Setting the Record Straight: Belgian Coma Patient Cannot Communicate | 80beats

brain-3 Late last year, a Belgian man in his mid-forties created a media stir when doctors announced that he had been misdiagnosed as being in a coma for 23 years. Rom Houben, the victim of a horrific car-crash in the eighties, was incorrectly diagnosed as being in a “persistently vegetative state.” But by using new diagnostic tests and brain scans that were unavailable in the eighties, scientists revealed that Houben was actually conscious.

Reports then breathlessly announced that Houben could also finally “communicate,” expressing his thoughts by having his hand supported by his therapist who reportedly helped him tap out his messages on a touch-screen computer. “I shall never forget the day when they discovered what was truly wrong with me,” Houben apparently tapped. “It was my second birth. I want to read, talk with my friends via the computer and enjoy my life now that people know I am not dead” [The Guardian].

But now one of Houben’s doctors, neuroscientist Steven Laureys, has declared the Belgian hasn’t been communicating after all.

When the story first broke, DISCOVER and other discerning publications noted that this type of communication, called “facilitated communication,” is very controversial, and has repeatedly failed under conditions of rigorous testing. [Psychology Today]. Skeptics argued that the facilitated communication therapist brought in by Houben’s family was really guiding the man’s hand and choosing which letters to press herself. Skeptics who read Houben’s messages were also amazed that someone who was in a minimally-conscious state for more than two decades was so lucid, articulate, and forgiving of the medical staff. Laureys wanted to study the case further to determine if Houben could indeed communicate.

He set forth by studying a group of minimally conscious patients, including Houben, and three facilitators. The patients were presented with words and objects while their facilitators were out of the room. When the therapists returned, the patients were asked to type out what they saw. Two out of the three facilitators, included Houbens’, failed–leading Laureys to conclude that the Belgian man wasn’t communicating in the first place.

Presenting his findings at a neuropsychiatry meeting in London, Laureys said: “To me, it’s enough to say this method (facilitated communication) doesn’t work” [MSNBC]. He added that the new findings don’t change the fact that Houben was misdiagnosed, but noted that Houben’s previous words could not rightly be attributed to him. Said Laureys: “The story of Rom is about the diagnosis of consciousness, not communication” [BBC].

The findings have vindicated skeptics. “It’s like using an Ouija board,” Arthur Caplan, a professor of bioethics at the University of Pennsylvania, said Friday. “It was too good to be true and we shouldn’t have believed it” [MSNBC]. Other experts have suggested that facilitated communication could be used on some paralyzed patients but not on patients like Houben, who have suffered severe brain injuries.

However, there may be other methods that Houben could use to communicate; several weeks ago, a fascinating study showed a way to communicate with some vegetative patients by reading their brain scans as they focused their thoughts on different activities or places.

Image: iStockphoto