The mind reader. Between life and death.

Panorama follows a group of severely brain injured patients in Britain and Canada, exploring the revolutionary efforts made to help them communicate with the outside world. The findings have profound implications for the patients and their familieis; as well as ethical consequences for scientists and medical staff. If scientists can use technology to read their thoughts it could release them from a silent world, unlocking feelings and memories and give them a voice. At the Royal Hospital for Neuro-disability in London staff are trying to assess whether patient Alex De Martelly Seaman is minimally conscious or in a vegetative state. Occupational therapist Claire Fundell discusses the use of SMART; an assessment programme which explores all five senses; looking for the smallest physical response that might show awareness. Patient Michael Taylor was injured in a car accident and has been diagnosed as being in a vegetative state, after using SMART his parents seek a second opinion. As vegetative patients make reflex muscle responses that resemble distress there is a fear patients may be in pain. Fundell discusses the use of splints to alleviate physical discomfort for patients. Dr. Ashraff Ali gives the results from weeks of physical assessments to Michael’s parents, who in turn discuss Michael’s condition. Neuroscientist Professor Adrian Owen talks about his work using Functional Magnetic Resonance Imaging (fMRI) to search for consciousness in patients who are on the edge of awareness. Using an fMRI brain scanner Owen runs test on Michael to search for hidden awareness. In London, Ontario Dr Bryan Young discusses the condition of his patient of ten years, Scott Routley. Scott’s parents are adamant Scott is capable of response, Young however feels this may be wishful thinking. Professor Aiden Owen runs similar tests on Scott using an fMRI to see if Scott has a functioning mind. The results show Scott is responding in the scanner and suggests he has awareness. Professor Owen examines patient Steven Graham who after positive results for brain activity undergoes more elaborate tests to examine his sense of identity. Stewart Newman was diagnosed in a vegetative state after a car accident, then started showing slowly emerging consciousness. His mother discusses Stewart’s progression, and after four years of treatment Stewart is now ready to return home. Using a printed alphabet Stewart is able to spell out words in answer questions and he tells of the frustration of being unable to communicate. In Cambridge, after further testing Michael’s results come back negative to displaying awareness. Further testing on Steven is used to examine his sense of identity. Steven is asked personal questions whilst under fMRI. The results suggest Steven is continuing to create and store memories about himself and his family, but the extent of these abilities are unknown. Complex tests are given to Scott that require him to use a distinct pattern of brain activity in which imagination is used to answer questions. By doing this the fMRI is used to establish communication through which in theory Scott can answer anything , thus science has given him back his voice. Owen discusses the possibilities of this communication and Dr Young argues this research rewrites to rules in assessing patients’ cognitive responses. Alex undergoes fMRI testing and Dr. Paola Finoia argues his results need further analysis before any conclusions are made. The results show he is consciousness some of the time, and that his journey to recovery has begun. As Stewart leaves the Royal Hospital for Neuro-disability to return home, chief executive Angus Somerville expresses his elation on seeing Stewart’s recovery.