Sci has a confession to make. I don’t own a TV. Well, rather, I do. It only works to hook a DVD player up to it. Being completely addicted to the internet as I am, I don’t miss it. I also never really watched TV as a kid. In a way, I miss out on a lot of pop culture this way (I must be the only person in the world who doesn’t have to spend the entire day debating “Lost” on Thursdays), but I don’t mind. Who knows? Perhaps if Scimom and Scidad had let little Sci watch tons of TV as a kid, she wouldn’t be the happy little geek she is today. I’m happy as I am, and so TV is something I don’t need.
But there is one thing I’ve never seen, yet only heard of. This elusive thing, this “soap opera” was a legend to me when I was little. When I was home sick from school, I would hunt through the TV for them, occasionally catching glimpses, but never have the patience or the stomach for a full episode. Mostly, they seemed to involve incredibly rich looking people posing tragically over something improbable, like suddenly finding out you are your equally rich mistress’ long lost identical twin. But apparently, it also involves a lot of people stuck in comas, usually to make a spontaneous recovery (probably with amnesia or thinking you’re someone’s long lost identical twin). And a few researchers decided to study this.
Casarett et al. “What’s in a name? Epidemiology and prognosis of coma in daytime television dramas” British Medical Journal, 2005.
Ah, where would Sci be without the glories of the British Medical Journal and Medical Hypotheses. Truly, there would be no weird science without these two glorious repositories of the odd. And this episode of Weird Science comes to you courtesy of Instant Egghead Guide to the Mind, where I found the original citation of this paper. Thanks, Eggheads.
But the real question is, why STUDY a daytime soap opera? Well, as I’m sure you all know, TV influences people’s opinions about stuff. All sorts of stuff, especially things like health. Unfortunately, the media can often exaggerate findings, or present views of health that are overly optimistic. A big example of this is CPR. Apparently, in daytime soaps, anyone who needs CPR and gets it will survive. In reality, the prognosis isn’t half so good. And it may be the same for coma. It could be that people may be persuaded that coma has a better prognosis than it really does through media exposure, which may produce disagreements about treatment if someone in their immediate family does go into a coma.
And of course, this may have also been the whims of a group of epidemiologists who REALLY like Days of our Lives. They probably got all their viewing in for a lifetime.
So what’s the prognosis of coma in soap operas? The authors went online and looked for episodes in which a character was unconscious for more than 24 hours after a medical event. Initial search strategy used Google (serious stuff, here). They identified 9 programs, and used episodes aired between 1995 and 2005. The candidates were:
General Hospital (sure to be a good source)
One Life to Live
Days of our Lives
All My Children
As the World Turns
The Young and the Restless
The Bold and the Beautiful
They included only the FIRST episode of coma for each patient, and even so, they got 73 characters who went into coma on 9 shows in the last ten years. Lessee, that’s…8.1 characters in a coma per show, so roughly 0.8 characters went into a coma per year per show. I imagine some shows had higher amounts than others. And that was only the FIRST episode of coma. This implies that some of these characters have a lot of comas. I wonder if there’s one overall winner? Some patient on General Hospital who’s been in a coma 4 or 5 different times in a year, maybe? Some of the patients had to be taken out, because it turned out that they were faking the coma, or that comas we pharmacologically induced, so the final number ended up being 64, which is still a rate of 0.7 characters per year per show.
They then worked out how each patient got into the coma (the vast majority of cases were gunshot wounds, though some were idiopathic, some were burns, poisoning, or near drowning, and my favorite one was a patient that was shipwrecked). They have to look at the characteristics of individual cases, which ended up being difficult, because apparently people on soap operas have face transplants a lot. LOL. They then followed the patients until recovery, death, or end of their contract on the show. Followup time was judged as real time, so that they experienced the time the patient was in a coma the way a viewer would see it.
They also used all the plot lines and storyboards to define the function of each patient on the Glasgow outcome scale. This scale is a determination of how functional a patient is, and based on that, you can form a limited prognosis on the likelihood the patient will regain full consciousness. There are sections for eyes, verbal, and motor. Eyes range from never open to open and tracking you, verbal ranges from nothing to being able to converse, and motor ranges from no movement, to withdrawing from pain, to obeying motor commands. Now, obviously, if your eyes are opening of their own accord, you can talk about stuff, and move, you’re doing ok. If you’re on the other end of the scale, less ok.
Then they took their analysis, how bad the patient was doing and whether they recovered, and compared it to real life coma data, analyzing only those who were in traumatic comas (after gunshot wounds or car accidents) and compared to real life trauma data. The median time patients were in comas was 13 days. 86% fully recovered. 8% (5 patients) died, but it turns out only three of those ACTUALLY died. The two other patients faked their deaths, and in one case was replaced by a mannequin. Two remained in a vegetative state, which must make for some really boring acting.
So mortality on soap operas ended up being 4% if you’re in a coma. Sound a little low? I should hope so. Real life mortality resulting from coma is 50%. Not only that, the patients on the soap operas that recovered mostly did so with no disability, though of course a bunch had amnesia. A few had trouble speaking or paralysis, but all who woke up ended up returning to their previous state of health, wealth, and looking beautifully tragic. This is in stark contrast to real-life, where 91% of patients in a coma will not return to normal.
So this is a Weird Science with a real lesson (though they all have real lessons, really. Learn to undo a bra strap in your youth, masturbate to relieve your nasal congestion, don’t stick things down your urethra…). Watching soap operas can give you a really skewed idea of coma and whether or not people recover from it, as well as HOW they recover. This may make people overly optimistic about a patient’s chances. But, the authors also note that soap operas are “not always written to reflect real life”. They may recover from coma really well, but they also tend to die off a lot more (as contracts get cancelled and actors move on).
Personally, I would really like to hope that regular viewers of soap operas are smart enough to know that what they’re viewing is fiction. Coma prognosis aside, how often do people in real life find out they are their lover’s twin, or fake their own deaths with mannequins for nefarious purposes? Still, looking at the data might help make it clear what is real and what is soap opera.
D. Casarett (2005). Epidemiology and prognosis of coma in daytime television dramas BMJ, 331 (7531), 1537-1539 DOI: 10.1136/bmj.331.7531.1537
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