Dr. Christof (Christoph) Koch

I might be aroused, so, you know, my eyes are open.

I'm now what used to be called vegetative state, what's now more often called behavioral unresponsive state, okay?

And there are thousands of these people worldwide because with proper care, with proper nursing care, you can stay in this state for weeks or months or, in the case of Terry Shivo, 14 years, okay?

Furthermore, what happens after, typically in most cases, after four to five days, the doctors will talk with their loved ones, is this what he would have wanted?

And 70 to 90% of the time they decide, no, this is not what you wanted and you withdraw life-sustaining therapy.

But we now know that 25% of these patients have what's called covert consciousness.

They're there.

We know this because, for example, some of these patients you can – there was a big study last year in New England Journal of Medicine made a front page of the New York Times where it can show 25% of these patients can still voluntarily up and down regulate their motor cortex in response to a command –

Clench your fist for 30 seconds, relax it.

Clench your fist for 30 seconds, relax it.

So these people that otherwise when you ask them, sir, can you hear me?

Can you track my finger?

Can you pinch them very hard to see do they do a withdrawal of limb reflex?

They don't do any of that.

So they have what's called a Glasgow Coma Scale, a very low Glasgow Coma Scale or Coma and Recovery Scale.

GSC-R scale, very low, but they still seem to be conscious.

They either have high brain complexity or they can modulate their brain.

So this is now the first time ever that we have a practical way in people that cannot respond, that clinically, behaviorally are considered unresponsive, first to convince the family that although their loved one doesn't respond, doesn't mean that they're unconscious.

And then try to see, well, okay, so this person is conscious.

Can we now give particular treatments to enable them to recover?