When neuroscientist Adrian Owen looked at the brain scan of his first patient 20 years ago, a woman by the name of Kate, what he saw changed the way doctors viewed the non-responsive.
When Owen showed Kate, who was believed to be in a vegetative state, photos of familiar faces, her brain lit up on a functional magnetic resonance imaging (fMRI) scanner.
The patient was part of a group so relatively new that it didn’t even have a name. It still doesn’t, but Owen has coined it the “gray zone”— an estimated 20 per cent of patients believed to be in vegetative states who are actually able to process — and even communicate — information in their own brains.
After 20 years of research, Owen has written a new book marketed for a general audience, rather than academic journals, entitled Into the Gray Zone: A neuroscientist explores the border between life and death.
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Owen, who was born in the United Kingdom, is currently the Canada Excellence Research Chair in Cognitive Neuroscience and Imaging at Western University’s Brain and Mind Institute in London, Ont., a position he’s held since receiving a $10-million grant in 2010.
The implications of Owen’s work have transcended the boundary between the medical and legal world. If vegetative patients can actually communicate through technology, what does that mean for patient care decisions like withdrawal of life support or even euthanasia?
Into the Gray Zone does address these ethical and legal questions, as well as some that are philosophical, such as whether consciousness can survive the loss of the body that houses it.
Speaking to AM980 Thursday afternoon, Owen said he wanted tell a different side of the story he’d been presenting through academic research over the course of his career.
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“I sort of came to the point where I’d be writing scientific papers about our discoveries in patients who were comatose or in a vegetative state for 20 years, and I came to the conclusion that it really was about time we wrote a few of the patients’ stories and tried to give some perspective from the patients themselves and their families, and to try to give an idea of what it’s like to be in this situation,” he said.
Owen said that it’s impossible to understand what could have happened in past cases had the technology and method driving his research been used, but he is optimistic about the future, noting how relatively new this all is in the field of science. Before he started researching what he now calls the gray zone, there would be no way to even identify patients he says are in it.
“It hasn’t been discovered because we simply didn’t have the technology,” Owen said. “Something like fMRI technology was only invented not much more than 20 years ago in the early 1990s. Prior to that, we really would have no way of knowing that these patients are there. It’s really taken the 20 years since we established these techniques to learn how to use them to tackle these really difficult clinical problems.”
Owen’s research is extensive, but by no means exhaustive. Moving forward, he says he’d like to apply the techniques to patients immediately after brain injuries rather than months, years or decades later.
“What we’re really interested in doing now is saying, ‘Can we apply some of these techniques in the first few days after a brain injury when somebody comes out of a serious car accident and they’re still in the intensive care unit?'” Owen said. “Can we put those patients into a scanner? Because, to be honest, that’s where decisions are really being made about whether people should live or die, whether life support should be withdrawn…. I’ve got very high hopes that some of our techniques are going to yield dividends there and are going to prove to be useful.”