06 February 2010

Locked in, locked out

Most new research doesn't make it to the general news media. This week's publication of a paper describing two-way communication with patients who had been believed to be in a persistent vegetative state, via functional magnetic resonance imaging, is an exception: it captures the imagination and horrifies to an irresistible extent.

As part of the spill-over from that story I overheard, on a passing radio in a crowded place, fragments of an account by someone who had been in this locked-in state for more than two years. (I can't, unfortunately, locate a reference for the radio programme.) As I listened to the bits I could hear, I was most struck not by the science or technology involved but by the calm, rational phrasing of the interviewee.

I am a person who considers myself able to cope well with isolation. I have, on occasion, spent weeks or even months on end without human company and (so far as I know; perhaps I delude myself and others think differently) suffered no ill effects. But I cannot imagine that, after two years in which I was fully aware of the world but unable to communicate with it, I would still be in any sense sane – never mind able to construct rational discussion of the experience. I know, from experience, that human beings are incredibly tough ... but thinking about this situation raises my amazement at the degree of that toughness by several orders of magnitude.


Dr. C said...

I'll read the article this week (if we ever dig out from the snow). However, remember that ancient time three years ago when we were discussing Information? Pertinent to that thread was the Isolation Tank. This is surely a perversion of that scenario where one has sensory input but still has the isolation aspect. Of course those in an isolation tank can go crazy, so I would agree with you. There is another scenario that is thankfully transient. If the anesthesiologist gives a paralyzing agent but forgets the anesthesia, the patient is able to sense everything but unable to communicate. The famous, if apocryphal, tale is that when this happened to a female patient undergoing surgery, after administering the muscle blocker, but not the anesthetic, the surgeon said "Let's get this tuna up on the table." The woman didn't care about the pain as much as the insult!

Felix said...

Agreed. I had the use of isolation (whether in a tank or in solitary confinement) at th back of my mind, and included reference to it in a first draft of the post.

I can't decide which would be worst for my sanity ... loss of sensory input, or full input and loss of motor output. [shiver]