| Summary: | 碩士 === 南華大學 === 生死學研究所 === 93 === In the recent years, both domestic and overseas press media have reported quite a few cases about Persistent vegetative state（PVS）patients regaining consciousness. For either PVS patients or their family, these cases are regarded as “miracles”. Especially in mainland China, several hospitals and medical teams that have dedicated all their time and resources --money and energy-- to researches on PVS patients are trying to help PVS patients regain consciousness through a combination of traditional Chinese and therapy western therapy. This thesis places the focus on three topics: one is to relate what a revived PVS patient experienced when he was lying in a coma, another to discuss the course of rehabilitation for a revived PVS patient, and the third to describe the experience of a PVS patient receiving treatment and his family taking care of him. In this research is presented a revived PVS patient’s world through the recounting of the patient himself and his family.
The first part of this thesis places the focus on PVS patients, trying to present how PVS patients exist and the course of a PVS patient’s entering this real world from a senseless world. In the first step, the researcher rearranged the information got in the reports about 23 revived PVS patients from Taiwan and 64 revived PVS patients from mainland China and then made comparison between it and the reference data extracted from related literature. In Taiwan more than 50 per cent of the persistent vegetative state is caused by such aged people’s chronic diseases as hypertension, apoplexy and dementia. It is foreseeable that when quickly increasing aged people in Taiwan results in yearly increasing PVS patients, medical care for these patients may form heavy burdens of many families and a breach in the entire social medical system.
With regard to PVS patients in the prime of life or the younger, though most of them have had their brains externally injured in accidents, the prognoses are more favorable for them and they have more chances to regain consciousness.
As for the diagnosis on a patient in a state of severe coma, there is usually alternative of too early suspicion of brain death or the formation of a gray area of suspicion because of deficient observation. For this reason, the demarcation between “with sense and consciousness” and “without sense and consciousness” gets more and more obscure and uneasily defined. A state of coma at least contains four successive different phases that are (1) brain death, (2) persistent vegetative state, (3) minimally conscious state, and (4) locked-in syndrome. Unfortunately, 42 per cent of PVS patients are a result of wrong diagnoses, and only 25 per cent of them are the real ones. According to the statistical figure drawn from overseas sources, prognoses differentiate PVS patients into five classes: (1) those who are in recuperation, (2) the medium disabled, (3) the severe disabled, (4) those who are in a persistent vegetative state, and (5) the deceased. Most revived PVS patients have to experience a long course of rehabilitation, and it is really a long way for them off either complete recuperation in consciousness or physical functions or independent life in which they need no longer lying in beds all the day long or they can freely move about and take care of themselves in daily life with no need of other people’s assistance. According to the probabilities for reviving PVS patients in several countries: 52 per cent in the United States, 60 per cent in Japan and 82.6 per cent in mainland China, a fact indicates that so long as medical personnel and the family of PVS patients persist in their belief and continue to provide patients with medical care and training for rehabilitation, patients have better chances to regain consciousness.
When the objects of this research including revived PVS patients and their family were interviewed, most of them expressed their embarrassing and hopeless situation at the time when patients lay in comas after accidents or their desperation in facing the too early judgment of PVS patients made by medical personnel. Five of six revived PVS patients expressed that they had had Near Death Experiences(NDEs) For further discussion in this thesis about the system of medical treatment and care applied to PVS patients, six cases about PVS patients as well as press reports on revived PVS patients in Taiwan, mainland China and other countries were collected and comparison was made. A conclusion was drawn from difference sources with five identical points and one in difference:
(1) When the accident occurred, the family of the victim insisted on urgent rescue and attached to a faith that the victim in a coma would regain consciousness.
(2) Applied a combination of traditional Chinese therapy and western therapy, including as application of high-pressure oxygen, Chinese herbs and acupuncture & moxibustion.
(3) Frequently massaged the patient’s whole body, kept his body clean and provided nutrients.
(4) Application of a wake-up therapy: Gave long and intensive gentle calls in the patient’s ear, provided him with a home-like environment, and filled the room with music that he was familiar with.
(5) Provided the patient with things that he preferred, satisfied him with his hobbies, such as mah-jong, songs and his favorable food and drinks.
(6) The only point in difference: Much more family of the patients in Taiwan asked for the aid of folk therapy.
Discussion is also made in this thesis about several signs appearing in the period before a PVS patient revives from a state of coma. And these signs that are usually found by the person who takes more care of the patient than any one else include:
(1) Eyes: There are changes in visual sense
(2) The slightly wriggling lips express that the patient wants to say or to eat something.
(3) Senses of his body have been regained.
(4) Consciousness is gradually regained.
In the foregoing relation, it is found that a PVS patient reviving from a long coma is like a baby, who has to learn everything from the very beginning and to accommodate himself to the brand-new circumstances including discrimination from society, unfair treatment and pains and sufferings caused by mental and physical barriers. Besides, he has to stand a long course of unceasing rehabilitation, and each act of this rehabilitation should be incorporated in daily life. In the experiences provided by revived PVS patients, quite a few simple and useful methods of family care and rehabilitation are presented for the reference of medical personnel and the family of revived PVS patients.
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