Imagine you wake up, locked inside a box,\u201d says Adrian Owen. \u201cIt\u2019s only just big enough to hold your body but sufficiently small that you can\u2019t move.<\/p>\n
\u201cIt\u2019s a perfect fit, down to every last one of your fingers and toes. It\u2019s a strange box because you can listen to absolutely everything going on around you, yet your voice cannot be heard. In fact, the box fits so tightly around your face and lips that you can\u2019t speak, or make a noise. Although you can see everything going on around the box, the world outside is oblivious to what\u2019s going on inside.<\/p>\n
\u201cInside, there\u2019s plenty of time to think. At first, this feels like a game, even one that is strangely amusing. Then, reality sets in. You\u2019re trapped. You see and hear your family lamenting your fate. Over the years, the carers forget to turn on the TV. You\u2019re too cold. Then you\u2019re too hot. You\u2019re always thirsty. The visits of your friends and family dwindle. Your partner moves on. And there\u2019s nothing you can do about it.\u201d<\/p>\n
Owen and I are talking on Skype. I\u2019m sitting in London, UK, and he\u2019s in another London three-and-a-half thousand miles away at the University of Western Ontario, Canada. Owen\u2019s reddish hair and close-cropped beard loom large on my screen as he becomes animated describing the torment of those with no voice: his patients.<\/p>\n
People in a \u2018vegetative state\u2019 are awake yet unaware. Their eyes can open and sometimes wander. They can smile, grasp another\u2019s hand, cry, groan or grunt. But they are indifferent to a hand clap, unable to see or to understand speech. Their motions are not purposeful but reflexive. They appear to have shed their memories, emotions and intentions, those qualities that make each one of us an individual. Their minds remain firmly shut. Still, when their eyelids flutter open, you are always left wondering if there\u2019s a glimmer of consciousness.<\/p>\n
A decade ago, the answer would have been a bleak and emphatic no. Not any longer. Using brain scanners, Owen has found that some may be trapped inside their bodies yet able to think and feel to varying extents. The number of patients with disorders of consciousness has soared in recent decades, ironically, because of the rise and success of intensive care and medical technologies. Doctors have steadily got better at saving patients with catastrophic injuries, though it remains much easier to restart a heart than restore a brain. Today, trapped, damaged and diminished minds inhabit clinics and nursing homes worldwide \u2013 in Europe alone the number of new coma cases is estimated to be around 230,000 annually, of which some 30,000 will languish in a persistent vegetative state. They are some of the most tragic and expensive artefacts of modern intensive care.<\/p>\n