The New Yorker has a fascinating story about Adrian Owen and other researchers into individuals in varying degrees of vegetative states. It turns out that many of these folks are much livelier than they appear.

Owen’s final experiment was the most ambitious: a test to determine whether vegetative patients who seemed able to comprehend speech could also perform a complex mental task on command. He decided to ask them to imagine playing tennis. (“We chose sports, and tried to find one that involved a lot of upper-body movements and not too much running around,” he said.) First, he took brain scans of thirty-four healthy volunteers who were instructed to picture themselves playing the game for at least thirty seconds. Their brains showed activity in a region of the cerebrum that would be stimulated in an actual match. “This was an extremely robust activation, and it wasn’t difficult to tell whether somebody was imagining tennis or not,” Owen said. He then repeated the experiment using one of the vegetative patients, a woman who had been severely injured in a car accident. The woman had to be able to hear and understand Owen’s instructions, retrieve a memory of tennis—including a conception of forehand and backhand and how the ball and the racquet meet—and focus her attention for at least thirty seconds. To Owen’s astonishment, she passed the test…

Few vegetative or minimally conscious patients ever recover fully, and many are unlikely to improve. (Some neurologists estimate that an adult who has been vegetative for six months following a traumatic brain injury has only a twenty-per-cent chance of regaining consciousness.) For the past three years, Schiff and Fins have been studying the brain of Terry Wallis, a forty-three-year-old man in rural Arkansas who had been the subject of national news stories in 2003, when it was reported that he had begun to speak after spending nineteen years in a nursing home, in a minimally conscious state. Schiff and Fins contacted Wallis’s family and offered to help him obtain medical care during his recovery, and to use brain scans to document his progress.

In 1984, Wallis, a nineteen-year-old truck mechanic, had been in a car accident and sustained a severe brain injury; he was also paralyzed. Wallis’s father had asked the nursing home to arrange an evaluation of his son by a neurologist, but was told that such an assessment was too expensive and, in any case, would not be useful. In 2003, when Wallis began to speak, he received twelve weeks of physical therapy, which was covered by Medicaid, but the Arkansas Department of Health and Human Services rejected his request for further treatment, concluding that he had not made sufficient progress. One day, in 2005, Fins, who had contacted Wallis’s congressman to solicit his help in obtaining additional medical care for Wallis, asked Mrs. Wallis for her son’s Social Security number. “I was on the phone, and Mrs. Wallis said to Terry, ‘What’s your Social Security number?’ ” Fins recalled. “He gives his number, and I write it down. And I said, ‘Mrs. Wallis, was that Terry?’ And she said, ‘Yup. The first time he told us his Social Security, we thought he was wrong. But we looked it up, and he was right.’ ”

Fins was astonished. Not only has Wallis recovered memories from his life before the accident but, Fins said, “he is picking up American culture. He now knows the song ‘Bad boys, bad boys, what are you gonna do.’ Why is that important? It’s important because that song didn’t exist in 1984, so Terry is laying down new memories. It shows sustained improvement.” In 2006, Schiff arranged for Wallis to be taken to Weill Cornell Medical College, where he examined his brain using a sophisticated technique called diffusion tensor imaging, which assesses the number and health of axons, long fibres that transmit nerve impulses from one brain cell to another. The scans suggested that the axons in Wallis’s brain were growing and forming new connections—a finding that contradicts the long-standing assumption that a damaged brain is incapable of healing after such a lengthy period. “We need to do longitudinal studies, to see if these kinds of changes are accruing over time, whether they happen frequently or infrequently, and what their association with the patient’s level of function is,” Schiff told me. In some cases, he speculated, the brain may sometimes be able to bypass an injured area and devise novel ways of connecting axons. Still, he went on, much about Wallis’s recovery—and the neurological developments that are driving it—remains a mystery. “After nineteen years, Terry spoke a few words, but within seventy-two hours he recovered fluent, expressive, and receptive language,” Schiff said.

Kate Bainbridge, the first vegetative patient that Adrian Owen studied in Cambridge, has also made considerable progress, recovering the use of her arms, and much of her mental function, although she is unable to walk. She still has difficulty talking, and uses a letter board to communicate with people who are not used to her speech. “Most scans show what is wrong with your brain, which doctors need to know,” Bainbridge wrote to me in an e-mail. “But Adrian Owen’s scans show what is working. I say they found parts of my brain were working. It really scares me to think what might have happened to me if I had not had the scans. They show people it was worth carrying on even though my body was unresponsive.”

As for us, don’t pull any plug. Put the iPod on shuffle, set up the audiobooks, and do as many Adrian Owen experiments as possible.

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