Each time andrea stuck her tongue out, it looked more and more as if she was trying to tell me something. I had met her only ten minutes earlier, but I already knew her background. Andrea had sustained serious head injuries in an automobile accident 13 months ago and was not discovered by the police for seven hours. On the way to the hospital, she had had a cardiac arrest. The emergency team was able to restart her heart, but she never regained consciousness.
Her three grown children had done everything they could to aid their mother’s recovery from coma—physical therapy, playing favorite music, stroking her, aromas, and even pleading with her. But after several months without any response, they had grown discouraged and begun seriously to consider how they could help fulfill their mother’s wishes. A divorced psychologist, Andrea had discussed with her children the case of Karen Ann Quinlan, the young woman who had sunk into a years-long coma, when it was in the news. She had made her children promise that if she was ever in what was called pvs, a persistent vegetative state, or was severely disabled and unable to express her own wishes, they would permit her feeding tube to be withdrawn so that she could die.
Now, 13 months after entering unconsciousness, Andrea’s family, through a lawyer, had asked me to examine her and perform a pet scan on her brain. pet, or positron-emission tomography, is a type of medical imaging done after injection or inhalation of compounds labeled with radioactive isotopes that emit positively charged electrons (positrons). With this technique, we can measure blood flow and glucose or oxygen metabolism in different brain regions.
