Comas have frequently played major roles in movies but are seldom depicted accurately.
The loose representations can distort the public's view of this condition and perhaps even affect real-life decisions, researchers say.
In a study published in the May 8 issue of the journal Neurology, Eelco Wijdicks, a coma expert with the Mayo Clinic, concluded that only two out of 30 movies accurately represented comatose patients.
What it is
A coma is a deep state of unconsciousness in which individuals are alive but unable to consciously respond to their environment. Comas can result from injuries, such as head trauma or stroke, or from complications of an illness like multiple sclerosis.
Comatose patients sometimes have the ability to move and respond to external stimuli. They can often smile, open their eyes, and even appear to have the desire speak.
Patients in a coma usually emerge with a combination of physical and mental difficulties that typically involve a long road to recovery and require special medical attention during that time.
Physical difficulties can involve infections from feeding tubes and catheters, bedsores, disruption of regulatory processes, and muscle deformity. Mental complications could occur due to inhibition of the central nervous system, which includes the brain and spinal cord.
What it isn't
Hollywood gets comas wrong most of the time, though. In the movies reviewed, Wijdicks found that after long periods of comatose, most patients woke with little to no traces of difficulties.
In the 2002 film "28 Days Later," Jim, a bicycle messenger who has been in a coma, suddenly awakens, steps out of bed, pulls out his catheter and walks out of the hospital.
Similarly, in "Kill Bill Vol. 1," an awakening patient suddenly sat upright in bed with little effort.
The movie patients are also portrayed as "sleeping beauties" whose eyes are often closed. They generally look well groomed with good coloring and complexion. There are typically no feeding tubes, and the patients seem to somehow suffer no loss of muscle tone.
In a similar study published in the British Medical Journal last year, American soap operas were shown to paint an improbably rosy picture of coma patients, too.
Only 8 percent of comatose patients in soap operas died compared with the real life 50-percent death rate, the researchers of that study said. And those who survived fully recovered, whereas realistically just one in 10 regain their previous health—usually after months of intense rehabilitation, said the authors.
But it's all just fiction, right? Yes, but it turns out there's some cause for worry.
“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,” Wijdicks said.
After collapsing at the age of 26, Schiavo went into a coma followed by a permanent vegetative state from 1990 until her death in 2005, when the courts ordered doctors to remove her feeding tube.
The new study also surveyed movie viewers and asked them if the movie scenes might influence their decisions regarding potential family members in comatose situations.
More than one-third of the viewers said that they would allow the scenes to aid in their decision-making.
“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."
One of the reviewed movies, "Dream Life of Angels," portrayed a comatose patient with reasonable accuracy. The movie's physician also spoke rather realistically, according to Wijdicks and his co-author and son, Coen Wijdicks.
Here's what the physician said: “She is unconscious, she can’t communicate. She can’t talk or move. She won’t answer you. We are watching for any sign of her waking or of an improvement. Spend some time with her. If the sound of your voice triggers off a sign, let me or one of the nurses know. It’s very important.”
Many movies trivialize the portrayal of long-term comatose states and rarely show damage from injuries, cognitive disabilities, or emotional trauma.
"Come to think of it, to have a family member in coma is devastating and a tragedy," Wijdicks told LiveScience. "You cannot show it in any other way."