Neuroscience: Puzzle of consciousness: Man was conscious but immobile 23 years … but who besides him knew?

_{Denyse O'Leary

November 23, 2009

Neuroscience}

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At the Mail Online, Allan Hall reports (November 23, 2009) on the case of a man who was conscious for 23 years, but no one knew because he was paralyzed.

A car crash victim has spoken of the horror he endured for 23 years after he was misdiagnosed as being in a coma when he was conscious the whole time.
Rom Houben, trapped in his paralysed body after a car crash, described his real-life nightmare as he screamed to doctors that he could hear them – but could make no sound.

‘I screamed, but there was nothing to hear.

Read more here.

I think doctors should be much more careful with the “persistent vegetative state” (PVS) diagnoses than they sometimes are – if consequences follow. Some people – like Rom Houben, above – can be conscious without being mobile. We aren’t even sure what consciousness is , after all, so why be definitive about who has it?

Here are some more articles about persistent vegetative state:

Is the patient vegetative or minimally conscious

Neuroscience: Can locked-in sufferers tweet, using brain signals alone?

Another “human vegetable” turns out to be wired for thought

Also just up at The Mindful Hack

Sociology: Should you add Satan to your Board of Directors?

Neuroscience and popular culture: Reasons not to buy “neuronovels” for people for Christmas

Neurolaw: Confusing intent with motive is a threat to civil rights

Neuroscience: “The Young and the Bureau”

Spiritual Brain: Me ‘n YouTube: Discussing my “Hot Apple Cider” essay (“Hot Apple Cider” is a project promoted by World Vision to help reduce prejudice against Christians in Canada)

Comments

It turns out there's plenty of good scientific evidence that Rom Houben is indeed conscious after all. See http://www.lifenews.com/bio3012.html .vjtorley_{November 26, 2009
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I would think EKGs and fMRI scans would be able to determine if the patient is truly conscious though totally paralyzed. Presumably the motor centers would be inactive, but other structures metabolically active, with electrical patterns indicative of consciousness. This is similar to the horrible occurrence of surgery without true anesthesia, where patients, rarely, are fully conscious and able to feel pain, though totally paralyzed. This is due to only the paralyzing agent in the anesthetic mix being effective. The mix had the wrong proportions for the particular patient. This leads to numerous lawsuits. There are a couple of EKG type devices now specifically designed to detect this condition and allow the anesthesiologist to correct the dosage mix. Otherwise the surgeons have to be extremely alert to detect subtle signs, like a little tearing in the eyes.magnan_{November 25, 2009
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Hmm. I've just been having a look at this article, which presents a fairly balanced summary of the case: http://www.dailymail.co.uk/news/worldnews/article-1230747/Is-coma-man-Rom-Houben-REALLY-writing-Mystery-critics-slam-Ouija-board-typing.html If Rom Houben is conscious, then facilitated communication is not the only method for him to get his message across. Here's another way he could communicate: http://en.wikipedia.org/wiki/The_Diving_Bell_and_the_Butterflyvjtorley_{November 25, 2009
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Also this transcript: http://www.pbs.org/wgbh/pages/frontline/programs/transcripts/1202.htmlCollin_{November 24, 2009
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It sounds like a fraud I've seen before. See this wikipedia article, http://en.wikipedia.org/wiki/Facilitated_communication#History This quote is telling: "Around the same time, controlled studies were done on the method, most of which reported that it was the facilitator who was unconsciously producing the communication. By the late 1990s, FC had been discredited in the eyes of most scientists and professional organizations, with some calling it pseudoscientific[citation needed]. FC retained acceptance in some treatment centers in North America, Europe and Australia."Collin_{November 24, 2009
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I watched the video, and there's no way he's providing any input into what she's typing for him, unless the entire message was rehearsed beforehand in preparation to televise it. That's hard to believe as well though, considering the length of the paragraph that was briefly displayed. This story is truly saddening however, and I hope this gives every medical facility reason to take whatever measures necessary in detecting consciousness in someone held prisoner within a completely unresponsive body. Personally, I can barely even tolerate the occasional small period of time it takes to completely regain normal bodily functions from particular dreams where I am unable to move and have difficulty even breathing. I can only imagine being stuck in that state for 23 years, which really really makes me appreciate a normal life outside of those situations. I do worry about how they just let his head hang to the side like that, you'd think it would make for some terrible problems in the long-term if he ever fully recovers.PaulN_{November 24, 2009
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Rom Houben, trapped in his paralysed body after a car crash, described his real-life nightmare as he screamed to doctors that he could hear them - but could make no sound. 'I screamed, but there was nothing to hear,' said Mr Houben, now 46, who doctors thought was in a persistent vegatative state. 'I dreamed myself away,' he added, tapping his tale out with the aid of a computer.
My emphasis. I heard that Mr Houben was able to "type with help" and I was amazed and gladdened. I expected what this meant was that his helper would be slowly moving his hand over a keypad and letting him use what small movement he has to touch the keys he wants. But now I have seen video reports and am worried that Mr Houben's family and the families of others in prolonged comas and coma-like states are being given cruelly false hope. For example see the video of Mr Houben supposedly typing out his own personal and unforced words in reports from AP, the BBC and CBS. These all show his helper holding his hand and pecking at letters on the keypad. She is moving his hand quickly and strongly, tapping away at the screen as if his finger is just a stylus. In the CBS video, at about 1:15 in, the swift tap-tap-tap of typing carries on even though Mr Houben's eyes are closed! I suspect this is the helper doing the typing, not the man who has lain paralysed for 23 years and now has at best very slight control of his movement. I hope Mr Houben can communicate, but I worry that his helper is typing on his behalf, no doubt sincerely and honestly believing that she is doing the right thing.waterbear_{November 24, 2009
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I don't understand your question. How is this not a living nightmare? Talk about being a prisoner of existence.Berceuse_{November 24, 2009
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Berceuse: How do you 'know' this to be horrifying?Enezio E. De Almeida Filho_{November 24, 2009
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No man should endure this. This is horrifying.Berceuse_{November 23, 2009
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