Coma: From Miracle to NightmareProgram: Body and Soul – Sveriges Radio P1Summary
The radio program Body and Soul from Sveriges Radio P1 explores coma and unconsciousness through real patient stories and medical insights. It recounts the story of Terry Wallas, who awoke after 19 years in a coma following a car accident, saying “Pepsi” as his first word. The program also features Malin Blom, who was in a coma for a month after a traffic accident with no memories, and Arne, who experienced terrifying hallucinations during a covid-19-induced coma. Experts like Karin Lövhagen and Per Hamid Ghatan discuss the complexities of coma, its effects on body and brain, and the importance of patient interaction. The program also addresses challenges in intensive care during the covid-19 pandemic and the role of patient diaries.

Article: Body and Soul – Sveriges Radio P1This episode of Body and Soul focuses on coma, unconsciousness, and the experiences of patients in these states. By blending real stories with medical perspectives, the program offers a deep dive into this complex phenomenon, showing how patients, doctors, and families navigate these challenging situations.Terry Wallas’ Story: A Miracle After 19 Years
The program begins with the astonishing story of Terry Wallas, who was in a coma for 19 years following a car accident in 2003. When his mother responded to him, he uttered his first word: “Pepsi,” followed by “milk.” This moment was a miracle for his family, who never gave up on him. They visited regularly, brought him home, and kept him part of family life, despite his lack of signs of awareness. Doctors believed medical treatments played a significant role in his recovery, but they were particularly curious about this “Sleeping Beauty” state from which Terry awoke. Subsequent studies on his brain showed that the brain’s ability to heal itself is far greater than previously thought, significantly impacting modern brain injury treatments. Terry’s case also highlighted that people in comas may perceive things, even if they don’t show it, underscoring the importance of interaction and communication with the patient.Intensive Care During Covid-19
The program then shifts to the current situation in intensive care units (ICUs), where many patients, especially during the covid-19 pandemic, are cared for in medically induced comas (sedation). Karin Lövhagen, chief physician and head of the ICU at Mölndal Hospital, part of Sahlgrenska University Hospital in Gothenburg, explains that covid-19 patients are admitted to the ICU when they can barely breathe due to insufficient blood oxygenation, which can cause multiple organ failure. If oxygenation doesn’t improve naturally or with extra oxygen, the patient is sedated and connected to a ventilator. The ventilator pushes air into the lungs, while exhalation is a passive process handled by the body. Initially, when the patient is deeply sedated, the ventilator fully controls breathing, with the number and volume of breaths carefully adjusted.Karin emphasizes that breathing must be as gentle as possible to avoid lung damage, requiring precise and advanced adjustments. As the patient’s condition stabilizes, sedation is reduced to allow them to tolerate the breathing tube, which can trigger the gag reflex. As soon as possible, the patient begins controlling their own breathing rhythm. If stable enough to respond to questions by nodding or shaking their head, the breathing tube is removed. However, the process isn’t always straightforward, and patients may fluctuate between improvement and deterioration, especially if lung function worsens or other issues arise.Coma’s Effects on Body and Brain
Each day a patient is sedated, they lose muscle mass. The extent varies, but Karin notes that surviving intensive care requires a reasonable physical condition from the start. To counter muscle loss, patients are kept as mobile as possible. They are turned at least every two hours, and once slightly conscious, they can sit up in bed or even stand beside it, even if connected to a ventilator. For example, physiotherapists use electric bed bikes that allow patients to pedal, either actively or with automatic assistance if they can’t contribute.For patients on ventilators for over 10 days, doctors often create a small hole below the larynx to insert a tracheostomy tube, which is more comfortable and allows the patient to stay more awake. All patients have diapers and catheters, and many severely ill covid-19 patients develop kidney issues requiring dialysis. Karin says waking covid-19 patients is challenging, sometimes taking days or over a week, due to prolonged sedation and stronger medications that linger in the body. Inflammation from covid-19, particularly in the lungs and possibly the brain, and blood clots in the lungs, kidneys, and brain contribute to this difficulty. Covid-19 patients are more prone to blood clots, and even with high doses of anticoagulants, the risk remains significant.Diaries: A Link Between Patients and Families
During the pandemic, relatives were not allowed to visit patients. To bridge the gap between the sealed ICU rooms and anxious families outside, staff at Mölndal Hospital write diaries for covid-19 patients who are sedated and on ventilators. These diaries record daily events, such as family calls or personal messages like “Your mom called today with greetings” or “You opened your eyes today.” For instance, an entry might read: “Your wife called today and said the lilac bush in the garden is blooming, hoping you’ll be home soon to smell it.” Studies show these diaries play a crucial role in reducing post-traumatic stress for patients after discharge, as ICU stays can be highly traumatic. Karin has hired doctors with lighter workloads to answer family calls and fill out these diaries, a practice with significant impact on patients.Malin Blom’s Story: From Coma to Rehabilitation
Malin Blom, a guest on the program, was in a traffic accident five years ago on her way to a party. While cycling toward Nacka, a car hit her, and the driver fled. Bystanders, including a woman named Nettan whom Malin credits with saving her life, helped her breathe until the ambulance arrived. Malin sustained multiple fractures in her ribs, both collarbones, shoulder blade, and left shin, which was completely crushed, requiring a surgical rod. She was also diagnosed with a diffuse brain injury, with small bleeds throughout the brain, similar to shaken baby syndrome, as her body was thrown far, causing her brain to hit the skull from the inside. She wasn’t wearing a helmet but believes it might not have made a difference in this case.Malin was in a coma for a month and has no memories of that time. After three weeks, she began opening her eyes but showed no recognition or response to movement or sound. When her tracheostomy was removed, the doctor asked her to say “hello,” and she whispered the word, with a spark in her eyes that hadn’t been there before. This was recounted to her, as she remembers nothing. Her mother, father, and sister were by her side throughout. Malin says it’s strange to think about this life-changing period with no memories. She decided to turn the experience into something positive, continuing as a “problem-solver.”Malin was set to start a master’s program in visual communication at Konstfack but postponed it for a year due to the accident. She attended outpatient rehabilitation at Danderyd Hospital and began her studies a year later, eager to resume her planned life. Her thesis focused on her brain injury. Through interviews with family and friends, she realized they lacked sufficient information about the severe impacts of brain injuries and recovery timelines. She wrote and designed a book, The Road to 2.0: Managing a Severe Brain Injury, as a guide for people with brain injuries and their families, using her own rehabilitation as a case study.Arne’s Story: Terrifying Hallucinations in Coma
Arne, another patient sedated and placed on a ventilator due to covid-19, had a starkly different experience. He endured eight days of terrifying hallucinations that felt entirely real. Upon waking, he thought he was in a parking lot and felt a needle in his neck before everything went black. He awoke in a dark, windowless room with blinking machines, like a bunker, unable to tell day from night. Tubes were connected to his body, he was dizzy and in pain, and he was convinced he’d been kidnapped. When asked his wife’s name, he said “Anna,” thinking the staff lied when they said she’d called.This marked the start of eight hellish days. He believed he was in a hospital where staff turned into torturers at night, tormenting patients for paying spectators. He tried to escape multiple times, pulling out tubes, but nurses forced him back to bed. In his hallucinations, the Catalan mafia tried to save him by blowing up the hospital, but the plan failed. He accused a doctor named Magnus Lind of being the mastermind behind the torture, calling him a “quack.” In one hallucination, pieces of his thighs were served as sushi to the audience. Eventually, a stranger wheeled his bed out, and they ended up in a mining town in Colorado, USA, where they took revenge on the torturers.In reality, none of this happened. Arne recovered after 19 days in the hospital, including 14 days on sedatives. He says the hallucinations still feel like real memories. He lost 10 kg of muscle, has five blood clots in his lungs, and is mentally exhausted, with reduced focus and patience. He believes his love for horror and action films may have fueled the hallucinations. It wasn’t until day 14 that he dared touch his thighs to ensure they were still there.Medical Perspectives: Delirium and Coma Management
Per Hamid Ghatan, chief physician and head of brain rehabilitation at Uppsala’s Akademiska Hospital, says Arne’s hallucinations are a classic delirium, where fragmented memories weave into an absurd narrative. This could stem from the disease, inflammation, or sedatives. He stresses the importance of grounding patients in reality, such as saying, “Hi, I’m Per, a doctor. You’re at Akademiska Hospital, it’s June 2, 2020.” Sicka Karlman, professor of anesthesiology at Karolinska Institutet, calls the experience horrific and tragic, noting that such coherent stories are rare. She doesn’t know how to reduce hallucinations during treatment but says staff work hard to calm patients.Per Hamid notes it’s unclear whether covid-19 directly affects the brain or if inflammation or medications cause these hallucinations. Some patients experience delirium post-recovery, but it usually fades during rehabilitation. If it persists, treatments can reduce physical reactions to memories to prevent post-traumatic stress. He believes Arne’s story may contain metaphors for real events during the acute phase that he interpreted differently.Importance of Environment and Communication
Malin Blom says she remembers nothing from her coma but sensed her family’s anxiety, as her blood pressure rose, triggering machine kitų alarms. Per Hamid emphasizes controlling the environment, like reducing loud noises (e.g., ward phones), to avoid distress. He says diaries can help patients sort their memories and reduce post-traumatic stress. A patient with terrifying experiences was helped by visiting the ICU and learning about what happened, reshaping their perception.Rehabilitation Challenges
Per Hamid says rehabilitation patients are stable but still need oxygen and are contagious. They require mobilization to walk, use the bathroom, and dress to return home. Breathing issues and blood clots are common, but psychological or cognitive issues are less frequent. Post-traumatic stress may appear months later. Doctors avoid the term “coma,” using “reduced consciousness” or “vegetative state.” Consciousness levels are assessed by teams including psychologists, occupational therapists, doctors, and nurses, with family involvement. Stimulating patients and eliminating factors like infections help raise consciousness.Conclusion
Body and Soul reveals that coma and unconsciousness are complex states affecting both body and mind. The stories of Terry, Malin, and Arne, combined with medical insights, highlight the importance of meticulous care, human connection, and support for patients and families. The program emphasizes rehabilitation and a positive mindset’s role in recovery, showing that hope and perseverance can transform lives even in the toughest situations. Next week, the program will explore love and why it ends, inviting listeners to share their experiences.Program Team
Producer: Changimum
Reporter: Malin Holgersson
Technician: Gustaf Sundén
Host: Ulrika Hjalmarsson NejdemanPodcast
The program is produced by Filt for Sveriges Radio and is available on the Sveriges Radio Play app.