August 15, 2024

"Teams of neurologists at six research centers asked 241 unresponsive patients to spend several minutes at a time doing complex cognitive tasks..."

"... such as imagining themselves playing tennis. Twenty-five percent of them responded with the same patterns of brain activity seen in healthy people, suggesting that they were able to think and were at least somewhat aware. Dr. Nicholas Schiff, a neurologist at Weill Cornell Medicine and an author of the study, said the study shows that up to 100,000 patients in the United States alone might have some level of consciousness despite their devastating injuries. The results should lead to more sophisticated exams of people with so-called disorders of consciousness, and to more research into how these patients might communicate with the outside world, he said: 'It’s not OK to know this and to do nothing.'"

From "Unresponsive Brain-Damaged Patients May Have Some Awareness/Many patients thought to be in vegetative or minimally conscious states may be capable of thought, researchers reported" (NYT).

Connect this to the previous post, about the newest brain implants. I wonder if it's because of the emerging technology that this research on unresponsive persons is happening. Are we just now learning things we could have learned before but those who control the research didn't want to know?

58 comments:

Aggie said...

It's the horror that any normal person feels - for some, their greatest fear: Of being outwardly unresponsive, unable to communicate in the slightest way, yet at the same time, fully aware, conscious and perceiving all activities going on around you - but forever unable to communicate even the smallest aspect of your sentience. It's very much like the primeval, claustrophobic fear of premature burial.

n.n said...

Viable states of life. #HateLovesAbortion

gilbar said...

when i was in my coma, my mom said; that when she (or other family) would talk to me.. My brain scan would light up.. Which made her feel better..
Needless to say, other than the brain scans, i was Completely unresponsive.

Also, Needless to say, i remember NONE of it (i came out of the coma with COMPLETE amnesia; I have recovered Nearly ALL of my memories: EXCEPT for the period from the day before my accident until about two weeks AFTER i came out of the coma)

gilbar said...

my coma was back in March, 2000.. Or, nearly 25 years ago.
The doctors were very familiar with the brain scan thingies, and pointed them out to my family

Jamie said...

Anybody remember Terri Schiavo?

I remember Althouse's blogging about her case. I know I commented here. It is of course possible that she really was brain dead with regard to higher brain functions, but her family was convinced that she was "in there" based on subtle physical signs, and they were willing to to take on the responsibilities, financial and otherwise, of her care. Her husband, though, wanted to remarry. The judge ruled that the husband had the right, not to "pull the plug" because she wasn't on that level of life support, but to withdraw her feeding tube, the only intervention she was receiving.

So she starved to death.

At this same time, Pope John Paul II was dying. He gave his flock an example of how to die in God's time. The contrast was stark.

I wonder what a study like this would have shown.

rhhardin said...

Brain in a vat. "That's you over there."

HoodlumDoodlum said...

Good thing this framework (of understanding consciousness and/or subjective experience) can't possibly extend in any way to the unborn/the abortion debate.

Jamie said...

My prior comment notwithstanding, I recognize that this study is going to lead to some heartache. There are going to be people who are outwardly unresponsive who can now be shown to be capable of understanding and cognition, but whose insurance has run out or whose chance of "waking up," of emerging from their present state, is zero thanks to physical injuries. And they're going to have to be told that they have to die.

One comment I tried unsuccessfully to publish this morning, on the ALS patient, was simply, "We live in an age of miracles." But these miracles we work - they can have dark or sad consequences too.

West TX Intermediate Crude said...

Anecdotal evidence supporting Gilbar-
I pent several decades taking care of critically ill patients in ICUs. The majority were not brain injured, but heavily sedated to allow toleration of breathing tubes in the airway and a ventilator to control breathing. We also routinely did very unpleasant things to them- large IVs inserted into the neck, large tubes inserted between the ribs, with an attempt at local anesthesia but not enough by any estimation. They were not under anesthesia, and responded to what we did with grimacing or withdrawal.
Many survived, and when I spoke with them after recovery, every one of them had no recollection of the miseries that medical and nursing staff had inflicted on them, even when I described specifically what had been done to them.
Not totally parallel to the situation described in the referenced article, but I always found it reassuring.

traditionalguy said...

Caregiving to a totally unresponsive human is a full time job. The people who do that give up their lives for another. That is the greater love.

Lloyd W. Robertson said...

For a while there were a number of cases where it was requested that care be withdrawn because of a "persistent vegetative state." Because of our disabled daughter in the late 80s, early 90s, we met various specialists, one of whom said: "True PVS is much more rare than the media is implying. There is such a thing as irreversible coma, but again one should not rush to a judgment about this."

Temujin said...

Terry Schiavo could not be questioned on her opinion of this.

In other news, "'It’s not OK to know this and to do nothing."
Apply this to Joe Biden in 2020. Apply this to Joe Biden in May of 2024. Apply this to today when no one is running the United States and no one seems the least bit curious about it, least of our our journalist class which is pounding the word 'Joy' at us for some reason.

Dixie said...

Althouse wonders: "Are we just now learning things we could have learned before but those who control the research didn't want to know?"

But they DID want to know how syphilis works, so they injected it into unsuspecting black men, then told the black men they were treating them for it, when in reality they were giving them shots of just water. So they could see the complete effects of untreated syphilis. Most of them died from it.

They call this "medical ethics."

Does this answer your question, Ann?

Mike (MJB Wolf) said...

Yes the horror that people who cared about the Terry Schiavo case brought up repeatedly, including her family of course that wanted to care for her, pointing to the minimal evidence we had then that she could possibly be saved. I remember some stupid talk-radio hosts (like Bill Handel in LA) insisting she was a vegetable and making fun of "right wingers" who were "making an issue" out of the case.

No humility on the Left. No room for well we might not know for sure, let's err on the side of caution. At the time I wondered why it was breaking down as a partisan issue. The fact Musk owns Neura-Link* might drive the Left to oppose these advances too.

Mike (MJB Wolf) said...

*How long until he changes it to X-Link?

Bob Boyd said...

Am I the only one who finds it disturbing that neurologists are teaming up now?

MadisonMan said...

Were they unresponsive patients, or were they Democratic readers of the Washington Post? And what's the difference anyway?

Jim said...

Is one of the centers the Jefferson Institute? Who will get the reference?

Mike (MJB Wolf) said...

I'm glad to see others remember her too. The hubris of the "kill Teri" crowd still gauls me. Humility is truly an undersold essential virtue of our time. It needs an advocate. But there's no glory in being a humility advocate. Maybe we need a humility influencer.

traditionalguy said...

Interestingly Medical Ethics is the name given to newly created EDU chairs at Medical Center Universities, such as Emory in Atlanta, providing prestige and high salaries to Death Panels.

Seriously all they do is give an elite sounding push of elderly people into suicide for the greater good of humanity. Go figure.

Gusty Winds said...

'It’s not OK to know this and to do nothing.'" Are we just now learning things we could have learned before but those who control the research didn't want to know?

Oh yeah it is. They've done NOTHING with the Autism spike for decades. They still pump cancer patients with chemo which just kills many of them faster. They killed unknown numbers of people with with unnecessary ventilation and remdesivir during COVID, and killed and injured many more with the mandated clot shot. The medical industry is a money making machine like colleges. Both with a never ending influx of money, and skyrocketing costs which outpace inflation. Both pat themselves on the back as benevolent altruists.

At least Erectile Dysfunction was cured. Party on your pants.

Looks like, as usual lately, the only guy interested in doing something about this specific topic is Elon Musk. But we're not supposed to hate him.

Gusty Winds said...

The most ethical neurologist I've ever seen was Dr. Michael Hfuhruhurr (Steve Martin) in "The Man with Two Brains."

Oh...and a smokin' hot, top of her game Kathleen Turner.

Gusty Winds said...

Took my son, who is not 22, to a Neuro-psychologist for testing when he was 17. He is somewhere on the autism spectrum which became apparent after puberty. He suspected Aspergers. Oh…and when I had this done in 2019 the waiting list was NINE MONTHS. That’s how many people are trying to get their kids into pediatric neuro psychological testing.

You wait nine months. Pay a shitload. And all the testing is done by an assistant with, yes, that’s right…a MASTERS DEGREE. Not the Neuro Psychologist.

So they tell me my son “is right on the border” of being autistic, but they weren’t going to diagnose him as autistic. Only thing I could get from that bullshit was and IEP at his high-school which is nothing more than extra time to do homework.

Now that he’s 22, and I don’t have the official diagnosis…we’re basically fucked. I can’t get any help without the diagnosis. “He’s right on the border of being autistic”.

$5000 out of pocket, to have some Master’s Degree yahoo hand one day’s worth of testing to Dr. Neuropsychologist for NOTHING. Basically, like a lot of western “medicine” they throw sand at a barn.

But if your looking for a cash cow career, go into child phycology. It's a never ending inflow of young patients being referred by the public schools.

Michael K said...

Years ago, I saw a case of "vigilant coma". I think it was carbon monoxide poisoning. She was there for several years and was kind of a curiosity. People would make rounds and talk over her. Then she woke up. She recounted the times when comments were made in her hearing about what a waste it was to keep her alive.

FullMoon said...

Oh…and when I had this done in 2019 the waiting list was NINE MONTHS. That’s how many people are trying to get their kids into pediatric neuro psychological testing.

I think of that every time I see comments how the "parents should have got him some help".
Yeah, good luck with that.
Then, the 'help" ends up being drugs never mentioned in the story

john mosby said...

It seems like everyone wants to keep a loved one alive in this condition.

But who wants to live in this condition?

Press this button and you die instantly, or at least quickly.

Press this other button and you will be aware but unresponsive for months? Years? Dozens of years? You may be in pain that no one notices. The ordeal may end in your waking up and returning to normal, or it may just end in death.

I think only the most advanced spiritual practitioners, or the orneriest winners-for-the-sake-of-winning, would pick the second button for themselves.

So why pick it for a loved one?

JSM

Gusty Winds said...

Oh, yeah. Had him at Rogers Behavioral Health in Oconomowoc for a while. They were throwing every psychotropic drug cocktail at him. Little of this, little of that... Sand at a barn. My son would just tell them what they wanted to hear. "yeah, I'm feeling great." When they released him from the program, he stopped taking the meds within a month. When I asked why he just said, "they don't do anything." So I didn't pressure him to take them.

Jim Gust said...

This was thoroughly and wonderfully covered in Awakenings, with Robin Williams playing Oliver Sachs. From my memory, the doctors are watching film of unresponsive patients:

Senior Doctor: They are unaware of their surroundings, they are not conscious.
Williams: How do we know that?
Senior Doctor: The alternative is unthinkable.

Aggie said...

That's not the way to think of it, except for yourself. I had a business acquaintance in the Caribbean, guy in his 70s, still sharp, still working. I was one of his clients. He picked up a tropical, mosquito-borne virus, don't remember which one. He slipped into a coma in the hospital, stayed there for a month, was brain dead. Family wouldn't give up (lots of old-fashioned Catholics there). He woke up spontaneously after about 8 weeks if I recall correctly, recovered, went through rehab, went back to work.

The Will to Live is stronger in some than in others. I could never make that choice for someone else having seen this, which was thought of as a miracle by the doctors.

john mosby said...

Daily Roman Empire thought: there’s no question what a Stoic would choose, either for himself or a loved one…

JSM

Lem Vibe Bandit said...

"Teams of neurologists at six research centers asked 241 unresponsive Kamala voters to spend several minutes at a time doing complex cognitive tasks, such as imagining themselves playing tennis. Twenty-five percent of them responded with the same patterns of brain activity seen in healthy people, suggesting that they were able to think and were at least somewhat aware."

Trump tweaked headline.

Jim said...

Geneviève Bujold in Coma. A surgeon, but still….

rhhardin said...

They should play educational podcasts or at least action audiobooks in coma wards lest anybody be bored.

Megthered said...

When I was on training we were always told to talk to the patient as if they were wide awake. So I always spoke to them. When my sister in law was in a coma I always took her hand and told her about what was going on in our day. Touch and speech is so important, and some of these stupid doctors don't believe it.

FullMoon said...

john mosby said...

It seems like everyone wants to keep a loved one alive in this condition.

But who wants to live in this condition?

Press this button and you die instantly, or at least quickly.

Press this other button and you will be aware but unresponsive for months? Years? Dozens of years? You may be in pain that no one notices. The ordeal may end in your waking up and returning to normal, or it may just end in death.


Amen, Brother.
Saw a First 48 where crazy relative killed six in family, woulded 3 more, including children. Don't give him death penalty, that's too kind. Put him in a coma where he is aware of surroundings and awarw enough to wish he were dead.
Anyway, had an elderly aunt, devout Catholic, nicest person in the world. She and her Catholic friend were near death at same time. Aunt praying to God to let her die, her friend begging God to let her live.

Rusty said...

So what you're implying here is that there's hope for Inga.

FullMoon said...

Gusty Winds said...

Oh, yeah. Had him at Rogers Behavioral Health in Oconomowoc for a while. They were throwing every psychotropic drug cocktail at him. Little of this, little of that... Sand at a barn. My son would just tell them what they wanted to hear. "yeah, I'm feeling great." When they released him from the program, he stopped taking the meds within a month When I asked why he just said, "they don't do anything." So I didn't pressure him to take them.


Yep, either "they don't work" or, "i'm cured now"
Had a friend who had a breakdown many years ago. Lithium straightened him out. After ten years or so, acquaintances, me included, began wondering aloud whether he really needed them. So, he quit. Another learning experience for me, guy was totally f'd up after a week or so. Back on, good now.
Learned to keep my medical opinions to myself, but still believe a lot of stuff is over prescribed.
Know a first grade teacher, she is frequently talking about rambunctious boys in class who need to be medicated. Glad they didn't do that when I was a kid. Teacher used the paddle instead. Which, by the way, was more embarrassing than painful until middle school when they turned paddle duty over to the P.E. teachers.

pacwest said...

Not a single Borg reference yet?

Tom T. said...

Have there been any examples of someone coming out of a coma or vegetative state and saying that they were aware of their surroundings but unable to respond? I don't know of any.

Gusty Winds said...

Know a first grade teacher, she is frequently talking about rambunctious boys in class who need to be medicated. From first grade to fifth grade they had my son on Ritalin. A LOT of the boys in his class were on Ritalin. And the SCHOOL would reccomend we ask for a higher dose. Running the boys around the block everyday didn't seem to be an acceptable alternative.

Bob Boyd said...

there’s no question what a Stoic would choose, either for himself or a loved one…

You will never find a more stoic man than one in a persistent vegetative state.

Just asking questions (Jaq) said...

I wish I didn't know now what I didn't know before I read this.

FullMoon said...

"tim in vermont Kamalesqually said...

I wish I didn't know now what I didn't know before I read this.

AA said couple of years ago:
"See, whatever happens can be said to have happened for the reason you've already reasoned is the reason for whatever happens to have happened. "

Jamie said...

Locked-in syndrome?

Jamie said...

Time to update the ol' advance directive... It's just, in which direction do I want to update it?

Michael K said...

In surgery, I always warned the staff about talking when the patient was asleep. I had many examples of patients telling me what was said around them when asleep.

Michael K said...

I do and related it above. She was in coma for three years if I remember correctly

Goetz von Berlichingen said...

If you are referencing the Tuskegee experiments, you have one fact wrong. They didn't give anyone syphillis. They just failed to actually treat with effective drugs many of the participants who came there for help. Some people got real drugs, some got placebos. Yours is a common misrepresentation of this study.

MfG
Goetz von Berlichingen

Enigma said...

This is not about doctors, rather, it's about the limited potential of treatment.

Conscious awareness (such as all of our written babble) reflects just the tippy-top fraction of all that happens in the brain. With mild brain disruptions one may have crippling anxiety, obsessive-compulsive disorder (e.g., gamblers), or lack the ability to control impulses (e.g., many criminals), etc.

More serious brain disruptions include schizophrenia (e.g., hearing voices; catatonia, etc.), or the decaying Swiss cheese brains of dementia (e.g., Alzheimer's, Parkinson's, etc.). How's it going Joe?

Then, there are the extreme and sometimes bizarre brain injuries and disruptions. Coma. Strokes. Left-right split brains. Major accidents and military Traumatic Brain Injuries (TBI). Amnesia (e.g., remember just the last 5-10 minutes), etc. Strokes are probably the most common type in this group, as people may understand speech but not be able to speak or find specific words. With a stroke, parts of the brain are fully destroyed by a broken blood vessel, and there's no way to regrow or repair or retrain the connections with current science/technology.

With this story, I'd say that most neurologists suspect that many of their "comatose" patients have partial functioning and understand a great deal of the world outside. They just can't do anything about it.

Rabel said...

"Are we just now learning things we could have learned before but those who control the research didn't want to know?"

The interviewed researchers are overselling the significance and novelty of their findings.

This isn't new information. Their method of reading the brain activity was new and a good thing but research has shown the same results with more intrusive technology for years.

donald said...

I learned about Bill Handel from the legal show and an appearance he did on CNN hosting g during an Israel Lebanon war. Loved him. Then Inheard his show in LA. A really dishonest guy.

Anne in Rockwall, TX said...

"Are we just now learning things we could have learned before but those who control the research didn't want to know?"

Well, duh.

Michael McNeil said...

Daily Roman Empire thought: there’s no question what a Stoic would choose, either for himself or a loved one…

A Roman Stoic would choose never to have sex except specifically to make a baby with his wife; ditto for the wife.

walter said...

Nice, sperg.

walter said...

Yeah well, if you start with it as a clump of cells prior to birth....

stlcdr said...

I'm hung up on the 'asked' part of 'non-responsive' patients.

mgarbowski said...

Remind me of a scene early in the movie Awakenings, when an older Parkinson's lecturer is asked by the Robin Williams how we know the Parkinson's patients have no higher brain functions.
His reply was "Because the alternative is unthinkable."

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