Unlocking the Mysteries of “Disorders of Consciousness”

By Dave Andrusko

It’s the end of the week and I am close to the deadline to post National Right to Life News Today for Friday. But it is important that I at least summarize some of the remarkable findings in an article that appeared in Discover Magazine under the headline Rediscovering Consciousness in People Diagnosed as “Vegetative” and return to Kat McGowan’s remarkable 5,700-word-long essay with a more in-depth look next week.

What is the heart and soul of this investigation of what she refers to as “disorders of consciousness”? Whatever we thought we knew about patients who’ve been severely brain-injured, work over the past decade has proven us to be wrong, wrong, wrong.

Because of the long and contentious fight over Terri Schiavo, who was eventually starved and dehydrated to death over her family’s frantic objections, most people are aware of what is called a “persistent vegetative state.” Terri’s estranged husband and some doctors insisted Terri was in a PVS (loosely defined as awake but unresponsive and unconscious), her parents and siblings and other doctors adamantly disagreed.

But what McGowan’s overview of massive amounts of research demonstrates is both that PVS is much more of mystery than is commonly understood and that way, way too often patients are diagnosed in a PVS when their real “disorder of consciousness,” while severe, is something far less.

“Three separate studies, the most recent in 2009, indicate that up to 41 percent of people diagnosed as being in a vegetative state are, when more carefully examined, found to be at least partly aware,” McGowan writes. (There is a kind of next step up category called “minimally conscious.”)

This can be examined by a host of factors: it takes patience and equipment and intellectual curiosity to probe beneath the surface unresponsiveness. In other cases, it’s a rush to judgment: after a traumatic head injury, too many physicians—eager to help the family “let go”—tell them that there is “no hope” when they cannot possibly know.

One of the key figures, Nicholas Schiff, tells McGowan of the first time he met a “vegetative” patient. It was in 1993.

“This woman had had a stroke more than six months earlier,” McGowan writes. “When Schiff examined her, he found no sign of consciousness, just as expected. Three years later, on a visit to a local rehabilitation center, he ran into his former patient again. Not only was she awake, but she spoke to him.

“’I was shocked,’ he says now. ‘I remember the visceral feeling of having seen somebody come back from the dead. It seemed truly surreal.’”

The article is brilliantly written and the average layperson can follow the work of Schiff, Joseph Giacino, and Steven Laureys  with ease. You come away with a deep appreciation for the complexity of consciousness, the unbelievable capacity of the human brain to repair and renew itself, the enormous potential of deep brain stimulation, and the scary truth if it weren’t for a handful of dedicated researchers, severely brain-injured patients would still be too often dismissed as not only a “lost cause” but one that doesn’t desire our care and compassion.

We’ve written in National Right to Life News about a number of the individuals in McGowan’s story who have “awakened.” They have taught me the importance of not pre-judging and never, ever dismissing someone as a “vegetable.”

Take 20 minutes of your time and go to http://discovermagazine.com/2011/mar/09-turning-vegetables-back-into-humans. You’ll be glad you did.

Your feedback is vital. Please send your comments to daveandrusko@gmail.com. If you like, join those who are following me on Twitter at http://twitter.com/daveha

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