The fear of death is most often seen as people's greatest fear. Yet, the fear of being buried alive trumps that.
Ten years ago, Adrian Owen, a young British neroscientist, heard about a patient named Kate Bainbridge, a twenty-six-year-old school teacher who had become comatose after a flulike illness, and was eventually diagnosed as being in what neurologists call a vegetative state.
The term "vegetative" was proposed in 1972, by Bryan Jennett, a neurosurgeon, and Fred Plum, a neurologist, who chose it based on a definition in the O.E.D: "an organic body capable of growth and development but devoid of sensation and thought." A person in a coma appears to be asleep and is unaware of even painful stimulation; a person in a vegetative state has periods of wakefulness but shows no awareness of his or her environment and does not make purposeful movements.
Owen decided to scan Bainbridge's brain. Whenever pictures of Bainbridge's family flashed on the screen, an area of her brain called the fusiform-gyrus, which neuroscientists had identified as playing a centrol role in face recognition, lit up on the scan. "We were stunned," says Owen. "The fusiform-gyrus activation in her brain was not simply similar to normal; it was exactly the same as normal volunteers."
Few vegetative or minimally conscious patients ever recover fully, and many are unlikely to improve. Doctors can miss signs of consciousness in vegetative patients. According to several American and British studies completed in the late nineties, patients suffering from what is known as "disorders of consciousness" are misdiagnosed between fifteen and forty-three percent of the time. For decades, doctors assumed that patients who have been diagnosed as vegetative lack any capacity for conscious thought.
Yet, we assimilate information unconsciously all the time; at any given moment, we process thousands of stimuli, of which we pay attention to only a few. As you read this sentence, you may not be aware of the birds singing in the back yard, but your brain has analyzed the sound and concluded that it poses no threat to you. In the past several decades, scientists have uncovered particularly dramatic examples of unconscious processing. Scans suggest that the axons in a severely injured brain grow and form new connections--a finding that contradicts the long-standing assumption that a damaged brain is incapable of healing after a lengthy period.
Recent research by Owen and other neuroscientists may eventually help make diagnoses more accurate, but it is not yet clear how the new brain-scan data will affect the medical understanding of consciousness. As Owen put it, "The thought of coma, vegetative state, and other disorders of consciousness troubles us all, because it awakens the old terror of being buried alive. Can any of these patients think, feel, or understand those around them? And, if so, what does this tell us about the nature of consciousness itself?"
Kate Bainbridge has made considerable progress, recovering the use of her arms, and much of her mental function, although she is unable to walk. She still has difficulty talking, and uses a letter board to communicate with people who are not used to her speech. "Most scans show what is wrong with your brain, which doctors need to know," Bainbridge wrote in an email message. "But Adrian Owen's scans show what is working. I say they found parts of my brain were working. It really scares me to think what might have happened to me if I had not had the scans. They show people it was worth carrying on even though my body was unresponsive."
Source: Silent Minds, The New Yorker, October 15, 2007