Background: Coma has been a theme of screenplays in motion pictures, but there is no information about its accuracy.
Methods: The authors reviewed 30 movies from 1970 to 2004 with actors depicting prolonged coma. Accurate depiction of comatose patients was defined by appearance, the complexity of care, accurate cause of coma and probability of awakening, and appropriate compassionate discussion between the physician and family members. Twenty-two key scenes from 17 movies were rated for accuracy by a panel of neurointensivists and neuroscience nurses and then were shown to 72 nonmedical viewers. Accuracy of the scenes was assessed using a Likert Scale.
Results: Coma was most often caused by motor vehicle accidents or violence (63%). The time in a comatose state varied from days to 10 years. Awakening occurred in 18 of 30 motion pictures (60%). Awakening was sudden with cognition intact, even after prolonged time in a coma. Actors personified "Sleeping Beauty" (eyes closed, beautifully groomed). Physicians appeared as caricatures. Only two movies had a reasonable accurate representation (Dream Life of Angels and Reversal of Fortune). The majority of the surveyed viewers identified inaccuracy of representation of coma, awakenings, and conversations on the experience of being in a coma, except in 8 of the 22 scenes (36%). Twenty-eight of the 72 viewers (39%) could potentially allow these scenes to influence decisions in real life.
Conclusions: Misrepresentation of coma and awakening was common in motion pictures and impacted on the public perception of coma. Neurologic advice regarding prolonged coma is needed.