No. 35 (November1999)
Restore Some Who Suffer
by Win Wenger, Ph.D.
Karen Ann Quinlan many years ago became the name synonymous with this type of "hopeless" medical case. Her family, as so many others have done, had to sue the hospital and doctors to "pull the plug" on the respirator, drip-feed and other special medical equipment which was keeping her body alive long after she had slipped into a terminal coma.
Practically every hospital today has, in its back wards, victims of car accidents or other head injury cases, diabetic victims of insulin shock, cases of drug overdose, whose brains were stunned into unconsciousness and who, long since, have gone into coma. The consensus is that, if they haven't wakened from that coma within a few days or several weeks, they never will.
Until family or insurance funds run out, medical and ethical considerations frequently require that these human vegetables be kept physically alive, sometimes for years. But no one expects them to ever recover, even though, very occasionally (according to newspaper reports), one does.
Usually, the medical belief is as in the instance I worked with many years ago for a brief hour that the patient has suffered so much damage so deep in the brain stem that there is "nothing left there to be brought back."
Penetrating a coma
After nearly twenty years in which I've failed to interest any neurophysiologist or other physician enough in what I found, enough to do any checking or experimenting, I am publishing here the information on howmomentarily at leastI partially "brought back" one head injury victim who had been in such a coma for six months at the time.
My hope is that either some neurophysiologist or other physician will come across this account and become interested enough to proceed accordingly with one of those long-term "hopeless" cases in the back ward, or that some family member or friend of such a victim, seeing this, will manage to bring this to the appropriate attention of such a physician. If, under proper medically authoritative circumstances, one such patient can be "brought back" and restored, then others may also well be restored in some numbers.
The instance I encountered was the son of the head of a school of nursing. He had become a head-injury case six months earlier in a car accident, and had been in a deep and apparently terminal coma ever since. His mother slipped me in to work with him during an hour in which other attendants were awayshe was afraid to be caught doing anything untoward for fear of losing her position and her livelihood. (Without her livelihood the boy would soon have been dead in any instance; she was really taking a major chance by bringing me in.)
General principles for such a restoration
1. First general principle is that universal natural law of behavior known to psychologists as The Law of Effect. Every complex system has to obey it in order to survive at all, it is that basic.Every such organism has to perceive feedback, internally and externally, on what it is doing, and respond to that "effect," that feedback, accordingly. Hence, "you get more of what you reinforce," even at the level of the individual cell, and much more so with more complex organisms.
Individual brain cells kept alive in vitro, without the other support systems of the body which would enable them to myelinate and to develop synaptically, when reinforced (chemically), can be trained to a much higher rate and speed of firing.
2. Derivative from that law is one of the first principles of neurophysiological development:As with an autistic child who keeps clawing his face or some other part of his body or gnawing on his own hand there is either an inadequacy in his developed sense of touch or a "noise" in that sense. At first he may barely be able to distinguish by touch rough sandpaper from fine silk, but with practice he comes to tell the difference even between two fine grades of velvet, or can tell by touch heads from tails on a coin. By this time, that particular form of "autism" has long since disappeared!
The relevancy here is: at some level in these deep or vegetative coma cases, there are some responses still working, which you can find and selectively reinforce to bring online more and more of the organism or person in question. No matter how deep the coma, if there is still life in the system, there are responses still there, even if they can only be found by bio-instrumentation or medical equipment.
3. You can also do what I did in this particular instanceby some stimulus or stimuli pattern to elicit responses which then can be reinforced. The system can be brought to arousal, and responses elicited, by setting up a stimulus pattern, repeating it three to six or however many times, then abruptly interrupting that stimulus.What I did in the first part of that brief hour was mainly the latter. I happened at that time to be carrying around with me one of the original "brain-mind" machines, invented in 1977 in one of my workshops by one Denis Gorges.
That machine used pulses of light (essentially, a stroboscope) and sound, in various phase relationships and speeds, to synchronize brainwaves and bring them to higher amplitude. It seemed to me then, and does still now, that the reason for brainwaves is to bring braincells into better communication with each other; that it is easier for cells to control one another's firing or not firing if they are "coming to the firing line" at the same time.
That idea, at least, was the main reason at the time that I brought one of those machines along, hoping to establish more communication with more of that comatose boy's system. Indeed, the machine may have played a positive role in that regard as part of what happened.
In this instance, I very carefully built a pattern, a sequence. Onto the boy I would slip the headset and goggles. I would then turn on the machine and gradually turn up the strength of the light-and-sound signals, up to the strength level we normally used it. We'd continue that a minute or so, then gradually turn it down, then turn the machine off, then remove the goggles and headset. After about five minutes, I'd put the headset and goggles back onto the boy and start that sequence again.
Parenthetically, I might add that with one's eyes closed, the effects of a strobe light are a very involved, very striking "light and color" show. Very vividand very hard to "hide from" in your attention, one might say, which is why in the first place I was being so carefully gentle and building a pattern which had the stimulus running at high levels only for 2 to 3 minutes at a time. This "show" may have helped attract/arouse the boy's attention from coma.
Every hospital has electro-encephalographic equipment which duplicates pretty much the light show effects of this brain-mind machine, and many makes of such brain-mind machines are sold commercially today. They fill the first dozen or so pages of the catalog of Tools For Exploration (1-800-456-9887 for example).
The pattern-interrupt? On the fifth or sixth repeat, I put the goggles and headset on the boy and did not turn the equipment on. He moved! His breathing had changed, I had his attention. I asked him questions, found he could exercise conscious movement in his right big toe and to some extent in his right foot, up and down for "yes" and sideways for "no." The rest of the session, until attendants came back, his mother and I were asking him questions and engaging him in meaningful converse.
From there it should have been a repeat of such sessions carried forward into physical therapy and further selective reinforcement techniques, carried forward into "Pole-Bridging" by identifyingto either side of the damaged region in the brainthe parts of the brain that were still working, and expressing their behaviors in some combined external form whose external sensory feedbacks would force a relationship, and an ever closer relationship, between those still-working regions of the brain until the lesion area was "bridged."
But that didn't happen, and here I am having to generalize from an instance of one.... (The same approach could conceivably retrieve some mental patients as well who are deeply cataleptic, certainly more gently than with the electric shock treatments so often used in such cases.)
A call to action
I am not a physician, nor a neurophysiologist, moreover have no one from either profession who is among my close friends. I have no medical authority or "right" to speak on such matters. However sound the reasoning and however basic the scientific principles cited, all the above has to be treated as a mere speculation until, somewhere, somewhen, such a recovery instance is repeated and under medically authoritative conditions.
But, over the years, as I've come to learn more and more, I've also become more and more convinced that pretty much this procedure could indeed also help a lot of other people in situations like that of this 16-year-old boy, that this one instance was no fluke.
It is my hope that in this age of the Internet, enough people will see thiswho still have enough left of both their humanity and their (scientific?) curiositythat someone, somewhere, will see this through to where some good can come from it.
Please pass this along to where, maybe, it can make a meaningful difference. Thank you.
email: Win Wenger
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