You've unfortunately had a terrible accident.
You're lying in a hospital bed, and you're aware,
you're aware but you're unable to respond.
And you have to lie there listening to them
deciding whether to let you live or die.
I can think of nothing more terrifying.
I'm Dr. Adrian Owen, I'm the author
of Into the Gray Zone, A Neuroscientist
Explores the Border Between Life and Death.
Communication is at the very heart
of what makes us human.
It's the basis of everything.
What we're doing, is we're returning
the ability to communicate to some patients
who seem to have lost that forever.
The vegetative state is often referred to
as a state of wakefulness without awareness.
Patients open their eyes.
They'll just gaze around the room.
They'll have sleeping and waking cycles,
but they never show any evidence of having any awareness.
Typically the way that we assess consciousness
is through command following.
We ask somebody to do something, say squeeze our hand,
and if they do it, you know that they're conscious.
The problem in the vegetative state
is that these patients, by definition,
can produce no movements.
The question I asked is, well, could somebody
command follow with their brain?
It was that idea that pushed us into a new realm
of understanding this patient population.
When a part of your brain is involved
in generating a thought or performing an action
it burns energy in the form of glucose.
It's replenished through blood flow.
As blood flows to that part of the brain
we're able to see that with the fMRI scanner.
I think one of the key insights was the realization
that we could simply get somebody
to lie in the scanner and imagine something,
and based on the pattern of brain activity,
we will be able to work out what it is they were thinking.
We had to find something that produces
really a quite distinct pattern of activity
that was more or less the same for everybody.
So we came up with two tasks.
One task, imagine playing tennis,
produces activity in the premotor cortex
in almost every healthy person we tried this in.
A different task, thinking about moving
from room to room in your house
produces an entirely different pattern of brain activity.
Particularly it involves a part of the brain
known as the parahippocampal gyrus,
and again it's very consistent across different people.
We realized that we could use this
for a simple mechanism for asking yes or no questions.
We could say, "I'm going to ask you a question.
"If the answer is yes, imagine playing tennis.
"If the answer is no, imaging thinking about moving
"through the rooms of your home."
I can still remember exactly what it felt like
the first time we saw a patient
that we thought was in a vegetative state
activate their brain in the scanner.
The patient's name was Kate.
Nobody would have predicted that we would have seen
brain activity in response to asking a patient
to do something.
When we first saw it, it was absolutely astonishing.
Before we made that discovery,
nobody ever bothered to look at any of these patients.
Very few people even asked the question,
Now people ask this question all the time.
We've scanned several hundred patients
who were presumed to be in a vegetative state.
It turns out that about 20%, or one in five of them,
is not that at all.
By that I mean they're aware of the situation they're in.
They're aware of conversations going on around them.
They have thoughts.
They have emotions.
They maybe even have feelings about their future.
But is largely unable to move any part of their body.
I think you could very easily describe
what we've done as an early version of mind reading.
I think over the next few years,
this is going to be a really exciting area of research,
and we will move closer and closer
to being able to decode what somebody is actually thinking.
We are now in a position where we can ask
some of these patients what it is
that will make them more comfortable,
even, "Are you in any pain?"
Of course, we can act on those questions.
We can make them more comfortable.
Communication is the thing that really makes us more human.
If we can give these patients back
the ability to make decisions,
I think we can give them back
a little piece of their humanity.
(light music)
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