WEBVTT - How Comas Work 0:00:00.280 --> 0:00:02.920 Brought to you by the reinvented two thousand twelve Camray. 0:00:03.160 --> 0:00:07.600 It's ready. Are you welcome to Stuff you Should Know 0:00:08.200 --> 0:00:11.719 from House Stuff Works dot com. This episode is sponsored 0:00:11.720 --> 0:00:14.200 by go daddy dot com, the world's largest web host 0:00:14.240 --> 0:00:16.599 and domain name registrar, with domains as low as a 0:00:16.640 --> 0:00:18.960 dollar ninety nine and hosting for less than five dollars 0:00:18.960 --> 0:00:21.840 a month. In a promo code stuff ten at checkout 0:00:21.960 --> 0:00:24.640 and save ten percent off your entire order. Get your 0:00:24.680 --> 0:00:27.800 piece of the Internet at go daddy dot com. Hello 0:00:27.880 --> 0:00:31.479 and welcome to the podcast. I'm Josh, I'm Chuck. The 0:00:31.520 --> 0:00:34.360 red light is on. We have one of those now 0:00:34.479 --> 0:00:36.640 we need one? Now, Yeah, we totally do. It's usually 0:00:36.680 --> 0:00:39.920 just a you know, we hear our producer Jerry President 0:00:40.000 --> 0:00:42.400 button right, and then we know to go. You just 0:00:42.440 --> 0:00:46.559 start talking like talking monkeys. It's like a German the 0:00:46.600 --> 0:00:50.600 German train system. It's very efficient. Yes, it is Chuck, Chuck. 0:00:50.640 --> 0:00:53.599 As you know, it's been in all together rotten day 0:00:53.680 --> 0:00:56.000 so far, right, Yeah, hasn't been our best And what 0:00:56.120 --> 0:00:59.960 is it like three in the afternoon? Yeah, yes, okay, 0:01:00.080 --> 0:01:04.800 so um, luckily it'll be over soon enough. And it's Friday. Um, 0:01:05.360 --> 0:01:08.600 I am even worse than I was before, because rather 0:01:08.640 --> 0:01:11.520 than getting my usual fresca, I got a diet cherry 0:01:11.520 --> 0:01:14.640 coke by accident. And you know, all respect to the 0:01:14.640 --> 0:01:16.840 Coke Cold company, they've done really well for themselves, but 0:01:17.080 --> 0:01:20.480 diet cherry coke is atrocious. I like that you're suffering 0:01:20.480 --> 0:01:22.440 through it anyway rather than I opened it. You know, 0:01:22.560 --> 0:01:26.160 I gotta I've gotta make do. But um, honorable. You know, 0:01:26.200 --> 0:01:29.440 as bad as our day has been, right, yeah, I 0:01:29.440 --> 0:01:32.400 can tell you somebody whose day was even Worse's how's 0:01:32.440 --> 0:01:35.600 that first segue? I actually just set up the setup 0:01:35.800 --> 0:01:37.880 for the podcast. So what do you think you're blowing 0:01:37.920 --> 0:01:41.880 my mind? Um? There's this woman named Patricia white Bull 0:01:42.520 --> 0:01:45.840 and she was a co cheaty Indian from outside of Albuquerque, 0:01:45.920 --> 0:01:49.480 New Mexico. And back when she was a lovely young 0:01:49.640 --> 0:01:52.960 twenty eight, she was giving birth to her fourth child, 0:01:53.280 --> 0:01:56.800 son named Mark, and uh, she was giving birth via 0:01:56.880 --> 0:02:01.120 C section, and there are complications in the surgery and uh, 0:02:01.360 --> 0:02:05.600 Mrs white Bull uh developed a blood clot in her 0:02:05.680 --> 0:02:08.840 lung and it actually cut off oxygen to her brain 0:02:09.120 --> 0:02:14.680 and she laughs into a coma. Okay, so comas actually happened. 0:02:14.840 --> 0:02:20.080 They can happen fairly frequently. They're not uncommon, but Mrs 0:02:20.080 --> 0:02:23.840 white Bull's type of coma actually very rare. She was 0:02:24.000 --> 0:02:28.320 in a coma for sixteen years, which is that's really 0:02:28.360 --> 0:02:32.840 that's a long time to be in a coma. So, um, 0:02:32.880 --> 0:02:35.400 there are other people out there like her. Um, have 0:02:35.520 --> 0:02:39.840 you heard of Sunny von Buelow reversal of fortune? Yeah, 0:02:39.919 --> 0:02:43.519 so she's been in a coma for nineteen years, uh huh. 0:02:43.520 --> 0:02:45.360 And a couple of years back, actually she was moved 0:02:45.400 --> 0:02:50.120 from this very very expensive um care facility to a 0:02:50.200 --> 0:02:53.000 slightly less expensive when it was estimated that her family 0:02:53.040 --> 0:02:55.800 is spending about half a million dollars on her care, 0:02:56.360 --> 0:02:59.880 as well as hairstylists and ran chairs and stuff like that, 0:03:00.360 --> 0:03:02.799 finally had to say we gotta move you. Mall Um. 0:03:02.919 --> 0:03:06.200 Was she in the coma from the attempted murder? Yes? Really, 0:03:06.560 --> 0:03:12.040 allegedly by her husband, Claus von Bull, who recently passed away. Correct, Actually, um, 0:03:12.040 --> 0:03:15.400 it was she who passed away. Okay, she did, um, 0:03:15.480 --> 0:03:17.399 And this is actually kind of common. I'm not sure 0:03:17.400 --> 0:03:20.960 how she passed away, but people in comas sometimes passed 0:03:21.000 --> 0:03:23.800 away from pneumonia or something like that. It's their their 0:03:23.840 --> 0:03:26.560 bodies not functioning very well, so they can succumb to 0:03:26.639 --> 0:03:28.640 things like that. Well, apologies for not being up on 0:03:28.720 --> 0:03:31.760 my von Buelow history. Hey, same here, Pale. It's okay. 0:03:31.960 --> 0:03:34.160 Things move pretty fast in this crazy world of ours. 0:03:34.760 --> 0:03:38.360 So back to Mrs white Bowl. Um, while Mrs von 0:03:38.400 --> 0:03:42.000 Bulow never woke up, Mrs white Bull actually did after 0:03:42.080 --> 0:03:46.760 sixteen years. This is amazing. This is exceedingly rare, rareer 0:03:46.760 --> 0:03:50.160 than a sixteen plus your coma is waking up from 0:03:50.160 --> 0:03:54.160 a sixteen plus your comma. Basically, Um, she woke up 0:03:54.640 --> 0:03:58.040 one day while her one of her caregivers was adjusting 0:03:58.040 --> 0:04:00.840 the sheets on her bed, and she lifted her head 0:04:00.880 --> 0:04:04.800 and shouted, don't do that, and scared. I imagine the 0:04:04.880 --> 0:04:08.880 daylights out of this woman. Yeah. Uh and uh. After that, 0:04:08.920 --> 0:04:11.840 she was writing notes to her family. She called her 0:04:11.880 --> 0:04:16.440 mother to say, marry Christmas has happened in December. Um, 0:04:16.520 --> 0:04:19.760 And within like a month she was at a mall. 0:04:20.000 --> 0:04:22.680 She wanted to see, you know, how the world had changed. 0:04:22.800 --> 0:04:24.280 So she went to them all. She went to them all. 0:04:24.279 --> 0:04:26.600 It's actually a pretty good place to start, right because 0:04:26.600 --> 0:04:28.800 I mean back when she fell into a coma, Reagan 0:04:28.880 --> 0:04:31.920 had just started his second term right right. Um there, 0:04:31.960 --> 0:04:35.400 just I think about how much the world changed between 0:04:36.360 --> 0:04:38.039 kidding and she woke up just in time to get 0:04:38.040 --> 0:04:41.680 nervous for Y two k Yeah you know good? Yeah? Wow, 0:04:41.720 --> 0:04:44.400 that's awesome, isn't that? It's kind of an uplifting story. 0:04:44.480 --> 0:04:46.640 We could end it right here and I would be happy. 0:04:46.760 --> 0:04:49.680 Probably I would too, actually, but we're not. Yeah, so 0:04:49.760 --> 0:04:51.800 you want to talk about combas that I think I 0:04:51.920 --> 0:04:55.360 take it from that solicitation. Yes, all right, well chuck, 0:04:55.800 --> 0:04:58.640 let me start, because I haven't spoken enough so far. 0:04:59.080 --> 0:05:01.080 I agree. I you're just gonna kick it off with 0:05:01.200 --> 0:05:04.839 Coma comes from the Greek word coma appropriately enough, with 0:05:04.880 --> 0:05:07.360 a with a K. That's the big distinction. And that 0:05:07.400 --> 0:05:12.560 word is to sleep in the Greek dialect um. And 0:05:12.560 --> 0:05:15.880 that's actually pretty misleading, isn't it. It is because when 0:05:15.880 --> 0:05:17.680 you're sleep, you can wake up, and if you're in 0:05:17.680 --> 0:05:19.719 a coma, you're not waking up. You don't respond to 0:05:20.240 --> 0:05:24.200 stimuli like you know, site or motor function stuff like that. Yeah, 0:05:24.360 --> 0:05:25.920 so you can sit there and shot all day at 0:05:25.920 --> 0:05:28.800 a comma patient. They're not waking up, right. Um. They 0:05:28.839 --> 0:05:33.359 also don't respond respond to pain stimuli. Um. There there's 0:05:33.520 --> 0:05:37.960 they're just basically out right, but the brain functions part 0:05:38.000 --> 0:05:41.000 of it does, right, Okay, So, um, we should probably 0:05:41.000 --> 0:05:43.080 talk about the brain. To understand that coma, you kind 0:05:43.120 --> 0:05:46.120 of have to have a minor understanding of the brain, right, 0:05:46.480 --> 0:05:51.279 major understanding, major understanding. Exactly. Um. So we've got basically 0:05:51.320 --> 0:05:54.320 three parts, yes, that that work to make us these 0:05:54.640 --> 0:05:57.320 you know, talking monkeys that we are. Right. Um, You've 0:05:57.360 --> 0:06:01.239 got the cerebrum cerebellum in the brains to him, uh, 0:06:01.279 --> 0:06:04.480 and they communicate with one another, So you're cerebrum. That's 0:06:04.480 --> 0:06:12.640 your higher brain. Yeah, that's controls things like emotion, memory, intelligence, personality, context. Yeah, 0:06:12.680 --> 0:06:14.320 it's what most people think of when they think of 0:06:14.320 --> 0:06:16.400 the brain. All that good stuff is in there, and 0:06:16.480 --> 0:06:19.160 it's the largest part. Two. And then you've got the cerebellum, 0:06:19.160 --> 0:06:22.400 which is in charge of balance movements, also very important. 0:06:22.440 --> 0:06:25.040 And then the most ancient part of the brain, um 0:06:25.080 --> 0:06:28.279 evolutionarily speaking, is the brain stem. Right, this is like 0:06:28.360 --> 0:06:32.839 the basic part of the brain that controls like, um, breathing, 0:06:33.279 --> 0:06:38.839 blood pressure, bowel movements. Actually, yeah exactly. So, Um, you 0:06:38.920 --> 0:06:42.320 put all these together and you've got us intelligent, reasoning, 0:06:42.720 --> 0:06:45.920 pooping humans, wrapping skull around it and some skin and 0:06:46.680 --> 0:06:49.480 you've got a human exactly. Um. And all these things 0:06:49.520 --> 0:06:52.160 have to kind of communicate with one another, and they 0:06:52.160 --> 0:06:55.200 do so through the thalamus um and they send chemical 0:06:55.240 --> 0:07:00.000 signals to one another. UM that makes your lungs um 0:07:00.040 --> 0:07:02.760 inflate and deflate and makes you think this person is 0:07:02.800 --> 0:07:05.719 making fun of me, or they're after me or something. Um. 0:07:05.760 --> 0:07:09.240 There there's all this stuff combined, as you said, makes 0:07:09.320 --> 0:07:11.760 us this way. If they stopped talking to one another, 0:07:12.600 --> 0:07:15.360 you got yourself an altered state of consciousness exactly. And 0:07:15.360 --> 0:07:17.200 there's quite a few of those. Yeah, you want to 0:07:17.200 --> 0:07:20.120 talk about some of the other altered states. Uh, well, yeah, 0:07:20.120 --> 0:07:22.760 there's a vegetative state that a lot of people, um 0:07:22.960 --> 0:07:26.120 get confused with comma. It's not exactly the same thing, uh. 0:07:26.120 --> 0:07:29.720 And a vegislative state is actually a type of coma um, 0:07:29.760 --> 0:07:33.560 but you're generally awake but unresponsive, so your eyes can 0:07:33.600 --> 0:07:37.520 be open, but you're still unresponsive. It is generally confused 0:07:37.520 --> 0:07:40.840 with with coma because it usually comes after a coma. 0:07:41.120 --> 0:07:44.160 Correct um. These people like Mrs white Bowl and Mrs 0:07:44.240 --> 0:07:46.560 von Buelow, who are in comas for dozens of years 0:07:46.640 --> 0:07:51.200 or tens of years, um, we're uh in a vegetative 0:07:51.240 --> 0:07:54.400 state after X amount of time. So if you're in 0:07:54.440 --> 0:07:57.200 a coma and you go into a vegetative state, you're 0:07:57.240 --> 0:07:59.520 probably in a lot of trouble. You're probably not going 0:07:59.560 --> 0:08:03.200 to come out of it. Um. You you some part 0:08:03.280 --> 0:08:06.960 of your brain stem responds to stimuli, stimuli like maybe 0:08:07.000 --> 0:08:11.040 a sound. So all of a sudden, your eyes um, 0:08:11.080 --> 0:08:13.640 which are no longer coordinated, so they're kind of lolling around, 0:08:13.640 --> 0:08:15.800 but both in the same direction towards the sound, but 0:08:15.840 --> 0:08:19.440 there's no awareness of it. You're not you're not using 0:08:19.480 --> 0:08:21.440 any of your higher brain function to figure out what 0:08:21.480 --> 0:08:25.280 the sound is. It's just like a basic response. Right. 0:08:25.320 --> 0:08:26.920 Your eyes can move, I believe that they could be 0:08:26.920 --> 0:08:30.760 like yawning, even you can yawn, that kind of thing, blinking. 0:08:30.920 --> 0:08:34.280 And the one real hallmark of a vegetative state is 0:08:34.320 --> 0:08:37.320 people in it have sleep cycles. So so you know, 0:08:37.400 --> 0:08:40.480 during the day they're diurnal. Still during the day they 0:08:40.520 --> 0:08:43.120 will you know, blink or their eyes a lull about 0:08:43.120 --> 0:08:45.640 in their head or there, they'll turn their their head 0:08:45.720 --> 0:08:49.720 towards something, um. And then at night they're not doing that, 0:08:49.760 --> 0:08:52.800 they're sleeping. In a coma, you're just you just appear 0:08:52.840 --> 0:08:55.720 to be sleeping the whole time. So that's one. There's 0:08:55.760 --> 0:08:58.440 another one that is one of my particular favorite altered 0:08:58.480 --> 0:09:03.520 states of conscious stupor that actually scared me. Apparently, if 0:09:03.559 --> 0:09:05.600 you are whacked out of your skull on drugs and 0:09:05.600 --> 0:09:08.760 you're in a stupor, you're like one or two steps 0:09:08.800 --> 0:09:13.080 away from Coma's host. It's all the same process is 0:09:13.120 --> 0:09:15.680 going on. It's just I guess to a slightly different degree. 0:09:16.120 --> 0:09:21.000 But that's alarming, you know, So watch out, buddy, I'm 0:09:21.000 --> 0:09:23.120 watching out. But I distracted. You know, I know which 0:09:23.160 --> 0:09:24.840 one you were going to talk about. You just like 0:09:24.920 --> 0:09:28.120 to say stupor um. The one I like the most 0:09:28.160 --> 0:09:30.839 is locked in syndrome. Yeah. I can't believe I just 0:09:30.880 --> 0:09:33.160 said that. The the one I liked the most, the 0:09:33.160 --> 0:09:35.760 one you find what's fascinating, Thank you, Chuck. Locked in 0:09:35.840 --> 0:09:41.199 syndrome UM is basically where you're, uh, you can move 0:09:41.520 --> 0:09:45.000 your higher brain is or you can't move. You're totally 0:09:45.000 --> 0:09:48.120 aware though your higher brain is functioning. You are literally 0:09:48.120 --> 0:09:51.719 locked into your body um and basically the only thing 0:09:51.720 --> 0:09:55.400 you can move are your eyes typically and uh, that's 0:09:55.440 --> 0:09:59.679 like Jean Dominique Bobie from the Diamond Bell in the Butterfly, 0:10:00.040 --> 0:10:02.640 which is a great movie. We were just talking with Jerry, 0:10:02.640 --> 0:10:05.480 our producer beforehand. We've both seen the film. It's really, really, 0:10:05.559 --> 0:10:08.160 really great. But you have not because you're too busy 0:10:08.160 --> 0:10:12.160 watching Magnet Pion. Yeah I have. I know enough about 0:10:12.320 --> 0:10:15.320 the story when it came out, you know, I listen 0:10:15.360 --> 0:10:18.199 to NPR and then talked about that like seven Days 0:10:18.200 --> 0:10:20.120 in a Row. I think it's really good. But the 0:10:20.160 --> 0:10:23.240 guy because he could move his eyes and he had 0:10:23.320 --> 0:10:28.080 a computer software system that he could type with it. 0:10:28.720 --> 0:10:30.800 But he he and he wrote a book in his 0:10:30.920 --> 0:10:34.600 in this locked in state. Yes, right, and um he 0:10:34.720 --> 0:10:38.280 typed every single letter of this book by looking at 0:10:38.280 --> 0:10:41.280 the by choosing like a keyboard, right or from from 0:10:41.320 --> 0:10:44.280 like a computer screen keyboard. I believe that's what happened. 0:10:44.320 --> 0:10:47.640 That's nuts. But I mean imagine that. Imagine being locked 0:10:47.679 --> 0:10:50.600 in and knowing exactly what was going on, and I'm 0:10:50.679 --> 0:10:53.800 very frustrating. Imagine it's very much like the Metallica video one, 0:10:54.160 --> 0:10:57.000 except that guy could move right, which was from the 0:10:57.040 --> 0:10:59.840 film Johnny got his gun. I think, thank you, Wow, 0:11:00.200 --> 0:11:02.800 very nice my fountain of film knowledge today. So those 0:11:02.840 --> 0:11:05.679 are a couple of other altered states of consciousness in 0:11:05.679 --> 0:11:08.360 case you're interested. If not, you should have fast forward 0:11:08.360 --> 0:11:11.280 it to to the last one minute and a half maybe two. Um, 0:11:11.320 --> 0:11:14.920 and we're back to coma again. Okay, so somebody falls 0:11:14.920 --> 0:11:17.480 into a coma. How how does this happen? What are 0:11:17.480 --> 0:11:19.199 some of the ways you can become coma tope? Well, 0:11:19.240 --> 0:11:22.440 there's a bunch of ways. Um. One way is from 0:11:22.480 --> 0:11:25.880 brain injury, obviously. UM, if you have severe head trauma, 0:11:25.920 --> 0:11:28.320 you can get an impact that actually makes your brain 0:11:28.440 --> 0:11:32.520 move within your skull. And uh, and now that if 0:11:32.520 --> 0:11:35.960 your brain actually hit your skull, that's what a concussion is, correct, 0:11:36.120 --> 0:11:38.840 I believe so. But something more severe than that can 0:11:39.160 --> 0:11:43.240 cause uh, nerve blood vessels and nerve fibers to swell up, 0:11:43.720 --> 0:11:46.680 and that can potentially cut off the flow of blood 0:11:46.720 --> 0:11:49.080 and therefore oxygen to the brain. And that's when you're 0:11:49.080 --> 0:11:51.480 in trouble. You want your skull to be stationary at 0:11:51.480 --> 0:11:54.439 all times, or you want your brain to be stationary 0:11:54.480 --> 0:11:56.400 at all times in your skull. Yes, it's just not 0:11:56.480 --> 0:11:59.400 good when it slaps around in there. No, it's not. So. 0:11:59.800 --> 0:12:04.119 You can also become comatast if you have diabetes, right, diabetes, 0:12:04.360 --> 0:12:07.680 certain diseases like meningitis can make it happen. Drug overdose 0:12:07.720 --> 0:12:10.640 can make it happen. Yeah, although I believe you told 0:12:10.679 --> 0:12:12.680 me that they don't even know exactly how that happens. 0:12:12.840 --> 0:12:15.080 I don't know how it happens. I couldn't find out 0:12:15.240 --> 0:12:17.720 what leads to it. The way I took it was 0:12:17.760 --> 0:12:21.800 that there is a m It slows your response, um it. 0:12:21.880 --> 0:12:24.120 Maybe it slows the oxygen to your brain, or the 0:12:24.120 --> 0:12:27.320 flow of oxygen your brain, or it just relaxes muscles 0:12:27.320 --> 0:12:31.080 that need to be working. I don't know. That's literally 0:12:31.240 --> 0:12:33.600 off the top of my head, right. I sense a 0:12:33.640 --> 0:12:37.520 neurosurgeon email in the near future to climbs up for us, Yeah, 0:12:37.760 --> 0:12:40.080 because we want to. But yeah, there are there are 0:12:40.080 --> 0:12:42.440 plenty of ways that you can slip into a coma, 0:12:42.720 --> 0:12:45.040 And actually you can slip into a coma. You can 0:12:45.080 --> 0:12:47.880 go through stages of altered consciousness and then end up 0:12:47.920 --> 0:12:50.720 coma toast, which is the granddaddy worst one of all, 0:12:51.400 --> 0:12:53.880 although I don't know, lockdan is probably worse. But it 0:12:53.920 --> 0:12:56.079 can't happen gradually, that's a good point. Or it can 0:12:56.120 --> 0:12:59.800 happen very quickly, like you know, through a major concussion, 0:13:00.240 --> 0:13:02.720 through a car accident or something like that if you've 0:13:02.760 --> 0:13:05.680 slipped into a diabetic coma, that would happen gradually usually 0:13:05.960 --> 0:13:09.959 right exactly, you might get feverish and uh dizzy and lethargic, 0:13:10.040 --> 0:13:11.400 and then all of a sudden you're in a coma, 0:13:11.440 --> 0:13:15.240 which is frightening. It is do you have diabetes? Me? Neither? 0:13:15.960 --> 0:13:17.840 I might one day, though I think my father got 0:13:17.840 --> 0:13:21.080 it later in his life. Is a genetic I don't know. 0:13:21.320 --> 0:13:24.960 I sense another letter from a personal type clear that 0:13:25.280 --> 0:13:27.480 at this point we could just start asking questions we 0:13:27.840 --> 0:13:31.160 read do do like a twenty minute reader mail segment. 0:13:31.240 --> 0:13:33.720 You just correcting ourselves every time. It's a good idea, 0:13:33.760 --> 0:13:35.160 all right, So what do you do if you're in 0:13:35.200 --> 0:13:38.319 a coma? I mean, here, let me just say one 0:13:38.320 --> 0:13:42.080 thing real quick. After researching comas, you know how when 0:13:42.120 --> 0:13:46.440 you have a heart attack, your your heart actually isn't stopped. 0:13:46.520 --> 0:13:50.200 It's it's gone out of its rhythmic beat. So when 0:13:50.360 --> 0:13:53.560 you are zapped, right when they when they hit you 0:13:53.600 --> 0:13:56.440 with the paddles, what they're doing is actually stopping your 0:13:56.440 --> 0:13:59.720 heart to give it a chance to restart. With a coma, 0:13:59.840 --> 0:14:04.840 it seems like the pattern of of um of discussion 0:14:04.920 --> 0:14:07.800 between the different parts of your brain that make you 0:14:07.840 --> 0:14:12.240 conscious and aware. Um, they it's been interrupted, but we 0:14:12.320 --> 0:14:15.080 don't know how to zap it back into place exactly. 0:14:15.120 --> 0:14:16.679 It's a good way to say it, but you know, 0:14:16.720 --> 0:14:19.720 I mean you still have to care for these people, exactly. 0:14:19.720 --> 0:14:21.600 You can't just say, well, you know, we don't really 0:14:21.600 --> 0:14:24.840 know how to do anything to make you better. There 0:14:24.840 --> 0:14:27.680 are some ways drug overdose, Uh, if you keep if 0:14:27.680 --> 0:14:31.040 you sustain someone's life processes, they can come out after 0:14:31.080 --> 0:14:34.480 the drug begins to wear off, or same with alcohol poison. Uh, 0:14:35.040 --> 0:14:38.680 diabetic coma that can be treated. Yeah, but once they 0:14:38.720 --> 0:14:40.600 like from a major brain injury, you may be in 0:14:40.640 --> 0:14:44.200 big trouble or stroke. Sure. I think the first thing 0:14:44.200 --> 0:14:46.280 that has to happen is a doctor has to determine 0:14:46.320 --> 0:14:48.400 whether or not you're actually in a coma. That's the 0:14:48.400 --> 0:14:50.680 first step. Yeah, how do they do that? Well, there's 0:14:50.680 --> 0:14:53.360 a couple of um, a couple of scales they use 0:14:53.440 --> 0:14:56.880 to determine your level of alertness. And one is from Glasgow. 0:14:57.000 --> 0:14:59.400 It's called the Glasgow Coma scale. Is that how it 0:14:59.520 --> 0:15:01.920 said it? There's no accent associated with it. I'm not 0:15:01.960 --> 0:15:05.080 gonna try my Scottish accent. And then there's the Rancho 0:15:05.200 --> 0:15:08.320 los Amigos scale. No, I'm not going to do that either, 0:15:08.400 --> 0:15:10.920 all right, We're gonna remain respectful in this one. And 0:15:11.240 --> 0:15:13.800 basically the doctors use these two scales and there's varying 0:15:13.800 --> 0:15:18.840 test of responsiveness with your eyes, verbal responses, motor responses 0:15:19.200 --> 0:15:22.840 to various stimuli and so um they do this to determine. 0:15:22.840 --> 0:15:25.680 They use both of these scales actually, uh to to 0:15:25.720 --> 0:15:28.280 basically gauge how alert you are and whether or not 0:15:28.320 --> 0:15:30.000 you're in fact in a comma. So is it like 0:15:30.200 --> 0:15:32.960 they just clap loudly next to your ears and command 0:15:33.000 --> 0:15:36.200 you to sit up or something like that, I would 0:15:36.200 --> 0:15:38.320 say so. I mean they use um like do your 0:15:38.320 --> 0:15:40.920 eyes open when someone speaks to you? Uh, do yours? 0:15:41.080 --> 0:15:44.280 Do your eyes open when there's pain involved? So there's 0:15:44.360 --> 0:15:46.600 all kinds of little ways that they can check. And yeah, 0:15:46.600 --> 0:15:48.440 they I guess they want to determine whether you're in 0:15:48.480 --> 0:15:51.280 a coma or whether you're just you know, resting your 0:15:51.280 --> 0:15:55.440 eyes or playing possum because of what comes after that, right, 0:15:55.480 --> 0:15:58.120 And they while they assign your score an arrange from 0:15:58.160 --> 0:16:01.200 three to fifteen, three e being a very deep coma 0:16:01.240 --> 0:16:04.160 and fifteen being uh less right now, right, Yeah, I'm 0:16:04.200 --> 0:16:08.880 about fourteen. But yeah, alright, so we've established you're in 0:16:08.920 --> 0:16:12.320 a coma. It's awful your three right, all right, so 0:16:12.360 --> 0:16:14.400 you are just completely dead to the world, but you're 0:16:14.400 --> 0:16:18.400 still alive amazingly right. That would be comatose and unresponsive 0:16:18.440 --> 0:16:21.720 is the official classification of that's deep of a comma. Okay, 0:16:21.760 --> 0:16:24.520 so you're in there. Um, if you're in a car injury, 0:16:24.520 --> 0:16:26.920 what they're going to do. They're gonna tree ours, your symptoms, 0:16:27.200 --> 0:16:30.600 your problems. So if you're in a car record something 0:16:30.600 --> 0:16:32.960 you have injuries from that, they're gonna, you know, control 0:16:33.000 --> 0:16:35.040 the bleeding that kind of thing. They want to stabilize 0:16:35.080 --> 0:16:38.040 everything else first not first, but you know once you're 0:16:38.080 --> 0:16:41.800 once you're stable though, um, and you're still in a coma, 0:16:42.720 --> 0:16:46.280 they you can't care for yourself any longer. So they 0:16:46.280 --> 0:16:48.240 it's kind of like they're going to poke around and 0:16:48.320 --> 0:16:52.000 determine what the causes. Maybe they'll use in e g. 0:16:52.280 --> 0:16:55.160 Electro and cephalography right or m r I or f 0:16:55.320 --> 0:16:57.280 m r I, which is basically an m r I 0:16:57.320 --> 0:17:02.040 for the brain, or CT scan which is computed tomography 0:17:02.280 --> 0:17:04.480 right now. They they'll use all these things to basically 0:17:04.480 --> 0:17:07.720 either look inside and e g actually is basically, um, 0:17:07.800 --> 0:17:11.520 kind of like cooking into your electrical system and checking out, 0:17:11.560 --> 0:17:13.960 you know what, how the impulses are doing right, and 0:17:14.000 --> 0:17:16.439 they'll diagnose, you know, maybe what caused the coma, that 0:17:16.520 --> 0:17:19.320 kind of thing. So once once you once you're stabilized 0:17:19.359 --> 0:17:22.560 diagnosed in a coma, you know, you've you've been given 0:17:22.600 --> 0:17:27.919 the scale rating, um, and you're in for the long haul. Clearly. Yeah, 0:17:27.960 --> 0:17:31.399 they're they're gonna basically use machines to care for you, 0:17:31.480 --> 0:17:36.520 like feeding tubes. Um. Oftentimes somebody in a prolonged coma 0:17:36.600 --> 0:17:41.400 or vegetative state. Uh, they'll perform a tricky otomy so 0:17:41.520 --> 0:17:44.000 they don't have to innovate you um because after a 0:17:44.000 --> 0:17:47.040 while the innovation too. But imagine gets real, you know, 0:17:47.320 --> 0:17:50.800 uncomfortable that actually so much so that you you would 0:17:50.800 --> 0:17:53.639 prefer a hole of the throat. Yeah, and you know, 0:17:53.800 --> 0:17:56.240 let me it's a little aside. One of my best friends, 0:17:56.440 --> 0:18:00.560 guy named Jen's Baty, in sixth grade, Uh, his mom 0:18:01.040 --> 0:18:06.240 started choking h in a restaurant and actually had an 0:18:06.240 --> 0:18:09.360 emergency trackeotomy with a stake knife and a pain performed 0:18:09.359 --> 0:18:11.879 on her. Yeah, there was a doctor there who did it, 0:18:12.200 --> 0:18:15.480 and he just went he was breathing. Again. That's the 0:18:15.480 --> 0:18:17.000 worst case scenario right there. And so he used to 0:18:17.040 --> 0:18:19.280 have this little scar and still I'm sure still does. 0:18:19.359 --> 0:18:22.040 But it was crazy. Guys. The only person I ever 0:18:22.119 --> 0:18:24.639 knew who had an emergency trade. I thought that was 0:18:24.680 --> 0:18:27.840 something just you know, you get on the er. Yeah, 0:18:27.920 --> 0:18:31.040 it happens, It happens. Uh. So back to comas, another 0:18:31.080 --> 0:18:33.640 thing that that is often done is a physical therapy 0:18:33.680 --> 0:18:37.679 just to keep the muscles moving. Um, they'll they'll, you know, 0:18:37.720 --> 0:18:40.119 the nurses will move the patient to prevent bed swords 0:18:40.119 --> 0:18:43.040 and then move the muscles, flex the legs to keep 0:18:43.080 --> 0:18:46.080 you know, atrophy from setting in. Or if you're uma therman, 0:18:46.119 --> 0:18:49.800 you can do a really focused you know, um regime 0:18:50.240 --> 0:18:55.600 right within an eight hour period and you'll be walking again. Right. Yeah. So, um, 0:18:55.840 --> 0:18:57.199 how we need to bring this down a little bit, 0:18:57.240 --> 0:19:01.440 don't we? I think so? Yeah, because searching it, it's 0:19:01.600 --> 0:19:06.080 when you really get a grasp on comas, in the 0:19:06.119 --> 0:19:08.679 peculiar nature of them and just the fact that we 0:19:08.760 --> 0:19:10.960 have no way to bring somebody out of a coma. 0:19:11.560 --> 0:19:13.679 It's kind of heartbreaking to think that their families out 0:19:13.720 --> 0:19:16.119 there who would go to the hospital every day or 0:19:16.160 --> 0:19:19.680 every week and yeah, and you hope because there's people 0:19:19.720 --> 0:19:22.320 like Patricia White Bull who sit up all of a 0:19:22.400 --> 0:19:26.040 sudden and there you have it. You know, somebody can 0:19:26.080 --> 0:19:28.879 come out of a long comma. It's that's rough true. 0:19:28.960 --> 0:19:30.680 I've got a study for you that might encourage you 0:19:30.720 --> 0:19:32.320 a bit. I'd love to hear it, just from two 0:19:32.320 --> 0:19:35.600 thousand six. It's from Dr Adrian Owen of Cambridge University 0:19:35.600 --> 0:19:39.040 and neuroscientists, and he's trying to determine a consciousness meter 0:19:40.000 --> 0:19:43.520 for people in comas and vegetative states. So what he 0:19:43.560 --> 0:19:46.480 does is he hooks a normal, healthy person up to 0:19:46.760 --> 0:19:48.920 uh an f m R I machine, which I know 0:19:49.080 --> 0:19:51.680 you understand how that works right, Well, it basically it's 0:19:51.480 --> 0:19:55.280 it it uses magnet magnetic imaging to see through the 0:19:55.359 --> 0:19:58.399 skull um and basically it's watching the brain. It is 0:19:58.400 --> 0:20:01.320 watching the electrical activit being in the brain. So if 0:20:01.359 --> 0:20:03.960 you know the the prefrontal cortex lights up when you 0:20:04.000 --> 0:20:07.040 tell somebody to you know, um, and when somebody sees 0:20:07.040 --> 0:20:10.720 a bunny, you'll know that the prefrontal cortex is involved 0:20:10.760 --> 0:20:14.320 in and taking cuteness into context or something. Well, that's 0:20:14.320 --> 0:20:17.879 I'm impressed. So he'll hook up a healthy person and 0:20:17.920 --> 0:20:20.160 then someone in a come our vegetative state and asked 0:20:20.240 --> 0:20:23.119 him to do something like, imagine playing a game of tennis. 0:20:23.160 --> 0:20:25.359 I believes what he is on this one woman, and 0:20:25.400 --> 0:20:28.480 he found that, um, the brain activity was really similar 0:20:28.840 --> 0:20:32.760 for both of these people, which led him to believe that, uh, 0:20:32.800 --> 0:20:34.919 there may be a lot more brain activity going on 0:20:35.119 --> 0:20:38.000 and some of these different states of mind. Yeah, that 0:20:38.000 --> 0:20:42.399 that pretty much flatly contradicts our understanding of vegetative states. True, 0:20:42.440 --> 0:20:45.480 but it also this was one one person. I believe 0:20:45.520 --> 0:20:48.239 that it was successful in and I'm sure there's been 0:20:48.280 --> 0:20:51.159 subsequent studies since. But he himself said that, you know, 0:20:51.200 --> 0:20:53.160 we need to keep studying this kind of thing before 0:20:53.160 --> 0:20:56.640 we make any determinations. Yeah, yeah, we need to basically 0:20:56.640 --> 0:20:58.879 figure out how to bring people out of comas. Right, 0:20:58.960 --> 0:21:01.920 but it does happen. You can come out of a coma. No, 0:21:02.040 --> 0:21:04.320 you totally can't. You can't bring someone out of a coma. 0:21:04.359 --> 0:21:08.720 But I think they said that who score a three 0:21:08.800 --> 0:21:11.240 or four on the on the scale within the first 0:21:11.280 --> 0:21:14.600 twenty four hours are likely to either die or remain 0:21:14.640 --> 0:21:17.520 in the vegetative state, So that's no good. And but 0:21:17.600 --> 0:21:21.240 on the other side, who score between eleven and fifteen 0:21:21.560 --> 0:21:24.359