A remarkable case of a boy born without the cerebral hemispheres traditionally thought necessary for self-awareness is forcing scientists to reconsider longstanding beliefs about the nature of human consciousness, according to a provocative new account published on June 1 by Mind Matters News (mindmatters.ai). The report details the life and case notes of a child pseudonymously called “Joey,” who, despite being born with hydranencephaly—a devastating condition that obliterates most of the cerebral cortex—demonstrated clear signs of consciousness and a rich range of emotions, fundamentally challenging many of neuroscience’s most prominent theories.
Contemporary neuroscience overwhelmingly attributes consciousness to the cerebral cortex—a wrinkled outer layer of the brain lauded as the seat of awareness, memory, perception, and thought. According to Integrated Information Theory (IIT), Global Workspace Theory (GWT), and other mainstream academic models, consciousness is thought to “emerge” from the vast computational complexity of billions of interlinked cortical neurons (Nature Reviews Neuroscience). Without a cortex, it was thought, consciousness could not exist.
Yet Joey, one of many children with severe hydranencephaly around the globe, appeared to shatter these assumptions. “He was unequivocally conscious—without a cerebral cortex and even without brain hemispheres,” recounts the author, a veteran neurosurgeon, in the Mind Matters feature. Joey responded to his caregivers with delight, affection, distress, and an observable awareness of his surroundings. Despite his inability to walk, speak, or perform tasks requiring higher brain functions, those who knew him best describe him as a friendly, responsive, and emotionally expressive child.
This revelation was especially striking for the attending physicians and neuroscientists, as it contradicted nearly every materialist theory that dominates Western neuroscience. The traditional materialist paradigm, heavily influenced by the Cartesian tradition and epitomized in the view of humans as “meat machines,” argues that subjective experience and sense of self are entirely products of coordinated neuronal activity in the cortex. Without this complex “workspace,” leading academic models would predict the absence not simply of thought, but of consciousness altogether (Stanford Encyclopedia of Philosophy).
Such cases, however, suggest that consciousness might not be so easily explained. A few prominent researchers, such as neuropsychologist Mark Solms, have begun to suggest that more primitive brain structures—the brainstem, for example—could be responsible for the phenomena of awakening and basic awareness (Mark Solms, “The Hidden Spring”). The brainstem, which Joey retained, is responsible for basic alertness and arousal—key features of consciousness. But even Solms’ position is controversial, as most neuroscientists still contend that genuine, subjective consciousness is impossible without a significant amount of cortex.
The underlying question is not merely academic. For decades, cases like Joey’s have repeatedly surfaced in pediatric neurology but often were dismissed as medical anomalies, or explained away as misread behaviors (ScienceDirect). A growing body of research, however, indicates that children with hydranencephaly do react meaningfully to their environment, recognize familiar faces, experience joy and discomfort, and communicate emotions through vocalizations and expressions.
The Mind Matters article’s author, drawing from decades of neurosurgical experience and referencing the philosophical history of the mind-body problem, contends that such cases expose the limits of materialist explanations. He goes so far as to suggest that basic consciousness may emanate not from the brain’s physical substrate, but from a non-material “soul” possessed equally by all humans—a perspective more in line with long-standing metaphysical traditions than with modern scientific materialism.
This suggestion is not without critics. While religious and dualist philosophies have long posited the existence of an immaterial soul capable of awareness independent of the body, most contemporary scientists remain committed to finding an answer within the physical structures of the nervous system. “The critical challenge remains for our empirical methods to distinguish genuine consciousness from reflex,” said a prominent neurologist at Bangkok’s Siriraj Hospital. “But anecdotal cases like these remind us that science must grapple honestly with outliers, not simply dismiss them.”
Thai medical educators have also noted the philosophical and cultural implications of such findings. In Thai Buddhist tradition, consciousness (วิญญาณ, viññāṇa) is treated as a fundamental aspect of existence, not reducible to physical form. “The case of children like Joey calls us to humility regarding the nature of mind,” observed a professor of philosophy at a leading Bangkok university, drawing parallels between Western debates and classical Buddhist teachings. “It forces us to question how much modern neuroscience can really say about the ‘self’.”
The broader scientific community is now being compelled to revisit its most fundamental assumptions. If children without cortices can nonetheless experience basic states of joy, fear, and social connection, this may open the door to new theories that better integrate evidence from real-life cases. In Thailand, where neonatal care and the education of neurologists draw on both Western and local traditions, cases like Joey’s have intensified dialogue over the limits of brain-based reductionism.
In the international arena, high-profile research efforts such as those at the Allen Institute for Brain Science, and proponents of Integrated Information Theory, have responded to such challenges by refining their ideas but largely maintaining their foundational commitments (Allen Institute). GWT, IIT, and competing models all face a difficult task: explaining how subjective experience arises and why, in the face of evidence to the contrary, damage to the cortex doesn’t always erase consciousness.
From a public policy perspective, these findings may also impact end-of-life care, organ donation protocols, and the treatment of patients in vegetative states. While Western legal systems often use criteria of cortical activity to determine death or incapacity, the Mind Matters report raises pressing ethical dilemmas for medical practitioners, lawmakers, and religious authorities in Thailand and beyond (The Lancet Neurology).
The historical resonance is further deepened by examining cross-cultural attitudes towards consciousness. Thai society, steeped in Theravada Buddhist and animistic beliefs, often embraces holistic perspectives on the continuum of body, mind, and spirit. This contrasts with the prevailing reductionist approaches of Western academia, reminding readers that science and culture are often woven together in how societies approach the mystery of awareness.
Looking ahead, the story of Joey and others like him is likely to accelerate efforts to develop a more nuanced, pluralistic understanding of consciousness. Some researchers advocate for a radical shift away from purely cortical explanations, aiming instead to study the interplay of all brain regions, or to revisit ancient philosophies that treat mind and body as inseparable (or distinguish but do not collapse the physical and the conscious).
For now, the practical takeaway for Thai readers is to approach claims about the “seat of consciousness” with healthy skepticism. Families of children with severe neurological challenges should be informed of the potential for emotional connection and quality of experience, even when prognosis seems dire by standard medical criteria. For the medical profession, humility, empathy, and respect for both science and lived experience should guide care for those who defy conventional explanation.
While the scientific community continues its quest for answers, cases like Joey’s remind us that the human mind—and consciousness itself—remain, in many ways, the greatest mystery of all. Readers interested in the full discussion and its philosophical ramifications can explore the original Mind Matters feature here.