I remember the way he looked at me like you’re looking at me right now but
you’re looking at me right now but
you’re looking at me right now but strangely different and when we were
strangely different and when we were
strangely different and when we were examining him with the coma recovery
examining him with the coma recovery
examining him with the coma recovery scale which is a scale we use in people
scale which is a scale we use in people
scale which is a scale we use in people who had a coma and what we’re trying to
who had a coma and what we’re trying to
who had a coma and what we’re trying to find out whether there is any recovery
find out whether there is any recovery
find out whether there is any recovery of consciousness which for example move
of consciousness which for example move
of consciousness which for example move a mirror in front of his eyes but he
a mirror in front of his eyes but he
a mirror in front of his eyes but he will never follow and the physicians who
will never follow and the physicians who
will never follow and the physicians who sent him to us initially thought he was
sent him to us initially thought he was
sent him to us initially thought he was in a persistent vegetative state I don’t
in a persistent vegetative state I don’t
in a persistent vegetative state I don’t like that term I don’t think we can
like that term I don’t think we can
like that term I don’t think we can compare humans with vegetables plans so
compare humans with vegetables plans so
compare humans with vegetables plans so it’s chairman of the European task force
it’s chairman of the European task force
it’s chairman of the European task force well we’ve proposed to refer to them as
well we’ve proposed to refer to them as
well we’ve proposed to refer to them as being in an unresponsive wakefulness
being in an unresponsive wakefulness
being in an unresponsive wakefulness because that’s what we see there after
because that’s what we see there after
because that’s what we see there after their coma awakening meaning they open
their coma awakening meaning they open
their coma awakening meaning they open their eyes with their own responsive
their eyes with their own responsive
their eyes with their own responsive they will never respond to a simple
they will never respond to a simple
they will never respond to a simple question they will show no oriented
question they will show no oriented
question they will show no oriented responses and even if with the team at
responses and even if with the team at
responses and even if with the team at the University Hospital in yet we’ve
the University Hospital in yet we’ve
the University Hospital in yet we’ve seen many hundreds of people like him
seen many hundreds of people like him
seen many hundreds of people like him it’s still for some of them a real
it’s still for some of them a real
it’s still for some of them a real challenge and I remember wondering is
challenge and I remember wondering is
challenge and I remember wondering is there anybody in there and the story I
there anybody in there and the story I
there anybody in there and the story I would like to share today with you is
would like to share today with you is
would like to share today with you is the one of a man named loris and he
the one of a man named loris and he
the one of a man named loris and he agreed that I would tell you historian
agreed that I would tell you historian
agreed that I would tell you historian so that his parents who actually
so that his parents who actually
so that his parents who actually encouraged me to tell what happens he
encouraged me to tell what happens he
encouraged me to tell what happens he was at a party with his girlfriend and
was at a party with his girlfriend and
was at a party with his girlfriend and two of his friends and they had quite a
two of his friends and they had quite a
two of his friends and they had quite a lot of drinks and
lot of drinks and
lot of drinks and wanted to drive back home but their car
wanted to drive back home but their car
wanted to drive back home but their car hit the truck and they all died except
hit the truck and they all died except
hit the truck and they all died except for Loras who survived the spirit and
for Loras who survived the spirit and
for Loras who survived the spirit and intensive care were initially was
intensive care were initially was
intensive care were initially was breathing through a machine and then he
breathing through a machine and then he
breathing through a machine and then he started to breathe on his own and he
started to breathe on his own and he
started to breathe on his own and he opened his eyes and he was one of these
opened his eyes and he was one of these
opened his eyes and he was one of these patients who were sent to us and yet
patients who were sent to us and yet
patients who were sent to us and yet from all over Europe actually basically
from all over Europe actually basically
from all over Europe actually basically for two questions and that is is there
for two questions and that is is there
for two questions and that is is there any consciousness and the second
any consciousness and the second
any consciousness and the second question is there anything we can do to
question is there anything we can do to
question is there anything we can do to help them so let me share here with you
help them so let me share here with you
help them so let me share here with you the brain scans so what we see here is
the brain scans so what we see here is
the brain scans so what we see here is an MRI looking into his brain and you
an MRI looking into his brain and you
an MRI looking into his brain and you see a normal brain with all these
see a normal brain with all these
see a normal brain with all these billions of neurons taking a lot of
billions of neurons taking a lot of
billions of neurons taking a lot of space and in his case there is an
space and in his case there is an
space and in his case there is an atrophy the brain really is much smaller
atrophy the brain really is much smaller
atrophy the brain really is much smaller and it’s this black this is fluid taking
and it’s this black this is fluid taking
and it’s this black this is fluid taking the place of what should be brain and
the place of what should be brain and
the place of what should be brain and that is caused by that traumatic car
that is caused by that traumatic car
that is caused by that traumatic car accident but now let’s look inside and
accident but now let’s look inside and
accident but now let’s look inside and look at the connections in this brain
look at the connections in this brain
look at the connections in this brain and again you see in a normal brain it
and again you see in a normal brain it
and again you see in a normal brain it sits like a tree with all these branches
sits like a tree with all these branches
sits like a tree with all these branches these connections we call axons and you
these connections we call axons and you
these connections we call axons and you see basically the fragility and in his
see basically the fragility and in his
see basically the fragility and in his brain it’s very clear that there is way
brain it’s very clear that there is way
brain it’s very clear that there is way less of these branches this is what we
less of these branches this is what we
less of these branches this is what we call by fuse external injury it’s it’s
call by fuse external injury it’s it’s
call by fuse external injury it’s it’s all over the brain and this shock
all over the brain and this shock
all over the brain and this shock basically broke these brain connections
basically broke these brain connections
basically broke these brain connections and was the reason for him to become
and was the reason for him to become
and was the reason for him to become Atos but we still wonder okay there’s a
Atos but we still wonder okay there’s a
Atos but we still wonder okay there’s a lot of damage here but would there still
lot of damage here but would there still
lot of damage here but would there still be a functioning brain somehow a
be a functioning brain somehow a
be a functioning brain somehow a functioning mind and that’s why we do
functioning mind and that’s why we do
functioning mind and that’s why we do another test which is called PET CT
another test which is called PET CT
another test which is called PET CT where we basically inject radioactive
where we basically inject radioactive
where we basically inject radioactive sugar and your brain is using a
sugar and your brain is using a
sugar and your brain is using a of energy and we can see it here you see
of energy and we can see it here you see
of energy and we can see it here you see the yellow it’s it’s these neurons using
the yellow it’s it’s these neurons using
the yellow it’s it’s these neurons using the sugar and in his case well we see
the sugar and in his case well we see
the sugar and in his case well we see that there are some parts some islands
that there are some parts some islands
that there are some parts some islands in his gray matter also being active so
in his gray matter also being active so
in his gray matter also being active so there seems to be a functioning brain a
there seems to be a functioning brain a
there seems to be a functioning brain a functioning mind and we can also try to
functioning mind and we can also try to
functioning mind and we can also try to access that by using what is called a
access that by using what is called a
access that by using what is called a brain computer interface so here we look
brain computer interface so here we look
brain computer interface so here we look at the electrical activity of his brain
at the electrical activity of his brain
at the electrical activity of his brain let’s just look at the from there in red
let’s just look at the from there in red
let’s just look at the from there in red and you see that when we’re presenting
and you see that when we’re presenting
and you see that when we’re presenting him with different sounds his brain will
him with different sounds his brain will
him with different sounds his brain will react differently that’s that green part
react differently that’s that green part
react differently that’s that green part so yes we’ve answered the first question
so yes we’ve answered the first question
so yes we’ve answered the first question he is somehow in there perceiving seeing
he is somehow in there perceiving seeing
he is somehow in there perceiving seeing feeling even if it calmed communicated
feeling even if it calmed communicated
feeling even if it calmed communicated this is what we call a minimally
this is what we call a minimally
this is what we call a minimally conscious State and I think it’s very
conscious State and I think it’s very
conscious State and I think it’s very important to try and answer that first
important to try and answer that first
important to try and answer that first question whether or not these patients
question whether or not these patients
question whether or not these patients are conscious because of course many
are conscious because of course many
are conscious because of course many things change because now we no llores
things change because now we no llores
things change because now we no llores can perceive emotions with also pain so
can perceive emotions with also pain so
can perceive emotions with also pain so we should be very careful we should give
we should be very careful we should give
we should be very careful we should give him painkillers make sure he’s
him painkillers make sure he’s
him painkillers make sure he’s comfortable what I wanted to say is that
comfortable what I wanted to say is that
comfortable what I wanted to say is that here we answered the first question and
here we answered the first question and
here we answered the first question and that’s is he somehow conscious and yes
that’s is he somehow conscious and yes
that’s is he somehow conscious and yes he is it’s a condition we now call
he is it’s a condition we now call
he is it’s a condition we now call minimally conscious and I think it’s
minimally conscious and I think it’s
minimally conscious and I think it’s very important because many things
very important because many things
very important because many things change already we now know that loris
change already we now know that loris
change already we now know that loris can perceive emotion was also pain so
can perceive emotion was also pain so
can perceive emotion was also pain so we’ll make sure he’s comfortable receive
we’ll make sure he’s comfortable receive
we’ll make sure he’s comfortable receive painkillers but we also want to make
painkillers but we also want to make
painkillers but we also want to make sure he gets proper we have we want to
sure he gets proper we have we want to
sure he gets proper we have we want to simulate his damaged brain and that can
simulate his damaged brain and that can
simulate his damaged brain and that can be a challenge he came from France and
be a challenge he came from France and
be a challenge he came from France and there some parts of the country it’s
there some parts of the country it’s
there some parts of the country it’s very difficult actually to get access to
very difficult actually to get access to
very difficult actually to get access to these rehab centers when I saw him he
these rehab centers when I saw him he
these rehab centers when I saw him he was 27 and in the Netherlands that’s too
was 27 and in the Netherlands that’s too
was 27 and in the Netherlands that’s too old to get access to rehab after
old to get access to rehab after
old to get access to rehab after traumatic brain injury and I think that
traumatic brain injury and I think that
traumatic brain injury and I think that is outrageous we should change that
is outrageous we should change that
is outrageous we should change that now everything I’ve been telling you so
now everything I’ve been telling you so
now everything I’ve been telling you so far is like clinical routine for us all
far is like clinical routine for us all
far is like clinical routine for us all the brains
the brains
the brains and now I would like to share with you
and now I would like to share with you
and now I would like to share with you what might be a potentially new
what might be a potentially new
what might be a potentially new treatment for these people with severe
treatment for these people with severe
treatment for these people with severe traumatic brain injury and that is
traumatic brain injury and that is
traumatic brain injury and that is called transcranial direct current
called transcranial direct current
called transcranial direct current stimulation where basically we’re trying
stimulation where basically we’re trying
stimulation where basically we’re trying transcranial means it goes through the
transcranial means it goes through the
transcranial means it goes through the skull and the direct current will be
skull and the direct current will be
skull and the direct current will be applied for 20 minutes every day you see
applied for 20 minutes every day you see
applied for 20 minutes every day you see the electrodes and we’re trying to
the electrodes and we’re trying to
the electrodes and we’re trying to increase the brain function of these
increase the brain function of these
increase the brain function of these parts here in yellow you see the
parts here in yellow you see the
parts here in yellow you see the electrical fields and of course this
electrical fields and of course this
electrical fields and of course this this is a new therapy so so we take this
this is a new therapy so so we take this
this is a new therapy so so we take this through the ethics committee and we need
through the ethics committee and we need
through the ethics committee and we need the patient’s to give their informed
the patient’s to give their informed
the patient’s to give their informed consent that they come because they
consent that they come because they
consent that they come because they can’t communicate so is the family who
can’t communicate so is the family who
can’t communicate so is the family who write down they agree to participate in
write down they agree to participate in
write down they agree to participate in this scientific experiment where if you
this scientific experiment where if you
this scientific experiment where if you want to find out that a specific drug or
want to find out that a specific drug or
want to find out that a specific drug or in this case the electrical stimulation
in this case the electrical stimulation
in this case the electrical stimulation really helps you need to perform what is
really helps you need to perform what is
really helps you need to perform what is called a placebo controlled randomized
called a placebo controlled randomized
called a placebo controlled randomized double-blind study whoa that means
double-blind study whoa that means
double-blind study whoa that means placebo controlled you’re going to
placebo controlled you’re going to
placebo controlled you’re going to compare your treatments often it would
compare your treatments often it would
compare your treatments often it would be a drug with a placebo sugar pill in
be a drug with a placebo sugar pill in
be a drug with a placebo sugar pill in our case it’s the electrical stimulation
our case it’s the electrical stimulation
our case it’s the electrical stimulation with some fake stimulation just put the
with some fake stimulation just put the
with some fake stimulation just put the electrodes and the machine pretends it’s
electrodes and the machine pretends it’s
electrodes and the machine pretends it’s doing something
doing something
doing something we’ll do it randomized it means you will
we’ll do it randomized it means you will
we’ll do it randomized it means you will just flip a coin that coin decides where
just flip a coin that coin decides where
just flip a coin that coin decides where the patient at this moment receives the
the patient at this moment receives the
the patient at this moment receives the real or the fake stimulation and then
real or the fake stimulation and then
real or the fake stimulation and then it’s double-blind that means the patient
it’s double-blind that means the patient
it’s double-blind that means the patient the family but also the clinician they
the family but also the clinician they
the family but also the clinician they done know whether it’s the real or the
done know whether it’s the real or the
done know whether it’s the real or the fake because you really want to make
fake because you really want to make
fake because you really want to make sure that if you see some change some
sure that if you see some change some
sure that if you see some change some improvement that it’s really caused by
improvement that it’s really caused by
improvement that it’s really caused by your treatment so Loras enrolled in this
your treatment so Loras enrolled in this
your treatment so Loras enrolled in this clinical trial put on the machine
clinical trial put on the machine
clinical trial put on the machine stimulate him and
stimulate him and
stimulate him and using this coma recovery scale then we
using this coma recovery scale then we
using this coma recovery scale then we see now he’s answering two simple
see now he’s answering two simple
see now he’s answering two simple questions in this case it would move
questions in this case it would move
questions in this case it would move your leg and then he starts to vocalize
your leg and then he starts to vocalize
your leg and then he starts to vocalize do this for every day one week then we
do this for every day one week then we
do this for every day one week then we stop take the other machine we don’t
stop take the other machine we don’t
stop take the other machine we don’t know which is the real fake one but the
know which is the real fake one but the
know which is the real fake one but the second time basically there was no
second time basically there was no
second time basically there was no change and of course in medicine we
change and of course in medicine we
change and of course in medicine we don’t like anecdotal evidence so we’re
don’t like anecdotal evidence so we’re
don’t like anecdotal evidence so we’re going to do this in many patients we now
going to do this in many patients we now
going to do this in many patients we now have over hundreds that benefited from
have over hundreds that benefited from
have over hundreds that benefited from this technique and what I show you here
this technique and what I show you here
this technique and what I show you here is the result from from that group and
is the result from from that group and
is the result from from that group and this is being published and in black you
this is being published and in black you
this is being published and in black you see the the scores going up the patient
see the the scores going up the patient
see the the scores going up the patient is getting better and in gray you see
is getting better and in gray you see
is getting better and in gray you see the fake stimulation basically it’s it’s
the fake stimulation basically it’s it’s
the fake stimulation basically it’s it’s not changing so we here think we could
not changing so we here think we could
not changing so we here think we could have something that could help patients
have something that could help patients
have something that could help patients with severe brain injury to get better
with severe brain injury to get better
with severe brain injury to get better and then one could bounce a question
and then one could bounce a question
and then one could bounce a question well alright but why should we care and
well alright but why should we care and
well alright but why should we care and Loras sure he’s still dependent on
Loras sure he’s still dependent on
Loras sure he’s still dependent on others to eat get dressed and we need to
others to eat get dressed and we need to
others to eat get dressed and we need to accept that everyone is different there
accept that everyone is different there
accept that everyone is different there and we all have our values and some
and we all have our values and some
and we all have our values and some people might prefer not to live in
people might prefer not to live in
people might prefer not to live in certain conditions and I think also as a
certain conditions and I think also as a
certain conditions and I think also as a medical doctor we should take care of
medical doctor we should take care of
medical doctor we should take care of those very difficult end-of-life
those very difficult end-of-life
those very difficult end-of-life decisions but here for Loras what to me
decisions but here for Loras what to me
decisions but here for Loras what to me was maybe the most important is when his
was maybe the most important is when his
was maybe the most important is when his father asked him are you happy and he
father asked him are you happy and he
father asked him are you happy and he gives a huge smile and his science yes
gives a huge smile and his science yes
gives a huge smile and his science yes so I think we should care and in Europe
so I think we should care and in Europe
so I think we should care and in Europe everyday there’s 200 people dying
everyday there’s 200 people dying
everyday there’s 200 people dying traumatic brain injury mostly young
traumatic brain injury mostly young
traumatic brain injury mostly young adults and there’s even more who
adults and there’s even more who
adults and there’s even more who survived their coma and remain severely
survived their coma and remain severely
survived their coma and remain severely disabled for the rest of their lives
disabled for the rest of their lives
disabled for the rest of their lives like Loras and I think as a society but
like Loras and I think as a society but
like Loras and I think as a society but also my medical community we’ve been
also my medical community we’ve been
also my medical community we’ve been ignoring this silent epidemic and so
ignoring this silent epidemic and so
ignoring this silent epidemic and so when some including my own colleagues
when some including my own colleagues
when some including my own colleagues would say I think you know it’s just a
would say I think you know it’s just a
would say I think you know it’s just a waste of time and money what you’re
waste of time and money what you’re
waste of time and money what you’re trying to do there I would strongly
trying to do there I would strongly
trying to do there I would strongly disagree and traumatic brain injury can
disagree and traumatic brain injury can
disagree and traumatic brain injury can strike anyone anytime I think we should
strike anyone anytime I think we should
strike anyone anytime I think we should care about persons like Loras and
care about persons like Loras and
care about persons like Loras and there’s hundreds of him and we should
there’s hundreds of him and we should
there’s hundreds of him and we should improve their care pathway and not
improve their care pathway and not
improve their care pathway and not ignore these patients with severe
ignore these patients with severe
ignore these patients with severe traumatic brain injury and is it worth
traumatic brain injury and is it worth
traumatic brain injury and is it worth it
it
it well I think his story and his smile
well I think his story and his smile
well I think his story and his smile definitely for me tells me this so I
definitely for me tells me this so I
definitely for me tells me this so I want to thank him his parents our team
want to thank him his parents our team
want to thank him his parents our team in the ash and all those who do care
”
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