Ruminations: Perseverance

Body and soul are not two substances but one. They are man becoming aware of himself in two different ways. C.F. von Weizsacker

A Belgian neuroscientist has published his study on how the human brain works, even when it is thought that an individual suffering catastrophic and complete bodily-dysfunction due to an irreversible and utterly damaging shock to the system has completely lost brain function. Dr. Steven Laureys, neurologist leading the coma science group and Department of Neurology at Liege University Hospital used state-of-the-art imaging technology to scan the brain of a man who had been in a coma for 23 years.

Rom Houben was diagnosed, post-accident, as existing in a persistent vegetative state. Medical science could do nothing for him. Initially, after his life-destroying car crash when he was twenty, completely paralyzed, doctors and nurses examined and tested his responses - or lack of them, on a regular basis, attempting to diagnose his condition other than as a write-off of a human life. Using a standard coma scale, judging patient response by eye, verbal and motor responses, he was judged to be 'extinct'.

His parents were not convinced. Although there was no way to ascertain whether his mind was alert and operative, since he was functionally incapable of any kind of response, they believed their son was still there, existing within the shell of the strong and capable body he once had. They never gave up hope. And we've seen that story many times before, with parents committed to their unresponsive children, languishing in a continued comatose state. Mr. Houben is now 46, he is completely physically dependent, but his thinking capacities are as normal as they ever were.

He lived the unspeakable nightmare of knowing he was consigned to the oblivion of never gaining consciousness in the minds of the medical community. Over two decades of hearing people speak, but incapable of responding, of offering even the minutest clue that he was aware. "I became a witness to my own suffering as doctors and nurses tried to speak with me until they gave up all hope", he explained. "I dreamed myself away", he said, describing how he could possibly have kept himself from complete and utter despair over his years of solitude.

Dr. Laureys not only discovered that Mr. Houben had a normally functioning brain, he also taught his patient how he might communicate, using a computerized device to spell out words. Mr. Houben now lives in an assisted environment, a nursing residence, able to read with the help of a device hovering above his head, and he can tap out messages to communicate. "All that time", before the discovery of his conscious awareness, "I just literally dreamed of a better life."

Dr. Laureys' intention in writing of his discovery and the subsequent rescue of Mr. Houben's mind from complete isolation, is to highlight the likely prevalence of such pernicious comas where people are assumed beyond rescue, are given up for good, allowed to live in neurological, bodily vegetative states until natural death occurs, or else life support assistance is removed, hastening death.

"In Germany alone each year some 100,000 people suffer from severe traumatic brain injury" Dr. Laureys pointed out. "Some of them die, others regain health. But an estimated 3,000 to 5,000 people a year remain trapped in an intermediate stage; they go on living without ever coming back again."

For some, that need not be their ultimate fate, as the experience with Rom Houben demonstrates.