Q and A: Can My Character, Who Has Been in a Prolonged Coma, Awaken, Fake His Coma, and Commit a Murder?

Q: I plan to have someone awaken from a coma to commit a murder. My current thinking is that the subject will have been in a genuine coma but awakens and, with the help of an accomplice, decides to carry on as if they are still in the coma.

Is it possible to fake a coma and fool the staff looking after them? Can a coma patient be cared for at home and simply have visiting medical professionals? This would obviously make it easier to carry on the deception when required. Is it plausible that someone could surface from a coma, carry out the murder, and still maintain the wasted appearance of someone who hasn’t moved in several years?

T. Cartledge

A: All this works except for your time frame.

Comas are funny things. They can last for a few hours or many months, even years and decades. When someone begins to awaken from a prolonged coma they usually do so gradually and in fits and spurts. That is, they will begin to become restless, open their eyes off and on (at first unfocused and then more focused), move their extremities (initially without purpose but gradually progress to more purposeful movements), and then speak (progresses from non-sense or just random words and sounds until they gradually begin to communicate). Though it is possible that someone in a long-term coma could suddenly awaken and be fully alert, the progression I described above would be more likely.

He would have no memory for the time he was comatose and might or might not remember what came before. This is called retrograde amnesia. This loss of memory could go back any period of time before the incident that caused the coma—a few minutes, a few hours, days, months, years, or forever. And his memory of previous events might be partial, spotty, or complete. It may return slowly over days, weeks, or months or very quickly. All is possible.

This is very general and each person reacts differently. This process from first arousal to full wakefulness might take a few hours, days, weeks, or months. This process is highly variable, but in general, the longer the coma, the slower the return to normal.

Yes, he could fake the coma but the problem is that with his slipping out of the coma slowly and erratically, he would not be “with it” enough to fake it and to enter into a conspiracy with another person. This takes full control of his faculties and that’s just not the case with long-term comas. But once he was fully awake and ware he could fake his coma.

Yes, a coma victim could be treated at home and this is not uncommon. It often requires special care but this is available. The main thing is that he is fed, kept well hydrated, moved frequently to prevent bed sores.
If he were indeed in a long-term coma, he could not simply wake up, get out of bed, and go kill someone. It would take weeks before he could even walk. That’s the problem I have with your time frame. Besides all the things above about awakening from a long-term coma, a coma of several years would cause severe muscular wasting in the victim. It would take weeks or months of physical therapy and strength training before he could go out and harm someone.

But, if you make the coma only a few days or a few weeks, then he could awaken quickly, fake his coma, and then have the strength to sneak out and do the deed.