A nightmare: being trapped in your own body, unable to move or signal awareness to anyone, listening to your loved ones talk casually about pulling the plug on you to “save you the pain.” Being conscious, but unable to prove your own consciousness. It’s a nightmare, indeed. But one that comes true all too often.
One woman defied this nightmare. Let’s call her Jane Doe. Totally (supposedly) unaware and unresponsive, Jane was asked a series of yes-or-no questions by neuroscientists who used an fMRI to track her brain activity. She was asked to imagine herself playing tennis when the answer was “yes” or walking through her house when the answer was “no.”
To everyone’s astonishment, her fMRI scan revealed patterns of activity that were indistinguishable from a healthy brain. So she was still, in some capacity, “there.” In her mind, the lights were still on — maybe flickering, but definitely on.
Adrian Owen was the neuroscientist behind Jane’s spectacular case. Owen understood that the implications of his work were vast. It wasn’t just some academic puzzle. It’s a fundamental shift in how we understand the nature of awareness itself, and one with serious repercussions for how we practice medicine. For decades, the medical world has split patients into neat categories: persistent vegetative state (PVS) means you’re gone in some way, and minimally conscious state (MCS) means there’s still hope, still some flicker of recognition. It’s this difference that often determines whether life support is withdrawn. But what if we’ve been wrong? What if the “unresponsive” are simply, as Owen’s work suggests, misjudged — maybe even ignored?
In Out of Our Heads, Alva Noë argues that consciousness research has got it all backwards. He posits that consciousness doesn’t exist in isolation, just firing off neurons in a kind of internal vacuum. It’s relational — woven through our actions, our engagement with the world, our interactions with each other. This means that if a person no longer has the capacity to respond or interact, we could be looking at someone cut off from the world, but not gone. This could mean that withdrawing care is an act of abandonment, or worse.
The solution seems simple: We should assume awareness exists until proven otherwise. We need to find ways — through brain-computer interfaces and other neurotechnologies, like Owen and his team did with Jane — to build communication where there was none. We need, in other words, to find new ways to listen.
The Neo-Neuron 
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