Nov
23
2009

Man in coma for 23 years… not actually in coma: AaaaaaAAAaaaaaAAaaahhhhh!!!!

Sorry, Rom
Sorry, RomCourtesy Shira Golding
Consider the following, Buzzketeers: a man in Belgium spent the last twenty three years in a hospital, being treated like someone in a coma, when, in fact, he was conscious the whole time and unable to communicate because he was (and remains) paralyzed.

Whoooaa! Whooooaaaaaoooooaaa!

That’s some serious Johnny Got His Gun stuff. Ugh.

A coma is a persistent unconscious state. One can become comatose in lots of different ways—severe head trauma, brain injury, or a coma can be intentionally induced as part of the treatment for some conditions—but the underlying cause is always damage to the reticular formation, the part of the brain that regulates the awaking/sleeping cycle. So, basically, a person in a coma is asleep, usually for just a few days, but sometimes for the rest of their lives—“persistent vegetative states” can last for decades, until (if the person doesn’t come out of the coma) a secondary infection like pneumonia causes death. This guy, Rom Houbens, was in a coma for 23 years after a car accident.

Except, again, he wasn’t. After his accident, Rom was diagnosed using the Glasgow Coma Scale. This is a series of tests that evaluate a patient’s eye, verbal, and motor responses. Check it out. With a score of 8, at all points before noon last Saturday I would have been considered to be in a “severe coma.” I could be wrong though—apparently the evaluation is easy to mess up, because that’s what Rom’s doctors did on every part of the test, and he was declared comatose for the next 23 years. It wasn’t until three years ago, when Rom was reevaluated with high tech brain scanning equipment, that the doctors realized that, whoops, heh heh, he was actually paralyzed but totally conscious the whole time. (A paper on the new diagnosis was just published.)

Therapy has since allowed Houbens to “tap” out messages on a computer screen keyboard. I’m assuming this is accomplished through eye tracking technology—I saw a demonstration of some eye tracking equipment recently, and it was pretty impressive, but it still makes me surprised that his eye movement wasn’t caught before. He seems to have taken it pretty well though, saying, “I shall never forget the day when they discovered what was truly wrong with me – it was my second birth. All that time I just literally dreamed of a better life. Frustration is too small a word to describe what I felt.” I suppose he did have 23 YEARS to come to terms with things, although if anyone has a good excuse for becoming a supervillain, it’s probably Rom Houbens.

So, if you’re really grasping at straws for something to be thankful about on Thursday, maybe this could be a pretty solid fallback.

Your Comments, Thoughts, Questions, Ideas

JGordon's picture
JGordon says:

Hmm. When I assumed that Houbens' quotes came from answers written with eye-tracking equipment, I was wrong. You can't blame me, though, because how they were actually written was slightly more... iffy, I guess.

Houbens' interview with Der Spiegel (where those quotes were drawn from), was conducted with the aid of a communication facilitator. The facilitator, basically, is someone who holds his hand and "helps" Rom type out messages on a touch screen. The quotation marks are there because lots of people think that facilitated communication isn't scientifically sound. Even if the facilitator isn't consciously directing the patient's hand, there's the thought that they might be subconsciously writing for them, like using a Ouija board. (Sorry about comparing a real person to a Ouija pointer, but that's the analogy that comes to mind.)

Houbens' scans do show the brain activity of someone who is at least minimally conscious, and he's able to answer yes and no by moving one of his feet, so nobody is saying that the whole thing is a hoax. And even Houbens' quotes might be genuine (although some doubt that 23 years in such extreme mental isolation could be followed by complete lucidity so quickly), but the facilitator ought to be looking away from the keyboard screen, and he or she shouldn't hear the questions Houbens is supposed to be answering. In the Der Spiegel interview, neither of these procedures were followed.

The article linked to above also says that Houbens' re-diagnosis (is that a word?) raises the possibility that, as some have suggested, as many as four out of ten people who are considered to be completely comatose may have been misdiagnosed. Yowza.

posted on Tue, 11/24/2009 - 6:35pm
Bhavana's picture
Bhavana says:

"Wow," is all I can say. I mean, the guy was in a vegetative state for 23 years? What if the doctors had disconnected him from his feeding/breathing tube... he would've died, while still alive!

posted on Fri, 11/27/2009 - 4:25pm
Traumatic Brain Injury's picture

We do have the fact that he is alive and that he is working towards getting better the best that he can.

First defining a coma and what exactly is a vegetative state helps clarify the discussion. It was a bit misleading to say that he was in a complete coma, but it is an inspiring story for many who deal with any type of coma or long term injury.

posted on Tue, 12/01/2009 - 3:11pm
JGordon's picture
JGordon says:

Hmm. Little bit of a "gotcha!" here.

It looks like some of Houben's doctors don't think that he was ever really communicating after all.

In the article linked to above, one of the doctors says that while Houben does seem to be conscious, he is not communicating, and that the the eloquent answers he "gave" were in fact coming from the speech therapist and the facilitated communication method he or she used.

It's easy to jump to the conclusion that (after reading supposed quotes from Houben like, "Just imagine, you hear, see, feel and think but no one can see that.") there's a Belgian speech therapist somewhere who deserves to be tarred and feathered, but it's likely that the therapist was really acting out of good intentions, and that the false messages were more like the product of a Ouija board, and were not intentional.

This isn't to say that other people in various levels of a coma would necessarily be unable to respond to verbal stimuli, only that Mr. Houben is unable to communicate, at least in that way.

posted on Fri, 02/19/2010 - 6:31pm

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