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It's Not a Real Coma, It Just Looks Like One

Movie portrayals of the condition can mislead people, producing real-life consequences, study says

WEDNESDAY, May 10, 2006 (HealthDay News) -- Hollywood may do a masterful job of portraying many of life's gravest ills, but when it comes to depicting comas, the film industry deserves two thumbs down, a new study contends.

Wrong or misleading portrayals of a coma can possibly lead to confusion among people who have to make real-life decisions about a loved one in the grip of this profound state of unconsciousness, the researchers said.

In their study, Dr. Eelco Wijdicks, a neurologist at the Mayo Clinic in Rochester, Minn., and his son, Coen Wijdicks, who's working on a master's degree in anatomy and cell biology at Rush University in Chicago, reviewed 30 American and foreign films that had characters in prolonged comas. Their finding: Only two of the films -- Dream Life of Angels and Reversal of Fortune -- offered a reasonably accurate portrait of a coma.

Among the problems the father-and-son researchers spotted was a coma patient suddenly awakening after many years with no physical or mental problems. Also, coma patients were often filmed as "Sleeping Beauty," with no loss of muscle tone, or feeding tubes, and perfect grooming with deep tans.

What's more, in all but one movie, coma patients were shown with their eyes closed. In reality, patients in comas often have their eyes open, or can open their eyes in response to speech and pain, the researchers noted.

Among the movies that offered flawed depictions of a coma, the researchers said, were: Kill Bill: Vol. 1, Rocky II, Dead Zone and 28 Days Later. The study findings appear in the May 9 issue of Neurology.

The Wijdickses showed clips of 22 scenes from 17 of the movies to 72 people who had no medical training. "More than a third of the time, the viewers weren't able to identify important inaccuracies in these scenes," Dr. Wijdicks said in a prepared statement. "We are concerned that these movies can often be misinterpreted as realistic representations, especially in the wake of the Terri Schiavo tragedy and public debate."

In the Schiavo case, which transfixed the nation, the 41-year-old Florida woman died last spring after doctors removed feeding tubes that had kept her alive for 15 years while she was in a persistent vegetative state.

And one comedy reviewed by the Wijdickses showed a coma patient tapping out a message in Morse code with his finger; 31 percent of the laypeople watching thought this was possible, the researchers reported.

The researchers also asked study participants how strongly they agreed with this statement: "If my family member would be in the same situation, it is possible that I would remember what happened in the scene and allow it to influence any decisions that I would make."

Thirty-nine percent said these scenes would influence their decisions.

"We understand that making motion pictures is an art form and that entertainment is a very important component of that art form," Wijdicks said. "But this misrepresentation in both U.S. and foreign movies is problematic."

A similar study published last year by U.S. researchers in the British Medical Journal was critical of American TV soap operas' portrayal of comas, saying the public could draw false conclusions about the serious nature of an actual coma.

One expert agrees that the way comas are portrayed in films can lead to unreal expectations for the recovery of real patients.

"This article adds to the growing evidence that media portray health-related issues in a misleading way," said Dr. David Casarett, a physician at the Philadelphia VA Center for Health Equity Research and Promotion, who authored the study on soap operas and comas. "Although we all know, at some level, that movies are not real, the impressions that they create are nevertheless quite vivid."

"We know that Uma Thurman didn't really wake up suddenly and walk out of the hospital (in Kill Bill: Vol. 1), but that image is hard to forget," Casarett said. "That image, and others like it, can create unrealistic expectations of recovery and survival."

Dr. David L. Katz, an associate professor of public health at Yale University School of Medicine, said he thinks movies should stick to make-believe, and people should look for help from real-world doctors.

"When media purport to convey reality, they should do it accurately," said Katz, who's also director of the university's Prevention Research Center. "But when the emphasis is on entertainment, the public should know not to rely on movies as guidance when it comes to medical decision-making in the real world."

More information

To learn more about comas, visit the National Institute of Neurological Disorders and Stroke.

SOURCES: David Casarett, M.D., physician, Philadelphia VA Center for Health Equity Research and Promotion; David L. Katz, M.D., M.P.H., associate professor, public health, and director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; May 9, 2006, Neurology
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