# Doctors "talk" to man in vegetative state **URL:** \ **Category:** In My Humble Opinion\ **Created:** [November 14, 2012, 4:04pm UTC](https://boards.straightdope.com/t/doctors-talk-to-man-in-vegetative-state/640990 "2012-11-14T16:04:19Z")\ **Posts on this page:** 16\ **Page:** 1
**Author:** ![Sateryn76](https://avatars.discourse-cdn.com/v4/letter/s/a88e4f/32.png) [@Sateryn76](https://boards.straightdope.com/u/Sateryn76)\ **Post date:** [November 14, 2012, 4:04pm UTC](https://boards.straightdope.com/t/doctors-talk-to-man-in-vegetative-state/640990/1 "2012-11-14T16:04:19Z")
Just skimmed this story, and it appears that a group of doctors are saying that they studied “brain scans” of a vegetative patient and determined that he could answer questions, including saying he wasn’t in any pain. I am…hopeful but very skeptical. How are they reading the scans to get language out of it? Has this been studied elsewhere, by an independent panel who hasn’t been prompted to “read” them a certain way? My grasp of neuroscience is sketchy at best, and I don’t understand how you read a scan and get words from it. And I can see how this could be a bad thing, as well as a good thing, in terms of loved ones and costs of medical care for these people. And, I bet it will bring up a huge new issue on the debate about euthanasia, if some patients ask to be killed. Your thoughts? Story here - [BBC News](http://www.bbc.co.uk/news/health-20268044) ---
**Author:** ![DMark](https://avatars.discourse-cdn.com/v4/letter/d/e68b1a/32.png) [@DMark](https://boards.straightdope.com/u/DMark)\ **Post date:** [November 14, 2012, 5:05pm UTC](https://boards.straightdope.com/t/doctors-talk-to-man-in-vegetative-state/640990/2 "2012-11-14T17:05:48Z")
Well, it would be fairly easy to prove. Ask many yes/no questions from the family that only the patient would know; did your mother ski, is your father allergic to shrimp, etc. If the doctors come up with 99% correct answers to 100 questions, you can be fairly certain this brain scan works. That said, I kind of find this story more horrifying than not. If true, think of all those people over the years who were indeed able to understand and not communicate, and forced to just have input in that netherworld. On the flip side, now you could ask the patient if they want to listen to music, or have a book read to them, or are cold or hot, or do they want to have a visit from obnoxious Aunt Jane. Additionally, there will be a way to allow that slight change in brain activity to be hooked up to a machine to vocalize at least yes and no - some communication from family would now be possible. Then again, now there is the problem of quality of life and the patient’s wishes…do they want the tubes and wires disconnected? Would this hold up in court and even be legal, assuming they ask to be “let go”? Interesting study, but raises lots of questions as well. ---
**Author:** ![Sateryn76](https://avatars.discourse-cdn.com/v4/letter/s/a88e4f/32.png) [@Sateryn76](https://boards.straightdope.com/u/Sateryn76)\ **Post date:** [November 14, 2012, 5:16pm UTC](https://boards.straightdope.com/t/doctors-talk-to-man-in-vegetative-state/640990/3 "2012-11-14T17:16:17Z")
The article notes that the patient indicated that he knew of a new niece that was born after his accident, which would seem to indicate that he had awareness of events of the outside world. I wish I could feel that this was Great News, but there’s so much potential for horror here… ---
**Author:** ![cochrane](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cochrane/32/10441_2.png) [@cochrane](https://boards.straightdope.com/u/cochrane)\ **Post date:** [November 14, 2012, 5:46pm UTC](https://boards.straightdope.com/t/doctors-talk-to-man-in-vegetative-state/640990/4 "2012-11-14T17:46:54Z")
> [@Sateryn76](#): > > The article notes that the patient indicated that he knew of a new niece that was born after his accident, which would seem to indicate that he had awareness of events of the outside world. > > I wish I could feel that this was Great News, but there’s so much potential for horror here… The article is actually about two different patients, Scott Routley and Steven Graham. Graham is the one who knew about his niece. ---
**Author:** ![you\_with\_the\_face](https://avatars.discourse-cdn.com/v4/letter/y/ecccb3/32.png) [@you\_with\_the\_face](https://boards.straightdope.com/u/you_with_the_face)\ **Post date:** [November 14, 2012, 6:29pm UTC](https://boards.straightdope.com/t/doctors-talk-to-man-in-vegetative-state/640990/5 "2012-11-14T18:29:26Z")
Imagine if you were a vegetable capable of communicating this way, but no one ever asked the one question you were praying that they’d ask. “Do you want to live?” **monstro** , if I ever get in this state, don’t tip toe around the mulberry bush by asking me about nieces and crap. Do me the favor of asking me the obvious. Thanks in advance. ---
**Author:** ![Winston\_Smith](https://avatars.discourse-cdn.com/v4/letter/w/e95f7d/32.png) [@Winston\_Smith](https://boards.straightdope.com/u/Winston_Smith)\ **Post date:** [November 14, 2012, 6:49pm UTC](https://boards.straightdope.com/t/doctors-talk-to-man-in-vegetative-state/640990/6 "2012-11-14T18:49:20Z")
I think this story only illustrates that the medical state described as “vegitative” actually occurs on a sort of continuum, which I guess isn’t all that surprising or all that hard to believe. ---
**Author:** ![Dendarii\_Dame](https://avatars.discourse-cdn.com/v4/letter/d/bbce88/32.png) [@Dendarii\_Dame](https://boards.straightdope.com/u/Dendarii_Dame)\ **Post date:** [November 14, 2012, 6:56pm UTC](https://boards.straightdope.com/t/doctors-talk-to-man-in-vegetative-state/640990/7 "2012-11-14T18:56:54Z")
> [@DMark](#): > > Then again, now there is the problem of quality of life and the patient’s wishes…do they want the tubes and wires disconnected? Would this hold up in court and even be legal, assuming they ask to be “let go”? > > Interesting study, but raises lots of questions as well. One question might be, what if the person says, “Don’t disconnect me.” (Or, if this is more relevant, “Keep feeding me. I want to live.”) ---
**Author:** ![RTFirefly](https://avatars.discourse-cdn.com/v4/letter/r/c77e96/32.png) [@RTFirefly](https://boards.straightdope.com/u/RTFirefly)\ **Post date:** [November 14, 2012, 7:22pm UTC](https://boards.straightdope.com/t/doctors-talk-to-man-in-vegetative-state/640990/8 "2012-11-14T19:22:29Z")
> [@DMark](#): > > Well, it would be fairly easy to prove. > Ask many yes/no questions from the family that only the patient would know; did your mother ski, is your father allergic to shrimp, etc. If the doctors come up with 99% correct answers to 100 questions, you can be fairly certain this brain scan works. Correct answers to five such yes-no questions should suffice to get 95% certainty that it is indeed the patient responding; seven would suffice for 99% certainty. ---
**Author:** ![Little\_Nemo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/little_nemo/32/3120_2.png) [@Little\_Nemo](https://boards.straightdope.com/u/Little_Nemo)\ **Post date:** [November 14, 2012, 7:51pm UTC](https://boards.straightdope.com/t/doctors-talk-to-man-in-vegetative-state/640990/9 "2012-11-14T19:51:11Z")
There’s a simple test for these type of claims (I’m including facilitated writing in this). Can the person communicate information the tester doesn’t know? Go into the patient’s room and tell them a number between one and ten. Call the tester into the room. Have the tester ask the patient what the number is. If the subject can communicate the number to the tester via brain scans or facilitated writing or a ouija board, then I’ll start believing the claims. ---
**Author:** ![TruCelt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/trucelt/32/523_2.png) [@TruCelt](https://boards.straightdope.com/u/TruCelt)\ **Post date:** [November 14, 2012, 7:57pm UTC](https://boards.straightdope.com/t/doctors-talk-to-man-in-vegetative-state/640990/10 "2012-11-14T19:57:26Z")
I don’t think they’re saying he can think “Ten” and they’ll pck it up; but that if the said “Was it six?” he’d be able to indicate “no.” ---
**Author:** ![lavenderviolet](https://avatars.discourse-cdn.com/v4/letter/l/cdc98d/32.png) [@lavenderviolet](https://boards.straightdope.com/u/lavenderviolet)\ **Post date:** [November 14, 2012, 8:12pm UTC](https://boards.straightdope.com/t/doctors-talk-to-man-in-vegetative-state/640990/11 "2012-11-14T20:12:44Z")
I have read about other research along these lines. They don’t LITERALLY get words from the brain scan. The way it works is that they use an fMRI (an MRI that shows levels of blood flow/activity in the brain) and they ask the person to think about things that you would expect to activate different parts of the brain to correspond to yes or no. For example, they might tell the person that to indicate “yes” you should picture yourself walking through your home, and for “no” you should picture yourself playing basketball. Different parts of your brain will light up for each activity. I think this is very exciting. If people are able to communicate non-verbally using their brain, that would be an incredible breakthrough for people with locked in syndrome and ALS, let alone those in apparent vegetative states. Just being able to ask them if they are in pain, would like to be repositioned, etc. would be a wonderful thing. ---
**Author:** ![Left\_Hand\_of\_Dorkness](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/left_hand_of_dorkness/32/7156_2.png) [@Left\_Hand\_of\_Dorkness](https://boards.straightdope.com/u/Left_Hand_of_Dorkness)\ **Post date:** [November 14, 2012, 8:36pm UTC](https://boards.straightdope.com/t/doctors-talk-to-man-in-vegetative-state/640990/12 "2012-11-14T20:36:36Z")
Can anyone track down the original study? The possibilities for a double-blind experiment seem so obvious that I can’t imagine they didn’t do them, but the article doesn’t mention any methodology. Unfortunately, there has been enough woo around similar subjects that I’m a little bit skeptical of these results until we know that the study was rigorous. ---
**Author:** ![Little\_Nemo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/little_nemo/32/3120_2.png) [@Little\_Nemo](https://boards.straightdope.com/u/Little_Nemo)\ **Post date:** [November 14, 2012, 9:09pm UTC](https://boards.straightdope.com/t/doctors-talk-to-man-in-vegetative-state/640990/13 "2012-11-14T21:09:11Z")
> [@TruCelt](#): > > I don’t think they’re saying he can think “Ten” and they’ll pck it up; but that if the said “Was it six?” he’d be able to indicate “no.” I’d have no problems with a series of yes or no questions being used. The issue is whether the subject can communicate a clear unambiguous piece of information, not the means used. ---
**Author:** ![hogarth](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hogarth/32/1773_2.png) [@hogarth](https://boards.straightdope.com/u/hogarth)\ **Post date:** [November 15, 2012, 3:11pm UTC](https://boards.straightdope.com/t/doctors-talk-to-man-in-vegetative-state/640990/14 "2012-11-15T15:11:23Z")
> [@Left\_Hand\_of\_Dorkness](#): > > Can anyone track down the original study? The possibilities for a double-blind experiment seem so obvious that I can’t imagine they didn’t do them, but the article doesn’t mention any methodology. Unfortunately, there has been enough woo around similar subjects that I’m a little bit skeptical of these results until we know that the study was rigorous. There’s a link in the BBC article: [http://www.nejm.org/doi/full/10.1056/NEJMoa0905370#t=articleMethods](http://www.nejm.org/doi/full/10.1056/NEJMoa0905370#t=articleMethods) From the paper: > [@](#): > > After the localizer scans had been obtained, all 16 control subjects and 1 patient underwent functional MRI during which they attempted to answer questions by modulating their brain activity, and a set of so-called communication scans were obtained. Before each of these imaging sessions, participants were asked a yes-or-no question (e.g., “Do you have any brothers?”) and instructed to respond during the imaging session by using one type of mental imagery (either motor imagery or spatial imagery) for “yes” and the other for “no.” **The nature of the questions ensured that the investigators would not know the correct answers before judging the functional MRI data.** Participants were asked to respond by thinking of whichever imagery corresponded to the answer that they wanted to convey. Communication scanning was identical to localizer scanning with the exception that the same neutral word “answer” was used to cue each response to a question (with “relax” used as the cue for rest periods). Cues were delivered once, at the beginning of each period. Three communication scans (with one question per scan) were obtained for each of the 16 healthy control subjects. To maximize statistical power, six communication scans (with one question per scan) were obtained for the patient. (Emphasis mine.) Also: > [@](#): > > Among the 54 patients, we identified 5 who could willfully modulate their brain activity (Figure 1). ---
**Author:** ![filmore](https://avatars.discourse-cdn.com/v4/letter/f/7993a0/32.png) [@filmore](https://boards.straightdope.com/u/filmore)\ **Post date:** [November 15, 2012, 3:22pm UTC](https://boards.straightdope.com/t/doctors-talk-to-man-in-vegetative-state/640990/15 "2012-11-15T15:22:31Z")
I wonder if they could come up with 4 unique scans? If so, the patient would be able to specify 24 characters by using combinations of 4 thought patterns. For example, if the four patterns were: - Baseball - Food - Math - Love Then by thinking of those things in certain orders he could specify different letters: A = Baseball, Food, Math, Love B = Baseball, Food, Love, Math … Z = Love, Math, Food, Baseball ---
**Author:** ![Filbert](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/filbert/32/3433_2.png) [@Filbert](https://boards.straightdope.com/u/Filbert)\ **Post date:** [November 15, 2012, 3:31pm UTC](https://boards.straightdope.com/t/doctors-talk-to-man-in-vegetative-state/640990/16 "2012-11-15T15:31:27Z")
> [@filmore](#): > > I wonder if they could come up with 4 unique scans? If so, the patient would be able to specify 24 characters by using combinations of 4 thought patterns. For example, if the four patterns were: > > - Baseball > - Food > - Math > - Love > Then by thinking of those things in certain orders he could specify different letters: > > A = Baseball, Food, Math, Love > B = Baseball, Food, Love, Math > … > Z = Love, Math, Food, Baseball You wouldn’t need 4, you could work out a kind of morse with just the two. However, how expensive is it to run even one scan of this kind? I’m afraid I can’t see that becoming common, even if there are only a small number of people currently diagnosed as vegetative who would be able to communicate that way.