Well today is a superb day.
Sabine has told us two incredibly important things, things that not only inform us as to where we are, but open up rather more optimistic possibilities than some of the darker options we’ve considered until now, based on not knowing.
I want to repeat, because it’s important to fully understand what will follow, that while “wakefulness” and “consciousness” usually are pretty much one and the same, after the brain is injured, the two can be dissociated. What do I mean?
Assuming that the terms are being used and translated correctly (and Sabine is a consummate professional and wouldn’t get this wrong), awakening refers to (at least) the appearance of . . . being awake. Basically that means eyes open. And as I mentioned before, this eye opening can even be cyclic, following what looks just like a sleep-wake cycle (even if not synchronised to real day-night hours).
Wakefulness WITHOUT consciousness is the definition of a vegetative state. The eyes are open, but there’s no interaction with the environment. If Sabine had “only” said that Michael was showing wakefulness, it would mean that he is not comatose. That in itself is a damned sight “better” than persistent coma, not just in terms of life expectancy, but in terms of the chances of neurologic improvement.
But Sabine has also told us that Michael is showing signs of consciousness. My lord, the brain is an amazing organ. And Michael a remarkable man. What does this consciousness probably look like? It consists of episodes of clear, purposeful interaction with the environment, and/or clear signs of awareness of self, even if these signs are not constantly present. For example, if Michael smiles when a member of his entourage talks to him – reproducibly and consistently on at least a few occasions. Or following people with his eyes. Or trying to communicate, or obeying simple commands. Any of this constitutes objective signs of contact between the “outside” and the “inside”. This then would be a minimally conscious state. And that is about the best news we could possibly get right now.
Why? Because of what it means for everyone – Michael himself, his loved ones, and his fans. It means that Michael may well see, hear, and feel the love that’s around him. That he is, in some very real way, HERE. It means his life expectancy has now improved VERY significantly. And last, but perhaps most important, it opens up a very real chance for further improvement. This would mean spending more time “in touch” with his surroundings, and also improvement in the quality of the interaction. How incredibly positive!
This means rehab, lots of rehab. Michael is used to working hard. Getting that brain to learn new ways of doing things, stimulating it, forcing it to handle data, and all the while working hard to build him up again physically. All very exciting. And very good.
Don’t get me wrong – this is a very important step, but we don’t want Michael to stay like this. But this is a very very very big step.
We all need to thank the team taking care of Michael as well as the people around him, for their devotion and patience. Everyone is going to need to be patient – for weeks, months, maybe years.
But if you’re even the slightest bit spiritual, it’s time cast a look upwards and mouth the words “thank you”.