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Thousands of coma patients may be conscious

285 点作者 ImpressiveWebs超过 3 年前

20 条评论

serf超过 3 年前
I absolutely believe the premise of the article.<p>I suffered an incomplete (cervical) spinal cord injury years ago.<p>Through my &#x27;medical journey&#x27; and many many months in the ICU before rehab I was placed on a variety of amnesiacs, as well as induced comas.<p>I remember <i>a lot</i> of things that I really shouldn&#x27;t -- and I can corroborate the events with eyewitnesses who were otherwise healthy spectators.<p>I was terrified, unable to communicate, uncomfortable, and most of the time in pain.<p>When I was finally brought back to &#x27;real&#x27; 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.<p>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.<p>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 &#x27;medical PTSD&#x27; out of the public arena of consideration as something that is &#x27;required, known, but terrible.&#x27; -- but I hope we one day come up with real methods of reducing or preventing that kind of experience all together.<p>It feels that at this point we&#x27;re much more adroit at healing bodies than psyches.
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bitL超过 3 年前
When my grandma had a stroke, she wasn&#x27;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&#x27;s surprise, her hand started moving over beads in regular intervals as required by the prayer, and my wide family understood she&#x27;s conscious but simply can&#x27;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.
pjerem超过 3 年前
That’s terrifying.<p>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.<p>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.<p>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.<p>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.
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md_超过 3 年前
Martin Monti is somewhat well-known for exploring similar cases: <a href="https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pmc&#x2F;articles&#x2F;PMC5741595&#x2F;" rel="nofollow">https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pmc&#x2F;articles&#x2F;PMC5741595&#x2F;</a>.<p>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.<p>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.<p>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.
appleflaxen超过 3 年前
What this kind of science desperately needs is double blind confirmatory evidence.<p>I suspect that the experiment is vulnerable to bias by an un-blinded scientist conducting the experiment. Almost all of these &quot;veiled consciousness&quot; and &quot;assistive communication&quot; reports are.
cpuguy83超过 3 年前
I suspect in addition to DNR&#x27;s there will end up being a DNL (do not link).
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adolph超过 3 年前
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.<p><i>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,&quot; a short story first published in 1844, the narrator describes his struggle with things such as &quot;attacks of the singular disorder which physicians have agreed to term catalepsy,&quot; 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.</i><p><a href="https:&#x2F;&#x2F;www.smithsonianmag.com&#x2F;sponsored&#x2F;people-feared-being-buried-alive-so-much-they-invented-these-special-safety-coffins-180970627&#x2F;" rel="nofollow">https:&#x2F;&#x2F;www.smithsonianmag.com&#x2F;sponsored&#x2F;people-feared-being...</a>
happy-go-lucky超过 3 年前
My mother nearly died and then bounced back.<p><a href="https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=29748259" rel="nofollow">https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=29748259</a><p>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.
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RoboTeddy超过 3 年前
I wonder whether this could be a good early human application for Neurallink — with sufficient direct brain I&#x2F;O we could interact with these patients in a metaverse setting!
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lr4444lr超过 3 年前
It&#x27;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&#x2F;no questions that test all of their non-motor conscious thought processes.
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AlbertCory超过 3 年前
This is not exactly neural imaging, but hey, it was written in 1844.<p><i>The Count of Monte Cristo</i> features an old man who can only communicate via eye blinks. At one point, he &quot;spells&quot; out words letter by letter by blinking a &quot;Yes.&quot;<p>So, as lr4444lr implies, you could easily have someone &quot;spell&quot; out their birthplace. How does statistical reasoning enter into that?
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RcouF1uZ4gsC超过 3 年前
Consider me skeptical.<p>See the dead salmon fMR study for dangers of relying on it too much.<p><a href="https:&#x2F;&#x2F;blogs.scientificamerican.com&#x2F;scicurious-brain&#x2F;ignobel-prize-in-neuroscience-the-dead-salmon-study&#x2F;" rel="nofollow">https:&#x2F;&#x2F;blogs.scientificamerican.com&#x2F;scicurious-brain&#x2F;ignobe...</a>
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jl2718超过 3 年前
General anesthesia contains three main components:<p>1. Atracurium blocks movement<p>2. Propofol blocks memory<p>3. Fentanyl blocks pain.<p>...on <i>most</i> patients [edit to remove PMI]
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rmm超过 3 年前
Worst fear.
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kazinator超过 3 年前
&gt; <i>It&#x27;s usually assumed that a person in a vegetative state has no awareness of the world around them.</i><p>Not in any movie dramatizing the topic or the popular imagination.
everybodyknows超过 3 年前
&gt; 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)<p>Last I read, Medicare would pay for this -- perhaps at the request of relatives in denial? And so there&#x27;s a &quot;ventilator farm&quot; industry, one that maintains a very low public profile.<p>Anyone with current inside knowledge here to clue in the rest of us?
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awb超过 3 年前
Conscious coma patients is the premise of the movie Awakenings from 1990:<p><a href="https:&#x2F;&#x2F;youtu.be&#x2F;7exeVt7CaE4" rel="nofollow">https:&#x2F;&#x2F;youtu.be&#x2F;7exeVt7CaE4</a><p>I thought it was established back then that this was a real phenomenon.
Ericson2314超过 3 年前
I wonder how this will effect the legalization physician-assisted suicide.
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stevenalowe超过 3 年前
“… test for consciousness using technologies like fMRI”<p>Agreed, should be mandatory!
elif超过 3 年前
i hope there is an opportunity for neuralink to establish some form of communication