Voice 1
Hello. I’m Liz Waid.
Voice 2
And I’m Ruby Jones. Welcome to Spotlight. This programme uses a special English method of broadcasting. It is easier for people to understand, no matter where in the world they live.
Voice 1
A woman sits by her son’s hospital bed. She talks to him in a motherly way. The son does not answer. But the mother continues anyway. She does not expect an answer. Her son is in a deep sleep - a coma. His eyes are open. But he does not move them. He has been this way for many years. Every day, his mother visits and talks to him. But her son just lies there, not moving, not speaking. It is like his brain is asleep. Doctors call his condition Persistent Vegetative State, or PVS.
Voice 2
Doctors still do not fully understand the condition of PVS. It is difficult to define. They know that the cause of PVS is damage to the cerebral cortex. This is the ‘thinking, feeling’ part of the brain. Such damage can happen during a severe accident, or a fall. The National Institute of Neurological Disorders and Strokes is an organisation in the United Kingdom. The group researches and supports work on problems in the brain and nervous system. It describes PVS in this way:
Voice 3
‘A coma is a deep state of unconsciousness. A Persistent Vegetative State sometimes follows a coma. People often use the term ‘brain death.’ This is not correct. Individuals in a state of PVS are not able to think. But other brain activities are still there - such as control of breathing and blood flow.’
Voice 1
In recent years, PVS has caused much debate and discussion. Part of the debate surrounds the issue of euthanasia - also called ‘mercy killing.’ Euthanasia is the killing of a person in a painless way, especially a very sick person. Supporters of euthanasia talk of ending suffering in cases where there is little or no hope of recovery.
Voice 2
Euthanasia is illegal in most countries. And many people think this ban is morally right. For example, many religious people believe that life is a gift from God. They say humans should not have the right to kill - even for merciful reasons. However other people have fought to change the law on euthanasia in particular cases - such as for people with PVS. They talk about quality of life. They talk about the great pressure on family members, husbands and wives. They ask: ‘would the person want to live in a persistent vegetative state?’ The word vegetative means to live like a vegetable - still and lifeless. However no one can see into the future. So, doctors may be able to say that recovery from PVS is extremely unlikely after a long period of time. But they cannot say it is impossible. This makes the issue even more difficult.
Voice 1
In 2006, a doctor in South Africa made an exciting discovery. His discovery has deepened the debate about PVS. And, his discovery was purely by accident! It began with a patient called Louis Viljoen.
Voice 2
Louis Viljoen was twenty-four [24] years old when his whole world changed. He lived in a small town thirty [30] minutes east of Johannesburg. He was riding his bike one day, when a large truck hit him. Louis suffered severe brain injuries. He went into a deep coma. Doctors thought he would die. His mother said later:
Voice 4
‘His eyes were open but there was nothing there. I visited him every day for five years. I spoke to him. But he did not recognise anything. He could not communicate. There was nothing.’
Voice 1
It was a very difficult time for the mother. And, to make things worse, there were possible signs that Louis was troubled. During the night, nerves in his arm caused it to move. The movement resulted in him tearing the bed covering. Was this a sign that somewhere deep inside, Louis was not at ease? Louis’s doctor was Wally Nel. Doctor Nel decided that a sleeping drug could help. He chose the drug Zolpidem. After he had given Zolpidem to Louis, something unexplainable happened. Louis’s mother said,
Voice 4
‘It was about twenty-five [25] minutes later. I thought I heard him make a little sound. I said, “Louis can you hear me?” He answered, “yes”. So I said, “Can you say hello to me? And he said, “Hello mummy”. I cried.’
Voice 2
Doctors and experts were all shocked. Surely this was not possible? Louis now takes Zolpidem daily. A newspaper reporter described a visit to Louis. The reporter was from London’s Guardian newspaper:
Voice 5
‘I see Louis before his daily medicine. His mouth falls to one side because of brain damage. His right arm is bent to one side.
Louis is given medicine. I watch. After nine minutes the grey colour goes, his face reddens. He starts smiling and laughing.
After ten minutes he begins to ask questions. His speech is impaired. But I can understand him.
A few minutes later, his right arm becomes looser. His mouth does not fall to the side as much.
After fifteen minutes, he reaches out and holds his mother. They laugh and joke together.’
Voice 1
After taking Zolpidem, Louis comes out of his coma - for a few hours each day. How is this possible? Experts took medical pictures, scans, of Louis’s brain. They did this before and after Louis had Zolpidem. The results amazed them. Before Zolpidem, areas of Louis’s brain appeared black and dead. After Zolpidem, the areas began to light up!
Voice 2
Experts are still investigating how a sleeping drug can ‘awaken’ brain cells. There are no published answers, only ideas and theories. So far, research is looking at the way Zolpidem acts with GABA receptors. GABA is a chemical in the brain. And the ‘receptors’ are particular brain cells that receive chemical messages from GABA. After severe brain damage, the GABA receptors ‘close down’ the brain’s higher powers. This happens to save energy and help cells survive. Experts are investigating how Zolpidem affects GABA receptors in a way that prevents them closing down the brains higher powers.
Voice 1
There are other reports of Zolpidem ‘awakening’ patients. Zolpidem has not worked on everyone. But, for some it has given a new kind of life. This puts a new light on issues of euthanasia. Patients may have a real chance of some recovery! This means that euthanasia may no longer be supporting someone’s right to die. Instead, it may be sacrificing their chance to live.