Trapped in the borderlands between consciousness and oblivion; just one block from the intersection of brain and behavior.

I might be writing at the intersection of brain and behavior, but sometimes I definitely feel like I am “trapped in the borderlands between consciousness and oblivion”. A lot of our discussion during seminar seemed to suggest that our self is dependent and defined by our interactions with the outside world. Though it makes me wonder, why do we place so much more importance on those interactions when we have so many experiences that occur entirely inside our head? Don’t worry, I won’t get all philosophical on all of you, that’s not my style. But, just from personal experience, I feel as though what I define as my self is something that is most salient when I am “cut off” from the outside world; like when I’m zoned out or “in my own little world”.  Yes, this self is influenced by my past experiences with the outside world as well, so maybe I’m getting more at consciousness than the self. In order to be conscious, must we be aware of the outside world or our own little world? Or both? This leads nicely into an article I’d like to discuss…

My roommate informed me of this fascinating article that was in the NY times today. It’s about some people in vegetative states that can come out of it by taking Ambien (a sleeping drug). One of the doctors discusses how a lot of these brain damaged people are floating in limbo somewhere between consciousness and oblivion, making diagnoses and decisions about treatment difficult. I thought about just posting this article and writing something separate for my last journal entry, but this was actually that topic from class that I found most interesting for the semester.

How is it that we are able to come to decisions about whether or not someone is “worth” keeping alive? In my perspective, I’ve always thought … if I’m unable to use the majority of my brain, that’s no longer me: please pull the plug and spare myself and my family the misery of keeping a body functioning without a mind. While articles like the one above make me question this decision (pulling the plug on a vegetative Robyn), I still feel pretty confident that this is preferable for me. In my neural plasticity seminar with Melissa, we learned about the different ways to euthanize laboratory animals. Despite my persistent unease with the actual act of beheading animals as our way of sacrificing, I am able to understand that this is in fact the best way. Learning about how “less gruesome” euthanasia is actually a pretty terrible experience for the animals (basically they suffocate to death) allowed me to realize the distinction between deciding what is best for the patient and deciding what is easiest for those making the tough decisions to stomach. This realization of the more humane approach for rat sacrifice however does not lead me to be able to conclude the best way to deal with vegetative states, since I hardly can imagine that we would ever behead humans. Though what I can take away from all of this is that we really need to be more insightful when it comes to determining ethics in these sorts of cases. Are we deciding on treatment based solely on the well-being of the patient, or are we allowing our own potential feelings of guilt and unease to get in the way of making the most humane decision.  If anything, I’ve decided that though my “self” is constantly changing, upgrading, and reinventing itself; an utterly brain-damaged and barely functional version of my “self” is not something that I personally value holding onto.

http://www.nytimes.com/2011/12/04/magazine/can-ambien-wake-minimally-conscious.html?pagewanted=1

One thought on “Trapped in the borderlands between consciousness and oblivion; just one block from the intersection of brain and behavior.

  1. I really agree with your speculation that we often decide treatments based on what is easier for us to handle and that this sometimes may come at a price for patients. Your post relates back to the article that we read in class about euthanasia and about how we should use a different method of terminating these patients lives–we ‘take them off of life support’, which sounds benign but actually means that they starve and dehydrate. It seems obvious to me that a more humane option would be to give them a drug that would end their lives quickly, or at least a painkiller, both of which were suggested in the article we read. I think people are resistant to these changes because they would see themselves as playing a part in the death. Sorry to be blunt, but I find that ridiculous. If there is any evidence that these patients feel pain it is absolutely necessary that we find another way to handle this sensitive and difficult situation.

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