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Were the Comas on "All My Children" Realistic?

Yesterday, ABC announced the cancellation of two long-running soap operas, All My Children and One Life to Live. The cancellations leave only four soap operas scheduled to air on the major networks through the end of the 2011-12 television season. (In case you're curious, the four are Days of Our Lives on NBC, General Hospital on ABC, and The Bold and the Beautiful and The Young and the Restless on CBS. You're welcome.) In the four decades the two shows have been on the air, they have each produced over 10,000 episodes, including just about every plot device you could think of. An old standby device, as soap fans know, is putting one of the characters into a coma. Given that soap operas are hardly the last word in gritty realism, though, just how inaccurate are these coma storylines?

They're rather optimistic, according to a 2005 paper in the British Medical Journal published by doctors at the University of Pennsylvania and Philadelphia VA Medical Center. Displaying an intrepid commitment to science, the authors reviewed the storylines in nine soap operas between 1995 and 2005, and identified 73 "period[s] of unconsciousness lasting at least 24 hours." The data set had to be reduced to 64, though, because three outcomes were unknown, and "six patients were ineligible (one seemed to wake for meals, two had fraudulent comas, and three comas were pharmacologically induced)." The comas lasted for a median of 13 days. Yet though comas were hardly a rare occurrence in these soap operas, the authors found that the outcomes were optimistic in two ways. First, "the vast majority of these patients survived" - almost 90%, while 8% died, and the remainder stayed in a vegetative state. "Moreover," they write, "because two deaths were staged, the true survival rate is actually even higher than that reported here. This finding is at odds with previous studies that have found coma to be associated with survival rates of 50% or less." Second, 86% of the survivors "had no evidence of limited function," and the remaining 14% eventually regained full function as well. Not surprisingly, this "is very unusual. For instance, typical rates of full recovery from coma after a non-traumatic injury are usually less than 10%. Patients typically experience subtle cognitive and functional deficits, which were not evident in these patients, who rapidly resumed their previous occupational, social, and romantic activities. In contrast, for real patients the recovery process usually involves months of rehabilitation with intensive physical and occupational therapy." However, the authors warn at the end, while "characters have much more favorable outcomes from coma...they also seem to face an extraordinarily high all cause mortality." Soap fans, you've been warned.

For more research on what’s in the news, check out the rest of TNR’s newest blog, The Study.