The day of my awakening, August 25, has become something of a second birthday for me. I don’t receive any presents beyond the gift of another year of life–after all, without life you have nothing–but it’s still a date to cherish. This Coma Day, as Keith has dubbed it, will mark my third year of complete consciousness, excluding mornings.
August 20th, however, isn’t a date we tend to mark as special. What happened that day wasn’t as outwardly dramatic, yet in its way was just as crucial to my recovery. Though it was the day I was moved to a nursing home, the important part was the move itself, which was like a cup of coffee to my slowly awakening brain.
The stages of my awakening can be traced to specific external stimuli. For instance, I believe the majority of my coma-dream began after a gastric feeding tube was surgically inserted in my stomach on August 16. Keith reports that I started moving my eyes and my tongue after that physical insult
Indeed, the earliest dateable segment in my roster of coma-dreams came from the MRI of my brain, just thirteen days after I slipped into my coma. In fact, I believe the MRI was the event that jumpstarted my awareness in the first place.
I couldn’t make out the words, probably because the language centers of my brain hadn’t been reactivated yet. Nor could I see anything, since my eyes were still shut. I did, however, feel a sensation of being dragged forward. After my awakening, I instantly recognized that deep, sonorous MRI voice because I had undergone MRIs before. It’s utterly unmistakable.
The MRI voice segment was a recurring serial amidst the rotating series of coma-dreams. In this particular coma-dream, I wondered if The Voice belonged to a serial killer who dragging me off to my doom (that never came). This ominous snippet alternated with my more complex coma-dreams, which were generated after my cognition improved. It was a flashback to an earlier state of simpler form of cognition. My awakening brain sought to make sense of these confusing sounds and sensations by forming a theory based serial killer movies I had seen.
Incidentally, the serial killer scenario was one of my theories about the strangely caring voice that kept telling me, “Remember, I will always love you and I will never leave you.” After all, I didn’t know where the voice was coming from. And, out of context, it does sound like something a stalker might say. That voice later morphed into my “new” boyfriend, who looked almost exactly Keith–down to the kludgey eyeglass repair he had improvised in Sicily (soon before my coma). The only difference was that he had a full beard. Oddly enough, after my awakening, I discovered that Keith had grown a full beard during the six weeks of my coma. He simply didn’t have time to shave.
But why would the MRI provide the spark that woke up my brain? Franz Mesmer strikes again? Not exactly. The MRI goosed my level of consciousness for the same reason I showed increased awareness after a gastric feeding tube was surgically inserted into my stomach. Every time I was moved or strongly stimulated, I woke up a little more. It wasn’t the MRI itself, but the strenuous transfer from my ICU bed to a stretcher and from a stationary respirator to a portable one, plus the move itself and the change in environment.Yet my doctors refused me any form of physical therapy whatsoever, even passive exercise, which would probably have greatly shortened my recovery time after my awakening. It’s impossible to say for certain, but there is evidence from a famous case that the stimulus itself might have improved my awareness, as I will detail in a future post.
But what was the use? my doctor’s thought. I was clearly a vegetable. I mean, look at all those dead spots on her MRI (the very one that goosed my sleeping brain to awaken). Clearly, she’s a basket case. The physicians pooh-poohed my loved ones reports of improving movement and awareness. My mom thinks that some of my nurses were gently guiding her to eventually pull the plug. Look at her, they would say with a sympathetic sigh. What kind of quality of life does she have? (Actually, I was perfectly happy in my fantasy world.)
Yes, I know many families see reflex movements in their loved ones and cling to tragically vain hopes of recovery, like Terry Schiavo’s family did. But covert cognition researchers like those in the Owen Lab have strong evidence that as many as one in five patients with disorders of consciousness experience some degree of covert awareness. Most will never recover to the degree I have, but as I will detail in a future post, Dr. Adrian Owen and his team shown that it’s possible to involve some of these outwardly unresponsive patients in their own medical decisions.
The hospital had been trying to ship me off to a nursing home for weeks, but I wasn’t stable enough until late August. My doctors at the hospital rated my chances of recovery as poor, but the doctor who received me at All Saints Healthcare told Keith that I didn’t seem to be the same patient described in my records. Indeed, Keith says that I showed increased signs of arousal between the time I entered the ambulance and my arrival at the nursing home.
Five days later, I awoke from my coma with no signs of cognitive damage whatsoever. I haven’t really gone in depth into the subject of covert cognition because, when I first started writing for The Secular Spectrum, I felt I needed to connect my posts directly to secularist subjects. I think that was too close a reading of the blog’s mandate. But to celebrate Coma Day, I’m going to be rectifying my oversight by writing about covert awareness.
Of those one in five patients, few recover as fully as I have. And as a writer, I feel I have a special obligation to speak for the patients who can’t…yet.