Another world
Permanent Vegetative State is a complex clinical condition classified among Severe Acquired Brain Injuries. Those affected retain vegetative functions — breathing, cardiac activity, the sleep-wake cycle — but have lost the content of consciousness, that is, self-awareness and perception of the environment. It may result from severe cranial trauma, cardiovascular events, cerebral infections, or the progression of severe tumor pathologies.
Patients are generally bedridden, with wheelchair mobilization limited to a few cases and for brief periods. They exhibit spontaneous eye opening but lack intentional communicative and motor capacities. They may vary widely in age: I have encountered individuals ranging from 19 to 70 years old.
In patients in a Minimally Conscious State, interaction suggests they may retain emotional reactions and some form of perception — such as smiles in response to a greeting or tears to specific questions. These experiences have taught me the necessity of approaches that are extremely respectful and finely calibrated: loud noises, sudden movements, or abrupt changes can provoke visible reactions.
My role
In this context, attention to small things takes on crucial significance: every gesture, every expression, every minimal change requires a keen and sensitive gaze. It is work rooted in deep, nonverbal listening, where I act as an empathic observer, capable of receiving what emerges without judgment.
My activities include:
- Descriptive narration — I describe the outside world in rich detail, evoking simple and serene images
- Olfactory stimulation — using delicate essential oils, when permitted
- Tactile experiences — offering materials that are soft and pleasant to the touch
- Soft lights and sounds — capable of activating or relaxing, always with extreme care not to cause distress
Seven inhabited rooms
The day begins with the customary team handover. I update myself on the patients, listen to their clinical conditions, the changes. Then I prepare the cart and begin my rounds. There are seven rooms, with one or two patients each.
Room 1. A patient gazes toward the window. It is a luminous day; the sun and wind move the leaves of the trees outside. His eyes follow the rapid play of the elements; a tear slides slowly down. I pause for a moment, respecting that instant of connection with the outside world.
Room 2. Empty.
Rooms 3 and 4. The patients are sleeping, settled with care, cushions at their sides. In the room, faint music resonates — almost imperceptible — chosen to accompany them without intruding.
Room 5. Two patients stare at the ceiling. Light from the windows enters and dances across the walls. The play of light creates a hypnotic choreography, capturing their gazes — and in that motionless silence, a space of stillness seems to open.
Room 6. Empty, after a death. The room seems to hold the memory of its former inhabitant, like a distant echo.
Rooms 7 and 8. Two patients watch television. One appears more present; her eyes follow the colorful images of animated cartoons. One of the two laughs suddenly and, as I pass, greets me with guttural sounds. That sound, so spontaneous, resonates like a welcome.
Rooms 9 and 10. Franco and Aldo share the room. Aldo sleeps a sleep that seems without end, while Franco, awake, appears to have returned to “living.” I approach carefully, trying to understand what might create a point of contact with him.
In this ward, every detail holds immense value. A movement of the eyes, a sudden sound, the hint of a smile: every gesture is a wonder that reminds us to be present and ready to receive. The stories that brought these people here are laden with pain — violent traumas, profound ruptures. For those at their side, too, waiting for an awakening, life becomes a suspension filled with hope and infinite expectation.