December 24, 2005
Soap Operas Paint Rosy Picture of Comas
Researcher says viewers could gain unrealistic expectations of condition
When is a coma nothing like a coma?
When it's a fictional coma, as depicted on the wildly popular daytime dramas warming the electronic hearths of America's living rooms.
A new study suggests, perhaps unsurprisingly, that soaped-up comas are fanciful constructs that have little to do with the real thing -- leading the public to draw false conclusions about the true and serious nature of an actual coma.
"It's unnerving that not only are soap characters more likely to survive, but their recovery process is amazingly rapid," said study author Dr. David Casarett, an assistant professor at the Center for Health Equity Research and Promotion in Philadelphia. "They go from being in a state of coma one day to walking down the runway as a fashion model the next -- with several romantic liaisons in between."
According to the National Institute of Neurological Disorders and Stroke, comas are characterized by a deep state of unconsciousness generally lasting two to four weeks, brought about by either a traumatic injury or an underlying illness.
A prolonged "persistent vegetative state" can last much longer -- years or even decades -- plaguing patients with severe discomfort, bone deformation and deadly infections.
Recovery from a coma is often unpredictable and partial. Depending on the amount of neurological damage incurred, a patient may face a wide array of physical, mental and emotional difficulties.
Casarett's team stacked this often grim reality against the fantastical world of nine soap operas airing between 1995 and 2005, including: Guiding Light, General Hospital, One Life to Live, Days of Our Lives, All My Children, Passions, As the World Turns, The Young and the Restless and The Bold and the Beautiful.
The researchers noted that between them, the programs are watched by more than 40 million Americans. An additional 90 countries acquire the shows for their domestic markets.
The authors scanned the Internet for episodes in which characters remained unconscious for a minimum of 24 hours following an accident or medical crisis.
Initially, 73 soap characters were identified as having had comas, but nine had to be culled because they had faked their condition, caused their own demise by popping pills, incongruously woke to eat while supposedly still unconscious, or had a strange outcome that could not be characterized one way or the other.
In the Dec. 24/31 issue of the British Medical Journal, Casarett and his colleagues report that, all told, soap comas bore little resemblance to actual comas.
The 64 soap patients spent an average of 13 days in a coma, and almost 90 percent experienced full recovery. Another 8 percent died, while 3 percent remained in a persistent vegetative state by the end of the study period.
The researchers pointed out, however, that the death figure really came in even lower, with two characters later revealed to have lived on to tell their tale. In one case, a supposedly dead coma patient was, in fact, nothing but a mannequin.
Non-fiction coma survival rates come in, by contrast, at under 50 percent.
Soap characters also faced much better odds for experiencing a full and speedy recovery. Half the characters staged their dramatic comebacks within one month, while almost all had bounced back completely within three months.
Eighty-six percent of the characters appeared to have absolutely no disability -- other than the occasional bout of amnesia -- on their very first waking day. The rest eventually walked away as healthy as the day they were born.
Casarett and his team said that in the real world, by contrast, regaining full function after a coma is very unusual. They noted that less than 10 percent of patients who suffer a coma after a non-traumatic injury gain complete recovery.
They concluded that soap opera patients are extremely, and unrealistically, lucky -- shot through a far-too-rosy lens that downplays the hard rehabilitative work patients typically must endure during recovery.
"Soap operas are really compelling narratives that encourage people to get involved and stay involved, which makes them fairly powerful in changing the way people think and act," said Casarett.
While stressing that he respects the intelligence of the average soap fan, Casarett emphasized that the question is not so much about smarts as it is about hidden messages absorbed subconsciously through repeated exposure to riveting, but misleading, stories.
"So, no, I don't think it's realistic to take out the shipwrecks and the face transplants and the alien abductions," he said. "But I would balance those entertaining elements with other elements that are more realistic."
Tari Signor -- the actress currently chewing scenery as the scorned vixen Margaret Cochran on ABC's One Life to Live -- has not yet, herself, had the good fortune to act comatose. But she puts the coma question in context.
"At one point, I was living in a house that I blew up and the roof caved in and the beams fell down and almost killed the man that I had abducted and been holding prisoner for a month to make him impregnate me," she recalled. "And the very next day, he was totally fine and the house was completely fixed, as if I had rebuilt it myself overnight."
"So with that, or with a coma, we just go with it and say, 'It's just a soap opera,' " said Signor. "I really don't think people take it literally. On the other hand, it does seem that people watch prime time medical shows like "ER" and think, 'They're not leading me astray, so this must be true.' So I understand how maybe there's some confusion. But still -- 'it's just a soap.' "
For more on comas, check the National Institute of Neurological Disorders and Stroke.