Table Of ContentThe Language and Imagery
of Coma and Brain Injury
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The Language and Imagery
of Coma and Brain Injury
Representations in Literature, Film and Media
Matthew Colbeck
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Contents
List of figures vi
Acknowledgements vii
Introduction 1
1 Contextualizing coma and brain injury: A linguistic, cultural and
medical history 13
2 Coma, trauma and the exilic self 37
3 Coma and the katabatic archetype 69
4 Selfhood and the post-coma condition 105
5 Coma, brain injury and lived experience 139
6 Metaphor and narrative prosthesis 159
Notes 191
Bibliography 192
Index 207
Figures
1.1 Still from The Cabinet of Dr Caligari, dir. Robert Wiene 22
1.2 Photograph of Price’s ‘Sleeping Beauty’, c. 1950s 23
1.3 The Glasgow Coma Scale 30
2.1 Facsimile of woodcut illustration from Alex Garland’s The Coma 64
4.1 Image of the ancient symbol of the Ouroboros 118
4.2 Image of the mathematical symbol for Infinity 122
4.3 Photograph ‘Anna and I Get Married’ by Mark E. Hogancamp 130
6.1 Facsimile of a page from Steph Grant’s ‘Unremembered Memoirs’ 176
Acknowledgements
It has been a long road between the inception of this book and its publication so there
are several people I would like to thank who have helped me in this journey. Many
thanks to Professor Brendan Stone and Professor Adam Piette for nurturing the project
in its earliest stages, and to Professor Sue Vice and Professor Roger Luckhurst for their
invaluable advice in developing it further. Thanks also to Professor Neil Roberts for
instructive conversations and insights into the life and works of Peter Redgrove.
Thanks to Andrew Wardell and Becky Holland at Bloomsbury for all of their
patience and support and for their constant faith in the project. Special thanks to the
production team, in particular Joseph Gautham at Deanta Global and Jophcy Kumar
at Bloomsbury, for their huge support (and patience!) in the final stages of pulling
this book together. Thanks also to Gurdeep Mattu at Rowman & Littlefield Publishing
Group who championed the book from the beginning.
I would also like to thank the University of Sheffield and, in particular, the School
of English; Headway and all at Headway East London, particularly Ben Platts-Mills
for his insights into the complex intersection of functional/organic pathologies of
brain injury; UKABIF; the Sheffield Community Brain Injury Rehabilitation Team at
LTNC, Sheffield; Nicholas Royle and Nightjar Press; John Oakey Design; H&H Reeds
Printers; Professor Jenny Kitzinger; and the Head Injury and Homelessness Research
Group (HIHRG).
Many, many thanks to all members of The Write Way for sharing their stories and
for their support for the project, for which I will always be incredibly grateful: Steph
Grant, Caroline Waugh, Gwynfa Grant, Laurence Cox, Joel Wilde, David Stead, Lesley
James, Heather Norton, Rachael Fox, Wilf Griffiths, Ste Jones and Jo Mariconda.
I am extremely grateful to all of my friends and colleagues who have helped me
along the way: Dr Steve Hollyman, Tom Carter, Antony and Kelly Buxton, Reanna
Heath, Dr Hannah Merry, Dr Adam Smith, Dr Pete Walters, Dr Zelda Hannay,
Dr Michael Flexer, Dr Sam Goodman, Matt McGuinness and his VAAST project
(which has soundtracked the writing of this book) and Matt Jones. Special thanks to
Paul Hare for giving me the push to embark on this research.
Above all, I am deeply grateful to my wife, Charlotte, for her endless encouragement;
to Fred, for getting me out of the house on walks around the streets of Sheffield to
help clear my mind and sharpen my focus; to Viv, Malc, Glyn and Janet; and to our
new little addition, Flora, who has been the happiest, most mischievous of distractions
during the final stages of writing. And of course, special thanks to mum and dad, for
their constant support throughout this process and encouraging me to make the leap
into this research.
Dad – I wish you were still here to see me see this through.
And so I dedicate this book to you.
viii
Introduction
Towards the beginning of Quentin Tarantino’s revenge thriller, Kill Bill Vol 1, we learn
that the film’s heroine, The Bride, while in a four-year coma, has endured years of
sexual abuse and rape at the hands of a corrupt nurse who is in charge of her care.
As the audience joins her in the hospital, she is bitten by a mosquito which triggers
a sudden ‘awakening’. Later, after taking revenge upon her abusers, she drags herself
across the hospital and underground car-park, her muscles atrophied during her time
in coma. Yet this physical consequence of her prolonged disorder of consciousness
(PDoC, ‘prolonged’ being a diagnostic term relating to the fact that a patient has been
‘unconscious for more than 4 weeks’ (RCP 2020: 20)) is only temporary, as, lying on
the flatbed of a commandeered van, she wills her ‘limbs out of entropy’ by repeating
the mantra: ‘Wiggle your big toe’ (Kill Bill Vol 1, 2003).
This particular representation of coma within contemporary culture, it seems to
me, is a good starting point for the discussions that will develop across this book.
It does, after all, contain the visual language typical of so many fictional texts that
portray this medical disorder: the idealized body of the coma-patient, beautifully
groomed and often sexualized and/or fetishized; a sudden and immediate emergence
from coma, cognition intact instantly, with no sign of long-term brain injury (BI). And
while Tarantino does portray some of the effects of long-term vegetative states (muscle
deterioration) this, again, is overcome through willpower and a linguistic imperative.
This image of an abused, comatose woman is similarly represented by the Spanish
auteur Pedro Almodóvar in his 2002 film, Hable con Ella (Talk To Her). The film
narrates parallel stories of two men who are supposedly in love with women who are
in comas: one woman, Alicia, a former ballerina who lies in a vegetative state after
being hit by a car; the other, Lydia, a female bullfighter who lies comatose after being
gored by a bull in what seems to be a failed act of suicide. It is in the characterization
of Alicia where the visual language of fairy tale is at its most extreme. Both Tarantino’s
representation of The Bride and Almodóvar’s representation of Alicia are paradigms
of what the neuroscientists Eelco and Coen Wijdicks term the ‘“Sleeping Beauty”
phenomenon’, a common trope that they discovered when analysing the representation
of coma in 30 feature films released between 1970 and 2004. As they discuss, Alicia
always appears on-screen perfectly groomed, serene, lips gently parted; as if merely
asleep. Moreover, her body seems flawless and, as the Wijdicks further observe, there
is no representation of the realities of the patient within a disorder of consciousness
(DoC): bladder and bowel incontinence, muscle atrophy and decubital ulcers (bed
sores) (2006: 3201). As Adrian Owen summarizes, ‘In the Disney version of Sleeping
Beauty . . . Aurora’s condition resembles coma, akin to a bewitched slumber. In real
life, the picture is far less romantic: disfiguring head injuries, contorted limbs, broken
bones, and wasting illnesses are the norm’ (2017: 4).
