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Coma patient's second birth

KATE CONNOLLY - Nov 27 2009 15:59

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For 23 years Rom Houben was imprisoned in his own body. He saw his doctors and nurses as they visited him daily during their rounds; he listened to the conversations of his carers; he heard his mother deliver the news to him that his father had died.

But he could do nothing. He was unable to communicate with his doctors or family. He could not move his head or weep, he could only listen.

Doctors presumed Houben was in a vegetative state following a near-fatal car crash in 1983. They believed he could feel nothing and hear nothing. For 23 years.

Then a neurologist, Steven Laureys, who decided to take a radical look at the state of diagnosed coma patients, released him from his torture.

Using a state-of-the-art scanning system, Laureys found to his amazement that Houben's brain was functioning almost normally.

"I had dreamed myself away," said Houben, now 46, whose real "state" was discovered three years ago and has just been made public by the doctor who rescued him, according to a report in the German magazine Der Spiegel this week.

Laureys, a neurologist at the University of Liège in Belgium, has published a scientific paper saying that Houben could be one of many cases of falsely diagnosed coma around the world. He discovered that although Houben was completely paralysed, he was also completely conscious -- just unable to communicate the fact.

Houben now communicates with the help of a computer with a special keyboard that he activates with his right hand -- movement developed with the help of intense physiotherapy over the past three years.

He realised when he came round after his accident, which had caused his heart to stop and his brain to be starved of oxygen for several minutes, that his body was paralysed. Although he could hear every word his doctors spoke, he could not communicate with them.

CONTINUES BELOW

"I screamed, but there was nothing to hear," he said, using his keyboard.

The Belgian former engineering student, who speaks four languages, said he coped with being effectively trapped in his own body by meditating. He told doctors he had "travelled with my thoughts into the past, or into another existence altogether". Sometimes, he said: "I was only my consciousness and nothing else." Care personnel and doctors at the hospital in Zolder in Belgium eventually gave up hope that he would ever come round.

The moment it was discovered he was not in a vegetative state, said Houben, was like being born again. "I'll never forget the day that they discovered me," he said. "It was my second birth."

Experts say Laureys's findings are likely to reopen the debate over when the decision should be made to terminate the lives of those in comas who appear to be unconscious but may have almost fully functioning brains.

Belgian doctors used an internationally accepted scale to monitor Houben's state over the years. Known as the Glasgow Coma Scale, it requires assessment of the eyes, verbal and motor responses. But they failed to assess him correctly and missed signs that his brain was still functioning.

Laureys, head of the Coma Science Group and neurology department at Liège University hospital, has advised on several prominent coma cases, such as the American patient Terri Schiavo, whose life support was withdrawn in 2005 after 15 years in a coma.

Laureys concluded in his study that coma patients are diagnosed falsely "on a disturbingly regular basis". In about 40% of cases diagnosed as vegetative, more careful examination shows that there is still some level of consciousness.

He examined 44 patients believed to be in a vegetative state, and found that 18 of them responded to communication. Houben was the most startling example. He said patients suspected of being in an irreversible coma should be "tested 10 times" and that comas, like sleep, have different stages and need to be monitored.

About a fifth of patients who suffer serious head and brain injuries spend more than three weeks in a coma. Of those, between 15% and 25% are technically still alive, but remain in a state of unconsciousness and never wake up.

Houben hopes to write a book detailing his trauma and his "rebirth". -- © Guardian News & Media

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Comments

I wouldn't want to 'wake' into a completely and permanently paralysed state. Presumably this patient was on life support all those years? If it ever happened to me, I hope they'd switch off the life support after a month or so. It must cost the earth too.

Madeleine Du Toit on November 28, 2009, 3:23 pm

Madeleine. As a counselling psychologist who has the privilege of working with such patients, perhaps I could take the liberty in responding to your post: It is possible to be fully conscious and yet 'locked-in' to a body that does not respond. This does not require life support and is entirely different to being in a coma. To read more about this distinction you can click on http://www.bmj.com/cgi/content/full/331/7508/94 . This is often called 'locked in syndrome' and is very eloquently explored in the book "The diving bell and the butterfly". What is tragic about the story above is that the treating doctors took for granted that their patient was in a coma, when, in fact, he was fully conscious (at least, from some point in the last 23 years). Yes, many of these people do wish that they could just die, but in reality, their lives go on. With the help of regular physical therapy they may also gain back some of their functions. I suppose the saddest aspect of Rom Houben's story is that for 23 years he never received the relevant therapeutic attention that he might have benefited from.

Jason Ross on November 28, 2009, 6:56 pm

Ms. Du Toit, as one who was paralysed and never supposed to walk again according to the doctors who spoke in hushed tones to my son, you have to be careful that you don't let people mess with your head (mental powers of positive thinking) until you've had the chance to examine and analyse your situation. Sadly people are too quick to say things like: 'You'll never walk again, etc.' Hit the web and check out the site called 'The Miracle Man' - Morris E. Goodman. Digest his story and then decide how quickly you want your life support turned off.
Personally I wouldn't allow anyone near who wanted to inflict their views on me.

Storm Ferguson on November 29, 2009, 11:23 am

The story of Rom is difficult to come to terms with. On a positive note modern science can benefit a great deal from his experiences. That Rom got into this position the same year I completed matric and is only now able to communicate now - after so many years - is indeed miraculous.

malose nyatlo on November 29, 2009, 1:09 pm

What a story. What do you do in your mind alone for 23 years? Do you sleep? Do you meditate? This would be the novel to end all novels. Think about it. How many people do not have the distractions of a physical body? Socrates put his eyes out to avoid distractions.

Hectique Prognosis on November 29, 2009, 7:33 pm

nothing but propaganda from the pro-life lobbyists.....

Themba Tantrum on November 30, 2009, 5:46 am

Nothing but propaganda from the pro-life sector...

Themba Tantrum on November 30, 2009, 8:53 am

I rather die. I just can't!

Bareng Madubanya on December 1, 2009, 9:24 am

What this man has gone through is truely awful, especially if it turns out that he has been fully aware the entire time. However, he is NOT communicating. The footage of him 'typing' his messages to the world clearly show it to be a fraudulant form of 'facilitated communication'. He is seen 'speaking' through a facilitator while not looking at the screen and even at times with his eyes closed, possibly asleep. This is just uncontrolled media spin until a double blind test shows him to be really communicating.

Serio RSA on December 1, 2009, 2:06 pm

I believe now that people die because it is time to die, despite all human efforts to kill or rescue.
Mr Rob Houden is a pioneer, despite his long years of real suffering, the good has emerged from his ordeal for the betterment of mankind. But i would be worried about how far modern medicine or technology might go. The natural necessities should NOT be interfered with. I pray.

Dikotsi Molefe on December 2, 2009, 11:52 am

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Coma patient's second birth

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