Tennis Anyone?–Communicating With the Vegetative

Tennis Anyone?–Communicating With the Vegetative August 23, 2016

Pointing to tennis ball--cropped

Dr. Adrian Owen needed to find a way to convince doubters of the existence of covert cognition. Then, he hit upon an ingenious method. Using a functional-MRI scanner that can detect brain activity by tracking patterns of blood flow, he asked vegetative patients to either imagine playing tennis or walking around their house. Tennis meant yes, while home indicated no.

Photo credit: Emanuele.
Photo credit: Emanuele.

The study’s tennis question stimulated the motor centers of the brain, while the navigational one light up the spacial areas. Using this method, five patients were able to answer verifiable biographical questions. One, Scott Routley, was able to answer five out of six correctly. Scott’s doctors had dismissed his loved ones’ reports of awareness, just as mine did. His DNR order was promptly rescinded.

As I mentioned in my last post, Dr. Owen went a step further with Scott and asked him if he was in pain. Fortunately, he wasn’t. But if he had been, steps would’ve been taken to ease his discomfort. Scott also indicated that he enjoyed the hockey games his brother put on the TV in his room. If asked, I would’ve said that I loved the snippets of Hitchhiker’s Guide to the Galaxy that played out in the background of my other coma-dreams. I’m a huge fan, and both Keith and my mom read/played Hitchhiker’s Guide to/for me during my coma. (My mom played the audiobook*, while Keith read from the book.)

But fMRI machines are bulky, immobile, expensive, and relatively rare. They could never be used as a widespread method of covert cognition detection. That’s why the Owen Lab is working to develop a system using EEGs, which are available in most community hospitals. (Indeed, I was given an EEG.)

Yet Kate Bainbridge, as I’ve referred to here and here, and Scott Routley are not the only patients who have already been helped by Dr. Owen’s research. The Owen Lab devised another clever way to gauge covert awareness. Cutting together a condensed version of a famous Alfred Hitchcock Presents called, “Bang! You’re Dead,” they played it for two unresponsive vegetative patients and a group of healthy control subjects while they lay in an fMRI machine. A predictable pattern of response to the plot’s many suspenseful moments–directed by the Master of Suspense himself–could be detected in the controls and compared to the patients.

One showed no response, but the other matched the healthy subjects almost identically. That showed the patient–Jeff Tremblay–was following the plot point by point.

The choice of Jeff Tremblay, however, wasn’t random. His dad had answered a call for vegetative subjects for their study. Paul Tremblay was eager to have his son tested. He had been taking his son to the movies once a week for more than a decade, ever since a kick to the chest put Jeff into cardiac arrest.

Jeff’s doctor’s dismissed Paul’s reports of his son’s enjoyment of the films If you’re surprised by this, you haven’t been paying attention to this series of posts. Jeff’s favorite genre is apparently comedies. Look at Jeff’s face in this article and tell me you don’t see the look of genuine delight on his face.

The landmark Hitchcock study didn’t change a thing about Jeff Tremblay’s life. He still requires round the clock care. But now, his Dad knows that his loving devotion to him hasn’t been in vain. Jeff really can follow the plots of the movies they watch together…and derive pleasure from them.

And maybe, from now on, Jeff’s doctors will take his dad’s observations more seriously.

Here is Part One, Part Two, Part Three, Part Four, and Part Five of the Coma Day series celebrating the third anniversary of my awakening and the advances in covert cognition detection.

*In my Skeptical Inquirer article, I incorrectly said that my mother played for me the original BBC radio series that Hitchhiker’s Guide was based on. She has both; I’m still learning things about my coma three years out.

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