Inside the Brain of a Coma Survivor: What We’re Learning About Consciousness

Jun 8

Written By Michele Edington (formerly Michele Gargiulo)

For some reason I always had a fear of being in a coma. I think it comes from childhood and learning that back in the days befor modern medicine people used to be buried alive when they were in comas and sometimes would wake up under ground. Or maybe it was this show I saw while sitting in the dentist as a kid when someone was in a coma and he heard the nurses plotting to murder him. Either way, fear of comas runs deep in my mind.

They call it the silent world because it’s a place beneath language, movement, and everything we use to say, “I’m still here.” Science is beginning to listen though, and what it’s hearing changes everything.

The thing is, some people in comas…are awake. They’re trapped, aware, and sometimes living entire lives behind closed eyes.

This story is of the liminal, of neurons firing in stillness, and of consciousness that refuses to die quietly.

What Is a Coma, Really?

If you watched too much tv growing up then you might just believe a coma is like deep sleep, something you either wake up from…or don’t.

Of course, the truth is much more layered than that. Now, according to the interwebs (I’m not a doctor, hellooo), coma is a medical state of unconsciousness where a person can’t be awakened, doesn’t respond to stimuli, and lacks normal sleep-wake cycles. It’s different from brain death, and it’s different from a vegetative state.

Here’s where it gets strange though, because not all comas are equal. Some are just the surface, and beneath that stillness, some brains are trying to speak.

In 2006, a young neuroscientist named Adrian Owen was asked to examine a woman who had been in a vegetative state for years after a car accident. She showed no sign of awareness, there was no blinking, no squeezing of hands, etc, just breath, and time. Owen had a new idea though, and instead of asking her to move, he asked her to imagine.

Inside an fMRI scanner, he told her: “Imagine playing tennis.” Her motor cortex lit up…just like a healthy person’s would. Then he said, “now imagine walking through your house.” Her parahippocampal gyrus, posterior parietal lobe, and lateral premotor cortex lit up again, perfectly.

She was in there, she understood, she followed commands. It was the first proof that a person who appeared entirely unresponsive could, in fact, be fully conscious.

There are a lot of terms when it comes to comas in case you didn’t know (I didn’t until I wrote this piece).

Locked-In Syndrome is when the person is fully conscious but cannot move any muscles except the eyes. Communication is possible with them via blinking or eye-tracking devices.

Coma is a deep, prolonged state of unconsciousness. There’s essentially no wakefulness, no response, no communication.

In a Vegetative State, eyes may open, and sleep-wake cycles return. Traditionally though, there’s no evidence of awareness.

Lastly there’s a Minimally Conscious State. These are small, inconsistent signs of awareness…like following objects with the eyes or responding to pain.

The thing is, when none of these apply, yet when people who show no behavior at all…but whose brains still light up when asked to think, we now call Cognitive Motor Dissociation. Frighteningly, it’s more common than we thought.

Consciousness Without Movement

For centuries, the ability to move was seen as proof of life, of mind, of self. These discoveries force us to reconsider, however.

Consciousness, it turns out, doesn’t always come with motion.

In one 2019 study, researchers used EEG and fMRI to examine over 100 patients in vegetative states. Around 15% showed brain activity that indicated hidden awareness. Fifteen percent…that’s one in seven.

One in seven people presumed unaware…are living inner lives no one can see.

What’s it like in there you might ask. Well, the unsatisfying answer is that we don’t know. Some coma survivors have returned with stories though. One man, later diagnosed with locked-in syndrome, said he was fully aware for years…trapped in a body that refused to move. He could hear doctors call him a “vegetable.” He could hear his family cry, and he was there. Screaming inside.

Another survivor said he had vivid dreams, internal narratives, emotions, thoughts. A kind of waking dream-state. A twilight existence where he felt time, but not space.

These testimonies are rare…and fragile. They do suggest that the coma is not always empty though, sometimes, it’s full.

If someone is aware but can’t communicate, how do we treat them? Do they feel pain? Do they understand grief? Are they suffering? When Owen’s team found brain activity in unresponsive patients, families faced heartbreaking questions. Should life support continue, should we try to engage them more, could they recover?

In one extraordinary case, a patient used fMRI to answer yes-or-no questions by imagining playing tennis for “yes” and walking through their house for “no.” He answered correctly, consistently. Science gave him back a voice at least.

Navigating the Gray Zone

This area (between life and death, sleep and wake, known and unknown) is now called the gray zone of consciousness. It’s the most mysterious terrain in neuroscience.

Patients in this zone challenge all of our past assumptions. They’re teaching us that consciousness is not binary.
It’s actually quite layered, slippery, and capable of hiding.

Like dark matter in the cosmos…it’s far more present than we ever imagined.

New technologies are helping us find hidden minds. EEG with Machine Learning: Algorithms now detect subtle patterns in brainwaves that suggest awareness. fMRI Imagery Tasks: Asking patients to visualize scenarios triggers telltale activation in brain regions. Transcranial Magnetic Stimulation (TMS): Sends pulses into the brain to gauge complexity of responses, helping map consciousness levels.

These tools are reshaping diagnostics, and they’re also changing how we talk to the silent.

This phenomenon isn’t only about comas. It forces us to ask deeper questions about consciousness itself. Where does it live? Can it exist without the body? Spiritual traditions have long spoken of “witness consciousness”…the part of you that watches even when thoughts are still. Now, science may be catching up.

There is a kind of witness in the fMRI, a mind behind the stillness i f you will, and it’s starting to wave hello.

Muse 2: Brain-Sensing Headband for Meditation and Focus
This sleek EEG-powered device lets users “listen” to their brainwaves. An elegant bridge between awareness, science, and stillness, exactly what we just explored.

Minimalist Brainwave Art Print

An elegant wall piece inspired by real EEG patterns, a tribute to the quiet complexity of the mind.

A New Kind of Listening

Imagine being the doctor who scans a patient assumed to be unconscious, and sees their brain light up in response. Think about the family who never gave up, or even being the patient, and finally being seen.

Science is learning to listen in a new way, because sometimes, the mind doesn’t go quietly, it waits in the darkness.

Inside the Brain of a Coma Survivor: What We’re Learning About Consciousness

What Is a Coma, Really?

Consciousness Without Movement

Navigating the Gray Zone

A New Kind of Listening

Related Reads from the Archive

The Science of Being Watched: Why You Feel Eyes On You

The Sins of the Father: How Paternal Stress Etches Itself Into Sperm