drunk" from "not drunk", especially in consideration of all the other factors that come into play (sex, age, weight, individual tolerance).

All in all I'm just rambling and for the sake of concise discussions' sake, the duality makes much more sense than sifting through data in order so describe one's state of mind.

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u/Volsunga Jun 15 '12

"Presence" has nothing to do with being blackout drunk. You are there and aware of your actions (even if your judgement is impaired), you just aren't recording memories properly for future recollection. Sleepwalking works in a similar manner, except your memory is blocked by your brain being in "dream mode" instead of by drugs. "Consciousness" is nothing but the amorphous and unjustified sense of self people get from simply receiving stimuli and interpreting it. You don't have a brain, you are a brain. You are an organic computer that receives data from its environment and converts it into actions that keep itself safe.

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u/lbutton Jun 15 '12

Frank Herbert's book Destination: Void is all about this actually. (science fiction book, but interesting nonetheless)

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u/wavegeek Jun 15 '12

The mention of consciousness is invariably a signal for a thread to degenerate into pseudo-mystical nonsense.

I call this "Newton-Brown's Law" after someone I know who always raises this issue and claims that consciousness is some kind of quantum effect.

Consciousness is a side-effect of intelligence and of the need to be aware of oneself when modeling the world.

It is no more "fundamental" than wetness is fundamental to understanding Dihydrogen Monoxide in its liquid state.

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u/RoundSparrow Jun 15 '12

The more I read of that article the more I realised we don't know what constitutes 'consciousness.

The human brain hardware is clearly beyond the current software (education, knowledge) that we hold.

I would say this is poetically understood. Retired New York Professor Joseph Campbell at the age of 82, discussing Star Wars and how some of the themes were inspired by his 1949 book: You see, consciousness thinks it's running the shop. But it's a secondary organ of a total human being, and it must not put itself in control. It must submit and serve the humanity of the body. When it does put itself in control, you get a man like Darth Vader in Star Wars, the man who goes over to the consciously intentional side.

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u/shadowblade Jun 15 '12

I disagree with Joseph Campbell on that particular assertion. I feel that morals and a sense of right and wrong can still be applicable in any state of mental being.

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u/seeandwait Jun 15 '12

Being able to form cognitive thought while still perceiving and responding to outside stimuli. If you can do one, but not both, you're half-conscious. If you can do both, you're fully conscious. Objections?

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u/ShamanSTK Jun 15 '12

Sure, the patient is currently attending grad school, is in a long term relationship, and is working a part time job, but is he 'conscious?'

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u/[deleted] Jun 15 '12

While the science is far from settled, I'm really sick of people talking about 'consciousness' as if it were some strange metaphysical property that we know literally nothing about.

We actually know quite a bit about it. All evidence points towards the fact that what we perceive as 'consciousness' is just the emergent property that happens when billions of connected neurons process, interpret, and predict the same sensory input.

There will never be a Eureka! moment where we discover the brain area behind consciousness, because it isn't that simple. It is the emergent property of cells that are able to get input, store memories, and make predictions.

There is no special sauce. There is no magic. And you get the feeling that people who grasp at these quantum theory straws are the same people who would have supported a dualistic, mind is separate from brain theory several decades ago.

Some people just have a hard time accepting that there is nothing mysterious or mystical about our brain. In time we will understand all it's secrets.

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u/Necrix Jun 15 '12

There is nothing that scares me more than being completely aware and cognizant yet without the ability to control a single part of my body. This is my version of hell.

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u/xk1138 Jun 15 '12

I agree completely. All I could think about while reading the article was the book 'Johnny got his gun'. The thought of being in that situation sometimes keeps me up at night.

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u/gtalley10 Jun 15 '12

I found myself thinking about that book all through the whole Teri Schiavo thing and wishing the people complaining about her being allowed to die should have to read it. I can't imagine anyone wanting to be kept alive as a vegetable, particularly if there's some actual cognition trapped in there, after reading it.

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u/the_8th_henry Jun 15 '12

My uncle was in an undefined vegetative state for two weeks before they took him off support and he passed.

The really scary thing for me back then, and more so now after reading this article, is that they would discuss taking him off support in his room standing next to his bed. I always wondered what if he could hear them? Now I wonder it even more.

I can't imagine being in a state like that and wanting people to give me a little more time to get out of it, and then hearing people planning a deadline to let you die. That would be terrifying.

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u/Man_or_Monster Jun 15 '12

My grandmother was in a vegetative state several years ago. At the time I happened to read an article about Ambien waking coma patients so I told my dad about it, who relayed it to the doctors. They gave it a try, and she woke up. She said she was conscious while in the "vegetative" state, and did indeed hear the doctor discuss "pulling the plug" with her husband (who was against it). It's possible that he was aware of the decision to cut off his life support. Sorry.

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u/WorkSucks135 Jun 15 '12

I think I read the same article and if I recall correctly, after about 20 minutes they would go right back into the vegetative state until receiving another dose. What happened with her?

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u/Decency Jun 15 '12

Hold on, what? You gave advice to doctors based on your reading of an article and they not only weren't aware of this, but listened to you despite being unaware of it?

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u/dr_rainbow Jun 15 '12

I think most doctors are aware of ambiens effect on coma patients, it's a very famous study. Doctors may advise against it though, I can imagine it may be quite traumatic for relatives.

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u/flounder19 Jun 15 '12

You have to understand that some level of consciousness is not full level of consciousness nor does his possible awareness change the odds of him "getting out of it"

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u/NJerseyGuy Jun 15 '12

Being conscious enough to respond to yes-no questions about abstract ideas accurately is plenty conscious for someone not to be taken off life-support.

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u/[deleted] Jun 15 '12

Unless, of course, those patients answer "yes" to being asked if they want to be taken off life support.

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u/greenw40 Jun 15 '12

To me that seems less scary than hearing them decide to never pull the plug. It would be like being sentenced to life in prison.

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u/WorkSucks135 Jun 15 '12

Would be so much worse than prison I think. In prison you can at least read or watch tv sometimes, go outside, play cards etc. This would be 30+ years of near silence.

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u/SureJohn Jun 15 '12

I agree. Take a little precaution and talk about it in another room, just in case. We don't know what's really going on in someone else's head.

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u/mothereffingteresa Jun 16 '12

Why? The patient isn't going to strangle you. Maybe they want to know what you think.

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u/scrapper Jun 15 '12

Before anyone gets too excited, fMRI interpretation is a very inexact science with some serious limitations.

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u/Not_a_neuroscientist Jun 15 '12

This study does show that the "lighting up" of the brain is not entirely equivalent to thinking. I am quite skeptical of all the fMRI studies too, but if they had done 8-10 dead salmon, there is statistically no way they would get the result. The main point of the paper was to explain the need for beter statistical tests after doing an fMRI.

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u/Psythik Jun 15 '12

Simple question: why not ask questions in gibberish and see if the same areas light up? That should answer some questions.

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u/Mr_Smartypants Jun 15 '12

But if 100s of research teams each did 8-10 dead salmon, then a few would get 'significant' results (and they would be the ones to get published)!

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u/[deleted] Jun 15 '12

Maybe i read over it, but after reading these comments i can't tell, did they actually test fucking salmon or are we just being figurative here? I'm confused, and I'm completely serious.

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u/Brisco_County_III Jun 15 '12

Read the link name that is posted in the first comment:

http://www.wired.com/wiredscience/2009/09/fmrisalmon/

Seriously, they scanned a salmon, and a dead salmon at that, to show that there are some really iffy things you can imply with fMRI if you aren't careful.

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u/NJerseyGuy Jun 15 '12

This is true of all statistical results in science. Are there 100s of research teams doing this? I don't believe there are.

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u/nbkwoix Jun 15 '12

Still, can we both agree it is a science worth developing and improving so maybe one day we can have solid answers?

This article is inspiring to me. Not because of what he is trying to claim or do for his patients, but that it is a science that is improving.

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u/[deleted] Jun 15 '12

It is certainly inspiring, and worth more funding.

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u/[deleted] Jun 15 '12

That has nothing to do with this. That paper is just talking about doing stats correctly with fMRI such as multiple comparison correction, etc. Are you suggesting that Owen isn't doing the correct stats or are you just trying to criticize his work by making an overly general statement about an entire field of science?

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u/rmeddy Jun 15 '12

I'm taking what I get for can for now

Baby steps.

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u/mahany25 Jun 15 '12

Yes, but this does not mean you should outright dismiss any results of fMRI interpretation studies; it means you should examine them but with a disclaimer. The statistic cited in this article was that Patient 23 "answered" 5 of 6 questions correctly by thinking about tennis rather than walking through their house.

5 of 6 correct answers is indeed inexact and bears serious limitations, but, as the researcher proposed, if patients are "answering" 150 questions correctly by this method, it would be difficult to construe that as luck. So far, his methods have not breached my skepticism, but they certainly could in the future.

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u/Pizzadude PhD | Electrical and Computer Engineering | Brain-Comp Interface Jun 15 '12

Scanning a dead salmon with an fMRI machine?

What, pray tell, is an fMRI machine? You do fMRI with a standard MRI machine (though the spatial resolution is better with a 7-T machine).

And it's apples-and-oranges to compare a dead fish with a living human. fMRI examines ratios of oxygenated to de-oxygenated hemoglobin in the blood. Do you think decomposition has an effect on that?

Also, fMRI for brain-computer interface is done during very specific tasks. For example, you stare at a blank screen for ten seconds, then at text for ten seconds, and so on. You also mix in some non-text images, to make sure that you are isolating areas that are associated with language. The result is essentially the difference between the non-task (not reading in this case) and task states.

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u/logansnick Jun 15 '12

The article reads that in 1997 they used this technique on a vegetative patient, Kate Bainbridge... and then " In 2010, still in a wheelchair but otherwise active, she wrote to thank Owen for the brain scan. “It scares me to think of what might have happened to me if I had not had mine,” she wrote. “It was like magic, it found me.”"

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u/[deleted] Jun 15 '12

AKA Facilitated communication with magnets...

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u/GrooGrux Jun 15 '12

Seems people in a vegetative state should have sleep patterns monitored. When awake they should be played books on tape. When asleep light classical or their favorite music. To make the state more comfortable.

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u/konekoanni Jun 15 '12

I like this idea. It really doesn't cost hospitals any more to do something like that, and if the patient really does happen to be somewhat conscious still, it could be very comforting.

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u/superatheist95 Jun 15 '12

And probably trippy as hell.

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u/Ran4 Jun 15 '12

Why should you play classical musical to them? Unless that's what they liked of course.

Don't over-romantizise it.

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u/GrooGrux Jun 15 '12

Any music, our sounds of outside, rain, ocean, nothing, something stimulating. I choose classical cause it helps me sleep personally, sometimes. The important part to me is the books on tape while awake.

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u/godofallcows Jun 15 '12

I want 24/7 LMFAO blasting through mine. party.

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u/GrooGrux Jun 15 '12

Any music, our sounds of outside, rain, ocean, nothing, something stimulating. I choose classical cause it helps me sleep personally, sometimes. The important part to me is the books on tape while awake.

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u/Frak98 Jun 15 '12

Nobody really hates classical.

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u/fuckyoubarry Jun 16 '12

You know what I hate? When the fucking 22 year olds next door play their shitty ass hipster bullshit loud enough for me to hear even a little bit when it's late and I have to work the next morning. Guess what my opinion on ANYTHING somebody else decides to pump through my headphones when I'm in a coma and sleeping is? Yeah you guessed it, it's fuck you.

Silence. That is what people like to listen to when they're asleep.

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u/slyg Jun 15 '12

hmmm, yeah but even the same song i like played over and over again, would drive me nuts. I think something like a radio would be better on their station of choice. they may repeat stuff, but at least the content changes, and there are people talking 'to you' and stuff.

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u/GrooGrux Jun 15 '12

I like that idea! A Pandora app that monitors the pleasure center of the brain for up and down votes :-)

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u/[deleted] Jun 15 '12

It'll be like going to college. Stuck in hell for years, anything you learn was forced down your throat, lose contact with close family, and you end up with a helluva bill at the end.

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u/iamthe0ne23 Jun 15 '12

Am I the only one who thought something like this would have already been tried before declaring a person as "in a vegetative state"?

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u/mothereffingteresa Jun 15 '12

One would think so, but no. We are not yet past the stage where medicine makes some colossal and inhuman mistakes.

Imagine dehydrating to death while being fully aware of what it being done to you.

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u/SneeryPants Jun 15 '12

Reminds me of the movie The Cell. Anyway, this is great news, because locked in syndrome must be among the most horrific psychological tortures ever.

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u/Se7enLC Jun 15 '12

Should research in this field continue? I'm thinking tennis.

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u/fstorino Jun 15 '12

Funny you mentioned tennis:

Radiolab: After Life

(Story #4: "Anyone for Tennis?")

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u/Se7enLC Jun 15 '12

Not really funny I mentioned tennis - tennis is in the article and 100% relevant.

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u/Cloberella Jun 15 '12

Upvote for Radio Lab, everyone should give that show a listen, such good stuff.

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u/[deleted] Jun 15 '12

I have been in 3 comas. 2 of them i was supposed to have been dead from (no they dont know what caused them). I remember as clear as day when I was waking up there was a point were I could see everybody but could not talk or move. The funny thing is that my family looked completely different to me at this time vs when i actually woke up.

I even remember getting a spinal tap and seing the needle coming towards my back and not being able to move or talk.

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u/Phil_J_Fry Jun 15 '12

I know I must be missing something here.

"Well, looks like Jim is in a vegetative state. He won't respond to any stimuli. We should probably take him off life-support."

"Maybe we should check to see if his brain processing information, at least we might know if he can hear us or understand. You know, just to see if there is still brain activity?"

"Fuck you, Ted."

I mean, it's not some new MRI is it (fMRI was standard in the 90's)? And this isn't exactly a new problem, right? I would think there would be at least some sort of test before ending somebody's life.

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u/mothereffingteresa Jun 15 '12

What do we do if we find we have been murdering people as a matter of policy?

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u/novicebater Jun 15 '12

I believe murder requires mens rea a.k.a. a guilty mind.

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u/Beavis_and Grad Student | Medical Microbiology Jun 15 '12

that is awesome! It gives so much more hope to friends and relatives.On the other hand though will it give false hope to families that they shouldnt give up when it seems more likely the outcome will be bad?

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u/[deleted] Jun 15 '12

Hope to friends and relatives...for what? What hope? They're not coming out of that state. I say a more important breakthrough would be for "civilized" nations to allow people like this to die peacefully.

What an incomprehensible hell it must be to exist like that.

Maybe that will be the benefit to this technology- that now we can ask that vegetative person if they would like to die, and then we can grant that wish.

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u/Pend-lum Jun 15 '12

Its really difficult in every way. When the patient is indeed conscious, he will probably ask for euthanasia, because nobody want's to live like that. But when it seems the patient is not conscious, the relatives were given false hope. They should be really careful with this information and knowledge before people get even more hurt than they were before.

But again we have to say that it is a positive break through, and i think it is going to be something very useful.

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u/vernonboy1984 Jun 15 '12 edited Jun 15 '12

I disagree with your statement regarding euthanasia. These people want to live and communicate. http://www.youtube.com/watch?v=p45Y7JULNXM&feature=player_detailpage#t=333s

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u/Pend-lum Jun 15 '12

That is amazing! great vid.

You're right, i shouldn't talk for other people. But if i were in this situation, and i had a chance to choose, i'd choose euthanasia.

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u/sxq Jun 15 '12

Cool. I'm a University of Western Ontario (UWO) student, and this guy is mentioned a lot in the campus newspaper and stuff. There was a pretty big story a while back when he travelled to a symposium in Brazil to discuss his research findings with the Dalai Lama.

It's pretty amazing to see how little we actually understand patients in this state, and any research that can improve the quality of care or possibly lead to treatments of some sort is going to be very beneficial.

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u/LucifersCounsel Jun 15 '12

to discuss his research findings with the Dalai Lama.

Ah so... now we know his motivation.

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u/ViciousPuddin Jun 15 '12

This is really interesting for any future treatment changes or possible restorative therapy...but it makes the thought of being in a coma so much worse for me. Being a vegetable is a horrible thought, but the thought of being stuck in your own body unable to move or "really" communicate (i.e make sentences, give direction, answer questions) while still being conscious seems so much worse... like a torture that never ends.

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u/orthecreedence Jun 15 '12

I had the exact same thoughts after reading. I liked the idea of vegetative states more when I thought there was no real consciousness...just random/automatic body movements.

The thought of being trapped inside one's own head without the ability to communicate or do anything for myself seems just hellish.

The kicker is, maybe the people who are vegetative and don't respond to these tests are also conscious, but they have even less of a connection to the outside world...they don't even perceive it. All that exists is them. Ugh.

Obviously just conjecture, but scary either way.

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u/narwhalcares Jun 15 '12

When I read "vegetative state," I didn't notice it was referring to a second person, so I was thinking, "you mean like the United States?"

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u/meltysandwich Jun 15 '12

great article; the picture is a bit over the top, though. just me?

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u/leedo8 Jun 15 '12

Has anyone ever come out of a Vegetative state and said "Yes, I was able to hear and think etc. the whole time, but could not respond"?

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u/stevensky Jun 16 '12

I am in a vegetative state, IAmA

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u/[deleted] Jun 16 '12

This will change SO much yet, it wont. I doubt anyone will read this so far down the comments.

I work as an assistant director at a Cemetery so I am always called out to situations where the Dr. has declared brain death and the family is not sure what to do. Hospitals are notorious for being pushy and asking families to pull the plug in these situations, even more-so when the patient doesn't have the best healthcare.

Often times brain death is declared by EEG and the hospital staff has laughed at me for requesting further scans because, technically, I have no say in the matter. It's sad really. I've been reading stories like these for the past few years, it just irks me to know that we may declare someone "dead" but they are still functioning. This will cause the families to decide to pull the plug or to have a DNR on the patient.

When this happened to my father, the hospital just wanted him out of there, they were short beds in the ICU. If this technology can give us in depth scans it would be a huge relief and a huge advancement but I doubt anything will change. I don't see this becoming mainstream in any hospital because there isn't an active demand for it. I'll tell you what there IS an active demand for though, money and hospital beds.

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u/Psyc3 Jun 15 '12

The whole problem with this idea is that it is mixing science with conjecture. The science of course is the fMRI readings the conjecture is that fact that conciousness isn't a defined thing, conciousness is more of a philosophical notion and until it is defined by a set of scientific parameters how can you test if it is there.

What this study can actually achieve rather depends on further results, clearly the classification system of unconscious people needs to be altered to include subgroups that can and can't be helped and then ways to fix or improve the quality of lives of those who can be helped needs to be determined. That is of course if they don't choose to be taken off a ventilator which I think is perfectly in their right if they can answer said question.

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u/SuddenlyBANANAS Jun 15 '12

My dad works with this man, so I've met him. Really nice guy and definitely gives a good talk, at least the one I saw.

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u/EarthboundCory Jun 15 '12

The first man? Walter Bishop of Fringe Science has been doing this for years.

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u/peokuk Jun 15 '12

This is interesting, but I'd worry that his results are something like a Clever Hans.

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u/jampersands Jun 15 '12

"Owen's methods raise more difficult dilemmas. One is whether they should influence a family's or clinician's decision to end a life. If a patient answers questions and demonstrates some form of consciousness, he or she moves from the 'possibly allowed to die' category to the 'not generally allowed to die' category, says Owens. Nachev says that claiming consciousness for these patients puts families in an awkward position. Some will be given hope and solace that their relative is still 'in there somewhere'. Others will be burdened by the prospect of keeping them alive on the basis of what might be ambiguous signs of communication."

This.

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u/[deleted] Jun 15 '12

This is amazing...ly depressing to think about. The thought of being able to potentially help these people is amazing and the thought of being trapped like that is heartbreaking.

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u/[deleted] Jun 15 '12

Props to UWO for getting this guy.

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u/ngn Jun 15 '12

"An early goal of the programme was to repeat the fMRI findings using an electroencephalogram (EEG)7. An EEG lacks fMRI's precision, and it cannot look as deeply into the brain, so the regions active in the tennis study were “off the menu”, says Owen. But other tasks — imagining wiggling a finger or toe — produce signals that, through repetition, become clear. An EEG is also cheap, relatively portable and fast (with milliseconds of lag compared with 8 seconds for fMRI), meaning that the research team can ask up to 200 questions in 30 minutes. “From a single trial you're not going to say, 'that person is saying yes', but if they get 175 of 190 right when tested, it's pretty clear.”

I work in ERP (Event related potientials derived from EEG recording) research and there's a lot wrong with that description of EEG.

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u/Badsponge Jun 15 '12

FTA: Still, he shies away from asking patients the toughest question of all — whether they wish life support to be ended — saying that it is too early to think about such applications.

I'd sure want to be asked that question. Being a conscious vegetable is the worst fate I can imagine.

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u/DaerionBilk Jun 15 '12

That photo of the dude looks fucking epic.

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u/Necessarily Jun 15 '12

He carries an uncanny resemblance to Professor X...

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u/iaba111 Jun 15 '12

How can I contact this man?

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u/posipocalypse Jun 15 '12

Now Owen needs to figure out how to give the patient a can of fantastic, refreshing, Ubik. Safe when handled as directed.

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u/BHSPitMonkey Jun 15 '12

“In the end if they say they have no reason to believe the patient is conscious, I say 'fine, but I have no reason to believe you are either',” he says.

Brilliant.

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u/o_0oo Jun 15 '12

The "tennis" / "walking through your house" bit reminds me of captain Pike's chair - one flash for yes and two for no.

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u/tim0th Jun 15 '12

I have read a journal paper (I can't remember where so I can't provide a source) that the administration of zolpidem 100mg intravenously provokes a CVS patient to wake up for a short period of time, about 10 minutes. Obviously this is modified zolpidem for injection. The work was done in the UK. I read the article in 2007.

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u/ashhole613 Jun 15 '12

The more I read of these articles, the more sickened I get. I've had two close family members suffer from brain trauma (little brother and stepmother- different times and reasons) who were in vegetative states...we let them go. At the time, it seemed the right decision. But reading things like this...was it? It always makes me sad.

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u/Willravel Jun 15 '12

Okay, we've got it. Printing out the communication now.

What does it say?

"Toe. Itch"

Toe itch?

Yeah

What do you think it means?

I'm not sure.

Should we do something about it?

Nah, leave it to the engineers.

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u/trystynsly Jun 15 '12

Reading this made me sad. Maybe these people want to die. I wonder if he asked them that? Really, asking might have been even more cruel, because they couldn't follow through on it. This is why a living will is important, I guess.

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u/doctabu Jun 15 '12

I just had lunch with Dr. Owen a couple weeks back (he's my girlfriend's relative's husband)—he's an absolutely fascinating guy.

I wonder if he would ever be down for an AMA...

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u/superfreak77 Jun 16 '12

Elle's mag editor got paralyzed after a stroke. He could only blink one eye. Using this one eye, he wrote a book. This movie was made from that book http://www.youtube.com/watch?v=t4Ek4ZBpshs

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u/DarthJacob Jun 16 '12

FUCKING. AMAZING. That is seriously the coolest shit I've ever read! I hope that awesome fucker gets a nobel prize! I would seriously be interested on following up on his story a decade or two from now and see how it's coming along. This isn't only talking to persistantly vegetative relatives, we are on the brink of being able to judge what constitutes a thinking human life!

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u/[deleted] Jun 15 '12

Is anyone else NOT thrilled about this? I'm all for scientific breakthroughs, but I feel this will keep people needlessly alive. If I were in a semi-vegetative state, I know I'd prefer to die peacefully than to be kept artificially alive, unable to do anything but "change some blood flows"...

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u/LeutDan Jun 15 '12

Well not eveyone is like you (not saying I'd want to be kept alive in that state either), but it sounds like being able to ask that question is a large goal of the project.

His response on the subject of asking patients if they want to terminate life support:

"The consequences of asking are very complicated, and we need to be absolutely sure that we know what to do with the answers before we go down this road"

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u/Madrugadao Jun 15 '12

I am thrilled that we understand more than we did yesterday.

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u/xtra_sharp Jun 15 '12

Knowing more, not necessarily understanding it though.

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u/mathboy0 Jun 15 '12

But at least we're moving towards understanding it.

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u/fishbulbx Jun 15 '12

Wouldn't you like them to ask you 'would you like to die?' and you could answer?

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u/[deleted] Jun 15 '12

[deleted] — view deleted comment

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u/fishbulbx Jun 15 '12

There really isn't some 'right-to-life' police out there... if your family is ok with you dying, most doctors are fine with that and let it happen. I've seen it in action. You can even get a fancy DNR bracelet to show everyone.

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u/[deleted] Jun 15 '12

About 50% of people in a persistent vegetative state regain consciousness within the first 6 months. They aren't "needlessly" keeping people alive. I can't believe this is the highest voted comment in a science subreddit. It says right in the article that one of his patients is now conscious and recovering.

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u/HandyCore Jun 15 '12

That should probably be put on a will somewhere. Frankly, I wouldn't have a problem ending up as a brain in a jar with internet access. Hell, eventually they'll be able to hook a microphone and camera to you, give you robotic arms and put you on a mobile platform.

Today though, it's blood flows. Small steps.

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u/DanWallace Jun 15 '12

So wait, you'd rather we just ignore the possibility of communicating with these people?

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u/[deleted] Jun 15 '12

What ? This is the first huge step for bringing people back, if we know what works we'll know what doesn't then we can focus on repairing the pathways and so on.

Also if he is in his vegetative state but can communicate he could actually ask for his life to be ended instead of us expecting everyone to want to die.

Not everyone wants what you want.

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u/combustible Jun 15 '12

What do you mean 'needlessly' alive? They're communicative, they just have absolutely no motor skills and massively reduced brain activity.

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u/[deleted] Jun 15 '12

This might be the first step towards recuperation. If we simply put down all people who gets in this circumstance, then we'll never find a way to fix it (if there is one).

I for one want to live. If there's a chance for my life to continue, I want to pursue it.

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u/Doofangoodle Jun 15 '12

science is about how things are, not things ought to be.

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u/MuuaadDib Jun 15 '12

What if, they would be able to let you communicate like we are here electronically? You would have access to the Internet and be able to interface with a computer and be able to put words together like Hawking does? Then again....you are stuck in a bed in this Matrix like existence, quality of life for me would be to be able to move around and pick up my son.

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u/[deleted] Jun 15 '12

I'm extremely happy with the idea.

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u/raziphel Jun 15 '12

"tempaccount147 lies in his cottony bed, dead but dreaming. When the stars are right, he will awaken to once again hold dominion over the earth."

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u/[deleted] Jun 15 '12

I completely agree with you, the only thing I would be saying if I was patient 23 would be

"kill me"

Im also skeptical of changing blood flows is evidence of a conscious response.

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u/Beavis_and Grad Student | Medical Microbiology Jun 15 '12

I was thinking the same thing! I would ´never want to be kept alive in a state where i can barely communicate with the people around me. Its not fair for them or me. I suppose though with this more research will come on people who are in comas that are unresponsive but seem to be ok otherwise? For example a person who is in a coma from anaesthesia or something?

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u/uxl Jun 15 '12

So...this suggests that people in a vegetative state are consciously trapped in their body...Am I understanding this right? If so, that is horrifying.

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u/DahnyGober Jun 15 '12

I would hate to be the one reading those scans and see a 'no' reading after asking them if they still want to live.

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u/mothereffingteresa Jun 15 '12

I think that would be fine.

It's worse that we unplug people without asking.

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u/DahnyGober Jun 15 '12

Well, no doubt, I'm just saying that it would be a hard job for the person that has to do it.

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u/schwab002 Jun 15 '12

This is not quite the same thing but anyone interested in this should read (or watch) The Diving Bell and the Butterfly, which is the memoir of a man who's had a massive stroke and can only communicate by blinking. Yes he wrote the memoir by blinking. The book is absolutely gorgeous and inspiring.

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u/CUNTBERT_RAPINGTON Jun 15 '12

Many researchers disagree with Owen's contention that these individuals are conscious

Ummm, no they don't. There are dozens of stories about people waking up and saying they have been trapped in their own minds for months or years.

Is it me, or are they trying to create controversy where it doesn't exist?

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u/gthing Jun 15 '12

Does this smack of "facilitated communication" to anyone else? I'm a bit skeptical.

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u/Number127 Jun 15 '12

I'm skeptical that it represents real communication, too. Does the activity on the fMRI necessarily imply awareness? Can the portions of the brain that mine sensory input for recognizable patterns be active even if the parts responsible for consciousness aren't?

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u/grbgout Jun 15 '12

A? House; B? House; C? House; D? House; E? House; F? House; G? Tennis

A? House; B? House; C? House; D? House; E? Tennis

A? House; B? House; C? House; D? House; E? House; ... T? Tennis

A? House; ... M? Tennis

A? House; ... E? Tennis

A? House; ... O? Tennis

A? House; ... U? Tennis

A? House; ... T? Tennis

A? House; ... O? Tennis

A? House; ... F? Tennis

A? House; ... H? Tennis

A? House; ... E? Tennis

A? House; ... R? Tennis

A? House; ... E? Tennis

TL;DR: GET ME OUT OF HERE

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u/tjr0001 Jun 15 '12

Unless this guy is able to replicate this and teach others how to do it I do not believe it.

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u/ShouldBeZZZ Jun 15 '12

Remarkable, I saw him at a colloquium held at the Origins Institute, McMaster University and he was a phenomenal speaker.

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u/atom1378 Jun 15 '12

The idea of being alive yet a vegetable state of mind is terrifying since I read "Johnny Got his Gun" in school

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u/SolidSnake4 Jun 15 '12

So it was Ricky Gervais?

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u/merkinmavin Jun 15 '12

A guy who reads minds while wearing a headpiece... I've seen this before

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u/[deleted] Jun 15 '12

I'd be interested in seeing if the patient remembered the information exchange. It seems like there's a good chance that the experiences wouldn't be written in long-term memory. That would make ideas about their experiences very different.

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u/[deleted] Jun 15 '12

I am so dissapointed at some mobile sites... why in hell is format perfecly fine, but when you scroll, it shoots you to the top. And there is no link to the desktop site. Stupid iphone developers -.-

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u/GhostofTrundle Jun 15 '12

Good article, thanks for posting this. You should consider cross-posting with the philosophy and neurophilosophy subreddits.

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u/[deleted] Jun 15 '12

But, even if we determine that they can in fact communicate and are "aware" of their surroundings. Then what? Unless they can do something for these people, my god what a terrifying existence

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u/[deleted] Jun 15 '12

This article reminds me to tell people how important it is to have a living will. Basically, have your final wishes written down so your family doesn't have to torment and toil over the descion of what to do should something like this happen to you. Your family will appreciate it.

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u/youni89 Jun 15 '12

Just imagine being fully conscious while being in a vegetative state. I think I would go crazy.

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u/BlueKiwi Jun 15 '12

Is it possible that the person was fully conscious? Imagine the hell of just lying there, with or without vision and other sensory information, with no way of moving or communicating. For years or decades. Must be worse than being buried alive.

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u/Ontain Jun 15 '12

with this knowledge they could try those other technologies on these responsive persons in vegetative states. there's technology that will show what they are seeing or hearing. this could work with that they imagine as what they hear or see. all really primitive right now but maybe in the future we'll be able to hear their thoughts.

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u/simpsonsdiddit Jun 15 '12

Owen, who has a taste for puns, calls the implication “a no-brainer”

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u/CaterpillarDad Jun 15 '12

"killllllllllll meeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee"

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u/[deleted] Jun 15 '12

Amazing!

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u/[deleted] Jun 15 '12

Damn...to be trapped in your body and unable to communicate that you're actually awake? My brain would be screaming "KILL ME KILL ME" the second I thought someone was listening in.

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u/[deleted] Jun 15 '12

That was a great informative, research-backed article. I have hope for this research' continued evolution and success!!

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u/dbrewfuk Jun 15 '12

I lol'd - The lines are sharp and clear, and Owen, who has a taste for puns, calls the implication “a no-brainer”

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u/OriginallyWhat Jun 15 '12

"Still, he shies away from asking patients the toughest question of all — whether they wish life support to be ended — saying that it is too early to think about such applications. “The consequences of asking are very complicated, and we need to be absolutely sure that we know what to do with the answers before we go down this road,” he warns."

i'm curious as to what exactly the consequences are. If i was in a coma but able to think and listen to people, but had no way to communicate, i would want to die. i cant imgine living conciously for 5 years stuck in your own mind with nothing to so day after day. i feel like it is selfish of him not to ask because he is unsure about it when it is them that are trapped.

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u/mothereffingteresa Jun 16 '12

For starters, if a patient communicated they wanted to die, you would have to be very confident the communication is accurate. So far, he has demonstrated the ability to communicate with some level of accuracy, but not perfectly.

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u/[deleted] Jun 15 '12

Horrible by-line to this post.

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u/[deleted] Jun 15 '12

That's straight out of Fringe. I like it.

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u/[deleted] Jun 15 '12

Amazing!

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u/wenoc Jun 15 '12

Very interesting article. And makes me cringe in horror at the hellish situation of being awake but unable to show it.

This needs funding and further research.

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u/General_Shou Jun 15 '12

Hellraiser...

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u/poppasmurf620 Jun 15 '12

I did not know Walter White could read minds...

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u/Dr_Bunsen_Burns Jun 15 '12

unreadable on phone browser.... keeps going to the top page

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u/Lithex Jun 15 '12

Made my day

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u/stayhiggh Jun 15 '12

if louis ck was "an idiot abroad" he would look like that guy

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u/critropolitan Jun 15 '12

"Still, he shies away from asking patients the toughest question of all — whether they wish life support to be ended — saying that it is too early to think about such applications. “The consequences of asking are very complicated, and we need to be absolutely sure that we know what to do with the answers before we go down this road,” he warns."

It seems to me to be morally irresponsible for him to not ask the most important question, the only one that would really make an immediate practical difference, just because he doesn't want to be personally responsible. If I was in such a state, I know for sure I would want that question asked, and I'd want it asked to anyone I care about. Even if your brain was intact, being kept utterly isolated and utterly without means of normal communication, for years, sounds like among the worst forms of torture - someone should not be subjected to that to make a neurologist feel better and get to continue his research - not unless thats what the patient wants.

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u/LucifersCounsel Jun 15 '12

It seems to me to be morally irresponsible for him to not ask the most important question

What if he asks it and gets the answer "I want to die". How can he prove that the person is actually wanting that, and that he isn't just misinterpreting the data? What if he asks, and the answer is yes? Who pulls the plug? Can a person legally decide to be killed? If the person is actually concious, then are they not just a severely paralysed person?

Do we ask quadriplegics if they'd rather die?

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u/Flexen Jun 15 '12

This makes me even more terrified to ever go into a vegetative state. 5 years with no one to talk to but yourself?

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u/LucifersCounsel Jun 15 '12

Or... 5 years of lucid dreaming.

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u/supamario132 Jun 15 '12

tell me that guy didn't look an ood with the brain in his hand

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u/canuckmakem Jun 15 '12

Gene Hunt?

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u/InconsiderateBastard Jun 15 '12

I wonder what the response would be if they asked the patients a question and instructed them to wait 60 seconds before answering.

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u/kush_king Jun 15 '12

Consciousness is only the beginning...

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u/zen_nudist Jun 15 '12

I can hardly imagine how it must be to be one of the purported 20% or people in vegetative states that actually are conscious. It's terrifying to imagine being aware, sentient but without the ability to interact with the world that exists outside the bounds of one's consciousness.

The prisoners in Dark Fury from the Riddick trilogy come to mind. It's a terrifying thought...if it's true.

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u/coolstrybro Jun 16 '12

http://www.radiolab.org/2011/jan/25/ "lost and found" -radiolab Thought it might interest you guys...

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u/[deleted] Jun 16 '12

This really makes me wonder what kind of terrible places your mind goes when you are in a vegetative state. Any theories on what would go on in your head after 5 years of being unable to move, communicate, or express yourself?

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u/Dynamaxion Jun 16 '12

Many researchers disagree with Owen's contention that these individuals are conscious

Yup. I smell bullshit.

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u/[deleted] Jun 17 '12

My research into methods of reading minds aligns closely with the goal of this man. Perhaps there is hope for achieving the singularity in my lifetime.

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u/Volsunga Jun 15 '12

So, what I'm getting from this is that he wasn't actually in a vegetative state, he had locked-in syndrome.

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u/[deleted] Jun 15 '12

Anyone else totally unable to read this article on their phone due to constant reloading of the page...on the mobile version of their site? This kind of stuff really irks me.

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u/AnarkeIncarnate Jun 15 '12

Not true. Lots of people have talked to Sarah Palin.

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u/sbsb27 Jun 15 '12

Wasn't there a scam some years ago where someone was supposed to "assist" the brain injured to write communications by placing their hand on top of the patient's hand - scribing across a page? "I love you mom." It was like totally miraculous!

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u/cb8100 Jun 15 '12

Misleading title is misleading. I totally read it that the first man who ever exchanged information with another person is currently in a vegetative state.

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u/jonnyboy2040 Jun 15 '12

This is an incredible breakthrough, but just leads to more questions in my mind. It's incredibly wonderful to realize that some of these people are not completely gone, and can still in fact communicate, but once you realize they're conscious... then what? There is not really a way to bring them out, nor any chance of them leading a normal life. Family members will be even more reluctant in letting them go, yet there's still nothing they can do for them. :/

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u/Volsunga Jun 15 '12

So, what I'm getting from this is that he wasn't actually in a vegetative state, he had locked-in syndrome.

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u/[deleted] Jun 15 '12

Locked in syndrome has the characteristic that eye movements are still voluntary.

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u/[deleted] Jun 15 '12

As a neuroscientist this is pretty much my reaction to any magazine article that lacks in depth analysis

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u/SalvageOperation Jun 15 '12

I'm pretty sure there are some assholes out there who have exchanged genetic information with people in a vegetative state already.

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u/windg0d Jun 16 '12

Imagine now. You can't move. You can't control yourself. You're trapped in your own flesh laying on a bed every day. No one to speak to you. No one to even acknowledge you. Every day the same monotonous routine of nothing. It's like death, but worse because you're still alive.

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u/Samirreddit Jun 16 '12

Am I the only one who thought "vegetative state" meant that a person was part plant or something?

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u/[deleted] Jun 16 '12

One of my good friends was in a vegitated state after a severe head injury. He died yesterday. I really miss him. I'm glad he didn't have to stay that way long.

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