Coma misrepresented in movies

ST. PAUL, Minn. Coma is often misrepresented in movies, which could skew public perception of coma and impact real-life decisions, according to a new study published in the May 9, 2006, issue of Neurology, the scientific journal of the American Academy of Neurology.

In a review of U.S. and foreign movies, only two out of 30 movies with characters in prolonged comas showed a reasonably accurate representation of coma, according to study author and coma expert Eelco Wijdicks, MD, Fellow of the American Academy of Neurology, a neurologist with the Mayo Clinic in Rochester, Minn.

Problems included showing a comatose person suddenly awakening with no physical or mental problems after many years in coma and portraying the comatose person as a "Sleeping Beauty" with no loss of muscle tone or feeding tubes and with perfect grooming and tanned complexions. All but one of the movies showed the comatose person only with closed eyes, when in reality people in comas often have their eyes open and can open their eyes in response to speech and pain.

Wijdicks and his son, Coen Wijdicks, who is working on a master's degree in anatomy and cell biology at Rush University in Chicago, IL, reviewed comedy, drama and thriller films made from 1970 to 2004 to identify the 30 movies in the study, which is published in Neurology's "Views & Reviews" section. They then showed clips of 22 scenes from 17 of the movies to 72 people with no medical training and surveyed them on the accuracy of the portrayal of coma.

"More than a third of the time the viewers weren't able to identify important inaccuracies in these scenes," Eelco Wijdicks said. "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."

One comedy showed a comatose person tapping out a message in Morse code with his finger. Thirty-one percent of those surveyed thought that this behavior was possible.

The researchers also sought to determine how much impact these movies may have on the public's decision-making. Survey participants were asked 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."

More than a third of the viewers, 39 percent, said that they would allow the scenes to 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 mispresentation in both U.S. and foreign moves is problematic. We have some concerns with using coma and awakening in comedies. A neurologist's review of the script or an actor visiting a NeuroIntensive Care Unit may be helpful to screenwriters. The public has become more sophisticated in their medical knowledge and we presume they would appreciate a more accurate display of devastating neurologic injury."

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The American Academy of Neurology, an association of more than 19,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating, and managing disorders of the brain and nervous system such as Alzheimer's disease, epilepsy, Parkinson disease, multiple sclerosis, and stroke. For more information about the American Academy of Neurology, visit www.aan.com.


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