Summary & Study Guide - Into the Gray Zone - Lee Tang - ebook

The Borderland Between Life and DeathThe must-read summary of “Into the Gray Zone: A Neuroscientist Explores the Border Between Life and Death” by Adrian Owen.The “gray zone” is the twilight region between full consciousness and brain death. People with sustained brain injuries or victims of strokes or neurodegenerative diseases, such as Alzheimer’s and Parkinson’s are often in the gray zone. Many of them are oblivious to the outside world, and their doctors and families often believe they are incapable of thought. But 20 percent of them are conscious although they never respond to any form of external stimulation.This complete summary of Adrian Owen’s book tells how Owen pushes forward the boundaries of science, using a variety of brain scans and brain-computer interfaces, to find patients who are in the gray zone and communicate with them. It sheds a light on how we pay attention and remember, and how the brain-computer interface technology is changing the prognosis for people with impaired brain function and creating the possibility of telepathy and augmented intelligence.This guide includes: Book Summary—The summary helps you understand the key ideas and recommendations. Online Videos—On-demand replay of public lectures, and seminars on the topics covered in the chapter.Value-added of this guide: Save time Understand key concepts quickly Expand your knowledgeRead this summary and reflect on what these fascinating borderlands between life and death have taught us about being human.

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Table of Contents

Title Page



Books by Lee Tang



1. The Ghost that Haunts Me

2. First Contact

3. The Unit

4. Half-Life

5. Scaffolds of Consciousness

6. Psychobabble

7. The World as Will

8. Tennis, Anyone?

9. Yes and No

10. Are You in Pain?

11. Live or Let Die

12. Alfred Hitchcock Presents

13. Back from the Dead

14. Take Me Home

15. Reading Minds


About the Author

Summary &Study Guide

Into theGray Zone

A Neuroscientist Explores the Border Between Life and Death

Lee Tang

Title: Summary & Study Guide - Into the Gray Zone

Subtitle: A Neuroscientist Explores the Border Between Life and Death

Author: Lee Tang

Publisher: LMT Press (

Copyright © 2017 by Lee Tang

All rights reserved. Aside from brief quotations for media coverage and reviews, no part of this book may be reproduced or distributed in any form without the author’s permission. Thank you for supporting authors and a diverse, creative culture by purchasing this book and complying with copyright laws.

First Edition: September 2017 

Issued in print and electronic formats.

ISBN 9780995943193 (ebook)

ISBN-13: 9781976076565 (paperback)

ISBN-10: 1976076560 (paperback)

Limit of Liability/Disclaimer of Warranty: The publisher and author make no representations or warranties regarding the accuracy or completeness of these contents and disclaim all warranties such as warranties of fitness for a particular purpose. The website addresses in the book were correct at the time going to print. However, the publisher and author are not responsible for the content of third-party websites, which are subject to change.

To my wife, Lillian, who is the source of energy and love for everything I do, and to Andrew and Amanda: watching you grow up has been a privilege.


For a complete list of books by Lee Tang and information about the author, visit


“Into the Gray Zone: A Neuroscientist Explores the Border Between Life and Death” by Adrian Owen.

Book Abstract

The book explains how traumatic brain injuries sustained by patients impact various parts of the brain, and what long-term consequences they produce. It writes about the cutting-edge procedures used to establish whether patients diagnosed as vegetative are cognizant of their surroundings. Each chapter details the author’s experiences while working with specific patients and their families. The brain injury sustained by the patients has placed them in the "gray zone"—the twilight region between full consciousness and brain death.


Adrian Owen is a world-renowned neuroscientist who has conducted research involving cognitive abilities in people with traumatic brain injuries. He is the Canada Excellence Research Chair in Cognitive Neuroscience and Imaging at The Brain and Mind Institute, Western University, Canada.

Important Note About This Study Guide

This guide is a summary and not a critique or a review of the book. It does not offer judgment or opinion on the content of the book. This summary may not be organized chapter-wise but is an overview of the main ideas, viewpoints, and arguments from the book. It is NOT meant to be read as a replacement of the book which it summarizes but, instead, a supplement for review of the book's main premises and to provide commentary and additional resources.


Before the accident seven months ago, Amy was a smart college-varsity basketball player with everything to live for. She had left a bar one night with a group of friends when she accidentally toppled, slamming her head on a concrete curb. The head injury had damaged the axons and blood vessels in critical regions of the brain. Now Amy was in a vegetative state and would require round-the-clock care for as long as she lived. The doctors had asked Amy’s parents if they would consider taking her off life support and allow her to die. But Amy’s parents were not ready to take that step. They signed a consent form to allow Adrian Owen at Western University’s Brian and Mind Institute to put her in a fMRI scanner and search for signs that Amy was still there.

Neuroscientist Adrian Owen specializes in assessing patients who have sustained acute brain injuries or suffered from neurodegenerative diseases such as Alzheimer’s and Parkinson’s. After five days of intensive investigation, Adrian and his team found that Amy was all along conscious, but could not move a muscle to tell.

Amy’s life changed following the scans. Knowing she was conscious, her mother barely left her bedside, reading to her constantly. Friends and relatives visited her regularly and threw birthday parties for her. She went home on weekends and was taken to the movies. Every intervention, drug, and change of routine was carefully explained to her by the care staff.


THE VEGETATIVE STATE is only one realm of the gray zone, the others are coma, and minimally conscious. Comatose people do not open their eyes and look unaware. People in the minimally conscious state, however, can occasionally, but rarely, show they’re aware. Do not confuse the vegetative state with locked-in syndrome, which is not a gray-zone state. Locked-in people are conscious and can blink or move their eyes.

Into the Gray Zone is the story of how Adrian Owen and his team figured out how to contact people in the vegetative state. They discovered that 15 to 20 percent of vegetative-state patients are conscious despite their appearance.



When Adrian Owen was a young neuropsychologist at the University of Cambridge in 1988, he felled in love with Maureen, a Scottish neuropsychologist living in Newcastle upon Tyne. After months of commuting between Cambridge and Newcastle upon Tyne, Adrian and Maureen both moved down to London and shared a small apartment.

Maureen was deeply affected by the patients at the Maudsley Hospital and the Institute of Psychiatry where she worked. She became a psychiatric nurse and spent long evenings out with her new colleagues while Adrian stayed home working on his scientific papers. Within a year, their relationship fell apart. Adrian met someone else and left Maureen in 1990 just as the UK housing market collapsed. Their £60,000 apartment was worth £30,000. To make the mortgage payment, they had to rent the apartment to friends. Maureen and Adrian were no longer on speaking terms.

The same year, Adrian’s mother experienced blinding headaches and could see nothing in her left visual field. A CT scan showed she had a cancerous tumor inside her brain pushing its way into her cortex, interfering with her behavior, affecting her moods and her vision. Soon she slipped into her own gray zone and died in November 1992.

After his mother’s death, Adrian accepted a three-year postdoctoral position at the Montreal Neurological Institute (the Neuro) in Canada.


ADRIAN ARRIVED AT the Neuro at the end of 1992 to work with Michael Petrides, the head of the Department of Cognitive Neuroscience. This was the year the positron-emission tomography (PET) “activation studies” took off. PET allows neuroscientists to capture digital images of the brain in action. Volunteers for PET activation studies would lie in the scanner and be injected with small amounts of a radioactive tracer and then asked to do a task. During scans, some parts of the brain work harder than others, depending on the patient’s thought, actions, or emotions. Active areas of the brain attract more blood. Because the blood has been tagged with radioactivity, the PET scanner sees where it goes. It was a neuropsychologist’s dream come true. They need not wait for a special patient with damage to one specific part of the brain to deduce what that brain area does.

But the PET technology has its limitations. The first limitation is “