November 22, 2009

A man believed to be unconscious was conscious, but completely paralyzed, for 23 years.

He had no way to communicate to the people around him that he could hear, think, and understand everything.
"All that time I just literally dreamed of a better life."
How terribly sad. The condition is unimaginable. All that time. What would you do with your mind as all those years passed? Wouldn't you drift into hallucinations and dreams? Could you reach enlightenment? Or would you dwell on your plight endlessly and ache for the times when people would be around you talking, hoping someone would talk to you, read to you, do something.

If this happened to one man, it seems that it must be happening to others.
Doctors used a range of coma tests, recognised worldwide, before reluctantly concluding that his consciousness was 'extinct'.

But three years ago, new hi-tech scans showed his brain was still functioning almost completely normally....

'Medical advances caught up with him,' said Dr Laureys, who believes there may be many similar cases of false comas around the world.

82 comments:

PatCA said...

I wonder if Obamacare will approve the new high tech scan...

Skyler said...

Johnny got his gun.

Chip Ahoy said...

I do not have any answers to these troubling and ponderous questions you've raised.

JAL said...

A friend (neurology nurse) has for years told me that the label "persistant vegetative state" is not definitive and in a number of cases these folks are with it.

She actually spent time in England checking out some of the research being done there.

Flexo said...

Lucky that they weren't more "compassionate" and didn't try to starve and dehydrate him to death.

Alex said...

This is beyond horrible!

Skyler said...

Horrible? I think it's fantastic! He has been saved. Let's be happy about that, and hope that more can be saved.

Blame Crash said...

A excellent movie was made many years ago about a similiar story line. The plot was about a first World War soldier who was blown apart (no eyes, ears, mouth, arms, legs) and thus was trapped alone in his own mine until a nurse detected that he was still in there by using Morse Code.
Sorry, I don't have a name for this movie, but it was a good one.

Harsh Pencil said...

The name of the movie is Johnny Got His Gun.

http://en.wikipedia.org/wiki/Johnny_Got_His_Gun_(film)

WV: ewallgeo. Hi ho, hi ho, ewallgeo we go.

Alex said...

Blame Crash - ok so the nurse could communicate via touch. How did the blown-apart solider communicate back with no arms or legs?

Harsh Pencil said...

He banged his head on the pillow in Morse code.

wv: stypon. A super absorbant thing to put in your eye if you have a stye.

Blame Crash said...

Alex, it was long ago that I seen this movie, but I believe the soldier would pound out "Help" in Morse Code with his head. Finally the nurse figured it out.

And Thanks Harsh Pencil, that was quick investigative work!

Skyler said...

Um, yeah. Good work harsh. :)

Blame Crash said...

After re-reading the comments I see Skyler was way ahead of us on this.
Good work Skyler and guns up!

vbspurs said...

It's like being buried alive. Thank God a team of doctors didn't sign orders to have him euthanised...as often happens in countries with national health care.

Cheers,
Victoria

Skyler said...

Actually I didn't know it was a movie. I only knew of the book. A very very hot babe asked me to read it before the gulf war. I only read it because she was really really hot. I didn't much like it. Too depressing and pointless.

Harsh Pencil said...

Skyler,

Well you see, I wrote "Johnny Got His Gun" while you wrote "Johnny got his gun".

See. See. See the difference?

So there. Proper punctuation matters.

wv: stregont. Popular Rockabilly band.

Skyler said...

I was making a allusion. :)

Blame Crash said...

It was a under stated anti-war movie, which didn’t exactly impress me to much. But none the less, it was a very impressive movie.

Not so impressive that I would remember the title, but still!

Nomilk said...

Proper punctuation matters.


So does proper capitalization.

careen said...

Shades of the Metallica video whose name I forget.

This can be the case in stroke, where the person can still think, but cannot express themselves well anymore so people treat the like they are mentally deficient. I wonder sometimes if it isn't the case with people we label mentally deficient as well. (Their thoughts/consciousness if fine, but they are unable to control their body enough to communicate.)

Blame Crash said...

Beware!

The Punctuation Patrol are crusing the joint.

As I said. This time to everyone.

"Guns Up!"

John Lynch said...

One

Chase said...

Let me up the ante here in the conversation.

Fuck the Euthanasia Crowd.

I seriously mean it.

John Lynch said...

"Johnny Got His Gun." That's the book, there was a movie, Metallica made a song and video about it.

howzerdo said...

Years ago, in my undergrad days, I took a course on anthropology and death. I don't remember the specific topic we were discussing one day when a woman in class raised her hand and described her experience, which I will never forget. Her condition was not as severe as this patient's, but she also was considered unconscious. However, she was aware of many things going on around her, although no one knew this. One thing that upset her terribly was hearing a nurse say about her rings "better try to get them off now before we have to cut them off later."

Kensington said...

Lest anyone get the wrong idea about Johnny Got His Gun, it's an unrelentingly depressing film. Yes, eventually the poor soldier communicates briefly with a nurse, but it comes to naught. Harrowing.

But back to this story, isn't it wonderful that technology advanced to the point where this poor fellow could be rescued, and isn't it also wonderful that the Democrats are on the verge of passing exactly the kind of crippling legislation that will kill the sort of R&D pursuits that led to such an advancement in the first place?

Good times.

Ralph L said...

Dr. House has faced this at least twice. Once they were about to harvest the patient's organs.

lyssalovelyredhead said...

When I was in college, I sat for a very nice family with a young boy and the wife's mother. The mother had suffered a stroke which left her paralyzed on one side, wheelchair-bound, and unable to speak. Her thought processes were fine, but when she attempted to speak, it just came out "bizzy bizzy" no matter how hard she tried to form words.

She wasn't very old (early 60's, I'd guess), and under normal conditions she would have certainly been able to care for her grandchild. My heart broke many times when she struggled to communicate by pointing and guesturing, while frustratedly repeating that phrase, trying to make it into words.

kentuckyliz said...

I believe it's worthwhile to talk to a person in an apparent coma...it's possible they can hear. I spoke to both my parents when they were dying. I even made my mother cry.

Expat(ish) said...

There is a great book - Beijing Coma - about this. My wife gave it to me for Xmass last year.

It took me 10 months to read - the style of writing was just difficult for me to read, though I enjoyed the story.

-XC

wv = light. Really.

datechguy said...

You know there is a reason why one defends life, why Christanity values life. Jayden Capewell is one reason and Ron Houben is another.

HokiePundit said...

I read Johnny Got His Gun in high school (and saw the movie). The movie Saw wasn't scary at all, but JGHS was about the scariest thing I could, and perhaps still can, imagine.

Pogo said...

"The locked-in syndrome is caused by an insult to the ventral pons, most commonly an infarct, haemorrhage, or trauma. The characteristics of the syndrome are quadriplegia and anarthria with preservation of consciousness."

I've seen a couple, including one woman in whom the episode (a TIA) lasted on a few days. Scares the bejesus outta you.


But look folks, if we can't afford Mammograms and Pap smears, I mean come on, people. Some of these hangers-on really don't seem to understand how much of a burden they are to society.

The new US national health service should have the docs wear buttons to reinforce the message:
Ask Me If I Care.

locomotivebreath1901 said...

Gee, I wonder what Terri Schiavo thinks of all this?

Oops.
.

Pogo said...

So some stroke and brain injured people can think even though they can't talk or move.

Whoop-dee-frickin-do.

Can they pay taxes?
No?
Well, then.
End of story.

Come back when these guys figure out how to monetize their suffering.

edutcher said...

Corollary to this is the practice of lying in state, so people are sure you're just unconscious and not dead.

WV "madhea" What a Southerner says when he loses his temper., as, "Now, listen, y'all, Ah'm gittin' plenty madhea"

MadisonMan said...

This is a great story about technology. I wonder why the Belgians messed up the standard test on the guy the whole time. I suspect it's because they (thought they) knew what they were looking for -- that's fatal to a good test, I think.

Skyler said...

Pogo opined,

Can they pay taxes?
No?
Well, then.
End of story.


Wrong answer. The person continues to pay taxes on his estate. No consciousness necessary.

Paco Wové said...

"...JGHS was about the scariest thing..."

What's JGHS? "Johnny Got His Saw"?

Pogo said...

The exact opposite problem, being able to move and speak, but unable to think at all, can land you a permanent Senate seat in most states.

Ed said...

What would you do with your mind as all those years passed?

Make lengthy meticulous plans for far-reaching revenge, in fact.

traditionalguy said...

At least he was not a tempting fat man in a coma facility in Peru.

Ignorance is Bliss said...

MadisonMan said...

... I suspect it's because they (thought they) knew what they were looking for -- that's fatal to a good test, I think.

Which brings us back to the AGW research.

knox said...

I think there was a movie about a soldier made a long time ago that this happened to. Anyone remember the name?

J/K

Ger said...

Sad case indeed.

Who should pay for the undoubtedly very expensive carer this patient and others like him receive?

Should private insurance cover the expense until the patient has reached their lifetime benefit cap?

Should government mandate that private insurance cover all the costs regardless of lifetime benefit caps?

Should government just step in and cover the costs to relieve the burden on the private companies?

Should the family bear the costs themselves and then rely on charity?

Ger said...

Sad case indeed.

Who should pay for the undoubtedly very expensive carer this patient and others like him receive?

Should private insurance cover the expense until the patient has reached their lifetime benefit cap?

Should government mandate that private insurance cover all the costs regardless of lifetime benefit caps?

Should government just step in and cover the costs to relieve the burden on the private companies?

Should the family bear the costs themselves and then rely on charity?

HokiePundit said...

"...JGHS was about the scariest thing..."

What's JGHS? "Johnny Got His Saw


James Garfield High School, actually. Still sends chills down my spine...

c3 said...

Ger;
Who should pay for the undoubtedly very expensive carer this patient and others like him receive?

Should private insurance cover the expense until the patient has reached their lifetime benefit cap?

Should government mandate that private insurance cover all the costs regardless of lifetime benefit caps?

Should government just step in and cover the costs to relieve the burden on the private companies?

Should the family bear the costs themselves and then rely on charity?



Good question Ger. And just to flesh in a few details.

Assuming the individual is not at home on a ventilator but in (at a minimum) a skilled nursing facility, this will be about $500/day minimum. If we look at a 5 year year survival rate then that's $182,500 per year or $912,500 over the five years. If no other costs are incurred then would not likely exceed a lifetime max. (It would be highly unlikely that no other costs would be incurred. Remember doctor visits, medications, hospitalizations etc.)

If additional costs occur (for example a prolonged an complicated admission to the hospital for a ventilator-associated pneumonia could add another $500,000) you can see how such an individual could reach an insurance lifetime max of 2 million.

Generally at that point the individual/family will need to "spend down" to become eligible for Medicaid and then continue in chronic ventilatory care under the state/federally-funded program.

Dust Bunny Queen said...

Wrong answer. The person continues to pay taxes on his estate. No consciousness necessary.

Also wrong. You don't pay taxes on your estate until you are dead.

Of course if they kill you sooner, your estate might be larger than if they take all the money for vegetative care. Wow. A conundrum. How best to get the money and which way is best to kill you.

I feel for this poor man. My mother was in a coma for almost a year following an auto accident at the age of 39. Following coming out of the coma it took several years to get good function back: speaking, walking, motor skills etc. She recovered and lived for over 20 more years, traveled the world with my father and was able to enjoy seeing her grandchild.

We were told several times during her coma that she would not live and that there was no hope. Had we listened to the doctors, and had my parent not had good medical insurance, my mother would have been dead at age 39.

Triangle Man said...

This seems like Locked-in Syndroma, depicted brilliantly in The Diving Bell and the Butterfly

class-factotum said...

Should private insurance cover the expense until the patient has reached their lifetime benefit cap?

It's been a long time since I worked in the insurance industry, but in the late 80s, most group health policies did not cover long-term nursing care. If I remember correctly.

Beaverdam said...

Reminds me of sex with the first wife, all still and such.

MadisonMan said...

Here in Wisconsin, the care for such a person would probably fall to the State and County. That's what I observe, at least, based on my ward at CWC. She's been in county care for >50 years, now aged 67.

Dust Bunny Queen said...

It's been a long time since I worked in the insurance industry, but in the late 80s, most group health policies did not cover long-term nursing care. If I remember correctly.


You are correct. Even though the policy covered the intensive care and hospital stays, once my mother was well enough/awake, to come home we had to take care of her at home and pay out of pocket for nursing care.

Physical therapy was covered up to a certain point but she wasn't well enough for that at first.

You haven't lived until you get to change your mother's diapers. My father, my brother and I took turns taking care of Mom on weekends and nights to cut down on the nursing expenses. Also so my father could continue working. My brother was still in high school and I was in my second year of college and working full time as well.

We learned a lot about range of motion exercises to keep her from becoming frozen. This lasted for about a year until she was well enough to participate in physical therapy which continued for about another year and half.

Fun times.

Tell me again how rationing care will not be a big deal?

tom swift said...

There's obviously more to this story that the new reports haven't told us. Stone-age technology like electroencephalographs will immediately show brain activity. It's not necessary to play "by guess and by gosh," poking and prodding the patient looking for signs of life. It should be no challenge at all to determine if the patient is conscious, in one or another stage of sleep, comatose, or brain-dead, if the right equipment is used.

tom swift said...

D'oh! News reports, not new reports.

AugustFalcon said...

Re: Blame Crash said...

...As I said. This time to everyone.

"Guns Up!"
11/23/09 12:05 AM

That was a book, not a movie. It's the phrase you used if you were a Marine in Vietnam to get the machinegunner to come up and put down some fire when you needed it.

John Galt said...

The Metallica song wqas called "One," and it was inspired by JGHG.

Interestingly, according to the wikipedia article, the book was written as an anti-war piece...when Hitler attacked Stalin, the author suddenly decided to let the book go out of print. When people started writing to obtain a copy, he turned them in to the FBI.

Nice. Real nice.

John Galt said...

Edited to add: Author's name was Dalton Trumbo, one of the Hollywood 10. How interesting that one of the people the Hollywood Leftards get so misty eyed about wasn't above using the government against his own fellow citizens when it suited his purpose.

crypticguise said...

This is really not news to anyone who is trained in hypnosis. Dave Elman taught over ten thousand doctors, psychologists, dentists and psychiatrists how to induce a coma state over 25 years ago.

It is called the Esdaille state after Dr. Esdaille who had accidentally done it years before.

It is possible to induce a "coma" state using hypnosis during which the subject is totally catatonic and in a euphoric state but capable of hearing, seeing and understanding all around him but without any kinesthetic feeling.

This is a very interesting situation in that it lasted as long as it did.

Lola said...

Interesting. There's a gentleman who brings his son to my church every once in a while. His son has been in a "persistent vegetative state" for years, but the father insists that the doctors are wrong, and that there are medical treatments that his son needs in order to get better, but which he cannot pay for, so he gets what donations he can get towards the goal.

I really feel for him. Anyone who goes to any Orthodox Christian church in the Washington DC metro area will know who I'm talking about.

JAM said...
This comment has been removed by the author.
Grayson said...

I think of all the parents of young kids .. auto accident victims, near drownings, etc., who OK'd docs who said there was no hope .. the plug had to be pulled.

Dave S. said...

"Lucky that they weren't more "compassionate" and didn't try to starve and dehydrate him to death."

Lucky?!?

I would pray for death.

Yeah, everybody knows he's conscious now. But he's still imprisoned in his body. What a nightmare.

Would you life-at-all-costs types let him die a merciful death if he asked for it?

Kensington said...

Dave S:
"Yeah, everybody knows he's conscious now. But he's still imprisoned in his body. What a nightmare.

Would you life-at-all-costs types let him die a merciful death if he asked for it"


Gee, I don't know, Dave. Would you death-worshipers care to acknowledge that he's glad to be alive?

Because he is, according to the story.

Jamie said...

Sanjay Gupta just wrote a book on... medical miracles, I do believe; he spoke at length on NPR about "PVS" patients who came out of their states, confounding doctors. I differ from Dr. Gupta on probably most subjects, but I was profoundly moved by his decision to step through the journalistic wall and perform neurosurgery on that child in the early days of Iraq, and in the recent NPR interview he said repeatedly that his research for his book had caused him to think very seriously about what we think we know about life and death.

I thought immediately of Schiavo, of course... That her family was willing to continue her care indefinitely, yet her husband's wish that she just die, already, was the one listened to - my mouth still tastes bitter. When the individual's wishes can't be known (as in, no living will) and there's someone willing to take responsibility for his or her continued living, why not err on the side of life? Why choose the side from which there's NO possibility of recovery?

I hope her husband has the occasional nightmare, is all.

MadisonMan said...

Would you life-at-all-costs types let him die a merciful death if he asked for it?

I wonder if the law has caught up to the technology in this case. How could one show that the person is in full control of their faculties, for example, and satisfy a judge to that effect? I don't suppose he had an advanced directive in place 23 years ago at age 23. I suspect even if he asked for it, his wish would not be granted, which is faintly ironic given the assertions above that he could have been euthanized by doctor as that "often" happens (but somehow, he wasn't -- why is that?)

Kensington said...

Jamie, I'll never forget how the ghouls gloated when that poor woman was finally killed. It was shameful, and there were ghouls on both sides of the aisle.

Kensington said...

...although mainly on the Left, to be fair.

MadisonMan said...

Re: Terri Schiavo: Why would he have nightmares? The post-mortem on his wife (ex-wife?) showed her to be blind with significant brain atrophy consistent with her PVS condition.

If you accept that her wish was not to "live" in such a state, then he followed her wishes.

That whole episode was a testament to making living wills.

Dust Bunny Queen said...

Would you life-at-all-costs types let him die a merciful death if he asked for it?

If it was HIS choice, I would say yes.

However, when it is the choice of some adminstrative bureacrats who are looking at the financial bottom line......no.

That whole episode(Schaivo) was a testament to making living wills.

Absolutely.

Jamie said...

Madison Man, the "if" in your sentence is the critical one: "if you accept that her wish was not to 'live' in such a state, then he followed her wishes." Problem is, the person communicating that "if" was her moved-on husband. On the other side of the issue, her parents and brother said that she had never communicated any such thing to them, explicitly or implicitly, and that they were willing to continue to care for her for as long as she lived.

Where's the burden of proof, when the individual whose life is on the line (and please spare me the "but is it really life?" as that is surely subjective) can't communicate his or her wishes and hasn't clearly done so in advance? My whole point, both at the time of Schiavo's dehydration-to-death (letting my biases hang out, obviously) and now, is that in that scenario, when continued life is presented as a reasonable alternative, why not choose continued life rather than the ultimate absolute unrecoverable - death?

Dave said...

There's no evidence that the guy is actually awake, as the method used to communicate with him is facilitated communication. Basically, someone else is using this man's hand to type, then claiming that it is the coma patient typing. I was stunned to see this pointed out pointed out today by James Randi, after believing the coma story.

Jamie said...

Over at firedoglake, at least one commenter mentioned that Schiavo has come up over here, "as if she would have stood up and started tap-dancing someday" or words to that effect. I'm not registered over there and don't want to be - so if whoever from fdl made that comment is listening:

No. I don't believe Schiavo had any reasonable hope of "standing up and tap-dancing" - or perhaps even of achieving something unequivocally understood as consciousness. What I've said here, there, and everywhere is that there were two factions at war over her: her essentially ex-husband, who wanted her gone (for whatever reason - give him the benefit of the doubt and say it's because he loved her SO much and hated her condition SO much that he couldn't stand to see her that way), and her parents and brother, who repeatedly expressed commitment to care for her even if she never recovered any normal function. Why not, in that case, go with the side that permits the possibility of any change, for good or ill? But instead, the decision was the only irrevocable one.

Come to think of it, there's a certain parallel to climate change here... Change bad (because possibly not controllable? Not in the direction one might want?), static good. Don't be afraid, progressives.

Kensington said...

Somehow I doubt anyone at Firedoglake will be willing to consider a more generous perspective on the Schiavo comments, however reasonably they are presented.

Dave S. said...

"Gee, I don't know, Dave. Would you death-worshipers"

I'm not a "death-worshipper", you hysterical a**hole.

"care to acknowledge that he's glad to be alive?

Because he is, according to the story."


That James Randi link makes a pretty damned convincing case that he's not saying anything. And that if he's truly conscious, he could very well be saying, "Stop putting words in my mouth and put me out of my misery already."

I really hope you're not religious, because the idea of keeping someone imprisoned instead of releasing them to a glorious afterlife is revolting.

So if there truly is a way for him to communicate, and he asks for release, would you oblige him?

Kensington said...

Dave S:
"I'm not a "death-worshipper", you hysterical a**hole."

F*ck you, Dave, you're the one who wrote that you'd "pray for death."

As for the religious merits of killing people, I think you're misguided. A religious person might well make the point that we are here to live, as best as possible, until the point when we no longer can, not merely the point when we no longer wish to. A religious person might well say that life is a gift from God not to be thrown away, however rough it might get.

On the other hand, compassion would move me greatly to want to assist Mr. Houben if he wanted to die. I get that, I'm moved by that, but there is a definite conflict between compassion in the here and now, respect for life and the obedience owed to God that obligate religious people. For a religious person, this would simply not be as easy to face as you blithely assume.

A religious Catholic, for example, is bound by the Church to remain alive from conception until "natural" death, and I'm not sure how natural it would be for Mr. Houben to die, although I suppose an argument could be made that, since he cannot take care of himself, it might be allowable under Church guidelines, for him to die.

A religious person also usually understands that there is merit in suffering, for example, as Christ did on the cross, and that, although a glorious afterlife awaits, there is value in remaining alive, now, even if there is suffering, and a religious person is humble enough to know that they can't easily presume the authority of life and death over another innocent person.

It's not easy, but being religious rarely is, and you don't seem to understand that.

So I don't know what I would do if Mr. Houben asked me to kill him. I know I'd instinctively want to help him, but I'd probably also be very wary about presuming the right to kill him. I would also have wanted to help Christ come down off his cross, but that wasn't what God demanded.

Invoking religion doesn't make things as simple as you think.

Kensington said...

Now, on another note, that Randi link, which I hadn't seen before, definitely puts a much more skeptical light on this whole story, and I do think the original story linked here is fundamentally flawed for failing to make it clear exactly how this man is "communicating."

Kensington said...

One more thing for Dave S, it was obnoxious of me to call you a death worshipper. It was a cheap shot, and I apologize, not only for that but for the "f*ck you" in my follow-up.

I'm sorry.

Dust Bunny Queen said...

A religious person might well make the point that we are here to live, as best as possible, until the point when we no longer can, not merely the point when we no longer wish to. A religious person might well say that life is a gift from God not to be thrown away, however rough it might get.


A religious person might also think that life is meant to be experienced in both the good and the bad, the easy and the harsh, so that the soul can learn and progress.

Karma and all that.

Sometimes the terrible things, such as happened to this man, can be a lesson for others as well. A test, if you will, for his family and society. Are we up to the challenges or do we shirk. These terrible things reveal to us who we really are, good or bad.

For some who are religious, this is the only way to come to grips with things like, young children with cancer or terrible birth defects. "How could God let this happen?" In some Karmic based religions they believe that the child/soul may have even volunteered to learn and to teach and by doing so advances their progress in the search for oneness with God.

This is somewhat how Palin has phrased it with her son Trig being a gift from God. Whether others believe or buy into this faith is immaterial because there is no way to know what is fact or faith.

Who knows. But you are right. It isn't a simple cut and dried proposition to throw religion into the mix.

I thought a lot about these things when my Mother and our family was going through our trials.

coronary quips said...

For all of you lunatics celebrating this man's survival, how about you consider how wonderful it would be to exist trapped in your own mind, wholly immobile, for twenty-three years.

Whoops, I just insinuated such a half-brain would be capable of "thinking." Please disregard.