Amazing! ( )

Rather fascinating look at the development of a new medical diagnosis and how it developed, from the guy that started it all. A bit dated, and will become more so as the field develops, but spotlights the incredible resiliency and fragility of the human brain and the unbelievable utility and application of modern medical diagnostic equipment and technique. Gives me hope for the future ( )

"...{T}he heart of grey zone science is about finding people who have been lost to us and reconnecting them with the people they love and who love them. Each contact feels like a miracle."

Adrian Owen is a neuroscientist who began to study the question of whether people in a persistent vegetative state (long-term comas) have any conscious awareness. He became interested in the subject, partly because of reports that some people who had awoken from such comas indicated that the did have some awareness of what was going on around them while ostensibly in a coma. In addition, Owen's former long-term girl friend suffered head trauma and was in such a "vegetative state."

At the time Owen began his research, PET scanning was in its infancy. I was fascinated with Owen's discussions on how he devised the various experiments he performed. His first experiment was to determine whether the brain activity of these patients changed when they were exposed to something familiar, for example photos of their families, or their voices. After expansive experiments, Owen was able to determine that in fact a significant percentage of those in persistent vegetative state had some degree of awareness and brain activity.

Owen then pondered whether this brain activity was merely involuntary, and not an actual conscious act of thinking. In his next set of experiments, Owen decided to whether he could in some way communicate with these patients, and show that their brain activity was the result of voluntary thought. By this time, Owen was working with MRIs, and the science of mapping the functions of the various parts of the brain was well under way. The basis of the experiment Owen devised was to ask the comatose patients a question, the answer to which would activate a specific known area of the brain. One of the questions to be asked was ask the subject to imagine entering their home and moving from room to room throughout the home. When asked of non-comatose patients this question elicited activity in the part of the brain related to spatial thinking. The second question was to ask the subject to imagine him/herself playing tennis. This was known to activate the part of the brain which initiates and controls voluntary movement.

Once again, Owen discovered that a significant percentage of patients thought to be in a persistent vegetative state consciously responded to these requests, activating the corresponding areas in their brains. As the experiment progressed, Owen began using the technique to have the patients answer specific questions, i.e. if the answer to the question is yes, think about playing tennis, if the answer is no, think about walking through your house. In this way, Owen was able to ask patients questions such as whether they were in pain, or whether they were aware of significant family events (i.e. the birth of a niece).

This was a fascinating book. It was very readable, and there is little to no mysterious medical jargon. There is an interesting BBC program on Owen's work that you can google. (I think it's called The Gray Zone). Highly recommended.

3 1/2 stars ( )

3 1/2 stars: Good

From the back cover: ... the twilight region between full consciousness and brain death. People who inhabit this middle region called "The grey zone" have sustained traumatic brain injuries or are the victims of stroke or degenerative diseases, such as Alzheimer's and Parkinson's. Many are oblivious to the outside world, and their doctors and families often believe they're incapable of thought. But a sizable number of patients, as many as twenty percent, are experiencing something different: intact minds adrift within damaged brains and bodies. In 2006, Adrian Owen led a team that discovered this lost population and made medical history, provoking an ongoing debate among scientists, physicians, and philosophers about the meaning, value, and purpose of life.

We follow Owen as he pushes the boundaries of science, using a variety of sophisticated brain scans, auditory prompts, and even Alfred Hitchcock film clips to not only "find" patients who are trapped inside their heads but to actually communicate with them and elicit answers to moving questions, such as "Are you in pain?" and "Do you want to go on living?" and "Are you happy?". Many grey zone patients do, in fact, claim to be satisfied with their quality of life.

Into the Grey Zone shines a fascinating light on how we think, remember, and pay attention. And it shows us how the field of brain-computer interfaces is about to explode, radically changing prognoses for people with impaired brain function and creating, for all of us, the tantalizing possibility of telepathy and augmented intelligence. [actually, I don't think the book discussed this at all...]. Ultimately, this is not just a spellbinding story of scientific discovery but a deeply human, affirming book that causes us to wonder anew at the indomitable bonds of love.

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I picked this up at an independent bookstore in Chicago, and read it shortly thereafter. The nature of consciousness and TBI is of interest to me, and I enjoyed reading the stories. In short, Owen writes in the first person, and follows his career, as MRI was coming into wide usage. He and his team used MRI to follow brain activity while posing questions to patients "in the grey zone". As often our career choices do, this also had a personal component. One of Owen's early romances was with a woman who suffered TBI after their break up. She never recovered, but this experience shaped his experience and came to understand her perspective on patients and medicine. In many ways I expect that Owen helped himself and his loss, by his career choices.

Ultimately I found the book interesting, but not "unputdownable". I'm glad I read it. I'd love to hear more how this field changes over time. (It was published in 2017, shortly before my review).

Some quotes I appreciated:

Psychological studies have shown the devastating effects that social isolation can have on the brain. Imagine being ignored and treated like an object for days, weeks, and months on end. Surely that's the worst kind of social isolation. How could anyone come back from that? What a relief it must have been for Kate to be talked to, read to, and included in every conversation. We don't know what effect that would have on the brain, but there's little doubt it would have been empowering. (This is from an early patient of Owen's, who not only was he able to reach, but she eventually emerged from the grey zone).

With the Monica Lewinsky-- Bill Clinton debacle and the OJ Simpson trial recently behind us, we had warmed up to the idea that the American legal system is unpredictable at best and occasionally absurd.

Contrary to what most of us might suspect, a significant portion of patients *72%) reported they were happy. What's more, a longer time in a locked in syndrome was correlated with how happy this group said they were!

[After a 21 yo patient, Jeff, was in the grey zone, his 18 yo brother said this] Now Jason knows that Jeff understands what he was trying to tell him. "When you're 18 and 21, you don't say things like 'I love you' Jason said. 'Your tests reaffirmed all those talks I had with him in private. To know that he's heard me-- it does feel good.

I "recovered" from cancer in 1981. I have a few residual health issues, but I'm essentially healthy and live a normal life. REcovery after serious brain injury is another matter. Few of the patients that I have seen return to anything resembling a "normal" life. Indeed, most don't recover at all.

[Recovered patients] Kate told me that although her capacities have diminished, she is at her core the same person she was, deserving of the same love attention, and respect that healthy people expect. Juan too feels he is the same person, altered perhaps in ways that are beyond the measurable diminishment of physical and cognitive functions that are so hard to define. It amazes me that who we are, our very being, the very stuff that makes me me, and you you, is phenomenally resistant to alteration, even by catastrophic brain damage. There's no escaping it: we are our brains.

I am convinced that consciousness is reducible to the connections between neurons firing at one another. Yet in its most elaborated form it is the part of being human that we treasure most: our sense of self, of agency, of being something. It's no wonder that it is so hard to comprehend. My explorations into the gray zone have taught me that consciousness is not inexplicable, mystical, or metaphysical. Strange, perhaps. Even magical. Especially in the way it spills out from us into the lives of others. Bigger than any of us, it carries us along in a ceaseless flux to destinations we can't even begin to comprehend. ( )

Excellent book: a historical review from the author's point of view of his and others' research into the state of mind of those have experienced severe brain injury. The book is accessible to the general reader, yet presents a thorough summary of what the current research suggests about this mysterious state of consciousness. ( )