Saturday, October 13, 2007

The inner lives of people classed as “vegetative”

A must-read for anyone who could find themselves in a vegetative state (= you and me) is a recent article in the New Yorker by Jerome Groopman, summarizing the recent findings about the inner life of many people who appear to others to be no more responsive than zucchinis:
Bainbridge had not spoken or responded to her family or her doctors, although her eyes were often open and roving. (A person in a coma appears to be asleep and is unaware of even painful stimulation; a person in a vegetative state has periods of wakefulness but shows no awareness of her environment and does not make purposeful movements.) Owen placed Bainbridge in a PET scanner, a machine that records changes in metabolism and blood flow in the brain, and, on a screen in front of her, projected photographs of faces belonging to members of her family, as well as digitally distorted images, in which the faces were unrecognizable. Whenever pictures of Bainbridge’s family flashed on the screen, an area of her brain called the fusiform gyrus, which neuroscientists had identified as playing a central role in face recognition, lit up on the scan. “We were stunned,” Owen told me. “The fusiform-gyrus activation in her brain was not simply similar to normal; it was exactly the same as normal volunteers’.”

One fellow, recently reawakened, recalled his social security number from over two decades earlier and helpfully offered it to his mother while she was on the phone with a bureaucrat.

Kate Bainbridge herself, ex-vegetable, wrote to Groopman to offer an opinion:
Kate Bainbridge, the first vegetative patient that Adrian Owen studied in Cambridge, has also made considerable progress, recovering the use of her arms, and much of her mental function, although she is unable to walk. She still has difficulty talking, and uses a letter board to communicate with people who are not used to her speech. “Most scans show what is wrong with your brain, which doctors need to know,” Bainbridge wrote to me in an e-mail. “But Adrian Owen’s scans show what is working. I say they found parts of my brain were working. It really scares me to think what might have happened to me if I had not had the scans. They show people it was worth carrying on even though my body was unresponsive.”

Something to think about, when we hear people say - about old or sick or developmentally delayed people - "Oh, So-and-so doesn’t understand what we are saying." The Mindful Hack humbly suggests: Don’t risk it. And if it not something that shows concern for them, don't say it. Don't even think it.

For Mindful Hack stories on brain absent people, go here “How much brain does a man really need?”, and here “Just how much brain do YOU need?”.

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