CUT! Neurologist to moviemakers: Your comas are all wrong

In "Kill Bill," the Bride wakes up suddenly. She remembers everything that's happened to her, and almost immediately gets into a life and death struggle -- first with a man and then with a woman.

She's lucid. She's in charge. And she seems to have a lot of strength for a woman who has been in a comatose state for four years.

Mayo Clinic neurologist Dr. Eelco Wijdicks says a portrayal of rapid and complete recovery from coma is common -- and totally wrong. He also says movies even get it wrong when a person is still in a coma.

"Patients are represented by actors and are beautifully groomed," he explains. "They do not represent the atrophy and ulcers that often are seen in prolonged coma. They look as though they are asleep."

As a research neurologist, Wijdicks works with coma on a regular basis. He wanted to examine how the public perceived coma. He culled examples from 30 dramas, comedies and action films. Then he showed the clips to 72 adults with at least some college education. Most worked at the Mayo. He found most couldn't identify a bad representation of coma in more than one-third of the scenes.

"That would suggest to the public that this is not so much of a tragedy," he says. "Just wait for the patient to awaken, and if the patient awakens he will be just fine. And will go on with his life." About 40 percent of participants said the movies would influence decisions they made about treating relatives in comas.

The problem here is that would suggest to the public that coma is not so much of a tragedy.

Dr. Wijdicks says it would be too speculative to suggest these portrayals might influence public policy decisions. But he says a distorted public perception of coma could lead to inappropriate expectations. And he wonders what people with less contact with the medical world or less education would think about these same movies.

Wijdicks only found two movies that gave relatively accurate depictions of a person in coma. One was the French film "The Dreamlife of Angels." The other was the 1990 movie "Reversal of Fortune," which recounts the notorious case of an aristocrat, Claus von Bulow, who may have tried to murder his wife, Sunny.

In the movie, Sunny lies face down on the bathroom floor. In a voiceover, she describes how her pulse and her temperature drop. Later, you see her in a hospital bed with her hands turned in awkwardly and the color drained from her skin. She maintains her physical composure, which Wijdicks says isn't typical with patients in a comatose state.

When a person does come out of a coma, Wijdicks says it's often very slowly. Their motor skills return incrementally. Depending on what caused the coma, there can be intellectual, physical or psychological damage.

Wijdicks acknowledges that feature films are fiction. They're aimed at evoking an emotional response. But he says that doesn't mean they have to be inaccurate. If military advisors and historians can be found on set, he says, why not a neurologist?

Dr. Eelco Wijdicks' study is published in the May issue of the journal Neurology.

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