Sometimes, following a brain injury, patients have periods of wakefulness but can’t communicate with those around them. Might they still be feeling pain, pleasure or discomfort? Could it be that they still understand when loved ones speak to them, even if they can’t respond? Doctors and families alike find themselves asking these questions, unable to answer them with any confidence.
Despite the lack of certainty, doctors are still expected to make a diagnosis. They follow established procedures, looking for signs of “purposeful behaviour” at the bedside. If a patient can follow commands or interact with their surroundings in seemingly purposeful ways (for example, by squeezing a doctor’s hand or following an object with their eyes) they are said to be in a “minimally conscious state”.
