Consciousness as a Vital Sign
- Dr. Howard A. Friedman MD, founder of HHOM LLC
- Oct 18
- 4 min read
10-16-2025
By Dr. Howard Friedman, M.D. | Veteran | U.S. Army Medical Corps | Internal Medicine | HHOM LLC
Poem: "The Witness"
The monitor’s green line ascends and falls,
A pulse, a breath, a body's silent calls.
The blood-red numbers, steady and so clear,
Betray no hint of inner storm or fear.
The brain, a storm of chemicals and light,
A city bustling, shielded from the night.
Its secrets charted, mapped by cold design
A million neurons firing on a line.
Yet, past the current, past the rising heat,
Beyond the rhythm of the pumping beat,
A presence waits, a ghost the doctors miss,
A silent self that sees the precipice.
The witness watching from a quiet place,
The one who owns the pain upon the face.
The truth that lives inside the conscious soul,
Is not a part, but holder of the whole.
We measure everything, but miss the one,
Who holds the story till the course is run.
For what is healing, if not to repair
The fragile witness, breathing in the air?
---Dr. Howard Friedman M.D.
Introduction — The Missing Vital Sign
Medicine measures everything—heartbeats, temperature, oxygen, blood pressure—but not awareness itself. We chart the pulse, not the presence. The temperature, not the tenderness. The mind, which experiences all of this, remains unmeasured. This blog asks a simple question: what if consciousness itself is a vital sign—one that tells us more about life than any number ever could?
The Vital Signs We Never Chart
Heart rate and blood pressure tell us the mechanics of survival, but not the meaning of living. What’s missing is the quality of awareness—the “observer” inside the data. Emotional honesty, resilience, curiosity, and peace are not abstractions; they’re the inner diagnostics of health. A physician who listens for consciousness—who observes not just the body but the story—begins to practice a deeper form of medicine.
What the Brain Knows vs. What the Mind Experiences
The brain processes: the mind perceives. Neuroscience can map the “neural correlates of consciousness,” yet it cannot explain why red looks vivid or why grief feels heavy. This is the “hard problem” David Chalmers described—the uncharted gulf between mechanism and meaning. In practice, this gap matters. The scan may locate the tumor, but not the terror. The chart may show progress, while the patient feels despair. Healing depends on reconciling these two realities.
The Physiological Footprint of Awareness
Consciousness leaves traces. Mindful awareness lowers cortisol, slows heart rate, and alters neural firing patterns. Long-term meditation even reshapes cortical thickness. EEG studies reveal that complex neural activity in deep brain networks correlates with rich states of consciousness—more so than the frontal cortex alone. These findings hint at a measurable energetic quality of awareness, a kind of electrical signature of being alive.
How Self-Awareness Predicts Healing Outcomes
Self-awareness is not philosophy—it’s prognosis. A patient who can name their emotions and observe their thoughts can also regulate their physiology. Predictive processing theory tells us the brain constantly forecasts what it expects to feel. When those expectations are reframed—through mindfulness, therapy, or faith—symptoms themselves can shift. Healing becomes not only cellular, but conscious.
Conclusion — The Beginning
Every generation of medicine adds new measurements. We now know our glucose, our genomics, our microbiome—but not our consciousness. What we still lack is a way to chart the witness: that part of us that observes joy and sorrow, and chooses meaning through it all. Perhaps the next revolution in medicine will not be more data—but deeper seeing.
Closing Poem — “Charting Light”
We chart the blood, the breath, the beat,
Each number tidy, each result complete.
But who records the moment seen,
When pain turns gentle, when fear grows clean?
Not every cure begins with scans,
Some rise within the trembling hands—
A thought observed, a tear allowed,
The silent healing unannounced.
The chart can’t show the soul’s repair,
The shift from grief to being aware.
And yet, within that quiet turn,
The body listens, starts to learn.
So write it down, though no device can read:
“Consciousness intact — continues to lead.
-----Dr. Howard Friedman, M.D.
—Dr. Howard Friedman, M.D.
Board-Certified | Internal Medicine | Veteran | U.S. Army Medical Corps
Founder of Howard’s House of Medicine (HHOM LLC)
Frequently Asked Questions:
Q : Why isn’t consciousness considered a medical vital sign?
A: Because it cannot yet be quantified. Modern medicine depends on measurable data—heart rate, blood pressure, oxygen saturation—but consciousness is experiential. It doesn’t fit neatly into a graph. Yet every clinician knows when awareness changes, healing changes too. The absence of a number doesn’t mean it’s not vital—it means medicine hasn’t caught up to what life already knows.
Q: How does consciousness influence physical healing?
A: Awareness regulates physiology. When a person becomes mindful of stress, pain, or fear, the body’s autonomic balance shifts—cortisol lowers, heart rate steadies, immune function improves. Consciousness acts like an internal physician, guiding self-regulation and recovery. Healing begins when the patient starts to observe their experience, not just endure it.
Q: Can consciousness ever be measured?
A: Science is inching closer. EEG complexity, neural synchrony, and patterns in the default mode network all hint at measurable signatures of awareness. But true consciousness may remain beyond instrumentation—it’s not only electricity in the brain, but electricity with meaning. The next evolution of medicine won’t just measure life—it will listen to it.
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