The Fragile Edge of Awareness

In Chapter 7 in Bor’s “The Ravenous Brain,” Bor explores the vegetative state, what he calls “living on the fragile edge of awareness.” He talks about how when a patient is in a vegetative state, there are all kinds of problems one can run into. First, he questions the fact if they are even conscious. Furthermore, if so, how conscious are they? And then there is also the issue of time. How long is a family expected to wait until they let their loved one go? He gives the painful example of Terri Schiavo, who’s heart had stopped and was in a coma for a while before entering a vegetative state. What ensued was about 15 years of back and forth arguing about whether she should be kept alive or let go. All this stemmed from the fact that no one knew if she was conscious or if she would ever even reach a point of consciousness and wake up from what seemed an indefinite slumber. 

Now, people are trying to figure out how to tap into the world of a person in a vegetative state. Researchers in the University of Cambridge recently conducted a study to try and figure out just that. They used EEG on 21 patients considered in the vegetative state or minimally conscious as well as 8 healthy volunteers. The participants were shown a bunch of different words while asked to attend to either the word “yes” or “no.” They did this in a span of 30 minutes, so the researchers would be able to see whether the patients were able to attend to the correct target word.

Their findings were interesting, to say the least. They found that one of the patients the doctors labeled as being in “the vegetative state” was not only able to filter out the unimportant information, but hone in on the words they were being asked to pay attention to, proving he really was not in a vegetative state, and was even conscious.  Before I read any other findings they had, that in itself, was significant to me; it’s very demonstrative of how inconsistent and uncertain current methods are for determining who is considered in the vegetative state. Aside from that unique finding, they saw that, overall, people considered minimally conscious or vegetative state might be able to direct their attention to the sounds and world around them; they showed an ability to pay attention and even follow commands. They hope that this finding, further studies, and progress, will eventually aid in such individuals communication with the outside world as well as better understand what is labeled as a person in a “vegetative state.” 

This scan depicts patterns of the vegetative patient's electrical activity over the head when they attended to the designated words, and when they when they were distracted by novel but irrelevant words. (Credit: Clinical Neurosciences)

http://www.sciencedaily.com/releases/2013/10/131031110558.htm