There’s a lot that we still don’t understand about our brains. One of the biggest mysteries is why and how we experience “consciousness,” or the sense that we exist as a person. And some of the most useful insight into consciousness comes from people who have experienced near-death states or comas. Coma survivor stories give us a glimpse into the minds of people in comatose states, and a greater chance of understanding the conscious mind.
“I was in a coma for 5 weeks due to Meningococcal. I had A LOT of “dreams”, most of that I can still remember pretty clearly. You can definitely take in what is being said by the people around you. I was 12 at the time (22 now), and my mother was reading Lord of the Rings to me while I was out. I had some pretty vivid LotR-related dreams. Like eating some ice cubes under a bridge with Bilbo Baggins.” When I woke up, it felt like I’d been gone a long time, but without knowing how long.” (deleted)
A coma is a state deeper than sleep, where a person doesn’t respond to strong outside sensations (like pain) and doesn’t have a normal sleep/wake cycle. People in a coma can have varying degrees of consciousness, from “completely unconscious” to “aware of everything is happening around them.” Often, patients will float between the two states, briefly “waking” to some level of awareness.
“I was in a coma (medically induced, with full-body paralysis) for six weeks. There were a handful of times that I distinctly remember where I “woke up” in my head. What was the experience like? It sucked.” (TheOpus)
There are two kinds of coma: a “real coma” and a medically-induced coma. The “real coma” is the kind of coma you hear about in-hospital soap operas, one where the person is comatose for reasons not under medical control (like illness or trauma). In a controlled coma, doctors “put the patient under” with a controlled dose of anesthetic to slow down blood flow to the brain. This usually only happens when the patient is experiencing life-threatening brain swelling, as slowing down blood flow to the brain helps decrease the swelling.
“I spent 8 days in a coma last year after a particularly traumatic surgery, my waking thoughts were wondering if I had died or made it. I couldn’t open my eyes and I was on a medical air mattress so I felt like I was floating, this lead me to think that I had died. I remember thinking it wasn’t so bad and wondering if my dad would come to find me. Once I realized that I was still alive, I thought I had been injured fighting in a war and worried that my wife might not know I was still alive.” (tinman556)
Generally, a coma happens as the result of damage to one of two areas in the brain: the cerebral cortex, or the RAS. The cerebral cortex is the “outside” part of our brain, responsible for conscious thoughts and feelings. The RAS, on the other hand, is a part of our brain stem responsible for regulating our sleep/wake cycles. Comas can be caused by many different factors, but the two most common ones are drug poisoning and lack of oxygen to the brain. Drugs are especially likely to damage the RAS, leading directly to a comatose state.
“When I “woke up” in my head, I could feel [my best friend] holding my hand and asking me to squeeze if I could hear her talking. I tried as hard as I could to squeeze my hand and I could feel it doing absolutely nothing. When she let go to walk away, I was completely devastated. I tried to scream for her to stay, but obviously, nothing happened. However, I was so glad that people I knew were there wherever I was and that I was getting help (even though I felt completely helpless).” (TheOpus)
Recently, scientists have developed a new way of communicating with people who are in comas but are unable to move or speak. fMRI machines measure blood flow to different areas of the brain when people think about different topics (i.e. playing tennis). Neuroscientist Adrian Owen asked patients in an fMRI machine yes/no questions, and then get them to think about different things depending on the answer. Using this method, he was able to test whether patients were conscious in some capacity or not, and what they could feel or experience while comatose.
“When I was finally brought out of the coma, my parents were there, which didn’t make any sense because my parents lived two states away at the time. I eventually learned that they had been there the entire time I was in a coma. They dropped everything in their lives and came to be with me and stayed there throughout the entire ordeal. After a couple of days, some doctors came in and asked me a bunch of questions. The first question was what year it was. That I knew because I remembered getting sick on New Year’s Eve, so I knew it was 2000. Next was who the President was. I answered Clinton, so I got that right. Then they asked if I knew where I was. I assuredly said, “Honolulu” because, in my dreams, I had been in Honolulu. When all of their faces had that confused Scooby-Doo look is when I realized that wasn’t quite right, so I figured that I must have been back in Salt Lake City.” (TheOpus)
Our understanding of what people experience during comas is still fairly limited. But, using today’s brain imaging techniques and what we know from coma survivor stories, we’re learning things about consciousness that may be able to help coma survivors in the future.
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