Saturday, December 15, 2007

Writing About -- Comas

Dear Dr. Josh,
My question has to do with comas. I've been told that people in comas sometimes hear, but cannot respond. My ex-husband went into a diabetic coma when he was 13, and though he was immobile and couldn't open his eyes or speak, he remembered hearing the doctor telling his mother he was going to die, and his mother crying.

Is it possible to bring a person out of a coma (or speed their recovery) by external stimulation, such as reading or talking to them, or playing music, or by touching them? If not, then is it possible for a person who comes out of a coma on their own (whatever that is!) to remember things that were said to them while they were in a coma?
-- Sherrie

Dr. Josh: Well, coma is a tricky word... it basically refers to a level of unconsciousness, which can be due to a number of different conditions. Novelists' comas are like novelists' amnesia - useful in a plot sense, but not very realistic.

Coma states vary in the level to which they alter someone's level of consciousness - we have multiple scoring systems used to evaluate them. They can be short-lived, often seen with severe infections requiring hospitalization, shock from blood loss, metabolic disturbances (as your husband had), or drug-induced (e.g., modern anesthesia intentionally induces a comatose state with short-acting drugs continuously infused). These are usually completely or nearly completely reversible, depending on the amount of permanent brain damage.

Longer comas usually result from a neurological insult - stroke, bleeding inside the head, brain damage from shock, or, as we commonly see, brain damage after cardiac resuscitation (loss of blood flow for minutes can cause very profound levels of brain damage. Those are usually reversible to a certain extent, but with increasing severity of the coma, the likelihood of a person emerging decreases. However, people can come out of them after either months or decades; the bad news is that they often have persistent neurological deficits.

As for your question, well, it depends on what caused the coma, and I assume you mean a longer coma (though I could be wrong). Modern medical science doesn't really have a good answer as to whether external stimulation can bring someone out of a coma. But since people rarely accept this as an answer, why should you? Many friends & family members of patients say they feel that stimulation helps their loved one to be more aware. I honestly haven't seen it myself as yet, but stimulation is unlikely to make matters worse.

Take three pictures and write a short story.

1 comment:

Anonymous said...

Hi Aimee!
ENjoyed much of your site but don't have time to read all of it now, (fighting a rather ridiculous deadline).

If your interested in a 'literary challenge,' email me at naturalhorse101@aol.com

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