Some People Who Appear to Be in a Coma May Actually Be Conscious

Jan Claassen & Brian Edlow:

A medical team surrounded Maria Mazurkevich’s hospital bed, all eyes on her as she did … nothing. Mazurkevich was 30 years old and had been admitted to New York–Presbyterian Hospital at Columbia University on a blisteringly hot July day in New York City. A few days earlier, at home, she had suddenly fallen unconscious. She had suffered a ruptured blood vessel in her brain, and the bleeding area was putting tremendous pressure on critical brain regions. The team of nurses and physicians at the hospital’s neurological intensive care unit was looking for any sign that Mazurkevich could hear them. She was on a mechanical ventilator to help her breathe, and her vital signs were stable. But she showed no signs of consciousness.

Mazurkevich’s parents, also at her bed, asked, “Can we talk to our daughter? Does she hear us?” She didn’t appear to be aware of anything. One of us (Claassen) was on her medical team, and when he asked Mazurkevich to open her eyes, hold up two fingers or wiggle her toes, she remained motionless. Her eyes did not follow visual cues. Yet her loved ones still thought she was “in there.”

She was. The medical team gave her an EEG—placing sensors on her head to monitor her brain’s electrical activity—while they asked her to “keep opening and closing your right hand.” Then they asked her to “stop opening and closing your right hand.” Even though her hands themselves didn’t move, her brain’s activity patterns differed between the two commands. These brain reactions clearly indicated that she was aware of the requests and that those requests were different. And after about a week, her body began to follow her brain. Slowly, with minuscule responses, Mazurkevich started to wake up. Within a year she recovered fully without major limitations to her physical or cognitive abilities. She is now working as a pharmacist.