Because his parents were in the next room, and modern technology allows real-time fMRI readouts, Owen was able to tell the Routleys that their son wasn't in pain right away. Although he's told family members about patient responses in the past, this time was special, Owen said.
"It was the first time I asked a question of a patient that would have some significance for their condition," Owen said. "That science for me was a major landmark moment. They [Routley's family] have known for some years that Scott had some residual abilities. They were relieved that we were able to determine this with the fMRI and provide a little more information with the good news that he's not in any pain."
Owen's colleague John Connolly, a neuroscientist at McMaster University in Ontario, began studying whether supposed vegetative patients were aware in the mid-1990s. He notably used an EEG --electroencephalogram -- to determine that a patient who'd been stabbed in the head and rendered mute could discern whether a sentence made sense. When he said a sensible sentence, the scan showed one kind of brain activity, and when he said a nonsensical one, the scan showed another kind of brain activity.
Connolly said about a dozen labs worldwide have worked at finding awareness and channels of communication with these patients for 20 years, and Owen made an important step forward.
"The whole idea of this interaction with patient, not just passively observing them but trying to engage them, is a very big deal," Connolly said, adding that in many health-care systems, patients are denied certain therapies if they seem uncommunicative because they're a thought to be a lost cause.
"I think the era of judging patients with communication problems, judging on purely behavior, I think those days have to end."
Since June, Owen has met with Routley two more times, focusing on whether he knows who he is or why he is in the hospital -- all as yes-or-no questions -- but Owen can't reveal the answers because he intends to publish the results in a medical journal within the next several months.