Le voyage des comateux à la frontière de la conscience

Ce documentaire explore la réalité complexe et souvent mal comprise du coma, un état qui va bien au-delà de la notion simpliste de « profond sommeil ». À travers des témoignages poignants de médecins, chercheurs, familles et patients, le film tente de démystifier les mystères du cerveau et de la conscience, se situant à la délicate frontière entre la vie et la mort.

Le récit suit plusieurs histoires personnelles et touchantes. David, victime d’un traumatisme crânien, plonge dans le coma et arrive à l’hôpital dans un état critique. Sa lente reprise de conscience, marquée par des étapes clés comme l’ouverture des yeux, les premiers mots et les premiers pas, est suivie avec une attention particulière, illustrant les moments de doute, d’inquiétude et de bonheur vécus par lui-même, sa famille et le personnel soignant.

En parallèle, le documentaire présente le cas de Jill, une jeune femme dont le processus d’éveil semble stagner. Recevant des soins spécifiques au Rehazenter au Luxembourg, elle passe une semaine d’examens intensifs avec le neurologue renommé Steven Laureys au CHU de Liège. Ces examens, présentés pour la première fois au monde, offrent une évaluation précise du degré de conscience d’un patient dans le coma.

Enfin, le film se penche sur les expériences d’Arnaud et Nicola, qui, après avoir été dans un coma grave pendant des semaines, se réveillent avec des séquelles importantes. Leurs parcours de rééducation longs et difficiles à Garches, où ils luttent pour retrouver leur autonomie et réintégrer la vie, sont minutieusement documentés.

Réalisateur : OLIVIER PINTE

– We got to the hospital and the only thing they said to us, It’s that he was in a coma and in a very, very serious condition. Then late at night, we were told that Arnaud would only have three days to live.

– I don’t remember neither the day nor the weather. I don’t remember anything. I do not remember from the hospital or whatever, but I read and learned after that the first prognosis I was given, it was 24 hour survival. Basically, we thought that I wasn’t going to survive

And that I was going to die. – She was a very pretty girl. Now she is different. Hair, everything. It’s not the Jil we used to have. Every year around the world, hundreds of thousands of people are go into a coma. Some wake up, some don’t. Still others keep irretrievable consequences

Of this passage at the borders of life and death. For most of us, the coma is this sleeping being which we don’t know if he will ever wake up. The medical reality naturally turns out to be more complex. The coma originates brain damage,

This fragile and mysterious organ that controls our actions, our thoughts, our vital functions. Coma is a situation where you are not conscious because you are no longer wakable. A patient in a coma, after severe brain injury will never wake up, open the eyes, even when stimulated.

The coma is the absence of interaction with the outside world. That is, the patient in a coma no longer able to integrate the information from the outside world and react to this information. Journey to the borders of human consciousness, on the shores of a coma and its mysteries.

When a person falls into a coma as a result of an accident or cardiac arrest, it all starts by emergency treatment. North Hospital of Saint-Étienne, arrival of a road accident. It is a young man who fell into a coma following a motorcycle fall.

He is taken directly in a room under the landing area. It’s called the Resuscitation room. – Where is the pressure head? Is he from the area? – Yes. This is where doctors from the SAMU pass the baton to the emergency physicians.

The medical team takes note of the patient’s condition and check their vital functions. The aim is to reduce any risk of respiratory and circulatory failure. – No, it’s okay. We purposely took this one because it was going there. Can you put an artery curve? – Yes

Without removing him from shell mattress, the young man is taken to the scanner to diagnose his lesions. You have to take it in traction. Ready to tow? We’re towing. Go on! One, two, three. Every part of the body is scanned. The young man has no fracture

Or lesion that requiring surgery. Despite the absence of a skull fracture, he’s suffering from head trauma. A trauma with micro-bleeding, like here, in white from the tearing of vessels inside the brain. These lesions are the cause of his loss of consciousness. The bleeding causes the brain to swell.

The resuscitators must take care of it as quickly as possible. The first operation is to install a pressure sensor at the upper level of the skull. – You put it on the edge of his hair now. – Okay. You are well on the side.

– Did you feel? – Yes. That’s what you need to feel. The skull is pierced to slide the sensor inside, in direct contact with the brain. Okay, that’s good. Perfect. Intracranial pressure appears in purple on the monitor. A normal pressure is between 5 and 10.

There is a slight hyperpressure here. The young man’s prognosis for awakening is favorable. He is expected to come out of the coma in the next few days. To take a decision, the doctors also based on another examination practiced at the scene of the accident, the Glasgow score.

The Glasgow scale allows ratings from 3 to 15 the degree of consciousness of an injured person. Are you in pain anywhere? Rescuers assess several criteria such as opening eyes, verbal and motor responses. – Look at me! Look at me! The Glasgow score allows doctors in intensive care

To assess the chances of recovery from the coma. – Can you hear me? Open your eyes. In intensive care, we breathe life back into patients. We reanimate them, we give them back their soul. Some will be brought back to consciousness from a deep coma on the verge of death.

Our goal in intensive care, it’s been the same since the start at the scene of the accident or medical problem, it is not to aggravate the neurological lesions. In fact, unfortunately, we don’t know how to repair the brain. We simply try to prevent new lesions from being superimposed.

We must put the brain in optimal conditions, that everything is normal, that it is normally oxygenated, That it is normally infused and make it suffer the least possible. David is 45 years old. He has been in a coma for two days.

Following a fracture of the skull after a violent fall in a staircase. David suffers from a severe head trauma. At the time of his treatment by SAMU, he was at level 8 on the Glasgow scale. Upon arrival at the hospital, he had emergency surgery

To evacuate a hematoma occupying nearly 20% of his cranial cavity. After the accident, intracranial pressure caused David’s brain to begin to engage the only available opening at the base of the skull compressing the brainstem. The operation that was performed to save him is called a craniotomy.

The neurosurgeon cuts out a piece of skull then evacuate the hematoma. The cranial flap is put back in place at the end of the operation. Forty-eight hours after his accident, David’s intracranial pressure is 24. An extremely high level. Normal is between 5 and 10.

When time goes by and things don’t get any worse, It’s a good sign, it’s quite encouraging. We’ll take it all back. I will explain to you so that you understand. David is single and has no children. He stayed close to his parents who live in the same village as him,

In Ardeche. I can’t give you good news that doesn’t exist. If he can’t see, if he doesn’t speak… I didn’t say that. – No, but I say it to myself. For now, it’s too early to talk about the after-effects.

I told you that we’ll talk about the after effects when we have more perspective. I explain to you, if you don’t understand, you stop me. Your son had a broken bone here and there’s blood pooled here importantly It compressed the brain. Okay. The concern is that in these situations,

The brain is like other organs. When you get hit somewhere, it gets blue. In the days that follow, there is edema and it swells. The concern is that if it swells in this skull that closed, It increases the pressure again. The basis of treatment is to put him to sleep.

That’s why he’s been sleeping ever since he’s been with us. He didn’t come out of the inn. There is still a way to go. – There is a long way to go. Months and months. Days and days at first to get through the first stage.

I told you not to look too far. Well, that’s it, days and days. David was put to sleep even more deeply using sedative drugs. This is called artificial coma. This came on top of the natural coma in which David found himself after his accident.

It reduces the oxygen consumption of the brain, therefore the volume of blood that rises to the head. For the same purpose, David was placed under a refrigerated tent to maintain his temperature at a normal level. It’s a tough one. Go break your face like that.

In what state of mind are you today? Listen, I’m telling you again. As long as there is life, there is hope. I can’t tell you that he’s going to… I saw people who were really down and came up, we wonder why they came back up? There are miracles.

There are very few, but they do exist. I think he will be one. We’ll see. The brain is made up of two main materials: gray matter and white matter. The gray matter, That’s where our 100 billion neurons are. The white matter is located deeper. It is made up of axons,

Kilometers of cables that connect neurons to each other. Axons make millions upon billions of connections and are traversed by an electrical signal, nerve impulses. There are two main causes of coma. First, cardiac arrest, there is no blood supply,

Of oxygen, to this gray matter that needs a lot of energy. If it takes too long the neurons, the nerve cells will die in the gray matter. After, you have the trauma where there, each case is different. You may have bleeding, bruising,

Edemas, swellings in different places of the gray matter. After an accident where you hit a bridge At 120 kilometers per hour, you have decelerations Where there is the white matter inside the gray matter, this very important structure, these connections between nerve cells that you see here

Are really going to be cut. So you have gray matter that may still be intact, but which is disconnected. David has been in a coma for four days. All its vital functions are managed artificially. He is fed through a nasal tube that goes down into his esophagus.

His breathing is dependent on a machine, the artificial ventilator. With it, doctors manage oxygenation precisely and the CO2 level in his blood. 20% of oxygen consumption of the human body is absorbed by the brain. The artificial ventilator therefore has an essential role.

It is also thanks to this machine that resuscitation was invented. It all started in the 1930s, When experimenting with the steel lung to allow polio patients to breathe. In the 1950s, the modern artificial ventilator is invented. The neurologist Pierre Mollaret

Used it to create one of the world’s first intensive care units at Claude Bernard Hospital in Paris. For the first time, we manage to save patients who have been plunged into a deep coma. All patients who are going to be on intratracheal artificial respiration

Will all have a cannula of this type. He testifies in the medical show by Igor Barrère and Étienne Lalou who film the first reanimated patients. This is someone who is currently in a coma. A toxic coma for which it was also necessary to perform a tracheotomy.

How long is he in a coma? Two days, two weeks, two months, and more. In a significant number of cases, after delays that are very variable, sometimes very long, we have profound joy to see someone reborn with the outside world. Before the appearance artificial respirator,

The only cause of death was heart failure. This machine brought up another form of death, brain death. What we called at one time, the overtaken coma. This man seems to be in a coma. His heart is still beating, he’s on life support unit.

It is the machine that maintains the oxygenation of his body. Nevertheless, this man is dead. His brain is destroyed. He is brain dead. Even though this patient no longer has any activity in his brain, Doctors must provide proof of death before signing the death certificate.

Among the diagnostic criteria for brain death, We must ensure that there’s no longer spontaneous breathing. We’re going to unplug the ventilator and be able to see that there is no longer any chest movement. As soon as the respirator is disconnected, the movements of the chest stop.

Here, the ventilatory movements that are recorded by the scope. We see that there are no more, that the patient no longer has any spontaneous breathing.. When the machine is plugged back in, breathing movements resume. To confirm brain death, The law requires a final scan.

This one will show that there is no longer any blood circulation in the patient’s brain. Brain death concerns less than one percent of deaths in France. It is in this rare case the organ removal can be carried out. In the collective imagination,

The end of the coma is associated with awakening from sleep. We think of someone who opens his eyes, who speaks, who gets up and returns to normal life very quickly. The reality is much more complex. Opening eyes is only one of the first things of awakening.

It does not necessarily announce the immediate return of consciousness. When you are awake, you are not necessarily aware. Awakening is the basis, it is the ignition of the brain. It’s putting your brain on. On the other hand, once you are awake, Other mechanisms are still needed

At the cerebral level so that we are aware. These mechanisms, therefore the fact that the information sensitive reaches the brain and then is integrated by the brain so that motor information comes down. Activation of the brain

Occurs in the depths of the cranial cavity, at the level of the brain stem. This is where vital functions are managed, including the regulation of breathing and heart rate. Consciousness materializes itself, in certain upper areas of the brain, between gray matter and white matter.

It’s been 13 days since David had his accident. Her intracranial pressure is back to normal. So the doctors decided to stop the drugs that were making him sleep. For the past few hours, David is showing his very first signs of awakening. David! David! David! David! David!

We can see very well that there, he opens his eyes. There is even a hint of tracking gaze at me. The fact that David opens his eyes is a sign that his brain is able to turn on properly. The opening of the eyes are not consciousness.

To get out of the coma, David needs to be able to interact with the outside world. We go to the next step where we will apply a painful stimulation. We see that he clearly has an adapted reaction to pain, which is a withdrawal reaction. That’s a good level.

The level above would be for him to take the other hand to take my hand away. There, he does not do it yet, but that’s a sketch of consciousness. This is the first time since his arrival that the doctors can do a clinical examination of David.

The end of artificial coma makes it possible to measure again his reactions to requests, therefore his level of consciousness. Two weeks have passed since David opened his eyes for the first time. This beginning of awakening had given way to a new phase of unconsciousness.

In the past few hours, David has been making progress again and manages to breathe without assistance. For the first time, he opens his eyes alone, without being stimulated. Chief! Are you hot? It’s hot here in Saint-Étienne. How does it feel to see David waking up like that?

I am very, very happy. It’s wonderful, it shocked me. It was a shock to me because I saw him in sleep so much. When you see someone opens their eyes, It’s marvellous. We can see that there is life. Now I can see that there is life. It is something else.

It is something else. Can you move your fingers a little? Just now, he squeezed my fingers a bit. You manage to squeeze my hand a little. It’s hard. – He is tired, but he opens them wide. Just now he smiled. The lively crank. My little David. Yes, his mom is happy.

It is good. So? We just had a big smile. Is it true? – Yes How are you doing? How are you? You say yes to this doctor, you have to say yes to him anyway. Shake my hand. He deserves to be said yes because he did a lot for you.

We’ll leave you alone, we’ll be back. You take good care of yourself. You’re good, we’ll be back. No worries, you are in good hands. Don’t worry, baby. He understood that she was leaving. – You must not cry, my darling. I will be back Don’t cry or I’m going to cry.

Don’t cry, come on, I’ll be back. You have to be happy because things are much better. You shouldn’t cry, you should laugh. There you go, that’s great. Come on, kiss. I call every day, at noon and in the evening. Come on!

What I’m telling your husband proves he’s got it all figured out. He understood that you were leaving. It’s good. – Yes, it’s good. I’m leaving Don’t feel guilty, it’s normal, you have a 3-hour drive. I am very happy to see him like this. Yes, we too. It’s great.

David’s smiles and tears Are the demonstrations of his return to consciousness with more and more elaborate reactions. Understanding of the world around him, expression of his emotions, interactions with loved ones. Awakening, coming out of the coma, is also this slow reconstruction, this return to the functions of relations.

This self-awareness, this awareness of others and the outside world, which is the essence of existence. For others, coming out of the coma will be more difficult. Despite the beginning of awakening and the opening of the eyes, some people will only recover a few bits of consciousness.

Try to look this way once. Are you cold? No, you’re not cold. Jil is from Luxembourg. She’s 27, she no longer speaks. Her body remains inert. She barely interacts with the world around her. Jil is in a mysterious state. She seems awake since her eyes are open

And that she alternates cycles of waking and sleeping. Jil only shows tiny signs of conscious life, even when she hears her father’s voice. Are you tired? For me, it’s always hard to judge if she sees anything. Jil was an educator at home for people with disabilities.

Six months ago she went into a coma following a cerebral hemorrhage. Since then, her life seems to have stopped, almost suspended. She kept her friends, her parents, her spouse come to see her every day. She was a very pretty girl. Now she is different. Hair, everything.

She’s no longer the Jil she used to be. How will she react when she sees herself for the first time Where she’s going to notice, the person you see in the mirror, but yesterday you were different. What is going on there? I am afraid of her reactions. I’m scared too

Of not being able to find the right words or the right thing to do to help her. Since leaving intensive care, Jil lives in a center that specializes in awakening from coma, the Rehazenter, in Luxembourg City. Jil! Are you awake? Jil! Jil, are you awake? Do you open your eyes?

To live, Jil doesn’t need heavy medical assistance. She breathes naturally. Her tracheostomy was kept for safety reasons. Come on, open your eyes. She’s just fed and hydrated with a tube that goes into her stomach. because she can no longer swallow properly.

Jil is one of those people whose awakening from the coma has been interrupted. A condition that is difficult to conceive of. When you’re in a coma, you have an impairment of your gray matter which is very sensitive and which, in some patients, will unfortunately not recover.

Whereas, deeper structures, when you open the brain, when you open the brain, you have between the gray matter and the marrow, the brainstem which is older in the evolution of our species and also more robust, and which can therefore recover proper functioning, without the gray matter following.

There you have this very difficult situation to accept and it goes against our intuitions that you have someone who lives, who breathes because the brainstem has recovered, but who shows no sign of conscience, because gray matter is permanently damaged. When coming out of the coma,

All patients go through different stages of arousal. A non-responsive awakening or vegetative state. Only the vital functions are active at the level of the brainstem. The person does not respond to any stimulation, then a minimal state of consciousness called pauci-relational. The person gives a few signs of conscience

Like the pursuit of the eye. Normally, the patient coming out of a coma, then progresses to more elaborate communication. Some, like Jil, evolve slower over months, even years. Still others stop on the way to awakening. The little ear. Like all patients in a state of minimal consciousness,

Jil suffers from muscle hypertonia. It’s okay, we’re going to open this little arm. Deprived of all brain control, her spinal cord retracts her muscles in an anarchic way. – A little bit lower. The treatment begins with physiotherapy sessions. That’s it, no further than that. The physio with Jil,

It’s a daily fight against muscle retractions because she has hypertonia. You see from her right arm and her left foot. She can’t relax her muscles which are constantly contracted. These sessions are required to avoid joint deformation. Deformations that can become irreparable and require surgery. There it is. – They’re soft.

Medicine remains helpless in the face of patients in a vegetative state and minimal consciousness. At the Rehazenter, as in all centers specializing in awakening from coma, we seek above all to solicit the patient to accompany him on the path to awakening. We are really moving forward in permanent doubt,

In hypotheses and we always look for interactivity in the relation. This thread which is fragile, but which feeds on symptoms. Initially, with a facial expression that changes, which goes from retracted to indifferent, even serene, even a little smiling at certain times.

We cling a little bit to these little signs. We pinch our nose a bit there, like that. For the past few days, Jil shows very small signs of presence. There, she looks at us, she hears us. You can see she’s there in the room with us.

In the last 10 days, we have climbed a step, if only on the face. The face is striking. The face was completely indifferent. There she is expressive. Now you even give us a slight smile. She caught her father with her gaze. It doesn’t last long. Yes, great! Again on this side.

Yes, good! Now, it’s more than an awakening, it’s a return to consciousness. Yes, but that’s a conscience that’s still far away because you have to be aware of her condition. Awakening is the very beginning of taking charge of the other functions. It’s really the first level.

For those close to her, Jil’s progress is almost imperceptible, on the scale of a day, a week or even a month. Her progression can only be understood over an infinitely longer period. We need time for this type of patient.

We rarely have a prognosis at six months or a year. It is said that you have to wait many years, sometimes even up to five years, to have a state that is more or less stable and to make a really valid prognosis.

We never give up, but we still have this fear, the fear or uncertainty. It drives you crazy. If for months no reaction or improvement is seen. We still have hope, but fear is becoming more important. Uncertainty, fear, etc. You are aware that it could still really take months. Even years.

Even years. We have time. Yes. Hope and uncertainty are feelings common to doctors and families. What stage is Jil at? Are the signs she shows proof of a minimal consciousness? Can we hope to see her return one day to a conscious life? When doubt persists,

The patients of the Rehazenter are sent to the C.H.U of Liège. The neurology department receives men and women who never recovered from their coma. Patients from all over the world. This is where Jil came for a week of tests. Complex examinations aim to track down

To the smallest signs of consciousness in her brain. Jil! Professor Steven Laureys and his team at the Coma Science Group are benchmarks in research on altered states of consciousness. There, for the moment, is there a physio every day? You can ask her to close her eyes.

Steven Laureys’ expertise is based primarily on clinical examinations performed at the edge of the bed. Every morning, his team is going to test Jil’s level of consciousness based on the CRS-R, a coma recovery scale. – Good morning. – Hi Jil. I am a neuropsychologist. Jil, move your head.

This scale was designed to distinguish patients in a vegetative state from those in a minimally conscious state. Jil, squeeze my hand. – Jil, look at the cup. It is based on different criteria such as the recognition of objects, gaze tracking in a mirror or startle reflexes to noise.

Jil, move your feet. Jil, again. Move your feet. Yes! Jil! Move your feet really, really hard. Despite appearances, Jil’s movements may just be reflexes. According to CRS-R, Jil would be in a vegetative state. This review also has its limitations. This is why the Liège team relies above all on new technologies.

– It’s all right, ok? It’s all normal. It’s all good I stay close to you. Functional neuroimaging makes it possible to observe the anatomy of an organ, but also its activity. First examination for Jil, the PET-scan. Before going through the scanner, the doctors injected Jil with glucose, labeled with a radioactive product.

Half of the carbohydrates consumed by a human being are used to feed their brain. Glucose is therefore an excellent marker of neuronal activity. Your companion was in the room. He will be back, at three o’clock he will be in the room. You will be in sync.

At the moment, everything is fine. In red and orange appear the areas that consume the most glucose. These are the ones that still work. In green and blue, the parts of the brain in which the neurons have died. On the left, a healthy brain,

On which glucose consumption is evenly distributed. On the right is Jil’s brain. We therefore see with the examination of the PET-scan, something surprising. That is, the examination shows that there are still regions in the brain that are functioning. We see that the right side shows very reduced activity

While the left side has near normal activity. – There is half of the patient’s brain that works, can we say it like that? – Absolutely. You see it here too. Regions that are darker consume more sugar, more glucose. We really see that it is the whole hemisphere,

The whole left side which has a preserved activity. So there is a form of consciousness. Unresponsive vegetative clinical diagnosis would not be correct. Part of Jil’s neurons are still active, turning matter in her brain into subjective thought. Jil would therefore not be in a vegetative state,

But in a state of minimal consciousness. What does this really mean? Does Jil perceive the world around her? Is it possible to quantify, to measure one’s level of consciousness? Two days later, doctors are continuing to analyze Jil’s brain with MRI. The exam includes two types of sequences.

First, the production of anatomical images of the brain. These appear live on screens. Then functional MRI sequences. Functional MRI makes it possible to observe the oxygen consumption of certain areas of the brain when these are stimulated. Now we’re going to play your music for you.

You don’t move and you listen well to your music. By having Jil listen to one of her favorite songs, the team tries to stimulate the areas of emotion and memory in her brain. Functional MRI is a complex examination, sensitive to the slightest disturbance.

For Jil, this sequence will not do anything, probably because of small movements of her head, but that does not mean that she has remained insensitive to the music. To update the presence of a consciousness network in Jil’s brain, the doctors are going to try a new experiment

By measuring the nerve impulses that run through her mind. Here we are at the border between research and medicine. This test looks at the brain’s response to electrical stimulation. We see on the screen. The red dots are where we will stimulate.

There are different regions that are important for consciousness. We’re going to stimulate those areas and see the brain’s response, like a kind of electrical echo. It is with this machine that we are going to excite the neurons by sending targeted impulses. To measure the reaction generated in the axons,

The electroencephalogram technique is used. It is this helmet equipped with 60 electrodes that records the variations of nerve impulses in Jil’s brain. Afterwards, there are complicated calculations that reduce all responses to a single number. It’s important for us. It is an index that goes from 0 to 0.8.

If the value is greater than 0.3, we know that there is a form of consciousness like here for patients with a brain injury. The Coma Science Group team is the first in the world to have defined a consciousness score. Jil is one of the very first patients

On whom this assessment was carried out. – This test aims to answer the question, is there a conscience or not? The answer here is, that the consciousness score was at 0.4, which is greater than 0.3. There is therefore a form of consciousness,

As we observe in these patients in a state of minimal consciousness who are not with normal consciousness either. In this case, I think the answer is very clear. Yes, she is conscious, she has a chance of recovery, but no false hope.

The damage is significant, we have seen it. In the next six months, we are putting ourselves in the best conditions so that she can go as far as possible. Expecting communication? Yes. Is it guaranteed? No.

The current state of medicine does not make it possible to pierce the mysteries of Jil’s thoughts. The progress resulting from neuro-imaging is immense. According to Steven Laureys, these technologies make it possible to diagnose signs of consciousness in almost a third of patients who were previously considered to be vegetative.

After months, some of them are even susceptible to go even further in the recovery from the coma. – For a very long time, we thought that ultimately, this cerebral plasticity, this ability to produce new neurons and new connections in the brain was non-existent.

I learned again that we only lose nerve cells, neurons in our brain, we now know that is not true, that there is a capacity that we still do not understand well enough, certainly not as part of recovery from coma. I think that is precisely where the challenge lies.

It’s to understand why some patients recover and others don’t. What happens in the brain? Another dogma is that if you don’t see any improvement in the months or even a year following the accident, you will never see any again. We know this is also wrong.

We sometimes have patients who, years after the accident, still show small improvements. There, we must increase our efforts to better understand. So we hope to treat better. People in a vegetative or minimally conscious state did not exist 40 years ago. They were born from the progress of resuscitation.

No one today knows their exact number, probably several thousand in Europe. – Sir, there are your parents coming. So? – Look. How are you doing? – It’s not true. You are well awake. My little David, it’ is great. You are flawless here.

I don’t know what they did to you, but they brought you back to life. A kiss. You’re good, that’s good. Can you see me well? – Yes Impeccable. Since his accident a month and a half ago, David continued to make progress in his awakening from the coma.

His vital functions are stabilized. He is leaving the intensive care unit today. Show your mom how you move that arm. Show your mom that arm. Show me your arm. Show how you move the other arm. That one. Show her. – That one. Come on, raise your arm. Show me a bit.

He moves it a bit, but mostly his fingers. Okay. It recovers a bit. – It recovers. Is that a good sign? – Yes, it’s progressing. It’s progressing. You’re going to go to rehab now. You won’t have the same people taking care of you. It does not matter.

It will be the same, it will be the same thing. – I am not accompanying you. We shake hands. Good luck for the future. We are very happy to see you leave like this. However, you promise to come back. Yes, we’ll be back.

We will come back, but not under the same conditions. Goodbye. – Thanks for everything doctor. Goodbye sir. Particularity of the Saint-Étienne hospital, a rehabilitation department is located right next to the intensive unit. It allows rehabilitation to begin as quickly as possible,

Even in patients who still need medical supervision. Do you need help? Over there, the head. Lie back down No more than that, otherwise you’ll knock yourself out. Impeccable. Okay? – I’ll be back. – Do you know where you are? We are at…What is that called? Shit!

What is the name of the hospital? – What? What is the name of the hospital? We are at the CHU in Saint-Étienne, we are at the Hospital-Nord in Saint-Étienne. You, where do you live? In Ardèche. On Aubenas. Okay, very good. Can you tell me what year it is? In your opinion.

It’s 1968. In which year were you born? In 1938. In 1938? Are you sure? We’re going to tell you that. He was born in 1968. You were born in 1968 and we are in 2014. You are a bit lost. Don’t worry, we’ll take good care of you,

And then you will get your memory little by little. Things are going to fall back into place slowly. – This disorientation of the patient after a coma, is it common? Yes. I used to say that you don’t wake up from a coma like you wake up from a sleep.

We do not regain all our cognitive abilities overnight. This period of amnesia called post-traumatic amnesia can last more or less long. Sometimes it passes so quickly that we hardly have time to evaluate it. Sometimes it lasts much longer, sometimes very, very long.

The moments that we are living, David will not remember? From the information we have, in my opinion, he will not remember. We will ask him, but a priori, he does not print them, he does not integrate them as of today. Coming out of a coma invariably goes through

This period of post-traumatic amnesia. The patient is confused, disoriented, unable to memorize new information. He may also have forgotten whole sections of his past life. Faces, events. As for the coma period, it seems to have disappeared forever in the form of a black hole.

The hallucinations, the dreams that are sometimes assimilated to close death experiences would only be the effects of the drugs administered to the patient to put them into an artificial coma. We’ve been working for a while now. David must now reconnect with his past

Beyond the deep scar left by his coma. It’s Thursday. Okay. Are you a town hall employee? – Yes Are you a roadmender? – Yes Okay. – That’s it. What do you like to do in life, David? Everything? – Yes When you have free time, what do you do?

Fishing, in Saint-Quentin. In Saint-Quentin? Fishing in Saint-Quentin, right? Yes. Okay. Angling? Fly fishing with a spoon? – Yes It’s fishing. To fishing. – To fishing. It is on these little nothings of life before that the doctors will rely to help David find his bearings. Okay. It is good.

David is able to talk about things from his daily life, that he likes to go fishing, things like that. Yes! So that speaks to you, fishing. It’s your sport. That’s good because we can see if there are still small links

That are between now and before, that go over this coma hole. Same with the family too, we try to enrich then to weave well this before and this after, so that it becomes a little bit of a continuum knowing that the hole will remain. During his rehabilitation,

David will gradually restructure his memories, regain a global perception of his body. There, it’s back there. He will have to relearn the simplest gestures, reclaim forgotten sensations. Open your mouth. Does that make you happy? Yes, not bad. For David, it’s a form of rebirth. We continue.

Isn’t it too tight? – No Show me the right foot. It has been over a week since David started his rehabilitation. Is it spinning? – Yes, a little bit. We will take the time. His muscle tone, his sense of balance have progressed enough

For him to be able to perform an eminently symbolic act, walking. At the very end of the great corridor over there. No! On the next hit. Let’s go ? – Yes Go straight ahead. Lift your right foot up firmly. Come on, turn.

It feels good to come out of the coma. It’s getting worse and worse. It’s getting better and better, actually. – Yes. – Go ahead! Come on, spread your feet wide. These important first steps are only the first step. David has a long way to go. Turn to sit down.

Months of rehabilitation to regain consciousness, autonomy that will allow him to return one day to the outside world. Grab the armrest. Great! It feels good. It’s not bad. Are you putting the toe clips back on? – Yes Arnaud, we agree, I am not helping you. Act like I’m not there.

Arnaud was a victim of head trauma. He has been staying at Raymond Poincaré hospital in Garches for eight months. Here, therapists help people emerging from comas readapt to daily life. – What is the purpose of the exercise?

It is to see to what extent Arnaud would be able to redo a simple meal at the home where he will live later on leaving the hospital. To see if he puts himself in danger, if he puts in place strategies that are adapted,

If he would be able to do this again on his own at home. How do we do that? Do we have a right hand that could help us? Rather, it is the right hand that will hold the pot. It’s great. Arnaud tends to underuse this hand

Which is beginning to have very good functional recovery. He’s so used to using his left hand that he completely forgets to use his right hand. Arnaud took months to regain partial use of his right arm. He also suffers from aphasia, that is to say severe language disorders

And has organizational difficulties. He hadn’t done that to me the first time around. It’s original, Arnaud. You wanted to put the tomato in the pasta? Wasn’t that the place to put it? Where should the tomato sauce be put? Once it’s been… It’s not a big deal. It will still be good.

– How can the mistake just made by Arnaud be explained? There are several explanations. I think that on the one hand, as Arnaud was told at the start, he had a disorder called apraxia, which is not knowing how to use the simple objects of life.

For things a little more elaborate, he can still go on. There, it is also linked to an attention disorder, because as soon as he saw that I winced, he said: “Damn, I made a mistake”. He realized that wasn’t how he should’ve done it. Maybe a little more haste.

What is it, Arnaud? Doesn’t it work for what you put out? If that doesn’t work for you, try to find something else. – Aude, what’s the problem? I think Arnaud is looking for a colander to drain the pasta. Looking for something to pour the pan on. Is that what you want?

No. Look. Is this what you need? This t is not what you are looking for. Come on, bon appetit! So, overcooked, you won’t make the mistake twice. Cheers. After a coma, rehabilitation doesn’t allow a full return to the previous life. Rehabilitation work only accompanies a natural process of

Restructuring the still living cells in the brain. In a very natural way, cells that are only asleep will wake up little by little. What the brain tries to do is to use cells that are very much alive

To compensate for cells that are not working as well, which are damaged. At the level of motor skills, a cell that took care of a lot of part of the forearm will perhaps be able to turn away a little, to take care of the hand

And give function to the level of the prehension. Hi there! Hello Arnaud. Are you alright? – Yes So how did it go today? Since coming out of the coma, Arnaud was placed under the guardianship of his mother. Amal lives a few kilometers from Garches.

She visits him several times a week. We put a sling on your valid arm today to force you to work on the disabled arm, right? Already? So? Yes. It is good. Come on! Hey! You need to give me your hand now. Come on! Wow! Well done! Yes! Come on, let’s go.

Arnaud was a lumberjack pruner in the city of Paris. If he is in this state today, it is following an attack on his 27th birthday. A single kick to the head that caused head trauma. Arnaud remained seven weeks in a coma, between life and death.

Given everything we had been told, we thought he would be in a chair. That was nice. Because between walking and being able to communicate, since that was actually the challenge. What is essential after such a serious accident? What is essential?

Is it that he can see, hear or understand and respond? Participate in life? It sends us all back to a lot of reflections on life, on what is essential, etc. Great! It’s super pretty. Since his arrival in Garches, Arnaud has made very strong bound

With another patient, Nicola, a 37-year-old American. We choose a place in the sun, what do you think? Nearly a year ago, Nicola was the victim of a terrible accident. Hit by a motorcycle, she was in a coma for over a month.

Today, they share a lot of things, beyond words. There are things you cannot share with friends, even very close friends, but which are outside the hospital environment. Even if we love them, we adore them and the same for them,

There is still a limit to what they can understand, to what we can share and what we manage to express, etc. I think that with Arnaud, we do not experience the same thing, we are not always in the same sessions, etc.,

But it does a lot of good for me, so that it is bearable here. Yes! After nine months of rehabilitation, Nicola has recovered a good part of her abilities. She will soon leave Garches and resume her professional life. Nicola is a translator, she speaks four languages.

Luckily, the head trauma did not cause her any language impairment. Nicola keeps a few discreet cracks from her coma. There are things that seem difficult to me today, but which were not before. Like, preparing a meal, organizing a little coffee, planning my weekend, planning something,

Putting together a shopping list or even organizing my bags. Here, when I pack my bag to go to balneotherapy at the pool, it’s very nice, but I pack my bags and sometimes it’s beyond me. Bag for this, bag for that. Did I take the jersey, this or that?

I feel like I’m going to the moon. The small suitcase, the big bag, the other bags. These organizational difficulties are common to most brain-damaged people. They can be explained by immediate memory problems. The personal things, I’m going to put them in my handbag instead. To slightly sketch,

We will say that we have two main types of memory. We have memories of memories. I remember when I was a child, when I was 8 years old, I went on vacation to such a place. That’s a memory that’s extremely robust. It’s a memory stored somewhere in the brain

Where it’s hard to make it go away. We have the memory of everyday life, this memory is a bit like a USB key. At any time, we use a USB key to put information, use it and then delete it. When you go shopping, you tell yourself,

I’m making my shopping list, I’m thinking about taking it, I’m going to do my shopping, I don’t forget anything and I come back with the packages. If this memory does not work, we find ourselves with a major handicap. We can no longer manage a daily life.

Arnaud, he still has months of rehabilitation. The number one goal for doctors, to further improve his ability to communicate. I will bother you. What is this object called? What is its name? Scissors. Yes, it’s not bad. What is this? We open a door with a? Key. Key.. It is good.

It’s really good. It’s great. There is a lot of progress. Yes, thank you. There is a lot of progress in speech. We started from a stage where he did not understand the question. We were not trying to articulate words.

Now he has an understanding that is good, that needs to be backed up. You have to have clues. We all have a library with all the words that are stored. To find the words, all he need now are small clues for Arnaud to catch the right word.

This one, which box would you put it in? Lumberjack. Today, Nicola is leaving Garches hospital. We’re going to look at Facebook. I’ve already updated my status three times today. She leaves this small room where she spent many long months, away from the outside world.

I put a little link on YouTube for the song It’s a new dawn, it’s a new day, It’s a new life and I’m feeling good. Because it expresses well too. I want to share my joy with people and especially with my friends.

Is it the joy of leaving here? – It’s mostly the joy of progress. It’s not so much joy to leave here, there are things I’m going to miss. It is the joy of living, of being alive, of being well, of being stronger and stronger

And of having the ability to walk, of having the ability to use my hands, having the ability to do lots of things, even the ability to pack my bags. It fills me with joy, it makes me feel good. I am also happy, it is especially this joy of progress.

I think it’s a very concrete feeling of progression. Hi, how are you doing? There is a meal coming. Yay! Hello! How are you? Fine, thank you. And you? Good! Thank you very much. Fantastic! Great! Thank you! Bon appetit! The last meal in the hospital.

I’ll call you, I’ll tell you everything I do. I want to see all your progress too. Yes, but you’re doing plenty already I want to see you continue to make progress. Definitely. How do you do it? It’s amazing. It’s really good.

If you can do it, I can do it too. Hold on ! I do it with the right. Yes. I want to throw it out the window. Hi Gilloux! We finish our star meal. It’s my friend Gilles who came to pick me up with the car. Arnaud. Over the next few months,

Nicola will continue her rehabilitation near home, returning home every evening. After a coma, the reconstruction of a person can only be accomplished over several years. Without it always being possible to return to the life before. In the case of serious brain damage in young people,

There is only a 25% return to work three years after the end of rehabilitation. Arnaud, see you next time! Yes! See you again soon. Okay. Arnaud left Garches hospital four months after the end of this shoot. He now lives with his mother and continues his rehabilitation in a day hospital.

Jil returned to the Rehazenter in Luxembourg. She gently continues her slow return to consciousness. David, he left the C.H.U of Saint-Etienne by walking. He is now continuing his rehabilitation in a specialized center located near his village in Ardèche. I see that you are happy.