The case of Terri Schiavo illustrates how misconceptions about a coma can cause problems for doctors and families, say researchers who are raising concerns about how comas are portrayed in film.
Schiavo, 41, was an American woman in a coma whosefeeding tube was removed over the objections of her parents.
Cinematic portrayals of comatose patients are often far-fetched, neurologistsin the U.S. found after reviewing 30 U.S. and foreign movies depicting characters in prolonged comas. The study is in Tuesday's issue of the journal Neurology.
Dr. Eelco Wijdicks of the Mayo Clinic in Rochester, Minn., showed scenes to a panel of neuroscience experts and asked them to assess the accuracy of the portrayals.
The study's authors then played the same clips to non-medical viewers andasked themwhether the scenes would influence their thinking about comas.
"When people see [a good outcome] in the movies, they hope for that," said Dr. Janis Myasaki, a neurologist at Toronto Western Hospital who wasn't involved in the study. "We don't want to take away people's hope, but at the same time, it gives them an unrealistic expectation."
People such as Schiavo who remain in a persistent vegetative state for months or years often bear little resemblance to their former selves.
Movies paint false pictures
Movies tend to portray a comatose person as a "Sleeping Beauty" who suddenly awakens with no physical or mental problems.
In reality, patients who are comatose have wasted muscles, as well as bladder and bowel incontinence. If they do wake up, they need years of rehabilitation that are seldom depicted on the silver screen.
The study's authors did single out two movies, Reversal of Fortune and The Dreamlife of Angels, for portraying the agony of waiting for someone to awaken and the complexity of care they need.
Screenwriter Carol Hay felt it was important to be as accurate as possible in her film Waking Up Wally, a TV movie about Walter Gretzky's recovery from a coma.
"It's hard for screenwriters to resist a good coma," Hay said. "It's great, like what's going to happen when he wakes up; is he going to know me, not know me, be a different person? I mean, it's pretty dramatic."
Directors and writers should wake up and realize viewers are more sophisticated in understanding medical issues and would appreciate greater accuracy on the screen, the study's authors conclude.
- Screenwriters use coma less in comedies, a genre that could ridicule the illness.
- Actors portraying those in coma could visit a neurology intensive-care unit or rehab centre to observe patients.
- Producers could ask a neurologist to review screenplays.