Girlfriend in a Coma

If you were born before 1980, you’ve probably heard (of) the Smiths’ very moving  and very short Girlfriensincomasong, Girlfriend in a Coma. If not just play the above video. I thought it was based on the novel Girlfriend in a Coma by Canadian author Douglas Coupland, but as a matter of fact it was Coupland who based it lightly on the Smiths’ song, and on the real life story of the notorious case of Karen Ann Quinlan, a 17-year-old girl who fell into a coma after a night of partying with friends. The lead character in Coupland’s novel is Karen Ann McNeill. In his story the heroine wakes after 17 years to find she gave birth while in the coma and now has a 17-year-old daughter. McNeill herself has the mind of a 17-year-old. The interplay between the two must be quite interesting. A friend of mine bought the book but was quite disappointed. To each her own I guess.

In reality two weeks before falling into her decade-long coma, Karen Ann Quinlan put herself on a near-starvation diet in order to KarenAnnQuinlanfit into a dress she had bought. When she became comatose she weighed 118 lbs. At the time of her death she weighed 80 lbs. For two days before a party Karen attended, she had eaten almost nothing. At the party she reportedly drank a few gin and tonics and took valium, a mild tranquilizer. Shortly afterwards she felt faint, and was quickly taken home and put to bed. When friends checked on her fifteen minutes later she was not breathing. They attempted mouth-to-mouth resuscitation and an ambulance was called. Karen fell into a coma that night. She remained in a coma for several months at which time her parents wanted her removed from an artificial breathing machine. The hospital fought against their decision and the Quinlans sued for the right to remove their daughter from the machine. In 1976, this resulted in a landmark case when the Supreme Court of Canada ruled it was permissible to remove a patient from artificial respiration when the victim was comatose. This decision affected laws worldwide.

A comatose person exhibits a complete absence of wakefulness and is unable to consciously feel, speak, hear, or move. For a patient to maintain consciousness, two important neurological components must function. The first is the cerebral cortex, the gray matter that covers the outer layer of the brain. The other is a structure located in the brainstem, called reticular activating system (RAS) Injury to either or both of these components is sufficient to cause a patient to experience a coma. Coma may result from a variety of conditions, including

  1. intoxication (such as drug abuse, overdose or misuse of over the counter medications, prescribed medication, or controlled substances)
  2. metabolic abnormalities
  3. central nervous system diseases
  4. acute neurologic injuries such as strokes, herniations, hypoxia, hypothermia, hypoglecmia,
  5. traumatic injuries such as head trauma, caused by falls or vehicle collisions.

It may also be deliberately induced by pharmaceutical agents during major neurosurgery, to preserve higher brain functions following brain trauma, or to save the patient from extreme pain during healing of injuries or diseases.

At that time, comatose states became big news in the 1970s media, inspiring the novel by former M.D. Robin Cook, entitled Coma. Coma was preceded by the lesser known The Year of the Intern  in 1973. Coma reached number 6 on the New York Times Bestseller List and was eventually made into a movie by Michael Crichton in 1978. Coma was included in the Fiction category of “The New York Times Outstanding Book of the Year” listing. As for Coupland, after he toured with a band called for Microserfs throughout Europe, Coupland  was burnt out and very fatigued. The period after this tour was, for Coupland, “one of the darkest periods of [his] life. I could barely open a can of soup or put gas in the car tank”. During this dark period, Coupland began to write a new novel. This novel became Girlfriend in a Coma.

Before the 1960’s very few people fell into a coma. Most people simply died. Comas became a modern 20th Century phenomenon, partly, but not entirely, because of the ability to keep people alive on artificial respirators. Why it was that people didn’t regress into a vegetative state but simply died is an unanswered medical phenomenon. Insulin-induced comas are not unheard of and are suffered by diabetics. One case involved a woman named Edwarda O’Bara, Just before reaching

edwardaadolescence, Edwarda was diagnosed as diabetic in 1969. If Edwarda had been given insulin shots, her bad bout with the flu likely would have been just that, nothing more. But every time she vomited, she was throwing up her medicine and sugar was building up in her system.  Dr. Louis Chaykin, who was on call that night the O’Baras brought their child to the emergency room, remembered the little girl saying to her mother, “Don’t ever leave me. And the mother said she never would.” True to her word, Kathryn remained by her daughter’s side after she fell into her coma, caring for her lost child for 38 years until Edwarda finally died at the age of 59. Former President Bill Clinton, Florida Gov. Jeb Bush, singer Neil Diamond and other celebrities visited the home over the years. Renowned self-help author Wayne Dyer penned a book, “A Promise Is A Promise,” about Kathryn’s unconditional love. Hundreds of people made pilgrimages to Edwarda’s residence. Edwarda is believed by experts to have lived longer than anyone else in a vegetative state.

Dr. Eelco Wijdicks studied 78 films that depicted the symptoms of coma and decided that only two portrayed a coma in a realistic manner, one of which was  Reversal of Fortune (1990)  starring Jeremy Irons and Glenn Close as Claus and Martha Sharp Crawford (Sunny) von Bulow  respectably.  It recounts the true story of the unexplained coma of socialite Sunny due to diabetic shock,  the subsequent attempted murder trial, and the eventual acquittal of her husband, Claus von Bulow. Sunny remained in a coma for almost 28 years until her death in a New York nursing home. The film`s ambiguous narrator is Sunny herself while she lies in her coma. Irons received an Academy Award for Best Actor.

A mystery of the mind that will always baffle medical science.

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