Adrian Owen is a neuroscientist whose groundbreaking work has forged new – and previously unimaginable – ways to communicate with people who are in a so-called vegetative state. His research has shown that up to 20% of people thought to be entirely non-responsive are actually vibrantly alive and conscious, but simply unable to respond in any physical way. His new book, Into the Grey Zone: A Neuroscientist Explores the Border Between Life and Death, is a compelling account of these scientific discoveries, as well as of the lives of those trapped in what Owen has termed the “grey zone”.
RRJ Editorial: It’s noticeable from the opening pages of the book that you felt a deep emotional connection to your patients. You give names to their stories, even for those patients whose real names can’t be given for legal or moral reasons. Through this, you weave the very questions of consciousness and what it means to be human that you discuss at length in the book into your writing and presentation of the topic. What did you hope to gain from encouraging your readers to forge their own emotional connections with the patients?
Adrian Owen: For 25 years I have been writing about these patients for a scientific audience, describing their brain damage, the studies we do with them and the results of those investigations. In that context, they remain anonymous and we generally provide very little information about the patient, beyond a rather sketchy description of how their brain injury came about. Yet, these are real people, who have lives and families that are often profoundly affected by their brain injury. I felt that these stories deserved to be told to a wider audience and, in doing so, I hoped to offer readers an accessible introduction to some of the amazing scientific discoveries that have been made about the brain over the last couple of decades.
RRJ: Into the Grey Zone contains information about people with brain damage or in a so-called vegetative state that could be devastating for many readers. The book’s revelations will be especially shocking for those who missed the press coverage of some of the more famous cases you discuss. How did you approach presenting such hard-hitting material for a non-specialist audience?
AO: Actually, I don’t think ‘devastating’ is the right word. While many of the stories I tell will certainly be surprising for some readers – and in that sense, they may be ‘shocking’ – I’ve tried to balance this by describing some of the incredible science that’s been done to help these people and to help us to understand their condition. One of the advantages of being a scientist writing for a non-scientific audience is that I am very used to writing factually. In scientific writing we don’t tend to dramatise things, but rather stick closely to the facts. And I adopted the same approach with the book; that is, I tried to tell these stories as they really are, even though that may be unsettling for some people. Actually, this is what really brings the book – and the characters in the book – to life. These are real stories about real people living extraordinary lives. And in many case, against all the odds, they are able to triumph over terrible adversity. I think this is why several early reviewers described the book as ‘strangely uplifting’.
RRJ: Neuroscience is an incredibly complex field that most non-specialists often feel daunted by. Why did you feel it was important to bring your work to a wider audience in the form of a book?
LO: I agree that the nitty-gritty of neuroscience might be a bit daunting for some people, as is the case with many specialist fields. That’s why I set out to write Into The Grey Zone because it’s not a book about the nitty-gritty of neuroscience, but about a much bigger picture. What are the big questions we all want answered about the brain? How is neuroscience going to get those answers? What are some of the most astonishing discoveries we’ve made about the brain the last 25 years? Who are the patients behind those discoveries and why are their stories so compelling? Into The Grey Zone is not a neuroscience book, it’s a book about the adventure of doing neuroscience, about the people who have shaped the course of neuroscientific discovery and about where we are going next. It’s been called “a fascinating tale”, “a scientific adventure story” and “a great detective story”. Hopefully, it’s a combination of all of those things.
RRJ: What is the difference between neuroscience and neuropsychology, and on which side of the line would you say your work falls?
AO: There is considerable overlap between neuroscience and psychology. I trained in psychology, and I think it provided me with many of the tools that I have used over the years to tackle the scientific questions that have interested me, from how to design a rigorous experiment to an appreciation of medical ethics. But there came a time when describing myself as a ‘psychologist’ no longer told people much about what I actually do. In fact, it often gave them the wrong impression entirely. One of the themes running through Into The Grey Zone is how the field that we now know as ‘cognitive neuroscience’ emerged out of psychology with a lot of help from brain imaging, and my career followed that very same path across the same time span. I am a psychologist at heart, but a lot of what I do is better described as neuroscience. I like to think that what I am best at is applying good psychological principles to neuroscientific questions, some of which may not seem very ‘psychological’ at all.
RRJ: Into the Grey Zone frequently points to the differences between life, habits and attitudes in the US or Canada and the UK. How do you think your nationality has affected your work and your attitude towards issues such as the right to die?
AO: I honestly don’t think my nationality has affected my work or my attitudes in any significant way, but being familiar with many different cultures and countries certainly has. I travel a lot and always have done, I have lived in Canada and in the UK (and in Africa as a child) and I married an American so I have spent a considerable amount of time in the USA too. My lab is also very international so I also get exposure to other cultures through my day to day interactions at work. What this broadly international environment has given me is an appreciation for those things that make us uniquely human and are not necessarily affected by culture, religion, place of birth and so on. What makes us human? What gives us a sense of being something in the world? Why do most of us have such a strong will to live? At what stage does a foetus or newborn become conscious and able to understand the world that we, as adults, experience and enjoy? How does animal consciousness differ from human consciousness and why do animals not respond as we do to the aesthetic qualities of music and art? These are all big, universal questions about being human that are not specific to any one country, culture or creed.
RRJ: Where do you think advances in neuroscience have the potential to take us next?
AO: As I say at the very end of Into The Grey Zone, “Twenty years ago, many people dismissed our quixotic quest to read the minds of patients lost in the grey zone. Yet soon such decoding will be commonplace. This is the magic of science, pulling the future into the past, chipping away at every problem until we can hardly believe the progress we’ve made as new realms of insight and understanding unfold before us.” Emerging technologies in neuroscience will undoubtedly one day allow us to read the minds of others. Not in the rudimentary sense that I describe in the book—but in the sense of interpreting and understanding exactly what another person is thinking based solely on some sort of readout from his or her brain. The ethical conundrums that this will produce will be immense in business, politics, and advertising; there will be an insatiable (and sometimes sinister) appetite for access to the thoughts of others. The way that the world operates will radically change, much as it has changed since the advent of the Internet and the World Wide Web. But we will adapt as a species, and these changes will just become the way things are: the tools that our children will use from birth, and the technologies that will define the blueprint for the generations that follow.
Into The Grey Zone: A Neuroscientist Explores the Border Between Life and Death by Adrian Owen is published in September by Faber & Faber (£16.99)