Man Awakes From Coma? Not So Fast...

Here now is a story that will sell newspapers. No doubt you have already heard of the Belgian man who, after an automobile accident, spent the last 23 years in a coma. After his family requested a new diagnosis, it was found through brain scans (of some sort) that his brain was functioning normally and that was when they realized he could communicate with a touch pad and a helping hand. The story that emerged is that he was fully aware during those 23 years and was "trapped", unable to speak or move. Here is the story on CNN.

It is a gripping tale that gains the interest of almost anyone. But is it true? As some people like PZ Myers have pointed out, it looks too good to be true. PZ points out that it is apparent that facilitated communication is being used. This is a form of communication where a facilitator is helping the patient, previously unable, to communicate. It is a bit like a Ouija board. Are those messages really originating from the netherworld?

Steven Novella, a fellow Skeptic and Neurologist weighs in on his blog, NeuroLogica. Regarding Facilitated Communication:

Facilitated communication, or FC, has nothing to do with coma but is relevant to this case because of some of the media reports. FC is the technique of holding a patient’s hand to “help” them communicate by pointing to letters on a board. When FC was first proposed to the therapy community, it seemed like a powerful new technique – countless children who were thought to be too brain damaged to communicate were believed, due to FC, to actually have almost intact intellects trapped inside a non-communicating body. Unfortunately, FC was promoted prior to proper scientific validation. When it was studied in properlyh(sic) controlled blinded trials it turned out the the facilitator, and not the client, was doing all the communicating. FC is nothing but a well-meaning delusion. But it is also a dangerous one – FC testimony has led to the false conviction of adults accused of abuse.
While we do not want to miss any cases of a person’s hidden ability to communicate, the FC experience teaches us to be cautious. We must always ask – is communication (or any sign of consciousness) real? Has it been validated in an objective and controlled way?

And that is a fair point. Has this FC been objectively demonstrated? I only wish that the media had more skeptic blood flowing through their veins. This is something that even a child would figure out. I and a friend did when an older neighbor boy and his friend tried to fool us with the Ouija board trick. We tested it rather than take the older boy's word. Of course, the first thing we discovered was a resistance to allow us to test it in a way that would reveal the trick. But has any effort been made for this instance of FC?

Now comes the tricky part – the clinical correlation. Looking at brain anatomy and activity is important, but must be placed into a proper clinical context. At present, the clinical exam is still critical. I don’t know what Mr. Houben’s exam is. But I do have a video of him communicating. What I can say with high confidence is that this is a video of bogus facilitated communication. The “facilitator” appears to not just be supporting Houben’s hand, but moving it around the keyboard. Houben is looking in the general direction of the keyboard, but at times not directly at it (which is necessary for single finger typing). It is not clear if he can even see, and since his eyes are not in line it is not clear which eye he would be using.

His hand is also in a brace; his finger is not touching the board – the plastic of the brace is – so he would have little sensory feedback.

And yet his hand flies dextrously across the board typing very quickly. It seems impossible that someone with his level of paralysis, and years of inactivity, would be able to type so quickly with just a little “support”. There is little doubt, in other words, that his typing is the product of bogus FC – the facilitator is doing the communicating, not Houben.

Indeed, this is exactly my impression from the video, which can be viewed at the CNN link above. It is possible that they were just putting on a show for the camera, a "dramatization", if you will. But why would they do that if he was sitting right there and could communicate?

Reporting of his typing is without skepticism, and so basic questions are not addressed. It would also be almost trivial to test whether or not the communication were legitimate – the report says he responds in Flemish – so have a non-Flemish speaking facilitator hold his hand. Apparently, he also understands English so you could have a non-English speaking facilitator answer questions posed in English. Or blind the facilitator to the keyboard or visual information that Houben has access to. What would not be sufficient, however, is a knowledge test – asking Houben about events in the past or about his life, for example. This is too difficult to tightly control – a facilitator may have been contaminated, or may just make obvious or lucky guesses. In an interview for NPR, Laureys reports that the family came up with the method of communication, and it was validated by having Houben identify objects that were show to him – that’s it. Laureys also reports that the medical doctors were skeptical of this communication, and it seems right that they were.
Until a tightly controlled test is done, the FC evidence is worthless.

Orac is also all over this. He makes the same connection that my wife made: to that of Terry Schiavo.

From Orac:
Regardless of whether Houben is locked-in or in a vegetative state, what is being shown on the videos above and described in the the news reports is indeed, as Randi put it, a cruel farce that allows the same cranks who claimed that Terri Schiavo wasn't in a persistent vegetative state to hijack the Houbens case as "proof that they might have been right."

But all the political ramifications aside, there is one more thing to consider, that both Novella and Orac mention, and that is the possibility that Houben may be "locked in" and aware of the scam being perpetuated.

As James Randi has said on this case, it must be stopped.

For those who may need further evidence for my contention, the proof can be found at -- where it is clearly seen that the “facilitator” is looking directly at the keyboard, while the subject is asleep! There can be no further doubt. This FC claim is simply untrue, a farce, a lie – and the “facilitator” knows it! And no, this man is not going to write a book, but the "facilitator" is, and if this humbug is not stopped, she'll make a fortune doing so. Put a stop to this, someone!"

Stay Skeptical!

Views: 32

Tags: Bouden, Orac, Novella, Randi, , coma, communication", facilitated

Comment by Jay Catt on November 25, 2009 at 11:41am
I had a family member in a "progressive vegetative state", His poor motherr was fooled into FC. It was sad. I knew it couldnt possibly be his words.. I knew he couldnt spell that well.
(she also wrote mother teresa, and tried to have the guy made a saint. sometimes we crumble under the weight of tragic events)
I thought then, 27 yrs ago, as I do now it was very much like a ouija board. Same as an afterlife. Some people can not bear the reality.
Then again there's Jean-Dominique Bauby - The Diving Bell and the Butterfly
Comment by Robert E. O'Dell on January 1, 2010 at 2:31pm
Very interesting!! I had seen the CNN report, but knew nothing about the scam (which now looks obvious) until reading this. You are exactly right, the Schiavo Nazis will be all over this as validation of their crusade.
Comment by Reggie on January 1, 2010 at 4:26pm
And not just the Schiavo Nazis, but everyday people at the water cooler use this as reasoning against end of life decisions being granted to anyone. No one seems to be aware that it is a scam and it seems to have quietly fell away from the public spotlight. Now, all people remember is the unskeptical headlines that fed them misinformation.
Comment by Robert E. O'Dell on January 1, 2010 at 9:02pm
Good point! And the Nazis won't let them forget what they "learned".
Comment by Reggie on February 20, 2010 at 7:10am

Finally, truth comes out that Houben is NOT actually communicating. Media,where is your embarrassment over lack of due diligence? And Dr. Laureys seems too easily fooled and too ready to believe that these patients are Locked In. I'd seriously question his judgement if he were caring for me or my loved one.


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