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There are numerous stories about how a person genuinely looks unconscious, but when awakened they report that they heard everything that was said and can prove it. There have been other situations where a person looks awake but is disconnected from the environment and is not aware of anything around them. They are awake but not aware. These situations are known as disorders of consciousness.
What does it mean to be conscious? What is consciousness? Psychologists basically define consciousness as simultaneously being aware of what is going on inside you, and what is going on around you. Put another way, moment by moment you are awake and aware of both internal states and the external environment. If you are fully conscious you are engaged with and actively aware of everything going on right now. If one or both areas of awareness are damaged or not functioning in some way, that is categorized as a disorder of consciousness.
Common examples of disordered consciousness can include coma, vegetative state, and minimally conscious state. A person in coma will have their eyes closed, are unable to be aroused, and do not appear to be aware of anything.That does mean that they don't hear you, and in some instances they may be able to comprehend what they hear. A person in a vegetative state is awake and their body is functioning but are not aware of the world around them or themselves. They are unresponsive but awake. A minimally conscious state involves being aware of everything for a while, then followed by a period of being disconnected and unresponsive. You can think of it as a type of cycle.
Medical researchers are learning that even in a damaged brain that has put a person into a vegetative or minimally conscious state, there may be at least some aspects of information processing (cognition/thinking) that have survived. For example, a person may not show much but may still experience pain. A person in a minimally conscious state may be able to keep their eyes pointed at something, or be able to shift to a different visual target. That does not mean that they know what they are looking at. It is possible for a person suffering a disordered consciousness to benefit from visual information, but if that person is actually consciously processing the visual information is another question.
It seems like being able to hear things when consciously impaired has received the most research. Generally, the person hears things but does not process or comprehend what the sounds are about. People may talk to him or her, but the processing may be no more than sounds, or possibly recognized as speech but not understood. Interestingly, a patient may indicate increased responsiveness to personal information, such as if you said their name.
This is just a snippet of research into what happens in the brain when a person is in some type of unconscious or vegetative state. Even after damage to the brain, some ability to process information, no matter how limited, can remain. Information may be brought into the brain from the senses, but not understood or have any awareness of what that information means. It is quite difficult to know for sure how much residual processing remains. The wiring of the brain can be disconnected enough that awareness and comprehension cannot work. This is frequently quite frustrating for both family and caregivers who want to help the poor victim.
Dr. Joseph E. Switras
Licensed Psychologist in Fairmont