Tuesday, November 24, 2009

CONSCIOUSNESS IN COMA

"I Screamed, But There Was Nothing to Hear"

[FIRST A WELCOME:
I am happy to welcome to our Blog Mohan Suswaram and another member who gave only a link. I eagerly look forward to your inputs.]

"I Screamed, But There Was Nothing to Hear"

Many times discussants on Advaita raise the question about Consciousness in a Coma patient.

It is true, we do not have a clearcut definition of coma to be able to discuss the state of consciousness under comatose condition. In our Post dated 27th Sept 2009, how a patient in a vegetative state could 'learn' was talked about.

Now we have the shocking report of a patient who was in coma for 23 years but had been conscious all the time!!

What a horrific misery he must have gone through. Unimaginable and heart wrenching even to think!

"For 23 years Rom Houben was ­imprisoned in his own body. He saw his doctors and nurses as they visited him during their daily rounds; he listened to the conversations of his carers; he heard his mother deliver the news to him that his father had died. But he could do nothing. He was unable to communicate with his doctors or family. He could not move his head or weep, he could only listen.........

"I screamed, but there was nothing to hear", he said, via his keyboard.

The Belgian former engineering student said he coped with being effectively trapped in his own body by meditating. ... Sometimes, he said, 'I was only my consciousness and nothing else'.......... 'Powerlessness. Utter powerlessness. At first I was angry, then I learned to live with it,' he tapped out on to the screen during an interview with the Belgian network last night, AP reported.."

The following is from The Guardian:

"In 1988 Jan Grzebski, a Polish railway worker, fell in front of a train and was diagnosed as being in a coma. In 2007, he "woke up" to learn the iron curtain had fallen and he had gained 11 grandchildren. Doctors discovered he had been conscious throughout.

Terry Wallis of Arkansas fell into a coma after a road accident in 1984. When he woke up 19 years later, his wife had gone off with another man, had three children and was embroiled in a legal battle over who was deemed his legal guardian. His mother was with him the day he woke up and a nurse asked: "Terry, who is that?" He opened his eyes and replied, "Mom".

In 1996 Patricia White Bull from Albuquerque, New Mexico, woke after 16 years in a persistent vegetative state, scaring the life out of a nurse who was tucking in her bedding by shouting, "Don't do that!". She had fallen unconscious during the birth of her fourth child.

Twenty years ago, Carrie Coons, an 86-year-old from New York, regained consciousness after a year in a coma. Only days before, a judge had granted her family's request for the removal of her feeding tube.

Mark Newton from Hertfordshire fell into a coma in 1996 after surfacing too quickly while diving. Doctors considered him brain dead and recommended turning off his life support. His mother resisted and he woke up after six months. He had been aware of what was happening around him, but could not communicate."

From Associated Press:

"A coma is a state of unconsciousness in which the eyes are closed and the patient cannot be roused. A vegetative state is a condition in which the eyes are open and can move, and the patient has periods of sleep and periods of wakefulness, but remains unconscious and cannot reason or respond.

"It makes you think. There is still a lot of work to be done" to better diagnose such disorders, said Caroline Schnakers of the Coma Science Group."

Consious Under Anesthesia:

Patients under anesthesia too may oftener be conscious, said Dr. Wong, a surgeon a couple of years ago. The patient cannot express because his/her muscles are paralysed/too relaxed and do not move under his/her command though he/she may be conscious.

Mr. Rom Houben's condition came to light through brain scanning. His case has only just been revealed in a scientific paper released by the man who 'saved' him, top neurological expert Dr Steven Laureys, says a report in Mail Online.

So we can reasonably say 'consciousness' exists even under comatose condition. Modern scanning techniques can tell us many things about the brain as the case of Mr. Houben proves. Can the scans help us understand the brain of a Jivanmukta?

[Neuronal Correlates:

Please see my Posts on Neuronal Correlates of a Jivanmukta. My argument, in short is as follows:

We perceive a world.

But neuroscience clearly shows through studies on illusions/magic etc. that we hardly perceive what really exists 'out there.'

In other words, there is a disconnect between the ‘reality out there’ and our perception. This means that the sensory apparatus (senses and the respective cortical neurons) are inadequate to show what "exactly" is 'out there.'

2. Our brain makes a “map” of the perceptions received from the senses and interpretation made by the sensory cortex. We are actually aware of that map formed in our head. We don't have a clue what "exactly" is out there.

This “map” in our head is obviously made up of ‘thoughts’ (generated by neuronal electrical pulses as waves), or thought-stuff - whether it is beautiful girl or an ugly duck or a river or a table, these are all represented as thoughts in brain. So the constituent of all so called perceived ‘objects’ is thought-stuff.

3. The thought itself is cognized by us because we have "consciousness." Or as philosophers put it, consciousness illuminates (shows up) the thoughts.

4. A ‘me’-thought acts as the ‘seer’ of the map in our head. This is the ego providing continuity in time, coherence to experience and ownership to knowledge. It gets generated based on autobiographical information.

5. Neuroscience is as yet unable to understand how "Consciousness" is engendered in us.

6. Non-dualists find a shift in their perception. Instead of seeing the 'map' of the world in their brain with ego at the center, they identify themselves with the illuminating Consciousness. And this shift happens within and to an individual.

7. Can this shift then not be a play or happenstance in the brain itself of a Non-dualist ?

8. I wish we could get some brain scans of a Jivanmukta to see if the autobiographical memory based I-thought (i.e. 'self') collapses in him/her to give place to a "Universal Self."]

Comments are welcome.

***
Comment Added on : 19 May 2011:  Vegetative and minimally conscious states:
"A person in a vegetative state will open their eyes spontaneously and make reflexive movements, but has no cognitive function and likely does not feel pain. Recovery is possible, but the chances of improvement are greatly diminished after a year. Someone in a minimally conscious state, by contrast, has intentional, non-reflexive but inconsistent responses to stimuli. They might speak a few words or track their image in a mirror, and they feel pain. In minimally conscious and healthy people the frontal cortex would then send a message back to the temporal cortex. The reason for this is uncertain; it may be to let the temporal cortex know what to expect in the future. But for people in a vegetative state, the communication was one-way: signals passed from the temporal to frontal area, but not back."
http://www.nature.com/news/2011/110512/full/news.2011.287.html?WT.ec_id=NEWS-201\
10517


Comment Added on Sept 1, 2011: REM Sleep could prompt life-saving Decision:
The minimally conscious state, persistent vegetative state and coma are all disorders of consciousness caused by severe brain damage. Minimally conscious individuals tend to have better outcomes than vegetative individuals, but distinguishing between them is difficult and misdiagnosis is common. Getting it wrong can sometimes mean that a person who might otherwise recover has their life-support machine switched off.
The brain waves associated with sleep and dreaming could be helpful for distinguishing between people in a persistent vegetative state and those who are minimally conscious – a distinction that could seal the fate of the individual.


Comment Added on Dec 01, 2011: The mystery of anaesthesia:
"For years we had been looking at vegetative and coma patients whose brains were
responding to speech and getting terribly seduced by these images, thinking that
they were conscious," says Owen. "This told us that they are not conscious."

Similar findings are coming in from studies of people in a coma or persistent
vegetative state (PVS), who may open their eyes in a sleep-wake cycle, although
remain unresponsive. Laureys, for example, has seen a similar breakdown in
communication between different cortical areas in people in a coma. "Anaesthesia
is a pharmacologically induced coma," he says. "That same breakdown in global
neuronal workspace is occurring."

Comment Added on Dec 05, 2011:  Ambien Revives the Unconscious:
"In 1999, Louis Viljoen was hit by a truck and declared vegetative, kept alive by machines for three years before his doctor prescribed him zolpidem thinking it might stop him from clawing his mattress in the middle of the night. Twenty minutes after receiving his first dose, he woke up and started talking to his mother. He floated in and out of consciousness over the next several days, waking up for increasingly long periods after receiving his zolpidem until he stayed awake without the drug."
http://the-scientist.com/2011/12/05/sleep-aid-revives-unconscious/

Added on Apr 06, 2012: As you awaken from anesthesia:
"We expected to see the outer bits of brain, the cerebral cortex (often thought to be the seat of higher human consciousness), would turn back on when consciousness was restored following anesthesia. Surprisingly, that is not what the images showed us. In fact, the central core structures of the more primitive brain structures including the thalamus and parts of the limbic system appeared to become functional first, suggesting that a foundational primitive conscious state must be restored before higher order conscious activity can occur."
http://medicalxpress.com/news/2012-04-primitive-consciousness-emerges-awaken-anesthesia.html

Added on 16 Jun 2012:  Communicating with people in a vegetative state:
"Despite highly controversial debate of consciousness, Owen believes that up to20 percent of people in a vegetative state in the United States are capable of communicating. "What we're seeing here is a population of totally locked-in patients. Over the past decade, he has used functional magnetic resonance imaging (fMRI) as a sort of interrogation tool—mapping the brain activity of comatose people as he asks them a series of questions. He has found that in a subset of patients thought to be far gone, the brain activity in response to questioning was comparable to what's observed in healthy people."
http://the-scientist.com/2012/06/14/fmri-mind-reader/
(See also: Brain Scans of Comatose Patients 
 http://www.scientificamerican.com/article.cfm?id=do-brain-scans-comatose-patients-reveal-conscious-state)

Added on 14 Nov 2012:  An “Unconscious” Man Talks:
"Scott Routley, a 39-year-old Canadian patient that doctors had considered vegetative and incapable of communicating following a car crash 12 years ago, was able to tell doctors that he’s not in pain via functional magnetic resonance imaging (fMRI) of his brain. Scott has been able to show he has a conscious, thinking mind."
http://www.the-scientist.com/?articles.view/articleNo/33264/title/An--Unconscious--Man-Talks/

Added on 27 Nov 2012:  Brain in a Coma:
"Compared with healthy patients in the study, high-traffic hubs of brain activity are dark in coma patients while more quiet regions spring to life. Scientists still don't understand exactly how human consciousness works, but the twilight state of a coma could reveal some insight. Past research revealed that a person in a coma is closer to being anesthetized than being asleep. Other studies have found that vegetative and minimally conscious patients have very different brain activity. But for the most part, it was hard to find obvious differences in brain functioning between healthy patients and those who have lost consciousness. In healthy patients, about 40 regions lit up in concert with many other parts of the brain. These high-traffic hubs, like busy airports, apparently process much of the electrical firing in the brain. But in the coma patients, many of these hubs were darkened, and other, normally peripheral regions took their place. Intriguingly, coma patients had fewer hubs in a region called the precuneus, which is known to play a role in consciousness and memory."
http://www.livescience.com/25030-coma-brain-reorganized.html

Added on 05 Dec 2012:  Brain networks restructured in comatose patients:
"By analysing the connectivity at a local level, the authors of the study have observed that some brain regions ("hubs"), which are highly connected in healthy volunteers, are less well connected in comatose patients. Conversely, the less densely connected regions in the network in healthy subjects become "hubs" in comatose patients."
http://www.eurekalert.org/pub_releases/2012-12/ind-trr120412.php

Added on 19 Apr 2013:  Measuring Consciousness: 

"Over the past 5 years, researchers have made significant progress in understanding what happens in the brain as consciousness departs and returns. Peering into the anesthetized brain with neuroimaging and electroencephalograph (EEG) recordings, scientists have found evidence to support the "integrated-information theory," which holds that consciousness relies on communication between different brain areas, and fades as that communication breaks down. EEG studies have also revealed distinctive brain wave patterns that signal when consciousness is lost and regained, offering easily identifiable markers for this impairment of communication. Though many questions remain, advances in brain activity monitoring promise to shed light the neural basis of consciousness."
http://www.the-scientist.com//?articles.view/articleNo/35140/title/Measuring-Con\sciousness/


Also See:  http://beyond-advaita.blogspot.com/2010/09/research-on-non-dualism-self-and.html



3 comments:

Cos Mic said...

A few points..

1) On Pt 4 above: How can a "me" thought that sees and provides continuity? Clearly thoughts cannot see. Consciousness is aware of thoughts. Its consciousness or a sense of presence that provides continuity. "you" can observe it yourself very easily - dont need much Sadhana/practise to observe this simple fact.

2) Is consciousness really in us or we are in consciousness? You can see this for yourself if you just observe for a few seconds. If you want to address is logically... clearly consciousness has no form, so how can it be caught inside our body. It must be oozing out in that case!

Approaching nonduality from a logical mind is ok to the extent that it will lead you soon to understand that a) logic cannot explain the whole universe - clearly universe haslogic and illogical stuff. Otherwise theconcept of logic would not be valid! So if universe/creation has illogic, you cannot use just logic to understand it. 2) Mind is finite. How can it comprehend that infinite.

However, if you focus on just awareness/ consciousness "you' (as consciousness, not the thought 'me') can be/know reality.

Cheers.

ramesam said...

First a big Thank you to Cos Mic for the time and thought he could spend on the Blog.

Re: "me" thought: It is used as a short hand to express the gateway 'node' of neuronal networks through which all such information which is related to the body organism are processed. It is not yet understood how this process engenders the subjective feeling of a 'self', a 'me', within the organism. Neuroscience could not find a specific 'spot' in the brain for the 'self.' The word 'seer' is used in a figuritive sense because after an object is cognised, the immediate thought that usually follows is : I 'see' the object.

Re: Consciousness: The word Consciousness in Advaita and Neuroscience undoubtedly point to different things. Neuroscience is still grapling with the issue, as I already indicated. The statements as given by Cos Mic are from the Advaitic standpoint and are absolutely indisputable.

RE: The brain scans: The main point made in the suggestion regarding brain scans of a Jivanmukta is this:
The "realization" of a Jivanmukta is totally confined to that specific individual and is happening within him/her. Would "realization" of Truth leave a foot-print within him/her or not? We may not look so much for a thing that is "present" as a foot-print in the brain. It could be the "absence" of certain processes that happen in a normal man (e.g. absence of 'self' node gateway, higher hormonal levels of oxytocin etc. In a Jivanmukta). At this investigative stage no suggestion is being implied about establishing any cause-effect relationships or logical derivations.

Thanks and regards

ramesam said...

Sound test could identify 'locked-in' patients:

[Takn from: New Scientist
http://www.newscientist.com/article/dn20471-sound-test-could-identify-lockedin-patients.html?DCMP=OTC-rss&nsref=brain]

"While some people with serious brain damage are totally unaware of their surroundings, others are in a "minimally conscious" state (MCS). These patients have some level of awareness but may be unable express it to those around them because of the injuries to their brain.

The discovery of a signalling pathway in the brain that is different in the two conditions could open the way to an easy and objective way of telling whether a particular patient has any remaining consciousness, even if they can't respond in an obvious way.

Melanie Boly's analysis points to a specific feedback mechanism between the temporal cortex, which is responsible for auditory processing, and a higher-level brain area called the frontal cortex. Both healthy and MCS subjects were able to send signals between these brain areas in both directions. In vegetative state patients, signals could pass from the auditory area to the frontal cortex, but not in the opposite direction.

Boly believes the loss of this so-called "top-down" process is what causes unconsciousness in brain-damaged patients, and that it can therefore be used to identify MCS patients."