Are People In Coma or In a Vegetative State Aware? Do They Hear and Understand Our Words?

Neuroscientists Have Found That Some People Are Aware and Do Understand Speech

Scientists now know that some people in coma, or in a vegetative state, are capable of cognitive activities.

Neuroscientists have been working for over 20 years to determine whether people in coma, vegetative states, or minimally conscious states, are aware. They are still in the early stages of their research, but they have already discovered that some people in these different conditions are in fact aware of their surroundings and of the people around them. They can and do hear and understand speech.

The progress that has been made may enable loved ones of people in these various states of consciousness to have simple communications in the near future. It will almost certainly help people with power of attorney to have better knowledge of what their loved one wants in the way of continued care.

People Have Wondered Over the Years if Their Loved Ones in Coma or Vegetative States Are Aware

Over the years I have had discussions with people both in and out of the classroom regarding whether or not I thought people in coma were aware. Whether or not it was beneficial to visit their comatose loved ones in the hospital and to talk to them.

Many years ago, not long before my mother died from cancer, she went into heart failure and was unconscious so far as her doctors knew. She was in that condition for most of a 24-hour day, unable to communicate with anyone. Initially her doctors had made several attempts to revive her with no success and so then informed us that they believed she would likely die before the day was done.

The following day my mother was conscious and up walking around! She told her doctors about watching them from up near the ceiling of the room they were in, and then proceeded to tell them what they had done and said! They were amazed that she had been aware the entire time, both of what was going on around her and even what was said – and she remembered what they had said. She told me later that one of her doctors had remarked that he would have to be more careful in future with patients they believed were unaware and could not hear what they were saying!

For that reason I have always recommended that people visit their loved one who is unconscious and talk to him or her about current events in the world or in the family -- talk and behave as though their loved one can hear and understand just in case they can.

Not because I believed all people react like my mother did, but because no one could be sure they were not aware. Often people do not regain consciousness sufficiently as my mother did, to tell anyone whether or not they were aware. Better to make that effort just in case your loved one is aware and so that you never have to look back and regret that you did not make that effort.

Not everyone in a comatose state or a vegetative state is aware, but some people are. Unless you know for a certainty that your loved one is not aware, I feel it is better to act as though they are.

Definitions of Consciousness Disorders

Brain Death – All functions of the brain and the brain stem have permanently ceased.

Coma – Loss of consciousness is complete. Cycles of waking and sleeping disappear and the person’s eyes remain closed. Coma is usually temporary, lasting only 2-4 weeks. After that period patients generally become conscious or move into a vegetative state, or a minimally conscious state.

Vegetative state – Sleep-wake cycles occur and the patient’s eyes may open spontaneously or in response to stimulation, but the patient’s behaviors tend to be reflexive, and an automatic response without any thought involved. In recent years Terri Schiavo and Karen Ann Quinlan were diagnosed in this category.

Minimally conscious state – Patients seem vegetative, but sometimes show signs of awareness such as reaching for an object, following a command, or responding to their environment. An example of this given by Dr. Owen is Terry Wallis who regained consciousness after 19 years.

Locked-in syndrome – With this disorder patients are fully conscious and so this is not technically a disorder of consciousness, but they are not able to move and may mistakenly be diagnosed as vegetative or minimally conscious. Some of these patients do retain the ability to blink and move their eyes, but many do not.

Dr. Adrian M. Owen

Dr. Adrian Owen continues to work toward finding easier ways for patients with consciousness disorders to communicate with loved ones.
Dr. Adrian Owen continues to work toward finding easier ways for patients with consciousness disorders to communicate with loved ones. | Source

Note

For individuals hospitalized after a TBI, almost half (43%) have a related disability one year after the injury.

From: Centers for Disease Control and Prevention (CDC)

Doctor Adrian M. Owen and His Goal

Dr. Adrian Owen has held the Canada Excellence Research Chair in cognitive neuroscience and imaging at Western University in Ontario Canada since 2010. He has worked in neuroimaging and cognitive neuroscience for more than 20 years, published more than 200 peer-reviewed scientific papers on his work, written several chapters in science books, and received recognition for his work.

Dr. Owen’s work is with brain-injured patients who are nonresponsive. His first challenge was to determine if these patients were aware despite appearances, and once he did that, to create a means of communication between them and the rest of the world.

Let me be clear. A great deal of progress has been made, but there is still much left to do. Not all persons with brain injuries sufficient to make them unresponsive are in fact aware, or responding to Dr. Owen’s methods for proving awareness, but Dr. Owen has determined that many are. This is the story of how Dr. Owen first started experimenting in this area and how he got to where he is now in his research.

The First Experiment to Try to Determine If Patients In a Vegetative State Are Aware Utilized a Pet Scanner

This is a Pet Scanner (positron-emission tomography scanner).
This is a Pet Scanner (positron-emission tomography scanner). | Source

The Importance of Communicating With Unconscious Patients

With advances in medicine, more and more people are surviving serious and severe brain trauma and ending up with consciousness disorders.

These disorders can be caused by injury, disease, stroke, cardiac arrest, or lack of oxygen to the brain for some reason.

It is more important than ever that a way to communicate with these people become available so that they can participate in decisions about their own treatment as much as possible.

Advances in neuroimaging has made communication with patients suffering from consciousness disorders possible in some cases, but not in all cases.


Dr. Adrian M. Owen writing for Scientific American May 2014 issue.

How Dr. Owen Became Inspired to Do the Research

Dr. Owen’s training and expertise was in neuroimaging. Not just taking brain scans, but finding new ways to take those brain scans so that more information could be learned from the scans. He was part of a team that was attempting not only to determine if some comatose or vegetative patients were aware, but also to determine if there was something that could be done to stimulate the brain to be aware and to function closer to what is considered normal. He studies brain injuries that result in disorders of consciousness and the cognitive impact of neurodegenerative diseases. His work at the time took place at Cambridge University in Cambridge, England.

As Dr. Owen states in his own article in the 2014 issue of Scientific American, a young woman who lapsed into a coma from an unnamed flulike illness became the subject of a discussion Dr. Owen was having with a colleague who was an expert in acute brain injury. The colleague suggested they put the young woman in their PET scanner (positron-emission tomography scanner) to see if they could determine if the young woman would show any signs of cognitive activity in her brain.

As Owen points out in his article, neither he nor his colleague had any particular expectations, but they thought it was worth a try to see if their new “brain imaging approaches” might discover something not discernible previously with the old methods.

While the young woman was inside the PET scanner, the doctors showed her photographs of family and friends on a computer screen while watching for brain activity on the scanner. Dr. Owen describes the results of this experiment as “nothing short of extraordinary.” The young woman responded to the photographs much as a healthy aware person might do.

However, the experiment was not conclusive for reasons Owen explains in his article and so it was another 10 years of experimenting before he could say definitively that some people with consciousness disorders are in fact aware. This first experiment, however, was what got the ball rolling and kept Owen working on this issue until he accomplished what he was hoping to discover – definite awareness in some vegetative patients.

Using an fMRI to Determine Awareness In Patients Diagnosed as In a Vegetative State

fMRI Scanner (functional magnetic resonance imaging) requires no tracer chemicals to be injected in the patient to work.
fMRI Scanner (functional magnetic resonance imaging) requires no tracer chemicals to be injected in the patient to work. | Source
Reading and fMRI
Reading and fMRI | Source

What Would It Take to Convince Dr. Owen’s Team that a Patient Was Actually Conscious and Aware? The Next Step . . .

Over the next 10 years Dr. Owen writes that their team in Cambridge tried many different ways to detect what they referred to as hidden or covert awareness in patients that had been diagnosed as vegetative. Some methods seemed to have more success than others, yet for a long time nothing worked definitively to indicate covert awareness.

The ideal would have been the old method most people are familiar with -- response to command, or squeeze my hand if you can hear me. Unfortunately the patients in this study were too injured to give any kind of physical response.

Instead, Dr. Owen and his team decided to explore whether or not the patients in this experiment could give a measurable brain response just by thinking about something.

Believe it or not, scientists have come far enough that they can watch our brain activity on a brain scanner and know what we are thinking about! They can do even more than that, but I will need to write another article to get into all that is known about our brains, what our brains can tell researchers about us, and did you know? It is even possible to erase memories. I am not sure I like that.

Anyway, back to how Dr. Owen and his team determined that some people with consciousness disorders are in fact aware.

Before starting their experiments on actual vegetative patients, Owen and his team had experimented with healthy volunteers, using them to test different scenarios they would ask the volunteers to think about while a neurologist observed their brain activity in the fMRI (functional magnetic resonance imaging). The fMRI requires no tracer chemicals to be injected like the PET scans do.

Mentally (not literally) playing a “vigorous” game of tennis was one of the scenarios that had worked well with the volunteers. The other was mentally walking from room to room in their home observing things as they went. Both of these mental activities had produced particularly strong fMRI activity in different regions of the brain, with the tennis scenario giving the strongest readings from the premotor cortex, part of the brain that plays a part in planning movement.

Owen wrote that their procedure worked on the very first vegetative patient they tried it on! It was a young woman who had been in a car accident as a pedestrian, and she had suffered some very serious TBI. She had been entirely unresponsive for 5 months before the experiment.

The young woman was asked repeatedly to do the different mental exercises and each time she did the one she was asked to do, it caused the expected parts of her brain to light up on the fMRI screen.

A strange thing happened after it was determined that she was in fact conscious despite appearances and her inability to function physically. Her family, caregivers, nurses, and doctors all started treating her differently. Dr. Owen writes, “While I cannot give details about specific patients, I can say that, in my experience, discovering that a patient is conscious spurs others to communicate, visit, reminisce, joke, and otherwise improve the quality of that patient’s life.”

Over several years, as many patients as possible were tested in this manner, and in fact the testing became more complicated. Using the same scenarios, playing tennis or moving from room to room in their home, patients were asked to use the tennis scenario for yes and moving from room to room in their house for no. The patients were then asked a series of simple questions, the answers for which had been provided by family. Out of 23 people tested, 4 were deemed to be aware and conscious. Not a lot, but it made some big changes in the quality of life for the four.

Once it was established that some of the patients were in fact conscious it was possible for doctors to ask them if they were in pain and in some cases what treatments they would prefer. Whether or not they wanted to continue living in their present state . . .

Communication allowed some patients to participate somewhat in their own treatment and be a part of decision making for their own lives.

fMRI Brain Scans: The top scans are of a normal healthy brain. The bottom set is the brain of a patient in a vegetative state during the experiment.

Brain Scans that show the parts of the brain that light up with activity during the questioning of patients diagnosed as in vegetative states.
Brain Scans that show the parts of the brain that light up with activity during the questioning of patients diagnosed as in vegetative states. | Source

Using EEG To Determine Awareness in Patients Diagnosed In a Vegetative State.

Electrodes are attached to the part of the body being tested with EEG (electroencephalography).  It is non-invasive can be made portable.
Electrodes are attached to the part of the body being tested with EEG (electroencephalography). It is non-invasive can be made portable. | Source

Traumatic Brain Injury (TBI)

In 2010, 2.5 million people sustained a traumatic brain injury (TBI).

TBI contributes to one third of all injury related deaths in the United States.

Most TBIs (nearly 32%) are the result of motor vehicle accidents.

People 65 years and older have the highest rate of TBI related hospitalizations and deaths.

Shaken Baby Syndrome is a leading cause of TBI deaths in abused children.


From: Centers for Disease Control and Prevention (CDC)

Moving Communication Equipment From the Scanner to Bedside?

Scanners (fMRI) are expensive and they are not available in every healthcare facility. Patients with metal implants (plates and/or pins), common in patients who have experienced serious accidents, cannot utilize the scanner at all.

The entire scanning procedure is known to be stressful for the patient from being moved by ambulance to a facility with a scanner, to the patient trying to stay still inside the scanner.

While fMRI scanners have moved the knowledge medical practitioners have of people with consciousness disorders forward considerably, they are not very convenient for general use or practical for some patients.

For those reasons and more, Dr. Owen and his team realized they needed to come up with an easier way to communicate with those patients who were in fact conscious and aware despite physical signs that they were not.

Dr. Owen writes, “Our recent efforts have focused on building a less costly, more portable way of assessing brain activity using electroencephalography (EEG).”

The EEG is noninvasive and depends on electrodes that are attached to the scalp to measure the activity of groups of neurons in the cortex that are the deeply folded layers of the brain. An EEG is not affected by metal implants and so it could benefit all patients that suffer consciousness disorders, and it can be utilized at bedside.

The negative side of the EEG is that it does not detect activity in the deepest brain structures very well and does not always detect a clear response in particular regions of the brain. EEG results are not as dependable as results from an fMRI.

Owen says he and his team are dealing with that drawback by designing mental imagery tasks that produce brain activity on the surface of the cortex. Those are the areas that control simple movements of a person’s arms and legs.

There were some problems with this method of detection compared to the fMRI in the beginning, but by 2011 Dr. Owen and his team were confident that they had found a method using the EEG that was reliable enough to be used to start testing patients at their bedside.

The Building of an EEJeep

The team started by developing what they referred to as their “EEJeep.” That is, they fitted a Jeep vehicle with electrodes, amplifiers and the most powerful laptops they could find, and went on the road taking their equipment to patients instead of patients having to be moved by ambulance to them.

The results of the tests with their EEJeep were about the same as the results they got from using the fMRI. About 19%, or three out of sixteen vegetative patients appeared to be conscious based on the new commands to the patient to imagine squeezing their toes or hands instead of imagining they were playing tennis or walking through their home.

Dr. Owen writes that he and his team were challenged by another research group regarding their findings, because as Dr. Owen writes “EEG analysis is notoriously complicated and their statistical algorithms were sufficiently novel (unusual) and complex that the other research team was not confident in Dr. Owen’s team’s findings.

To answer the questions posed by the competing research team, Owen’s team verified their EEG findings by retesting the patients who had tested positive for awareness with the fMRI test. Most of the patients confirmed as aware with the EEG also passed the fMRI. They also revised their EEG methodology and worked to find credible answers to all other questioned posed by the competing research team that had questioned their findings.

Good science involves peer review and must follow the scientific method for testing hypotheses and new ideas. The same methods described in the report about what methods were used and exactly how they were used in a particular experiment must be repeated over and over and over again, getting the same results, before other scientists in that field will consider them credible.

Oversight of experiments by other experts in a particular scientific field is a good thing. It helps weed out charlatans, and better yet, discourages them before they start. It stringently encourages people to be serious and conscientious in their work, because many eyes are looking over their shoulder at every step.

People depend on the findings of these experiments and sometimes lives are at stake when the methods of some experiments are used as treatment, so it is important that many eyes and many people involved with that particular part of science review and question techniques, methods, and results before any of these things are put into practice generally.

As a result of all those other people in different parts of the world, all experimenting on basically the same thing, and therefore interested in any progress anyone else in their category of work might have made, Dr. Owen reports that he and his team are now working with research teams in two other countries as well as continuing to work with the team in Liege, Belgium where most of the work with fMRIs and EEGs took place.

The challenge from these other teams brought about the development of standard protocols (official procedures and a system of rules) for using fMRI and EEG to detect consciousness in vegetative patients. The best news is that it is now possible to determine if a person in a vegetative state or coma is actually conscious and aware.

Note

In principle, it is already possible to directly ask a patient if he or she wants to continue living in his or her current situation using our fMRI or EEG techniques.

Dr. Adrian M. Owen writing for Scientific American May 2014 issue.

What Comes Next?

There May Not Be Any Guessing for Much Longer

With the new discoveries from recent research, it may not be long before people will know whether or not their love one is capable of simple communications. I say simple communication because it is likely they will be limited to yes and no as far as responding to anything said. They would also, in many if not most cases, be able to understand the same things they understood before their condition trapped them.

Scientists are now looking at designing a computer that can read more complicated thoughts than simply yes or no -- a brain interface that would enable people with consciousness disorders to communicate with the world beyond yes or no.

Most patients with consciousness disorders rarely have control over their eye movements so that a computer could detect whether they have blinked once or twice, or whether they have fixed a gaze on a particular visual. As a result a computer program that could read and analyze eye or facial movement will not be beneficial. Dr. Owen readily admits it is going to be a challenge to come up with something.

For now, it is a great relief to many people who have loved ones that suffer from consciousness disorders to be able to know whether or not they are in fact aware, and hear and understand their words when they visit. It is nice to know that even simple yes/no communication with their doctors is now possible for some patients.

For anyone interested in more specific details about this break through, I highly recommend getting a copy of the May 2014 issue of Scientific American. It can be found online by clicking here.

Sources

CDC Statistics

http://www.cdc.gov/traumaticbraininjury/severe.html


University of Western Ontario

http://communications.uwo.ca/cerc/about.html


Scientific American, May 2014 issue, “Is Anybody In There?”


EEJeep at the Owen Lab (photos and specs)

http://www.owenlab.uwo.ca/faq/the%20eejeep.html


Adrian M. Owen

http://en.wikipedia.org/wiki/Adrian_Owen

© 2014 C E Clark

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Comments 74 comments

Au fait profile image

Au fait 5 months ago from North Texas Author

Peggy W., thank you for taking the time to share and tweet this article. I hope the information was helpful to your cousin too.


Peggy W profile image

Peggy W 5 months ago from Houston, Texas

I was mentioning this very subject to a cousin of mine when his dad was in a coma. He was unfamiliar with this. Hope it helped. My uncle died shortly thereafter. Going to share once again by tweeting and sharing to HP.


Au fait profile image

Au fait 8 months ago from North Texas Author

Pinto2011, thank you for reading and commenting and for your kind compliment. Glad if this article was educational and informative.


pinto2011 profile image

pinto2011 9 months ago from New Delhi, India

Nice to know about the advancement made in this field as this is certainly a gray area but once given a path going to help many determining the patient health care and other attributes. Great research by you.


Au fait profile image

Au fait 14 months ago from North Texas Author

Peggy W., thank you for your high praise and for sharing this article!


Peggy W profile image

Peggy W 14 months ago from Houston, Texas

Happy to bring more attention to this well written article about people who are in a coma and how the people around them should think of responding when visiting or caring for them. Will once again share.


Au fait profile image

Au fait 15 months ago from North Texas Author

Patricia, (Pstraubie48) thank you for coming by and sharing your thoughts, and for sending the angels. I hope angels will be with you at all times to help you deal with all you must and to keep you and your loved ones safe.


pstraubie48 profile image

pstraubie48 15 months ago from sunny Florida

Back to visit again....this is such an interesting topic.....I know of those who have been in comas (have visited some) and do believe they are aware of the presence of others even though they are unable to respond.

Sending more Angels your way this morning ps


Au fait profile image

Au fait 16 months ago from North Texas Author

Thank you Shyron, for the votes, and the share, and your high praise. I hope the information in this article will help people interact better with their loved ones who are in this state, and hopefully give them a little more peace of mind knowing that in many cases they can communicate.


Shyron E Shenko profile image

Shyron E Shenko 16 months ago

This is by far one of your best articles, so much research went into this.

I thought I would come back and share this again for all the new hubbers

that may have not read this.

Blessings, voted up UABI and shared.


Au fait profile image

Au fait 17 months ago from North Texas Author

Thumbi7, thank you for coming by and commenting!


thumbi7 profile image

thumbi7 17 months ago from India

This is very useful information for people who have their loved ones in coma.

I have seen many patients in vegetative state and always wondered whether they could feel or hear


Au fait profile image

Au fait 19 months ago from North Texas Author

TorriLynn, than you for reading and commenting on this article, for sharing your thoughts, and for the votes and share!


torrilynn profile image

torrilynn 19 months ago

I feel that people that are in a coma are able to hear and understand words that are being said to them. I just feel due to their vegetative state that they are unable to communicate that they can understand. overall, very great hub and thorough points made. Voted up and shared.


Au fait profile image

Au fait 20 months ago from North Texas Author

Peggy W, thank you for sharing this article!


Au fait profile image

Au fait 20 months ago from North Texas Author

TIMETRAVELER2, thank you for reading and commenting on this article and for sharing your experience with this issue. Yes, I know that my mother had an out of body experience, and it gave her doctors something to think about for future situations with all their patients.

Thank you also for the votes and especially for your high praise! Glad you enjoyed reading this.


Peggy W profile image

Peggy W 20 months ago from Houston, Texas

This is such an important topic and for people who may be facing the prospect of a loved one who may be in a coma or so called vegetative state...I am happy to share this information once again so that they can approach their loved one in a different way. Talk to them! Sing to them! Play their favorite music!


Au fait profile image

Au fait 20 months ago from North Texas Author

Pstraubie48, Patricia, thank you for sharing your mother's out of body experience, a very common experience for people in tough situations. I'm wondering if she was floating near the ceiling the entire time she was in coma or just for part of that time . . . would be interesting to know.

As always, thank you for the angels and hoping they are with you at all times as well as with your daughter/grandson, etc.


Au fait profile image

Au fait 21 months ago from North Texas Author

Shyron,, thank you for visiting and for the votes, share, etc. What a terrible thing to do to a baby! I hope all goes well for its recovery. Blessings and hugs to you and John too . . .


TIMETRAVELER2 profile image

TIMETRAVELER2 21 months ago

This is one of the most meaningful articles I have ever read, and I am so glad that you did all of the research and published it here. I have always believed that "unconscious" people could hear and understand, and many doctors have agreed with me on this over the years. What your mother went through, however, is a bit difference. If you read "Life after Life" you will see that she had an out of body experience. This is more common than most people think and many doctors know this. Excellent work, Au Fait. Voted Up!


Au fait profile image

Au fait 21 months ago from North Texas Author

Ezzly, thank you for the up vote and the Tweet! I think it's wonderful too, for both the patient and their loved ones.


pstraubie48 profile image

pstraubie48 21 months ago from sunny Florida

First of all this is so well researched that I am awed by the lengths you go to present your topic.

I have an Aunt who was comatose for a long period of time (it was a long time ago so I do not recall exactly but she reported being way up above the doctors and was able to see and hear what they were doing.

This is the stuff that scifi stories were once made of and now they are coming to fruition.

Thanks for sharing Angels are on the way to you this evening ps


Shyron E Shenko profile image

Shyron E Shenko 21 months ago

Au fait, I am back to read this again. I just read about a baby that was buried alive and was found before he/she died and is now in a stable condition. I thought of this article when I read that.

Voted up, UABI and shared

Blessings and hugs


ezzly profile image

ezzly 21 months ago

Wow what a brilliant hub, this is something I've wondered about for years! The portable equipment to improve communication sounds marvelous! Voted up and sharing of twitter


Au fait profile image

Au fait 21 months ago from North Texas Author

Thank you DeborahDian for your continued interest in this important subject. I thought I heard that Houston's daughter had been removed from life support several weeks ago . . . ?


DeborahDian profile image

DeborahDian 21 months ago from Orange County, California

With Whitney Houston's daughter currently in a medically induced coma after she was found, like her mother, unconscious in a bathtub, I thought even more people would like to read this informative article. Voted UP and sharing.


Au fait profile image

Au fait 21 months ago from North Texas Author

Tillsontitan, thank you for reading and commenting and for your kind compliments. Also for voting on this hub. I think it's great news because both the afflicted and their loved ones must be so frustrated with communication. Hopefully this breakthrough will help.


Au fait profile image

Au fait 21 months ago from North Texas Author

peachpurple, thank you for sharing your experience on this issue. I should think it took a huge weight off your family's minds to have your aunt take part in the decision for her care.


Au fait profile image

Au fait 21 months ago from North Texas Author

Paul Kuehn, thank you for reading, commenting, voting on, and sharing this article on HP and FB. Thank you also for your high praise as coming from you it is all the more meaningful. I wrote this article hoping it would bring comfort, as much as that is possible, to people who have loved ones in these states where communication is difficult to impossible. And what a relief when a patient can participate in their own medical decisions!


tillsontitan profile image

tillsontitan 21 months ago from New York

As always you take a subject, investigate it, and in the end conquer it. This was very interesting and hopeful to say the least. It is indeed hopeful to think there are more doctors like Dr. Owen working on this complicated matter. Thank you for writing this.

Voted up, useful, and interesting.


peachpurple profile image

peachpurple 21 months ago from Home Sweet Home

Great hub, my aunt went to vegetable state after a stroke, doctor leave to family to decide what to do. They asked my aunt whether to agree to remove her oxygen mask. She was in vegetable state but aware what was going on. She consented.


Paul Kuehn profile image

Paul Kuehn 21 months ago from Udorn City, Thailand

Au fait, This is another one of your awesome hubs which is well-researched and very well written. I certainly admire you for having the intellectual prowess to tackle such an interesting subject like this. I agree that some comatose people are aware of their surroundings and really liked the story about your mother. I have voted this up and am sharing it with HP followers and my Facebook followers.


Au fait profile image

Au fait 23 months ago from North Texas Author

Jandee, thank you for sharing your experience!


Au fait profile image

Au fait 23 months ago from North Texas Author

Lisavanvorst, thank you for reading this article and sharing your thoughts on this important subject. I agree that it does no harm to treat all such patients as if they can hear, because you may be providing them as well as yourself with a great deal of comfort.


Au fait profile image

Au fait 23 months ago from North Texas Author

Peggy W, thank you for commenting and for sharing this article! I hoped writing about this subject would help get the word out so that people with loved ones in these various states might be comforted. Appreciate your shared thoughts.


jandee profile image

jandee 23 months ago from Liverpool.U.K

I have been there, and I saw it all happen. I was floating, and saw myself lying in a deep trance like sleep. I climbed back into.................


lisavanvorst profile image

lisavanvorst 23 months ago from New Jersey

A very interesting and informative hub. I being a Director of Recreation in a nursing home believe that those in a coma can hear us. I feel it is very important to talk to your loved ones, hold his or her hand and let them know you are there. As you mentioned in your hub people have been known to come out of comas. The brain is a very complicated organ that control our entire body, I'm not ready to give up on it and the magnitude of it components and mechanisms.


Peggy W profile image

Peggy W 23 months ago from Houston, Texas

Sharing this once again in case people missed reading this. It should give people comfort to know that their words can be heard by friends or family members who may be in a coma. Why not err on the side of it happening even if given no hope by doctors? Too much evidence exists that hearing is one of the last things to go and/or return. Excellent hub!


Au fait profile image

Au fait 2 years ago from North Texas Author

Vespawoolf, thank you for reading, for sharing your experience on this issue, and for your high praise. I hope knowing about all these new breakthroughs with consciousness disorders will bring peace of mind as much as that is possible, to people who have loved ones in these unfortunate states.


vespawoolf profile image

vespawoolf 2 years ago from Peru, South America

What amazing and commendable research by Dr. Owen! I agree, though, that much is unknown and still to be learned about this subject. I didn´t realize there were so many consciousness disorders. My mother-in-law also went into a coma before she died of cancer and the nurses encouraged us to continue to talk to her as if she were awake. I believe she could hear us because of some of the slight movements she made with her body. As all your articles, this is very thorough and informative. thank you!


Au fait profile image

Au fait 2 years ago from North Texas Author

DeborahDian, thank you for reading and commenting on this article! I think as it becomes easier to communicate with comatose people, it will be an immense relief to their loved ones. They will be able to participate in their own treatments for one thing, lifting the burden of difficult decisions from the shoulders of their family.


DeborahDian profile image

DeborahDian 2 years ago from Orange County, California

This article is amazing. I had no idea that people in a coma might be so aware of what is going on around them. Thank you for sharing this information with us.


Au fait profile image

Au fait 2 years ago from North Texas Author

Paula (fpherj48), so glad if this article has brought you comfort.

It will be helpful to many people, I think, when it becomes possible to bring equipment into the hospital room so that people can communicate with their unresponsive loved ones one on one. So often the brain is injured and unable to cause physical movement in the way of gestures or form words, yet it can process what is happening around it.

Thank you for the votes also!


fpherj48 profile image

fpherj48 2 years ago from Beautiful Upstate New York

C.E. Another amazing piece of work.....fully educational. High on my list of interests, I appreciate the massive research you put forth to share this with your readers.

Besides giving fabulous insight on this topic, it touched me in a very personal way. Present at both death beds of my sister and my mother, I must tell you of the comfort & peace your article provides me.

Just the possibility that they both may have heard me as I spoke to them each day, while in a state of unconsciousness......brings both a smile to my face and a tear to my eye.....Thank you, C.E. This is Wonderful...Up++++


Au fait profile image

Au fait 2 years ago from North Texas Author

Faith Reaper, thank you for reading and sharing your thoughts on this issue, as well as the votes, etc. Hopefully these breakthroughs will be a blessing to many people.

Blessings for you also . . .


Faith Reaper profile image

Faith Reaper 2 years ago from southern USA

Interesting and inspiring article. I just recently was listening to a fascinating story on Faith Radio of a woman who was in a comma after giving birth, a medically induced comma. It was so fascinating as, at some point, she was able to hear her loved ones speaking to her, but describe the feeling when she could not respond. She only remembers two times of hearing her loved ones.

Voted up and more and away

Blessings always


Au fait profile image

Au fait 2 years ago from North Texas Author

Nadine May, thank you for sharing your thoughts and experience on this subject. Agree, that I would not want to exist in this state if it were me. Existing is all that is possible for these unfortunate people it would seem.


Au fait profile image

Au fait 2 years ago from North Texas Author

Suzettenaples, thank you for stopping by and sharing your thoughts!


Au fait profile image

Au fait 2 years ago from North Texas Author

DDE, thank you for coming by and sharing your personal experience on this subject. Always good to see you!


Au fait profile image

Au fait 2 years ago from North Texas Author

Laura Schneider, thank you for reading, commenting, and voting on this article! The possibility of being able to communicate with people considered unreachable just a short time ago is very promising.


Au fait profile image

Au fait 2 years ago from North Texas Author

Pamela Kinnaird W, thank you for reading, voting on, and sharing this article. Very much appreciate your sharing your experience while anesthetized and how to avoid that situation happening.


Au fait profile image

Au fait 2 years ago from North Texas Author

Mary615, thank you for reading and sharing your experience and thoughts on this subject. Not all people with consciousness disorders are aware, but many are and so it makes sense to me to act as if they are for their sake. Better than being wrong the other way and saying or doing something hurtful thinking they don't know. I should think it would be hell to be trapped in a body unable to respond and yet to know what was being said and done around you.

Thank you for the votes, the Google+ing, and the shares too!


Au fait profile image

Au fait 2 years ago from North Texas Author

Shyron, thank you for reading, sharing your thoughts and experience on this subject, and voting on and sharing this article. Also for your high praise because as I know, you are an excellent researcher as well.

I almost forgot to publish this. Nothing is safe from my forgetfulness these days. You got here and that's the most important thing.

Hope you got the email I sent you yesterday. Have great weekend and God bless. TTYS


Au fait profile image

Au fait 2 years ago from North Texas Author

Lady Guinevere, thank you for reading and sharing your thoughts and experiences on/with this subject. The world is full of things we haven't discovered yet or don't understand. Even though only 19% of people in a vegetative state have been found to be aware despite appearances, one of these days someone may invent or discover a way to reach many of the ones that remain unreachable yet today/ Agree that this is a fascinating subject. Thanks again for taking time to come by.


Au fait profile image

Au fait 2 years ago from North Texas Author

Nell Rose, thank you for reading and sharing your experience and thoughts on this subject. Could your friend ask that her son be tested? I'm thinking that this is not yet a technology used very often as it's still in the infant stages and probably a bit more expensive than it might be if it were more common, but if a person can handle 'no' then there's nothing to lose by asking.


Au fait profile image

Au fait 2 years ago from North Texas Author

Peggy W, thank you for reading and sharing your thoughts on this issue! Really appreciate your Google+ing, tweeting, pinning, and sharing this article, too.

My mother was never even considered to have died. She was in congestive heart failure for just under 24 hours and wasn't responding to anything the doctors were doing, but she was not on life support. She obviously had an out-of-body experience, but she never died, nor did her docs suggest she had. She was up and walking the next morning and lived for about 2 weeks after that.

Initially she had been given 3 months to live when her cancer was first diagnosed, and she managed to live for just under a year from that point. Her determination to triumph over the disease even to the very end was incredible and her doctors were continually amazed that she made it through some of the things she did. That is one of the reasons I know that one's mind can do some pretty amazing things -- and not just limited to thwarting medical diagnoses. :)

Yes, I agree with you completely, that people should interact as normally as possible with friends and family members, etc., who are in coma, vegetative state, or other.

It is now possible to know if a person is aware, and hopefully soon there will be portable equipment that will enable more and better communication where that is possible. That will greatly improve the quality of life patients with consciousness disorders currently experience.

Thank you for your high praise, Peggy. Coming from you that means a great deal.


Au fait profile image

Au fait 2 years ago from North Texas Author

PegCole 17, thank you for stopping by and sharing your thoughts. In fact the question has been answered as to whether or not people in altered states of consciousness are aware. These studies were conducted mainly with people in vegetative states and about 20% were found to be aware. It is now possible to ask these people yes/no questions and get answers

The problem left to resolve is developing easily portable equipment that gives accurate dependable results and then developing a way to get beyond the yes/no conversations that are now possible, to more complicated conversations.

Appreciate your sharing your father's situation. I think it is always best to imagine people do hear and understand just in case they can. People often talked over my grandfather too. He'd had several strokes and sometimes was coherent and other times not. There were always a few who assumed he was never coherent. When they ignored his efforts to communicate and was ignored, you could just see the light go out in his eyes.


Nadine May profile image

Nadine May 2 years ago from Cape Town, Western Cape, South Africa

I'm truly impressed with this article. Well researched and informative. During the sixties we were told to always treat comatose people as if they could hear us when i was a nurse. Personally i would hate to be kept alive after a few weeks even if i could hear but not interact. Especially people who are diagnosed in a locked in syndrome. Being earthbound, trapped in a human body must be pure hell. Thanks for sharing your mom,s experience. Voted up


Au fait profile image

Au fait 2 years ago from North Texas Author

Rebeccamealey, thank you for reading and commenting on this article! As stated here, about 20% of people in vegetative states can hear and understand, it may be more for people only in coma -- or fewer, since most of the research was done with people in vegetative states. Talking to them as normally as possible actually improves their quality of life and some have seen improvement as a result.


suzettenaples profile image

suzettenaples 2 years ago from Taos, NM

Well, we believe in talking to babies in the womb and playing music etc. for their benefit. It is supposed to add to their stimulation and some believe their IQ. So, why not do the same for someone in a coma or vegetative state? I do believe they can hear and be soothed or stimulated as a baby is in the womb. Anything is possible.


DDE profile image

DDE 2 years ago from Dubrovnik, Croatia

I knew of someone who was in a coma or vegetative state for three months and his family visited him daily without giving up hope. They spoke to him at all times. After three months he came through and their presence were felt by him giving a second chance to wake up. Interesting hub and so much to think about here.


Laura Schneider profile image

Laura Schneider 2 years ago from Minneapolis-St. Paul, Minnesota, USA

This is excellent, inspirational news that is presented well and equably in your well-researched article! Thank you for giving hope to everyone with a loved one in such a condition! Voted way up, awesome, etc!


Au fait profile image

Au fait 2 years ago from North Texas Author

JayeWisdom, thank you for reading and sharing your thoughts and experience on this issue with me and my readers. I'm so glad things came out so well for your son and for you and the rest of his family.

I have thought for a long time that people really need to have some medical knowledge in order to have some hope of getting the best medical help possible for their situation. I really believe medicine is as much an art as a science, and as with anything else, some people are getter suited to that vocation than others and some people are more talented and have more aptitude for it.

I always take an active part in any treatments doctors recommend and any drugs they want to prescribe. Had I taken the drug prescribed for me when I was first pregnant with my daughter chances are good she would have been born deformed and/or severely mentally challenged -- that's if one can believe what is reported about the drug when pregnant women take it.

It was a drug to address depression. As it turns out, I am one of those rare women who experience depression in the first trimester of pregnancy, but that was not known at the time the drug was prescribed. I never had the prescription filled and that prescription paper is floating around here somewhere still. The doctor who wrote it asked if I was pregnant and took my word that I was not. I had never been pregnant and had been told I could not get pregnant, so I just assumed I was not and doc accepted that without testing.

As you might imagine, I am even Ms. Popularity with doctors because I do not always agree with what they want to do and if they cannot give me a good reason why I should go with it and what worthwhile result I can expect, then I refuse. Doctors accustomed to being looked up to as only slightly below God are miffed to put it mildly. Not all doctors are like that, but some are.

I do think the better informed a person is the bigger part they can play in their own medical treatments and if they are reasonably intelligent and of sound mind, I believe they should play an important part in their own treatments.

I hope writing this comment has truly helped to lift a burden from your shoulders Jaye. Once something is set in stone, even though it may be so, so hard to do it, putting it on the back shelf of your mind is better so that it doesn't infect the future. Rejoice in all the good years your son has had and all the times you have been able to enjoy with him and his family. They might not have been -- except they were! Yes, the most important thing is that all came out well for your son and his entire family, including you. Don't let the past spoil the present or the future.

Nothing can change the past. It's cast in stone. Rejoice instead that you have your son and his family has him too. Enjoy the present because no one is promised a future. Do not cry for the past, because the past is just that, the past, and it is gone. Instead smile and laugh because the doc was wrong.

I'm sure Jesus must have had a huge smile on His face, and may even have laughed as He ascended from the cross having just been victorious over death. All He went through paid off in that He broke the chains of death and it no longer had any control or authority over Him and as a result it need not have any over us either.

Just as Jesus surly had a huge smile on His face once He had triumphed over death and broken death's hold, I hope you too will have a huge smile and be happy that your son succeeded in being everything his doctor said he would never be and doing those things his doctor said he never would.

From what you have said, your son woke up on his own and he didn't need the ventilator. Yes, it was the voices of his children that woke him, but he would not have lived if he really needed that ventilator. Had he been truly as bad off as the doc said, even his children's voices would have had little affect. His time wasn't up yet.

I'm so sorry you and your son and family had to go through such a terrible time, but try to see the wonderful developments since that time. Don't let that awful time hold you hostage. Put it behind you. It's over. Rejoice in today. Refuse to let those thoughts of what might have been ruin your today. They can't touch today unless you let them. I know there are some things that are so hard to get past, but for your own sake and that of your family, every time one of those thoughts comes along about what almost was , replace it with what IS.

Some hurts run ever so deep and may never fully heal. Your best bet is to think about the wonderful years you have had since and the present. That is a sort of pain reliever such as it is. Some people use alcohol or drugs. I hope you will use the power of positive thought.

Thank you for sharing this difficult experience with all of us.


Pamela Kinnaird W profile image

Pamela Kinnaird W 2 years ago from Maui and Arizona

I enjoyed this very thorough hub you've done and I've enjoyed the comments, too. I am so glad JayeWisdom's son survived.

Peggy W's comment reminds me that I learned the hard way why and how we can feel pain and hear people around us while being operated on -- under anesthesia. It took me some 35 years to have another operation after feeling such excruciating pain during an operation in the 1970s. A doctor recently explained to me that if we elect or if the anesthesiologist decides to give us muscle relaxants along with the anesthesia -- it then prevents us, very unfortunately, from moving a muscle and thereby prevents getting the nurse or doctor to realize we need more anesthesia while they are cutting us open or chiseling away at a bone. They have no signal from us so they have no way of knowing whereas if we have not been given a muscle relaxant and if the anesthesia was not sufficient, our body will jerk from the pain. All we have to do is tell the anesthesiologist during our pre-operation talk with him or her: we do NOT want muscle relaxants.

I am not surprised at the findings of a low number -- but still a certain amount of patients -- being aware of what is going on around them, but that is in a physical sense that most are not aware. Spiritually and out of their body, I believe they can be very aware -- like your mother said and as Peggy W said.

Voting up, useful, awesome and interesting, plus sharing.


mary615 profile image

mary615 2 years ago from Florida

I remember long ago when I first entered the medical field as a lab tech, I was told by a doctor to be cautious when I spoke to a patient in a coma. He believed the patient could certainly hear what was said around him. Now, this was back in the 70's.

I have seen families sit around the bedside of a loved one who was in a coma reading to them or playing their favorite music. They truly believed their loved one could hear them.

I enjoyed reading your very interesting Hub, Voted UP, etc. Will share here and on Google +


Shyron E Shenko profile image

Shyron E Shenko 2 years ago

Au fait, this is amazing to me, you did an outstanding job on the research for this article. I believe that people in a coma do feel and understand, like in my husband's coma and Little John was talking to him and days later when he woke up he vaguely remembered.

I wish I had know you had published this I would have been here yesterday. This is really wonderful to know.

Voted Up UABI and shared.

Blessings to you my dear friend.


Lady Guinevere profile image

Lady Guinevere 2 years ago from West Virginia

This is so fascinating. I remember watching s show years ago about a person who was in a coma and they said that they heard everything people said around them but it was like in a distance to them. They were living another life while in a coma in this life. They finally came out of the coma leaving the other life and coming back to this one and that is what they told the doctors what had happened to them. I do not remember what show it was, but I still remember it for some reason. My husband had a closed head injury years before I met him and she still has some effects of that to this day.


Nell Rose profile image

Nell Rose 2 years ago from England

Hi Au fait, this was particularly interesting for me purely because my friends son is in a vegetative state and I often wonder if he is aware or not. this has gone a long way to explaining the process, and I hope one day that they will test him too, thanks, nell


Peggy W profile image

Peggy W 2 years ago from Houston, Texas

I have read many books regarding NDE (near death experiences) where the people who do come back as your mother did briefly have related the same thing as she did. Apparently the soul lingers for a while and if they come back into their bodies they can relate what has transpired when people thought that they were clinically dead.

Children or adults who would have had no possible way of describing medical equipment used on them have done so and have also described the people in the room at the time.

I have long believed in speaking to a person who is unresponsive as if they can hear. Another thing...people who have gone under anesthesia and are purposely "put to sleep" for operations often relate hearing things. Thus hearing is one of the last things to go and/or first to return.

With that and now reading about this research, it should have many people treating their friends or family members who are in comas differently. Go ahead and play their favorite music. Talk about wonderful memories or things going on of which they would be interested.

Wonderful hub Au fait! Sharing this by tweeting, G+, pinning and HP.


Au fait profile image

Au fait 2 years ago from North Texas Author

Billybuc, thank you for stopping by!


PegCole17 profile image

PegCole17 2 years ago from Dallas, Texas

Au fait, This is an interesting question and Dr. Owen's study shows promise of answering the question in the near future. When my father drifted into a vegetative state, I felt certain he was still quite aware of his surroundings. His expression changed considerably when something was going on in the room between two of his visitors, yet, he had lost the ability to move his arms or verbally communicate.

We must act as if these patients are fully aware of their surroundings and treat them accordingly. I was quite disturbed by the people who came to visit and talked over his minimal attempt at responding, completely clueless that he was trying to get their attention. I hope that these findings become known to those who care for patients in this state.


rebeccamealey profile image

rebeccamealey 2 years ago from Northeastern Georgia, USA

These are really interesting findings. I have never had a loved one to be in a coma, but I would imagine it would be instinctive to talk to them. But this article would influence me to talk more about what's going on rather than just murmuring sentiments. Very helpful!


JayeWisdom profile image

JayeWisdom 2 years ago from Deep South, USA

Au fait - This is a well-researched, organized and written hub. The research by Dr. Owen and his team and its results give hope to the loved ones of patients in a coma. This is an issue that is important to me for personal reasons.

About eight years ago, my younger son was placed in an induced coma due to brain swelling and some brain bleed from a stroke. While he was on a ventilator, he overheard his children crying, telling him they loved him and saying their goodbyes because an incompetent neurologist stated (unequivocally) that my son would be a vegetable if he survived and convinced his distraught wife that even if he survived it would be with massive brain damage. This doctor insisted that my son's hippocampus was 'essentially gone' and said the ventilator should be removed so my son could be allowed to die. I was fighting this tooth and nail, but mothers aren't considered 'immediate family' when there is a spouse.

As mentioned, my son heard his brokenhearted children's anguish and woke up from the coma! When he was taken off the ventilator, he was able to breathe on his own. Although the hospital managed to give him septicemia that endangered him further, he lived through all of it and recovered. The ONLY problem with which he was left--and it's very slight--is some effect on his short-term memory, but not enough to keep him from functioning well. His intelligence is intact, as are his thinking process, his ability to communicate, fine motor skills, etc. His two daughters are now married, and he's become a proud grandfather. His son is engaged to be married in a few months. They enjoy happy relationships with a dad they could have lost, but--thankfully--didn't after he heard their voices while in a coma.

That was difficult to write. I feel as though I let go of parts of my mind and heart that have been carefully wrapped and put away for many years because it was so painful to remember how close my son came to death.

Unfortunately, that @#$%! neurologist is still practicing, but I wrote an account of his complete misdiagnosis and recommendation that would have caused the murder of my son and placed it on every website I could find that reviews doctors. I hope I've cost him many potential patients, because I consider that man dangerous. However, the AMA and licensing entities protect even incompetent doctors and allow them to go on jeopardizing the lives of unknowing patients.

So, even if a doctor says that a patient is brain dead, vegetative, beyond hope of recovery, that may not be true. Remember that doctors--even neurologists--can be wrong. There should always be further testing to determine without a doubt the actual state of the patient's brain activity. Dr. Owen's research and his mission are inspirational.

Voted Up++++

Jaye


billybuc profile image

billybuc 2 years ago from Olympia, WA

Much too complicated a topic for me to even render a guess at, but I know without a doubt that we are not even close to understanding the human brain and all it is capable of.

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