9 ms·

This article is about a year old. Here is a later article about the patient's death a few months after treatment. https://www.theguardian.com/science/2017/oct

This article is about a year old. Here is a later article about the patient's death a few months after treatment. https://www.theguardian.com/science/2017/oct/05/scientists-concealed-death-of-patient-at-centre-of-vegetative-state-breakthrough https://www.theguardian.com/science/2017/oct/05/scientists-c...

browsercoin 8y ago
it was no linked to the protocol and they wanted to keep it under wraps for a good reason.
- nonbel 8y ago
  From that link: >"a concern that people might have wrongly linked the therapy, which involved nerve stimulation, to the 35-year-old’s death from a lung infection." The vagus nerve also innervates the lungs, and performing a surgery to stimulate it could impact the lungs or immune system in general... so there is definitely reason to suspect a link. I mean he was kept alive for 15 years apparently and then died relatively shortly after this procedure. Just because there is no way to verify anything doesn't mean you can conclude "no link". If the doctors/researchers did actually make this claim (as opposed to the journalist), I would suspect this story about restored consciousness is more likely total BS than not. EDIT: There is a quote later on coming directly from the doctor, so looks like this study is probably BS.
  - thomasfedb 8y ago
    I think you're wrong to link the implant to the lung infection on the basis that the vagus nerve "innervates the lungs" - which is a best an oversimplification. It's a very unlikely route for infection compared to standard hospital acquired or ventilator associated pneumonia. I'm a student doctor.
    - nonbel 8y ago
      I didn't "link" anything. I proposed a few possible links. And you don't think stimulating the vagus nerve could have some effect on the lung (eg secretions) which can result in infection? Here is a random article that gives plausibility to such a link: Vagus Nerve through α7 nAChR Modulates Lung Infection and Inflammation https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4127262/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4127262/ I am certain there are many, many research articles like that.
      - thomasfedb 8y ago
        You suggested that the doctors were wrong to dismiss a causal relationship - I'll call that "link" and you can call or whatever you like. Don't weasel. Could the implant have had an impact on the infection? Yes, sure. In medicine the answer to "is it possible… ?" is always "yes". But is it likely to be a significant factor, I'd say not.
        nonbel 8y ago
        >"You suggested that the doctors were wrong to dismiss a causal relationship - I'll call that "link" and you can call or whatever you like. Don't weasel." Where did I weasel? I said you can't disprove a link based on that information. They concluded no link... >'Could the implant have had an impact on the infection? Yes, sure."In medicine the answer to "is it possible… ?" is always "yes".' Yes, exactly my point. >"But is it likely to be a significant factor, I'd say not." This is a totally different thing than concluding "no link", as did the original doctors. But why not? They guy was kept alive for 15 years, they started doing this new procedure, and he was dead within a few months. Also, its reported elsewhere that vagus nerve activity, the mechanism by which this procedure is supposed to work, affects lung infection rates...
      - 14 8y ago
        I am going to have to agree with you and say that I too feel that it would be irresponsible for the study to conclude that there is "no" risk. I unsuccessfully tried to find out the side effects the clients experienced during this particular trial, but other patients who receive vagus nerve implants for conditions such as epilepsy or depression, they experienced many side effects such as coughing, breathing problems and difficulty swallowing. To me it seems that those three side effects alone could put a person in a coma at risk of aspiration and thus lung infection. https://www.mayoclinic.org/tests-procedures/vagus-nerve-stimulation/about/pac-20384565 https://www.mayoclinic.org/tests-procedures/vagus-nerve-stim...
forkerenok 8y ago
Not excusing ethicality of the cover-up, but I would trade a vegetative eternity even for a day of consciousness. As a bonus point, you get to help advance the science.
dean177 8y ago
It’s kind of dishonest to share that without also adding that the patient died of a lung infection.
- erikpukinskis 8y ago
  I don’t think it’s dishonest. Can you explain why you think it must be? And I will add I think the word “dishonest” gets used a bit too much on HN in particular. It imputes intent when such is very difficult to guess reliably.
  - browsercoin 8y ago
    OP intentionally left out the context to discount this study and the team intentionally did not disclose exactly because of deniers like OP that will use the lung infection as a crutch for their main argument: any effort on vegetative state rehabilitation is bad.
    - erikpukinskis 8y ago
      None of that was stated. I don't even see how it was implied. You're reading way too much into it.
dogma1138 8y ago
Seriously you’ve created an account just to post this? The patient died from an infection unrelated to the specifics of procedure.
pygy_ 8y ago
The implantation of a vagal nerve stimulator is not a dangerous procedure. It is less invasive than for a pacemaker for example. What most likely happened is that the patient recovered to the point where they were able to feed themselves, or at least to swallow food. They then inhaled some, which is a common occurrence in brain damaged patients, leading to the pneumonia and the subsequent death.
- subroutine 8y ago
  Jeannerod told the Guardian: “He is still paralysed...”
  - pygy_ 8y ago
    Paralized doesn’t mean locked in. He might have been hemiplegic or hemiparetic, which can cause pulmonary aspirations. The patient’s family wanted their death to remain confidential, for whatever reason. The authors lied, but it wasn’t for nefarious purposes.
    - ben_w 8y ago
      If it’s not nefarious, it would be better to say the author erred rather than lied, as the latter implies deliberate deceit.
      - pygy_ 8y ago
        Indeed. Even if the patient died, and even if only a subset of patients are eligible, this is still a major breakthrough. Waking up after years in a vegetative state is extremely rare. People with ischemic or traumatic brain injury severe enough to cause a coma, and who don’t die early, end up either in permanent vegetative state, or recover somehow. People who recover must often deal with physical, cognitive and behavioral impairments that make them prone to complications such as infection, even when they wake up spontaneously.

browsercoin 8y ago

it was no linked to the protocol and they wanted to keep it under wraps for a good reason.

nonbel 8y ago
From that link: >"a concern that people might have wrongly linked the therapy, which involved nerve stimulation, to the 35-year-old’s death from a lung infection." The vagus nerve also innervates the lungs, and performing a surgery to stimulate it could impact the lungs or immune system in general... so there is definitely reason to suspect a link. I mean he was kept alive for 15 years apparently and then died relatively shortly after this procedure. Just because there is no way to verify anything doesn't mean you can conclude "no link". If the doctors/researchers did actually make this claim (as opposed to the journalist), I would suspect this story about restored consciousness is more likely total BS than not. EDIT: There is a quote later on coming directly from the doctor, so looks like this study is probably BS.
- thomasfedb 8y ago
  I think you're wrong to link the implant to the lung infection on the basis that the vagus nerve "innervates the lungs" - which is a best an oversimplification. It's a very unlikely route for infection compared to standard hospital acquired or ventilator associated pneumonia. I'm a student doctor.
  - nonbel 8y ago
    I didn't "link" anything. I proposed a few possible links. And you don't think stimulating the vagus nerve could have some effect on the lung (eg secretions) which can result in infection? Here is a random article that gives plausibility to such a link: Vagus Nerve through α7 nAChR Modulates Lung Infection and Inflammation https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4127262/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4127262/ I am certain there are many, many research articles like that.
    - thomasfedb 8y ago
      You suggested that the doctors were wrong to dismiss a causal relationship - I'll call that "link" and you can call or whatever you like. Don't weasel. Could the implant have had an impact on the infection? Yes, sure. In medicine the answer to "is it possible… ?" is always "yes". But is it likely to be a significant factor, I'd say not.
      - nonbel 8y ago
        >"You suggested that the doctors were wrong to dismiss a causal relationship - I'll call that "link" and you can call or whatever you like. Don't weasel." Where did I weasel? I said you can't disprove a link based on that information. They concluded no link... >'Could the implant have had an impact on the infection? Yes, sure."In medicine the answer to "is it possible… ?" is always "yes".' Yes, exactly my point. >"But is it likely to be a significant factor, I'd say not." This is a totally different thing than concluding "no link", as did the original doctors. But why not? They guy was kept alive for 15 years, they started doing this new procedure, and he was dead within a few months. Also, its reported elsewhere that vagus nerve activity, the mechanism by which this procedure is supposed to work, affects lung infection rates...
    - 14 8y ago
      I am going to have to agree with you and say that I too feel that it would be irresponsible for the study to conclude that there is "no" risk. I unsuccessfully tried to find out the side effects the clients experienced during this particular trial, but other patients who receive vagus nerve implants for conditions such as epilepsy or depression, they experienced many side effects such as coughing, breathing problems and difficulty swallowing. To me it seems that those three side effects alone could put a person in a coma at risk of aspiration and thus lung infection. https://www.mayoclinic.org/tests-procedures/vagus-nerve-stimulation/about/pac-20384565 https://www.mayoclinic.org/tests-procedures/vagus-nerve-stim...

forkerenok 8y ago

Not excusing ethicality of the cover-up, but I would trade a vegetative eternity even for a day of consciousness. As a bonus point, you get to help advance the science.

dean177 8y ago

It’s kind of dishonest to share that without also adding that the patient died of a lung infection.

erikpukinskis 8y ago
I don’t think it’s dishonest. Can you explain why you think it must be? And I will add I think the word “dishonest” gets used a bit too much on HN in particular. It imputes intent when such is very difficult to guess reliably.
- browsercoin 8y ago
  OP intentionally left out the context to discount this study and the team intentionally did not disclose exactly because of deniers like OP that will use the lung infection as a crutch for their main argument: any effort on vegetative state rehabilitation is bad.
  - erikpukinskis 8y ago
    None of that was stated. I don't even see how it was implied. You're reading way too much into it.

dogma1138 8y ago

Seriously you’ve created an account just to post this? The patient died from an infection unrelated to the specifics of procedure.

pygy_ 8y ago

The implantation of a vagal nerve stimulator is not a dangerous procedure. It is less invasive than for a pacemaker for example. What most likely happened is that the patient recovered to the point where they were able to feed themselves, or at least to swallow food. They then inhaled some, which is a common occurrence in brain damaged patients, leading to the pneumonia and the subsequent death.

subroutine 8y ago
Jeannerod told the Guardian: “He is still paralysed...”
- pygy_ 8y ago
  Paralized doesn’t mean locked in. He might have been hemiplegic or hemiparetic, which can cause pulmonary aspirations. The patient’s family wanted their death to remain confidential, for whatever reason. The authors lied, but it wasn’t for nefarious purposes.
  - ben_w 8y ago
    If it’s not nefarious, it would be better to say the author erred rather than lied, as the latter implies deliberate deceit.
    - pygy_ 8y ago
      Indeed. Even if the patient died, and even if only a subset of patients are eligible, this is still a major breakthrough. Waking up after years in a vegetative state is extremely rare. People with ischemic or traumatic brain injury severe enough to cause a coma, and who don’t die early, end up either in permanent vegetative state, or recover somehow. People who recover must often deal with physical, cognitive and behavioral impairments that make them prone to complications such as infection, even when they wake up spontaneously.