Zimmer C. What if there is something going on in there. New York Times Magazine. September 28, 2003.
This article is a layperson's interpretation of findings published by Nicholas Schiff (Brain. 2002;125:1210-1234). Schiff's study involved 5 patients diagnosed in a persistent vegetative state who underwent MRI, MEG, and PET while sensory stimulus was applied.
Zimmer provides a review of the article's findings through interviews with Schiff and "collaborator" Joseph Giacino, interspersed with vignettes of patients who have sustained severe traumatic brain injury. The author defines coma and vegetative for the reader along with descriptions of the vegetative state, some factual, others prosaic (such as the allusion to Pedro Almodovar's movie "Talk to Her"). The vignettes of patients are written with a dramatic flair and often overtake the article. Still, they provide the general reader with a glimpse of what it might be like to be vegetative or minimally conscious.
This is an article that is likely to be read by many families of patients with traumatic brain injury. It may be helpful for professionals in the field to read this article, as well as the original publication by Schiff, in order to better answer questions that may arise.
The vegetative state: guidance on diagnosis and management. Clin Med. 2003;3(3):249-254.
The Royal College of Physicians has compiled a set of recommendations to guide clinicians and families in diagnosis and management of patients in the minimally conscious/vegetative state. It is a report of a working party composed of physicians, lawyers, and public health officials.
This is a helpful publication for those who specialize in the area and for those with limited exposure. The vegetative state, wakefulness, and awareness are defined. Criteria for diagnosis are based on etiology and clinical findings. Differential diagnoses are described and also presented in a clear, concise table format. Guidelines for assessment, proper medical care, and decisions concerning life support are given. There is a helpful checklist to aid families and clinicians in determining the diagnosis of the vegetative state.
The language used makes this document easy to read and understand at a professional and layperson level. It is a useful tool to complement current medical management. It may also be useful when counseling families and educating consultants.