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According to rough estimates by the Federal Association for Traumatic Brain Injury Patients in Need, around 40,000 people in Germany fall into a deep coma each year due to severe traumatic brain injuries. About 20,000 of them then remain in what is known as a vegetative state, often for months, sometimes even years. The rest either wake up immediately or die.
Stuck in an in-between world
The brain stem, deep within the brain, regulates the body’s vital basic functions such as breathing, swallowing and circulation. The midbrain, part of the brain stem, transmits information from the spinal cord to the cerebrum. This is where our consciousness lies. It processes all sensory impressions into an overall perception. In a persistent vegetative state, also called appalling syndrome, the information transmission of the midbrain is usually disturbed. Often the brain stem and cerebrum are also directly damaged.
Patients in a vegetative state have a normal life expectancy. But nobody knows if and when they will re-emerge from the deep depths of consciousness. Sensational reports of people who are said to have woken up from a vegetative state after years are controversially discussed by experts and considered unlikely: Was it really a real vegetative state or just a less severe form of disturbance of consciousness?
Close to death
There are only a few reports of people who have returned from a vegetative state. The majority remembers nothing. The reports of those who can remember are similar to those of near-death experiences . They all saw a white light at the end of a tunnel. And they saw their lives again in fast motion before their inner eye. There are many levels of consciousness between life and death. Only a few of them have been researched so far.
Doctors are now able to check which “sensory channels” are open in the brain : Can patients in a vegetative state hear, see, feel, smell and taste? To clarify this question, they use, among other things, brain wave measurement (EEG).
Misdiagnoses
What if a patient is deaf and blind and therefore does not respond? There is no clear diagnosis as to whether a person is in a vegetative state or is simply trapped in his body but mentally completely clear. On the contrary: the misdiagnosis rate is 40 percent. Even today. The reason is often a lack of examinations, as not all clinics have the latest and most modern examination equipment and methods.
Unfortunately, traumatic brain patients and therefore also people who are in a vegetative state belong to a “fringe patient group”. While a person is in a vegetative state, which can last for months or even years, his or her care and support situation as well as his or her financial security are completely unclear. Anyone who does not have the employer’s liability insurance association, a well-paying opposing insurance company, as a cost carrier, or who is wealthy or on welfare, will find themselves in a complete gap in their benefits.
After unsuccessful early rehabilitation, most of those affected have no choice but to care for the coma patient themselves at home, because health insurance companies no longer declare themselves responsible for the clinical picture of “apallic syndrome” / persistent vegetative state.
According to the Federal Association, relatives are often dismissed with the words: “The patient has exhausted all treatment options, unfortunately there is no further hope.” But who knows, maybe life in the in-between world is more beautiful than we imagine. And perhaps scientists will soon be able to shed light on this dark, unknown world.
