11 ms·

Thousands of coma patients may be conscious

285 points by LouisLazaris 5y ago

awb 5y ago
Conscious coma patients is the premise of the movie Awakenings from 1990: https://youtu.be/7exeVt7CaE4 https://youtu.be/7exeVt7CaE4 I thought it was established back then that this was a real phenomenon.
cpuguy83 5y ago
I suspect in addition to DNR's there will end up being a DNL (do not link).
- Ancapistani 5y ago
  Not sure why this is being downvoted, as it’s a valid observation and probably prescient. Consider that in most every dystopian sci-fi, there is always a faction somewhere - explicit or illicit - that refuses connection to the “net”. We have that even today with the Internet.
- Havoc 5y ago
  Then again once-off linking to determine the patient's true wishes may be helpful
rmm 5y ago
Worst fear.
- deleted 5y ago
  [deleted]
RoboTeddy 5y ago
I wonder whether this could be a good early human application for Neurallink — with sufficient direct brain I/O we could interact with these patients in a metaverse setting!
- hericium 5y ago
  I'd stay away from a corporation attempting to mess with my brain. Especially Elon Musk's corporation. The guy shows tyrant tendencies, made people pay monthly for unfinished software in upfront-paid "self driving" cars, exploits and endangers his employees for profit and is a COVID-downplaying dick using his influencing potential to endanger even more people. I consider Elon Musk too unstable and unethical sociopath to trust that Neuralink would be used to better mankind, not just Elon Musk. The dude wants power.
  - api 5y ago
    I will say no to any kind of direct neural interface run by anyone with any kind of connection to “the cloud.” I must have absolute control over it or absolutely not. The only exception would be something used by a proper doctor to treat an actual medical condition. A neural link could be thousands of times worse in terms of privacy invasion, addiction, and “rabbit hole effect” brainwashing than anything we have now. Phones and home assistants are invasive but they are not merging with our biology. One can put them down or disconnect them. History has shown that overt malice or ill intent is not required for things to go evil either. All you need is perverse economic incentives and/or feedback loops leading to destructive emergent behaviors. So no, absolutely not.
    - hericium 5y ago
      > The only exception would be something used by a proper doctor to treat an actual medical condition. And in an off-line setting. But sadly, we're going a different route, into consumer-hostile XaaS model. With medical equipment, too.
    - londons_explore 5y ago
      But if the choice is that or be a vegetable for a few weeks before my family decide to pull the plug on me, I'll take musk/zuckerbergs brain implant, as I suspect many people would.
  - supperburg 5y ago
    He did a ton of good things too. I would say the good outweighs the bad, especially since FSD has started to pan out in the past few months.
RcouF1uZ4gsC 5y ago
Consider me skeptical. See the dead salmon fMR study for dangers of relying on it too much. https://blogs.scientificamerican.com/scicurious-brain/ignobel-prize-in-neuroscience-the-dead-salmon-study/ https://blogs.scientificamerican.com/scicurious-brain/ignobe...
- mahkeiro 5y ago
  Did you read your link? I quote: "Some people like to use the salmon study as proof that fMRI is woo, but this isn't the case, it's actually a study to show the importance of correcting your stats."
  - tyingq 5y ago
    Stories I can find about using fMRI to test for consciousness all have the same theme that it's promising, but that there are false positives and no definitive test that tells you for sure.
- deleted 5y ago
  [deleted]
- omnicognate 5y ago
  Interesting article, but as it says: > Some people like to use the salmon study as proof that fMRI is woo, but this isn't the case, it's actually a study to show the importance of correcting your stats. And > The original poster almost didn't make it to a conference, but when it did, it made a major splash, and reactions were very positive. And > The authors note that at the time the poster was presented, between 25-40% of studies on fMRI being published were NOT using the corrected comparisons. But by the time this group won the Ignobel last week, that number had dropped to 10%. And who knows, it might, in part, be due to a dead fish. Sounds like the salmon study is evidence of a field with a healthy attitude and improving statistical techniques rather than one that should be seen as discredited.
- csdvrx 5y ago
  I'm also skeptical of the salmon study, and I would love to see replication results, because another alternative explanation is that, even after clinical death, the brain tissue may still weakly react to stimulis: the "fresh" fish would have been kept in ice due to chain-of-cold requirements (and humans can survive for 30 minute in hypoxia, and recover: https://abcnews.go.com/Health/hypothermia-save-boy-trapped-ice-30-minutes-heartbeat/story?id=9506900 https://abcnews.go.com/Health/hypothermia-save-boy-trapped-i..., turtles up to 6 month https://www.openaccessgovernment.org/survive-without-oxygen/69678/ https://www.openaccessgovernment.org/survive-without-oxygen/...) and other tissues have shown similar feats (heart tissue in the same article) Actually, it'd be sad, because for all we know, dead people could have this limited consciousness without being able to communicate, just like the coma patients! See also the "experiments" proving severed head remain conscious for 30 seconds (https://www.thesun.co.uk/news/6044102/beheading-experiments-guillotine-severed-heads-remain-alive/ https://www.thesun.co.uk/news/6044102/beheading-experiments-... and https://unrealfacts.com/a-condemned-man-tried-to-keep-blinking-after-his-head-was-cut-off/ https://unrealfacts.com/a-condemned-man-tried-to-keep-blinki... )
lr4444lr 5y ago
It's not clear to me that the doctor established as good a baseline with Carol as the other patient, but at any rate, seems easy enough to seek out a binary response signal provable on known facts for each patient to determine their responsiveness, and then develop a battery of yes/no questions that test all of their non-motor conscious thought processes.
- gus_massa 5y ago
  I'm also skeptical. FTA: > By changing his pattern of brain activity in the scanner to indicate a ‘yes’ or a ‘no’, Scott was able to tell us that he knew where he was, how long he’d been there, what he enjoyed watching on TV, and whether or not he was in any pain (he wasn’t). These questions are very open ended and it's difficult to guess how they were made. Is there a link to the paper? Did the person asking the questions know the correct answer? Did the person asking managing the fMRI know the correct answer? Did the person looking at the patterns know the correct answer?
pjerem 5y ago
That’s terrifying. When my grandmother had a stroke, she was unable to speak for multiple days. She was able to hear and understand me and she was able to answer my questions by squeezing her right hand once or twice. It was an horrible situation. When it happens, you understand that someone you loves can understand everything you say but can’t inform you of anything they wish. I could not imagine the horror if you can’t even answer with yes or no and being surrounded by people who don’t know that you are here. Btw, that’s some important discovery that we can communicate via MRI. It must have been a relief for those patients to be able to communicate.
- laurent92 5y ago
  For anyone here caring for relatives with brain injury, PLEASE don’t underestimate or don’t forget to try the visual keyboard solution: Just draw letters on a big board and let the patient point at them. When it’s a possible solution, it is surprisingly efficient as you can guess orally and he “thumbs up” so he doesn’t have to spell everything out, and after a few tries you can tell stories. You can add bonus pictograms for ideas that repeat. Thoughts to a fiend I cared for, a few days per week during his last months. After one night playing guitar, he never woke up, and I realized he went to sleep while we were singing him his own songs. What an enemy he was during life, he would have killed me if he knew my political opinions, but once he became weak and harmless and alone, no-one deserves to go alone. If only such people didn’t fight so much against the white christian male ceo archetype during their life… I hate life.
  - deleted 5y ago
    [deleted]
  - Strom 5y ago
    Your point about the visual keyboard is important. As long as they have a repeatable 1 bit worth of output, you can extract any number of bytes. You can have a keyboard where they can see it, move your finger from one letter to the next, and then when they do their 1 bit of output (e.g. blink) that locks in the letter. For the film lovers out there, there's a great dramatization of this in the 2007 French movie The Diving Bell and the Butterfly. [1] -- [1] https://www.imdb.com/title/tt0401383/ https://www.imdb.com/title/tt0401383/
kazinator 5y ago
> It's usually assumed that a person in a vegetative state has no awareness of the world around them. Not in any movie dramatizing the topic or the popular imagination.
appleflaxen 5y ago
What this kind of science desperately needs is double blind confirmatory evidence. I suspect that the experiment is vulnerable to bias by an un-blinded scientist conducting the experiment. Almost all of these "veiled consciousness" and "assistive communication" reports are.
adolph 5y ago
As people grow awareness of possible consciousness behind a “vegetative state” I wonder what lengths people will go to avoid the situation. It reminds me of live burial fears. In the 19th century, master story teller Edgar Allen Poe exploited human fears in his stories, and the fear of being buried alive was no exception. In “Premature Burial," a short story first published in 1844, the narrator describes his struggle with things such as "attacks of the singular disorder which physicians have agreed to term catalepsy," an actual medical condition characterized by a death-like trance and rigidity to the body. The story focuses on the narrator’s fear of being buried alive and the corrective actions he takes to prevent it. He makes friends promise that they will not bury him prematurely, does not stray from his home, and builds a tomb with equipment allowing him to signal for help in case he should be buried alive only to wake from one of his episodes. https://www.smithsonianmag.com/sponsored/people-feared-being-buried-alive-so-much-they-invented-these-special-safety-coffins-180970627/ https://www.smithsonianmag.com/sponsored/people-feared-being...
AlbertCory 5y ago
This is not exactly neural imaging, but hey, it was written in 1844. The Count of Monte Cristo features an old man who can only communicate via eye blinks. At one point, he "spells" out words letter by letter by blinking a "Yes." So, as lr4444lr implies, you could easily have someone "spell" out their birthplace. How does statistical reasoning enter into that?
- Supermancho 5y ago
  The modern day has the movie and memoire of a Frenchman with locked-in syndrome. https://en.wikipedia.org/wiki/The_Diving_Bell_and_the_Butterfly https://en.wikipedia.org/wiki/The_Diving_Bell_and_the_Butter...
  - AlbertCory 5y ago
    When I (finally) finished the book, I resolved to watch all the adaptations. Got as far as the first one.
    - Supermancho 5y ago
      I was able to consume the relatively short book in a day. I went to watch the movie and didn't quite make it through.
      - AlbertCory 5y ago
        I think this must be like Les Miserables where there are abridged versions. I read the unabridged, not that I'd necessarily recommend that. Although I did find myself wondering how he was going to get even with Danglars.
Ericson2314 5y ago
I wonder how this will effect the legalization physician-assisted suicide.
- thinkingemote 5y ago
  I pray that our politicians will listen to people and doctors and realise that euthanasia is fundamentally wrong from multiple angles.
  - rad_gruchalski 5y ago
    What if my will is exactly that: please end my life if I’m ever in this state and it’s not obvious I’m ever going to come back?
- nickff 5y ago
  I would hope it would boost coma recovery research.
serf 5y ago
I absolutely believe the premise of the article. I suffered an incomplete (cervical) spinal cord injury years ago. Through my 'medical journey' and many many months in the ICU before rehab I was placed on a variety of amnesiacs, as well as induced comas. I remember a lot of things that I really shouldn't -- and I can corroborate the events with eyewitnesses who were otherwise healthy spectators. I was terrified, unable to communicate, uncomfortable, and most of the time in pain. When I was finally brought back to 'real' consciousness I had tubes in every orifice, a new tracheotomy, a new HALO drilled into my skull, the inability to speak and the inability to move my arms -- through no ones direct fault my only means of communication , my voice , was taken from me while I was pharmaceutically inebriated and unable to consent -- an emergency action that was medically required. I eventually regained enough upper limb movement to communicate with a small whiteboard and soft erase markers while in the medical facilities. When the trach was finally removed I regained most of my voice within months of therapy, but the memories and experience still haunt me. I sincerely hope that we learn enough about human consciousness at some point to allow us to better manage patient awareness and memory forming through trauma -- I think that the medical industry as a whole kind of pushes 'medical PTSD' out of the public arena of consideration as something that is 'required, known, but terrible.' -- but I hope we one day come up with real methods of reducing or preventing that kind of experience all together. It feels that at this point we're much more adroit at healing bodies than psyches.
- pcurve 5y ago
  Jesus, that is truly horrific. I'm sorry you had to go through that not seeing light at the end of the tunnel. I hope they had enough sense to still give you proper anesthesia before plugging things into your body.
- nate_meurer 5y ago
  How are you doing now?
- ainiriand 5y ago
  What you describe was pretty much my experience when, at 14 years of age, I had to endure brain surgery and spent the next 4 days in an induced coma. I remember everything and I thought I was never going to wake up. It was terrifying and I think I was a bit traumatised by the whole experience.
happy-go-lucky 5y ago
My mother nearly died and then bounced back. https://news.ycombinator.com/item?id=29748259 https://news.ycombinator.com/item?id=29748259 While my mother was still aphasic, I was exploring ways to communicate with her and then it occurred to me that she was literate and numerate. At the time, I began writing questions with possible answer choices on a scratch paper and had her read them and select the answer she wanted by tapping her fingers on it. This is how I got to know how she was feeling, what she wanted for a breakfast etc. By the way, she is a technophobe.
- deleted 5y ago
  [deleted]
everybodyknows 5y ago
> no one knows exactly how many vegetative-state patients there are in the world (in the United States, it has been estimated that there are between 15,000 and 40,000) Last I read, Medicare would pay for this -- perhaps at the request of relatives in denial? And so there's a "ventilator farm" industry, one that maintains a very low public profile. Anyone with current inside knowledge here to clue in the rest of us?
- arthem 5y ago
  > And so there's a "ventilator farm" industry, one that maintains a very low public profile. This sounds like an interesting rabbit hole to go down. Unfortuantely I could not find any websites/articles on this topic. Do you have any links?
  - robbiep 5y ago
    Louis Theroux has a documentary on it - Edge of Life I believe it is called (although Google says that’s about cedars Sinai so possibly not, but there is an episode he does that predominantly features room after room of ventilated patients)
tompower 5y ago
smartidiot 5y ago
elif 5y ago
i hope there is an opportunity for neuralink to establish some form of communication
aaron695 5y ago
bitL 5y ago
When my grandma had a stroke, she wasn't able to do anything at all, no reactions to outside stimuli though brain was showing up alive in scans. As the family gathered around her, weeping and trying to say goodbye, I had an idea to give her a rosary to her hand so that she feels something familiar. To everyone's surprise, her hand started moving over beads in regular intervals as required by the prayer, and my wide family understood she's conscious but simply can't respond to anyone, which brought a bit of a relief and hope to this situation. She managed to be with us for another two months before her state deteriorated further. With the knowledge I have now I could have probably helped her to recover further, but at that time I could only do that for her.
md_ 5y ago
Martin Monti is somewhat well-known for exploring similar cases: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5741595/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5741595/. While it seems highly likely that at least some “minimally conscious” patients do, in fact, have much greater interior consciousness than we might have thought, I also think that these stories tend to underemphasize the potentially fragmentary nature of consciousness. A patient who is able to respond to commands to “visualize playing tennis” may be fully and completely conscious, with only a motor defect—or they might be much less conscious than that, but nonetheless able to process spoken commands and trigger relevant neural activity in response. From the few cases I’ve read, it seems like the bandwidth (so to speak) of the “imagine this if yes, that if no” method of communicating via fMRI is far too limited to draw conclusions about exactly what the interior experience of the patient is. Not to say this research isn’t interesting. It’s fascinating. But I do sometimes think it makes the same sort of mistakes Benjamin Libet famously did, in making assumptions about the indivisibility of consciousness.
jl2718 5y ago
General anesthesia contains three main components: 1. Atracurium blocks movement 2. Propofol blocks memory 3. Fentanyl blocks pain. ...on most patients [edit to remove PMI]
- AnthonBerg 5y ago
  I’m so, so sorry that you had to endure the time when you learned this.
stevenalowe 5y ago
“… test for consciousness using technologies like fMRI” Agreed, should be mandatory!

285 points by LouisLazaris 5y ago

awb 5y ago

Conscious coma patients is the premise of the movie Awakenings from 1990: https://youtu.be/7exeVt7CaE4 https://youtu.be/7exeVt7CaE4 I thought it was established back then that this was a real phenomenon.

cpuguy83 5y ago

I suspect in addition to DNR's there will end up being a DNL (do not link).

Ancapistani 5y ago
Not sure why this is being downvoted, as it’s a valid observation and probably prescient. Consider that in most every dystopian sci-fi, there is always a faction somewhere - explicit or illicit - that refuses connection to the “net”. We have that even today with the Internet.
Havoc 5y ago
Then again once-off linking to determine the patient's true wishes may be helpful

rmm 5y ago

Worst fear.

deleted 5y ago
[deleted]

RoboTeddy 5y ago

I wonder whether this could be a good early human application for Neurallink — with sufficient direct brain I/O we could interact with these patients in a metaverse setting!

hericium 5y ago
I'd stay away from a corporation attempting to mess with my brain. Especially Elon Musk's corporation. The guy shows tyrant tendencies, made people pay monthly for unfinished software in upfront-paid "self driving" cars, exploits and endangers his employees for profit and is a COVID-downplaying dick using his influencing potential to endanger even more people. I consider Elon Musk too unstable and unethical sociopath to trust that Neuralink would be used to better mankind, not just Elon Musk. The dude wants power.
- api 5y ago
  I will say no to any kind of direct neural interface run by anyone with any kind of connection to “the cloud.” I must have absolute control over it or absolutely not. The only exception would be something used by a proper doctor to treat an actual medical condition. A neural link could be thousands of times worse in terms of privacy invasion, addiction, and “rabbit hole effect” brainwashing than anything we have now. Phones and home assistants are invasive but they are not merging with our biology. One can put them down or disconnect them. History has shown that overt malice or ill intent is not required for things to go evil either. All you need is perverse economic incentives and/or feedback loops leading to destructive emergent behaviors. So no, absolutely not.
  - hericium 5y ago
    > The only exception would be something used by a proper doctor to treat an actual medical condition. And in an off-line setting. But sadly, we're going a different route, into consumer-hostile XaaS model. With medical equipment, too.
  - londons_explore 5y ago
    But if the choice is that or be a vegetable for a few weeks before my family decide to pull the plug on me, I'll take musk/zuckerbergs brain implant, as I suspect many people would.
- supperburg 5y ago
  He did a ton of good things too. I would say the good outweighs the bad, especially since FSD has started to pan out in the past few months.

RcouF1uZ4gsC 5y ago

Consider me skeptical. See the dead salmon fMR study for dangers of relying on it too much. https://blogs.scientificamerican.com/scicurious-brain/ignobel-prize-in-neuroscience-the-dead-salmon-study/ https://blogs.scientificamerican.com/scicurious-brain/ignobe...

mahkeiro 5y ago
Did you read your link? I quote: "Some people like to use the salmon study as proof that fMRI is woo, but this isn't the case, it's actually a study to show the importance of correcting your stats."
- tyingq 5y ago
  Stories I can find about using fMRI to test for consciousness all have the same theme that it's promising, but that there are false positives and no definitive test that tells you for sure.
deleted 5y ago
[deleted]
omnicognate 5y ago
Interesting article, but as it says: > Some people like to use the salmon study as proof that fMRI is woo, but this isn't the case, it's actually a study to show the importance of correcting your stats. And > The original poster almost didn't make it to a conference, but when it did, it made a major splash, and reactions were very positive. And > The authors note that at the time the poster was presented, between 25-40% of studies on fMRI being published were NOT using the corrected comparisons. But by the time this group won the Ignobel last week, that number had dropped to 10%. And who knows, it might, in part, be due to a dead fish. Sounds like the salmon study is evidence of a field with a healthy attitude and improving statistical techniques rather than one that should be seen as discredited.
csdvrx 5y ago
I'm also skeptical of the salmon study, and I would love to see replication results, because another alternative explanation is that, even after clinical death, the brain tissue may still weakly react to stimulis: the "fresh" fish would have been kept in ice due to chain-of-cold requirements (and humans can survive for 30 minute in hypoxia, and recover: https://abcnews.go.com/Health/hypothermia-save-boy-trapped-ice-30-minutes-heartbeat/story?id=9506900 https://abcnews.go.com/Health/hypothermia-save-boy-trapped-i..., turtles up to 6 month https://www.openaccessgovernment.org/survive-without-oxygen/69678/ https://www.openaccessgovernment.org/survive-without-oxygen/...) and other tissues have shown similar feats (heart tissue in the same article) Actually, it'd be sad, because for all we know, dead people could have this limited consciousness without being able to communicate, just like the coma patients! See also the "experiments" proving severed head remain conscious for 30 seconds (https://www.thesun.co.uk/news/6044102/beheading-experiments-guillotine-severed-heads-remain-alive/ https://www.thesun.co.uk/news/6044102/beheading-experiments-... and https://unrealfacts.com/a-condemned-man-tried-to-keep-blinking-after-his-head-was-cut-off/ https://unrealfacts.com/a-condemned-man-tried-to-keep-blinki... )

lr4444lr 5y ago

It's not clear to me that the doctor established as good a baseline with Carol as the other patient, but at any rate, seems easy enough to seek out a binary response signal provable on known facts for each patient to determine their responsiveness, and then develop a battery of yes/no questions that test all of their non-motor conscious thought processes.

gus_massa 5y ago
I'm also skeptical. FTA: > By changing his pattern of brain activity in the scanner to indicate a ‘yes’ or a ‘no’, Scott was able to tell us that he knew where he was, how long he’d been there, what he enjoyed watching on TV, and whether or not he was in any pain (he wasn’t). These questions are very open ended and it's difficult to guess how they were made. Is there a link to the paper? Did the person asking the questions know the correct answer? Did the person asking managing the fMRI know the correct answer? Did the person looking at the patterns know the correct answer?

pjerem 5y ago

That’s terrifying. When my grandmother had a stroke, she was unable to speak for multiple days. She was able to hear and understand me and she was able to answer my questions by squeezing her right hand once or twice. It was an horrible situation. When it happens, you understand that someone you loves can understand everything you say but can’t inform you of anything they wish. I could not imagine the horror if you can’t even answer with yes or no and being surrounded by people who don’t know that you are here. Btw, that’s some important discovery that we can communicate via MRI. It must have been a relief for those patients to be able to communicate.

laurent92 5y ago
For anyone here caring for relatives with brain injury, PLEASE don’t underestimate or don’t forget to try the visual keyboard solution: Just draw letters on a big board and let the patient point at them. When it’s a possible solution, it is surprisingly efficient as you can guess orally and he “thumbs up” so he doesn’t have to spell everything out, and after a few tries you can tell stories. You can add bonus pictograms for ideas that repeat. Thoughts to a fiend I cared for, a few days per week during his last months. After one night playing guitar, he never woke up, and I realized he went to sleep while we were singing him his own songs. What an enemy he was during life, he would have killed me if he knew my political opinions, but once he became weak and harmless and alone, no-one deserves to go alone. If only such people didn’t fight so much against the white christian male ceo archetype during their life… I hate life.
- deleted 5y ago
  [deleted]
- Strom 5y ago
  Your point about the visual keyboard is important. As long as they have a repeatable 1 bit worth of output, you can extract any number of bytes. You can have a keyboard where they can see it, move your finger from one letter to the next, and then when they do their 1 bit of output (e.g. blink) that locks in the letter. For the film lovers out there, there's a great dramatization of this in the 2007 French movie The Diving Bell and the Butterfly. [1] -- [1] https://www.imdb.com/title/tt0401383/ https://www.imdb.com/title/tt0401383/

kazinator 5y ago

> It's usually assumed that a person in a vegetative state has no awareness of the world around them. Not in any movie dramatizing the topic or the popular imagination.

appleflaxen 5y ago

What this kind of science desperately needs is double blind confirmatory evidence. I suspect that the experiment is vulnerable to bias by an un-blinded scientist conducting the experiment. Almost all of these "veiled consciousness" and "assistive communication" reports are.

adolph 5y ago

As people grow awareness of possible consciousness behind a “vegetative state” I wonder what lengths people will go to avoid the situation. It reminds me of live burial fears. In the 19th century, master story teller Edgar Allen Poe exploited human fears in his stories, and the fear of being buried alive was no exception. In “Premature Burial," a short story first published in 1844, the narrator describes his struggle with things such as "attacks of the singular disorder which physicians have agreed to term catalepsy," an actual medical condition characterized by a death-like trance and rigidity to the body. The story focuses on the narrator’s fear of being buried alive and the corrective actions he takes to prevent it. He makes friends promise that they will not bury him prematurely, does not stray from his home, and builds a tomb with equipment allowing him to signal for help in case he should be buried alive only to wake from one of his episodes. https://www.smithsonianmag.com/sponsored/people-feared-being-buried-alive-so-much-they-invented-these-special-safety-coffins-180970627/ https://www.smithsonianmag.com/sponsored/people-feared-being...

AlbertCory 5y ago

This is not exactly neural imaging, but hey, it was written in 1844. The Count of Monte Cristo features an old man who can only communicate via eye blinks. At one point, he "spells" out words letter by letter by blinking a "Yes." So, as lr4444lr implies, you could easily have someone "spell" out their birthplace. How does statistical reasoning enter into that?

Supermancho 5y ago
The modern day has the movie and memoire of a Frenchman with locked-in syndrome. https://en.wikipedia.org/wiki/The_Diving_Bell_and_the_Butterfly https://en.wikipedia.org/wiki/The_Diving_Bell_and_the_Butter...
- AlbertCory 5y ago
  When I (finally) finished the book, I resolved to watch all the adaptations. Got as far as the first one.
  - Supermancho 5y ago
    I was able to consume the relatively short book in a day. I went to watch the movie and didn't quite make it through.
    - AlbertCory 5y ago
      I think this must be like Les Miserables where there are abridged versions. I read the unabridged, not that I'd necessarily recommend that. Although I did find myself wondering how he was going to get even with Danglars.

Ericson2314 5y ago

I wonder how this will effect the legalization physician-assisted suicide.

thinkingemote 5y ago
I pray that our politicians will listen to people and doctors and realise that euthanasia is fundamentally wrong from multiple angles.
- rad_gruchalski 5y ago
  What if my will is exactly that: please end my life if I’m ever in this state and it’s not obvious I’m ever going to come back?
nickff 5y ago
I would hope it would boost coma recovery research.

serf 5y ago

I absolutely believe the premise of the article. I suffered an incomplete (cervical) spinal cord injury years ago. Through my 'medical journey' and many many months in the ICU before rehab I was placed on a variety of amnesiacs, as well as induced comas. I remember a lot of things that I really shouldn't -- and I can corroborate the events with eyewitnesses who were otherwise healthy spectators. I was terrified, unable to communicate, uncomfortable, and most of the time in pain. When I was finally brought back to 'real' consciousness I had tubes in every orifice, a new tracheotomy, a new HALO drilled into my skull, the inability to speak and the inability to move my arms -- through no ones direct fault my only means of communication , my voice , was taken from me while I was pharmaceutically inebriated and unable to consent -- an emergency action that was medically required. I eventually regained enough upper limb movement to communicate with a small whiteboard and soft erase markers while in the medical facilities. When the trach was finally removed I regained most of my voice within months of therapy, but the memories and experience still haunt me. I sincerely hope that we learn enough about human consciousness at some point to allow us to better manage patient awareness and memory forming through trauma -- I think that the medical industry as a whole kind of pushes 'medical PTSD' out of the public arena of consideration as something that is 'required, known, but terrible.' -- but I hope we one day come up with real methods of reducing or preventing that kind of experience all together. It feels that at this point we're much more adroit at healing bodies than psyches.

pcurve 5y ago
Jesus, that is truly horrific. I'm sorry you had to go through that not seeing light at the end of the tunnel. I hope they had enough sense to still give you proper anesthesia before plugging things into your body.
nate_meurer 5y ago
How are you doing now?
ainiriand 5y ago
What you describe was pretty much my experience when, at 14 years of age, I had to endure brain surgery and spent the next 4 days in an induced coma. I remember everything and I thought I was never going to wake up. It was terrifying and I think I was a bit traumatised by the whole experience.

happy-go-lucky 5y ago

My mother nearly died and then bounced back. https://news.ycombinator.com/item?id=29748259 https://news.ycombinator.com/item?id=29748259 While my mother was still aphasic, I was exploring ways to communicate with her and then it occurred to me that she was literate and numerate. At the time, I began writing questions with possible answer choices on a scratch paper and had her read them and select the answer she wanted by tapping her fingers on it. This is how I got to know how she was feeling, what she wanted for a breakfast etc. By the way, she is a technophobe.

deleted 5y ago
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everybodyknows 5y ago

> no one knows exactly how many vegetative-state patients there are in the world (in the United States, it has been estimated that there are between 15,000 and 40,000) Last I read, Medicare would pay for this -- perhaps at the request of relatives in denial? And so there's a "ventilator farm" industry, one that maintains a very low public profile. Anyone with current inside knowledge here to clue in the rest of us?

arthem 5y ago
> And so there's a "ventilator farm" industry, one that maintains a very low public profile. This sounds like an interesting rabbit hole to go down. Unfortuantely I could not find any websites/articles on this topic. Do you have any links?
- robbiep 5y ago
  Louis Theroux has a documentary on it - Edge of Life I believe it is called (although Google says that’s about cedars Sinai so possibly not, but there is an episode he does that predominantly features room after room of ventilated patients)

tompower 5y ago

smartidiot 5y ago

elif 5y ago

i hope there is an opportunity for neuralink to establish some form of communication

aaron695 5y ago

bitL 5y ago

When my grandma had a stroke, she wasn't able to do anything at all, no reactions to outside stimuli though brain was showing up alive in scans. As the family gathered around her, weeping and trying to say goodbye, I had an idea to give her a rosary to her hand so that she feels something familiar. To everyone's surprise, her hand started moving over beads in regular intervals as required by the prayer, and my wide family understood she's conscious but simply can't respond to anyone, which brought a bit of a relief and hope to this situation. She managed to be with us for another two months before her state deteriorated further. With the knowledge I have now I could have probably helped her to recover further, but at that time I could only do that for her.

md_ 5y ago

Martin Monti is somewhat well-known for exploring similar cases: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5741595/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5741595/. While it seems highly likely that at least some “minimally conscious” patients do, in fact, have much greater interior consciousness than we might have thought, I also think that these stories tend to underemphasize the potentially fragmentary nature of consciousness. A patient who is able to respond to commands to “visualize playing tennis” may be fully and completely conscious, with only a motor defect—or they might be much less conscious than that, but nonetheless able to process spoken commands and trigger relevant neural activity in response. From the few cases I’ve read, it seems like the bandwidth (so to speak) of the “imagine this if yes, that if no” method of communicating via fMRI is far too limited to draw conclusions about exactly what the interior experience of the patient is. Not to say this research isn’t interesting. It’s fascinating. But I do sometimes think it makes the same sort of mistakes Benjamin Libet famously did, in making assumptions about the indivisibility of consciousness.

jl2718 5y ago

General anesthesia contains three main components: 1. Atracurium blocks movement 2. Propofol blocks memory 3. Fentanyl blocks pain. ...on most patients [edit to remove PMI]

AnthonBerg 5y ago
I’m so, so sorry that you had to endure the time when you learned this.

stevenalowe 5y ago

“… test for consciousness using technologies like fMRI” Agreed, should be mandatory!