March 9, 2019

Book: "Into the Gray Zone", by Adrian Owen

Do you know anyone who had stroke?

This book strikes a personal issue. To be honest, I was afraid to read the book (originally published in 2017) for a while. But once I started reading, I found that the book was a fascinating read. I'll recommend it fully to anyone interested.


My father had a bad stroke in 2006. 

[I wrote about the incident in 2012 with more details.]

https://beginningargentinetango.blogspot.com/2012/03/life-my-father-on-st-patricks-day-2012.html


He was hospitalized and stayed on bed, for next 9 years. My mother had been visiting the hospital for almost every day, tending and talking to him. 

On 2015, he passed away due to pneumonia. In the end, he could never clearly communicate during the 9 years.

Now, 3 years and 9 months has passed since his passing, and due to my mother's Alzheimer's disease that started later in 2015, the last years of his seem to be getting lost even from my mother. Everything is slipping away toward the past. I feel some ambivalence, not happy nor unhappy, about current state.


In the years, there were nagging questions; is he still there? Are we not doing terribly cruel or anything to him?

What happened to him scared me, too. To me it looked terrible way to go. Even if one was alive, to be in such a locked-in state for such a long time looks nothing but terrible.


I read some research papers on patients in the "gray zone"; people who lost nearly all bodily functions and in a vegetative state due to severe brain damage (stroke, traumatic incident, heart attack and oxygen deprivation, etc).

They say, 15-20% of such "gray zone" patients may still have consciousness, and still recognize surroundings including family's call and care.

Striking, isn't it?


This book was published in 2017. The author is one of leading neuroscientists who established notion of the consciousness in the "gray zone" through advancing brain scanning technologies (PET, fMRI, etc). Some of research papers I glanced through in scientific journals might have been his group's.


Of course, the book cannot give answers to my question. 

After all, it was only 15-20% of the "gray zone" patients they could "confirm" consciousness (or, "find the patient"). Even when they got scanned, 80-85% of them may have been lost, or too injured/damaged to be confirmed. There have been much greater number of vegetative state patients who never got scanned. We will never know about them.


But scanned or not, people raise hopes.

Each patient is unique. Although we can categorize the situations and establish medical and legal guidelines and suggestions, how I (or each of you) feel about it is a different matter.


Science is based on statistics and reproducibility, and do not mix well with miracles. Depending on few champion data (read: miracles) is strictly discouraged in science. Yet, when the issue becomes personal, and when you are not a scientist, applied standards can be different.


In my case, I was (and still am) not sure what to hope for back then. To me it looked awfully cruel if my father was still there. But if he was not there, it would have been cruel to my mother.

Also, I am still unsure if I would hope to stay or to go if I find myself in such a vegetative "gray zone" state. Tough question indeed.





[The book cover]