Belgian Thought To Be In Coma Now Responsive

Twenty-three years ago, a Belgian car-crash victim was diagnosed as being in a vegetative state. But doctors now say he appears to have been conscious the whole time. The man is now communicating using a special touchscreen. Neurologist Steven Laureys, who leads the Coma Science Group at the University of Liege in Belgium, says people in non-communicative states are misdiagnosed up to 40 percent of the time.

Copyright © 2009 NPR. For personal, noncommercial use only. See Terms of Use. For other uses, prior permission required.

MICHELE NORRIS, host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Michele Norris.

MELISSA BLOCK, host:

And I'm Melissa Block.

For 23 years, a man in Belgium named Rom Houben was believed to be in a vegetative state after a near-fatal car crash. Now, Rom Houben is writing a book. He has regained the use of one finger and can communicate on a special touch screen. This, after neurologists in Belgium did more sophisticated tests and found he had been misdiagnosed, that he had, in fact, been conscious for years.

The lead neurologist on his case is Steven Laureys, who leads the Coma Science Group at the University of Liege in Belgium. Welcome to the program.

Dr. STEVEN LAUREYS (Director, Coma Science Group, University of Liege): Hello.

BLOCK: And Dr. Laureys, what made you decide to retest Rom Houben?

Dr. LAUREYS: Well, he was sent to us three years ago. He was one of those patients now coming, actually, from all over Europe for a short stay in our university hospital, where we employ a number of different scanning techniques, so, basically, using all possible machines to objectively measure what's happening in the brain of these patients. And there, to our surprise, we saw an intact brain function. His brain activity was comparable to yours and mine.

BLOCK: Rom Houben has been communicating and has said this: I would scream, but no sound would come out. I became the witness to my own suffering. And you're saying that may be more common than we think.

Dr. LAUREYS: Well, what I'm saying is that the diagnosis of the vegetative state is difficult. What we showed in the study, looking at over 100 patients who recovered from their coma, was that 40 percent showed minimal signs of consciousness. That doesn't mean they were fully conscious and having the thoughts Rom Houben had.

He was definitely a very special case. First of all, because he was fully conscious, and next, because it took such a long time - over two decades - for, apparently, the medical community to be convinced. And I think, also, in this particular case, there is the point that the insurance companies actually refused to recognize the new diagnosis for financial reasons, which of course is unacceptable.

BLOCK: What was it like the first time that this patient, Rom Houben, was able to communicate with you?

Dr. LAUREYS: Actually, it was his family who has the credit there. They had their own ways of communication. And, well, the first questions were very down to earth. It was just making sure that this was a true way of communication coming from the patient himself. So, basically, showing him different object and asking him afterwards what I've been showing him. So the first word he communicated to me was the word key - my car keys that I just showed him.

BLOCK: So the first time that you saw Rom Houben, he was already communicating with his family.

Dr. LAUREYS: Well, he, with his family, had come up with a means of communication which was not taken serious by the medical doctors, but what turned out to be a real mode of communication and that has only been improved and now is happening through a computer system.

BLOCK: Dr. Laureys, you said that Rom Houben is a special case. Would there be a danger, do you think, that families might hear this and get false hopes, really, about someone in their family?

Dr. LAUREYS: Well, it's definitely not black and white and this is just one case. I think he gives the human face a story to the difficulties we face in those chronic disorders of consciousness. It's, in that sense, a message of hope. We should not consider all patients in a vegetative state as uniformly hopeless. We should, however, remain realistic. And, unfortunately, the majority of cases will not show such recoveries. And there is something as a vegetative state truly unconscious and truly irreversible.

I think it's very important to take the time, use standardized and repeated clinical assessments to be more precise in terms of the diagnosis and in terms of the prognosis.

BLOCK: Dr. Laureys, thanks very much for talking with us.

Dr. LAUREYS: Thank you.

BLOCK: That's Steven Laureys. He leads the Coma Science Group at the University of Liege in Belgium.

Copyright © 2009 NPR. All rights reserved. No quotes from the materials contained herein may be used in any media without attribution to NPR. This transcript is provided for personal, noncommercial use only, pursuant to our Terms of Use. Any other use requires NPR's prior permission. Visit our permissions page for further information.

NPR transcripts are created on a rush deadline by a contractor for NPR, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of NPR's programming is the audio.

Comments

 

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Support comes from: