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Jewish World Review Jan. 5, 2007 / 15 Teves, 5767 Medical Mind-Reading: How Much Myth? By Drs. Michael A. Glueck & Robert J. Cihak http://www.JewishWorldReview.com | What's on her mind, anyway? Mel Gibson heard directly, in his role as an arrogant advertising executive in the romantic comedy movie "What Women Want." After suffering an electric shock from a bathroom hair dryer, he could hear what women were thinking. Until then, he'd been pretty oblivious what women were thinking about his own behavior What he learned surprised him. Eventually, as he saw himself through other people's thoughts, he realized some of his limitations and became somewhat more humble. The rest of us, including medical professionals, also have a lot to learn about what's going on in other people's minds. This is especially poignant when we deal with people suffering with brain or mental disturbances. Normally active people often wrongly guess the mental state of people afflicted with apparently devastating conditions or even total paralysis. For example, over time, people suffering with amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease) lose the ability to control or use their muscles. Initially, these people notice weakness in their arms or legs, or difficulty swallowing or speaking. Nerve cells, which normally activate muscles, deteriorate. The electric signals from the brain and normally carried by nerves cannot reach muscle cells. As a result, muscles do not contract or move. In such conditions, a person is often alert and conscious, but cannot speak or even move fingers, eyelids or other parts of the body to signal their needs or thoughts. Medical caregivers often call this a "locked-in" state, as the person's mind cannot express itself with muscular and physical motion. As researchers at Institute of Medical Psychology and Behavioural Neurobiology in Tbingen, Germany, put it on their website http://www.mp.uni-tuebingen.de/mp/index.php?id=137 "From a healthy individual's point of view one might consider the quality of life in such patients very low. However, it has been repeatedly shown that quality of life can be maintained despite the physical decline." Scientists can now use external electrodes attached to the skin over the head to detect brain waves, as used in electroencephalograph machines. Computers recognize brain wave patterns under the patient's control. Specially designed computer microchips then stimulate the patient's own muscles or directly control a control battery-powered wheelchair to move around. Patients can also communicate through the computer. These machines are called brain-computer interfaces or BCIs. Niels Birbaumer, Ph.D., one of the German scientists, found that a patient could learn to use such a brain-computer interface to communicate before total paralysis sets in. Later, even after becoming totally paralysed, these people were able to communicate using the device. Dr. Birbaumer also found that these patients had a much better quality of life than their family or medical professionals guessed. This was true even in completely paralyzed patients who depended on a motor-driven respirator for breathing. In a recent article "Breaking the silence: Brain-computer interfaces (BCI) for communication and motor control," in the journal Psychophysiology Dr. Birbaumer found that "only 9% of the patients showed long episodes of depression, most of them in the time period following the diagnosis and a period of weeks after tracheostomy," a hole surgically created through the front of the neck to allow assisted breathing. "In fact, they are in a much better mood than psychiatrically depressed patients without any life-threatening bodily disease." He concludes, "The facts on end-of-life issues and quality of life, do not support hastened death decision in ALS." We're sure the same is true for many people suffering brain injury from trauma or stroke. We've all seen reports in newspapers and medical journals about patients regaining consciousness and an ability to communicate, even after many years of unconsciousness. For example, Terry Wallis, in a "coma" for about 20 years after a severe automobile crash, is speaking and making jokes, although he thinks Ronald Reagan is President, according to the Indianapolis Star. Medical judgments about premature babies are also very limited. Doctors told Andrew Schlafly's parents that their son born two months prematurely "would never attend a regular high school. College was out of the question" according to the New Jersey Daily Record. He's now 6 feet 6 inches tall and is taking Harvard University's toughest freshman math class, Math 55. Most medical studies only look at the first few days, or months after brain damage, creating "a silent epidemic in which there is only minute attention devoted to the long-term diagnostic, prognostic, therapeutic, and social problems of persistent (albeit sometimes transient) disorders of consciousness" according to Prof. Steven Laureys of the University of Liege in Belgium writes in the Journal of Clinical Investigation . We hope these experiences teach us how little we know about what other people are thinking, especially the most limited among us. Editor's Note: Robert J. Cihak wrote this week's column Every weekday JewishWorldReview.com publishes what many in in the media and Washington consider "must-reading". Sign up for the daily JWR update. It's free. Just click here. Michael Arnold Glueck, M.D., is a multiple award winning writer who comments on medical-legal issues. Robert J. Cihak, M.D., is a Discovery Institute Senior Fellow and a past president of the Association of American Physicians and Surgeons. Both JWR contributors are Harvard trained diagnostic radiologists. Comment by clicking here. Archives © 2006,

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