The Washington Post today reports on an unprecedented experiment to detect awareness in patients previously classified as vegetative:
According to all the tests, the young woman was deep in a “vegetative state” — completely unresponsive and unaware of her surroundings. But then a team of scientists decided to do an unprecedented experiment, employing sophisticated technology to try to peer behind the veil of her brain injury for any signs of conscious awareness.
Doctors were shocked by what they found:
Without any hint that she might have a sense of what was happening, the researchers put the woman in a scanner that detects brain activity and told her that in a few minutes they would say the word “tennis,” signaling her to imagine she was serving, volleying and chasing down balls. When they did, the neurologists were shocked to see her brain “light up” exactly as an uninjured person’s would. It happened again and again. And the doctors got the same result when they repeatedly cued her to picture herself wandering, room to room, through her own home.
Doctors were also stunned:
“I was absolutely stunned,” said Adrian M. Owen, a British neurologist who led the team reporting the case in today’s issue of the journal Science. “We had no idea whether she would understand our instructions. But this showed that she is aware.”
and they were shocked again:
“This is a very important study,” said Nicholas D. Schiff, a neurologist at the Weill Cornell Medical College in New York. “It’s the first time we’ve ever seen something like this. It really is kind of shocking.”
The article cautions that people should not take these findings and leap to the conclusion that they are applicable to the Terri Schiavo situation:
But Owen, Schiff and others stressed that the research does not indicate that many patients in vegetative states are necessarily aware or likely to recover. Schiavo, in particular, had suffered much more massive brain damage for far longer than the patient in Britain, making awareness or recovery impossible, they said.
“I’m quite confident that [Schiavo] would not have responded in this way,” said James L. Bernat, a neurologist at Dartmouth Medical School. But, he said, the findings indicate that current methods of evaluating awareness are unreliable. He added: “Still, if Schiavo had reacted this way, I would be shocked and stunned.”
OK, I made up that last line. But my point is very real: the experts are often wrong. This is a point I have made before (for example, see UPDATE x3 to this post). But it keeps getting made again — all the time.
Recall the case of Terry Wallis, the man who was in a minimally conscious state for 19 years, and whose brain then “spontaneously rewired itself.” The doctors were wrong about him too:
Wallis was frequently classified as being in a permanent vegetative state. Though his family fought for a re-evaluation after seeing many promising signs that he was trying to communicate, their requests were turned down.
When doctors turned out to be wrong about Wallis, they were amazed:
Krish Sathian, a neurologist and specialist in brain rehabilitation at Emory University School of Medicine in Atlanta, US, describes it as an amazing finding. “The bounds on the possible extent of neural plasticity just keep on shifting,” he says. “Classical teaching would not have predicted any of these changes.”
“Most neurologists would have been willing to bet money that whatever the cause of it, if it hadn’t changed in 19 years, wasn’t going to change now,” [Dr. James] Bernat said. “So it’s really extraordinary.”
An amusing side note: the research in the Wallis case was led by Dr. Nicholas Schiff — the same guy who was shocked by the revelations in today’s Washington Post article. He termed Wallis’s case “miraculous” — but apparently thought that the era of brain-related miracles ended with Wallis.
So evidently, these doctors can be shocked and stunned by the power of the human brain . . . and then quickly retreat back into their natural state of all-knowing complacency — only to be shocked and stunned again when the next extraordinary case comes along.
Maybe this will help explain why some of us weren’t so quick to write off Terri Schiavo’s life just because some “experts” assured us that she was in a persistent vegetative state with no hope of recovery. I’ll concede that, with the autopsy, the experts were almost certainly right — and they usually are.
Except when they’re not — at which point they become shocked, stunned, and amazed.