Do random thoughts rattle that addled brain? Does she feel fear, confusion, terror, or pain? Does she wonder where she is and why nothing’s the same?
I’m talking about my sister-in-law, Eva, whose entire existence is now on hold. Because last November her seemingly durable consciousness got yanked from its permanent mold.
That’s when she and her boyfriend, hopelessly inebriated, decided to take his motorcycle for what turned out to be a fateful spin. The completely predictable result: a horrific accident that hurled both of them to the blood-spattered pavement where he, wearing the only helmet, lay whimpering with a seriously shattered leg while she wallowed in the silent echoes of a seriously shattered brain.
Today, just over five months later, my wife’s 42-year-old younger sister spends her days and nights in a persistent vegetative state. Which is to say that she opens her eyes, looks around, and even exhibits pained facial expressions, though blind, mute, and showing only vague signs of awareness or comprehension.
“Given her relatively young age,” a doctor told us after the accident, “there may be some recovery, though it could take years.”
And indeed, we have seen minor improvement though its pace has been painfully slow. Which makes us wonder just what’s happening inside that banged-up head.
A recent article in the New York Times Magazine offered some clues. Two years ago, the article reported, the New England Journal of Medicine disclosed the results of a 17-year study examining 241 unresponsive patients in comatose, vegetative, or minimally conscious states. Using advanced brain monitoring techniques, the researchers made an astonishing discovery: that 25% of them could follow high-level mental commands.
When asked to imagine playing tennis, for instance, they consistently complied. Which meant, the experts concluded, that they were “covertly conscious” suffering mainly from a “disconnect” between their bodies and their brains.
“I interviewed many people whose loved ones had been diagnosed as being in a vegetative state,” author Katie Engelhart said in an interview accompanying her piece, “and whose doctors never even raised the possibility of covert consciousness.”
So, how would she treat a family member in such a condition? “I would speak to him as if he were aware,” Engelhart confidently asserts.
Which, interestingly enough, is exactly how my wife and her family speak to Eva.
But that study’s findings have stirred controversy in America, where most vegetative patients end up in nursing homes. Unless, of course, their families—informed by doctors that the loved ones in question are forever gone—choose to “pull the plug” on their existence by withholding critical care.
In Eva’s case, that was never an option. No one ever suggested it, nor would we have considered such a thing; a difference I attribute to culture. Is it because snuffing out a life—even a hopelessly unconscious one—offends the dictates of the predominately Catholic Philippines? Or is it simply that the country’s strong family values preclude such ragged outcomes? Most likely, I suspect, it’s a combination of both, amply supported by the law.
In any case, after several weeks in the ICU, we brought our silent sister home, transformed a bedroom into a makeshift hospital room, and hired several professional caregivers. Their job: to feed Eva through a tube in her stomach, administer brain-aiding vitamins, bathe her, massage her legs, and maintain the tracheotomy through which she breathes. And, yes, talk to her as if she’s really all there.
They’re not alone. Our house, in fact, has become something of a hub for visiting friends, relatives, and paid professionals there to aid in Eva’s care. Many of them have even moved in, including her two minor children for whom my wife and I now act as parents.
There are no guarantees, of course, that their mom will ultimately recover or, if she does, that she’ll ever be the same. But at least Eva’s alive. And, who knows, maybe one day she’ll even hear us.
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David Haldane is an award-winning American journalist, author, and radio broadcaster with homes in Southern California and Northern Mindanao. His latest book is Dark Skies: Tales of Turbulence in Paradise. This column appears weekly in The Manila Times.
