If your knowledge about comas comes from TV soap operas, you need a reality check.

Just ask real-life doctor David Casarett, MD, and colleagues from the University of Pennsylvania. They studied how soaps portray comas and gave soaps a thumbs-down review for accuracy.

Soap operas aren’t medical documentaries, but media messages may subtly shape people’s views, the researchers note.

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"Although these programs are presented as fiction, they may contribute to unrealistic expectations of recovery" for patients in a coma, they write in BMJ.

Uncanny Survival

Casarett’s team studied the depiction of comas on U.S. television soap operas from 1995-2005. During that time, 64 soap opera characters had what appeared to be comas.

Here’s how those characters fared:

· Nearly nine out of 10 fully recovered

· 8% (five "patients") died

· 3% (two "patients") remained in a vegetative state

Those results are "unrealistically optimistic," write the researchers.

What’s more, two of those deaths were faked so that the characters snuck away to live on. Viewers didn’t know that right away, so the phony deaths were counted as actual deaths.

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No word on how the comatose characters maintained perfect hair and makeup, whether actors’ contract negotiations or TV ratings raised their risk of having a coma, or if the faked deaths prompted new storylines of lawsuits against the fictional caregivers.

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Coma in the Real World

Here are some coma facts from Casarett and colleagues:

· Previous studies have shown survival rates of 50% or less for coma patients.

· Typically, less than 10% of patients recover fully from comas not caused by trauma. That’s about nine times rarer than what happened on the soaps.

· Recovering coma patients often face subtle mental and functional deficits.

· Months of intensive physical and occupational therapy are usually needed after coma.

"Of course, soap opera storylines are not always written to reflect real life," the researchers write.

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"Soap operas are not designed with the goal of educating the public about the realities of health and illness or even about the realities of interpersonal relationships, but they may contribute to public misperceptions in these areas."

In other words, don’t believe what you see.

The researchers call for soap operas and other media to "balance stories of improbable survival and recovery with compelling and compassionate stories of characters who die with comfort and dignity."

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Written by Miranda Hitti; Reviewed by Ann Edmundson, MD

SOURCES: Casarett, D. BMJ, Dec. 24-31, 2005; vol 331: pp 1537-1539. News release, BMJ.