# Why don't they wake people in a coma through pain? **URL:** \ **Category:** Factual Questions\ **Created:** [May 12, 2016, 3:16pm UTC](https://boards.straightdope.com/t/why-dont-they-wake-people-in-a-coma-through-pain/754609 "2016-05-12T15:16:10Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![pianodave](https://avatars.discourse-cdn.com/v4/letter/p/e79b87/32.png) [@pianodave](https://boards.straightdope.com/u/pianodave)\ **Post date:** [May 12, 2016, 3:16pm UTC](https://boards.straightdope.com/t/why-dont-they-wake-people-in-a-coma-through-pain/754609/1 "2016-05-12T15:16:10Z")
Hi SD, Simple question: Ignoring the ethical implications, what would happen to a comatose person if you tried to wake him or her through extreme noxious stimulation? Sorry to sound macabre, but if you actually set them on fire, or other painful stimulation, would they not wake up? I’d think the human body would snap out of anything, even a coma, if it was a matter of life and death? I mean, I can see a situation with a person in a vegetative state for years being woken up by setting their legs on fire, and then treating them for burns. I find this image terrible and amusing. I can’t imagine this comatose person just lying there and letting themselves be burned to death. Wouldn’t the body automatically make itself aware to defend against a threat to life? Do not worry, I am not studying to be a doctor. But I’m curious to know if noxious stimulation has been attempted in trying to wake comatose people? I’m assuming here the damage done by the noxious stimuli can be repaired, and that the overall benefit of being restored to consciousness will outweigh the painful method of restoration to a conscious state. Thanks for clearing this up. Dave ---
**Author:** ![boffking](https://avatars.discourse-cdn.com/v4/letter/b/858c86/32.png) [@boffking](https://boards.straightdope.com/u/boffking)\ **Post date:** [May 12, 2016, 3:37pm UTC](https://boards.straightdope.com/t/why-dont-they-wake-people-in-a-coma-through-pain/754609/2 "2016-05-12T15:37:09Z")
If you think lighting patients on fire is a good idea, then you should not be allowed to step foot inside a hospital. ---
**Author:** ![panache45](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/panache45/32/64_2.png) [@panache45](https://boards.straightdope.com/u/panache45)\ **Post date:** [May 12, 2016, 3:41pm UTC](https://boards.straightdope.com/t/why-dont-they-wake-people-in-a-coma-through-pain/754609/3 "2016-05-12T15:41:10Z")
I’m too tired right now to list them . . . but ALL of your assumptions are wrong. ---
**Author:** ![Procrustus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/procrustus/32/2994_2.png) [@Procrustus](https://boards.straightdope.com/u/Procrustus)\ **Post date:** [May 12, 2016, 3:47pm UTC](https://boards.straightdope.com/t/why-dont-they-wake-people-in-a-coma-through-pain/754609/4 "2016-05-12T15:47:39Z")
> [@panache45](#): > > I’m too tired right now to list them . . . but ALL of your assumptions are wrong. right. People in a coma are not “asleep.” ---
**Author:** ![pianodave](https://avatars.discourse-cdn.com/v4/letter/p/e79b87/32.png) [@pianodave](https://boards.straightdope.com/u/pianodave)\ **Post date:** [May 12, 2016, 4:00pm UTC](https://boards.straightdope.com/t/why-dont-they-wake-people-in-a-coma-through-pain/754609/5 "2016-05-12T16:00:12Z")
> [@boffking](#): > > If you think lighting patients on fire is a good idea, then you should not be allowed to step foot inside a hospital. No, it’s not a good idea. Look, I know my assumptions are wrong. Just asking you guys to educate me. I don’t know the first thing about this stuff, and I am sure if it worked it would be done all the time. Am I right to assume that the first ancient caveman who found his fellow caveman in a coma would have tried to use pain to snap them out of it? Why doesn’t it work, and how would the body react? ---
**Author:** ![dracoi](https://avatars.discourse-cdn.com/v4/letter/d/90db22/32.png) [@dracoi](https://boards.straightdope.com/u/dracoi)\ **Post date:** [May 12, 2016, 4:06pm UTC](https://boards.straightdope.com/t/why-dont-they-wake-people-in-a-coma-through-pain/754609/6 "2016-05-12T16:06:38Z")
There are different variations on comas, but the basic principle is that the brain has suffered enough damage that the person cannot wake up. Furthermore, the brain might be damaged enough that it cannot even sense the pain. What you suggest is like saying “If my car has no spark plugs, maybe I just need to turn the key in the ignition extra hard.” I don’t know the extent to which it’s been tried because it’s just the wrong mechanism altogether, but some coma patients have other injuries that would be causing pain if they were capable of feeling it. ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [May 12, 2016, 4:07pm UTC](https://boards.straightdope.com/t/why-dont-they-wake-people-in-a-coma-through-pain/754609/7 "2016-05-12T16:07:42Z")
If a person is “in a coma”, then they may respond in some way to pain, but they will not regain full consciousness. If they regain full consciousness in the presence of pain, then they’re not in a coma. Part of how we determine the level of consciousness in a person is to carefully apply painful stimulation and see how they react. It’s part of an evaluation tool called the “Glasgow Coma Scale”. Basically, you get points for different responses in eye, verbal and motor response to different kinds of stimulus. > [@](#): > > Eye Opening (E) > > 4 = spontaneous > 3 = to voice > 2 = to pain > 1 = none > > Verbal Response (V) > > 5 = normal conversation > 4 = disoriented conversation > 3 = words, but not coherent > 2 = no words, only sounds > 1 = none > > Motor Response (M) > > 6 = normal (responds to commands) > 5 = localized to pain > 4 = withdraws to pain > 3 = decorticate posture (an abnormal posture that can include rigidity, clenched fists, legs held straight out, and arms bent inward toward the body with the wrists and fingers bend and held on the chest) > 2 = decerebrate (an abnormal posture that can include rigidity, arms and legs held straight out, toes pointed downward, head and neck arched backwards) > 1 = none (Note that you literally cannot score lower than a 3. A dead body gets a 3.) We don’t set them on fire. We press on the nail bed of a finger or rub their sternum (breastbone) firmly. These are painful enough to wake a sleeping person and to make a faking person respond in some way. ---
**Author:** ![DrCube](https://avatars.discourse-cdn.com/v4/letter/d/a3d4f5/32.png) [@DrCube](https://boards.straightdope.com/u/DrCube)\ **Post date:** [May 12, 2016, 4:43pm UTC](https://boards.straightdope.com/t/why-dont-they-wake-people-in-a-coma-through-pain/754609/8 "2016-05-12T16:43:31Z")
> **[Coma](https://en.wikipedia.org/wiki/Coma)** > > A coma is a deep state of prolonged unconsciousness in which a person cannot be awakened, fails to respond normally to painful stimuli, light, or sound, lacks a normal wake-sleep cycle and does not initiate voluntary actions. The person may experience respiratory and circulatory problems due to the body's inability to maintain normal bodily functions. People in a coma often require extensive medical care to maintain their health and prevent complications such as pneumonia or blood clots. Co Clini... Not waking up due to external stimuli like you suggest is the very _definition_ of “comatose”. ---
**Author:** ![Azeotrope](https://avatars.discourse-cdn.com/v4/letter/a/0ea827/32.png) [@Azeotrope](https://boards.straightdope.com/u/Azeotrope)\ **Post date:** [May 12, 2016, 6:26pm UTC](https://boards.straightdope.com/t/why-dont-they-wake-people-in-a-coma-through-pain/754609/9 "2016-05-12T18:26:45Z")
> [@WhyNot](#): > > We don’t set them on fire. We press on the nail bed of a finger or rub their sternum (breastbone) firmly. These are painful enough to wake a sleeping person and to make a faking person respond in some way. I remember reading in one of my college textbooks a case study of a man who was faking a coma, but he woke right up when the nurse announced she was about to put in a catheter. 😉 Hands up if you’re also squeezing your fingertips and rubbing your sternum to see how bad it hurts… ---
**Author:** ![Joey\_P](https://avatars.discourse-cdn.com/v4/letter/j/919ad9/32.png) [@Joey\_P](https://boards.straightdope.com/u/Joey_P)\ **Post date:** [May 12, 2016, 6:41pm UTC](https://boards.straightdope.com/t/why-dont-they-wake-people-in-a-coma-through-pain/754609/10 "2016-05-12T18:41:35Z")
> [@Azeotrope](#): > > Hands up if you’re also squeezing your fingertips and rubbing your sternum to see how bad it hurts… It was my first thought when I read the OP, I don’t remember if I saw it on House or ER or something else, but they wanted to see if someone was faking so the doctor put on a rubber glove and rubbed (I think his knuckle) back and forth on the patients sternum, just a few times, but hard enough to create some friction. Almost like using a pencil eraser. It always reminds me of a self defense thing I was taught, that when someone (if they’re wearing shorts) grabs you from behind, you can run the heel of your shoe down their shin. The pain should hopefully catch them off guard long enough that you can get away. ---
**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\ **Post date:** [May 12, 2016, 6:55pm UTC](https://boards.straightdope.com/t/why-dont-they-wake-people-in-a-coma-through-pain/754609/11 "2016-05-12T18:55:59Z")
Are people in a coma capable of having dreams? Or nightmares? I’ve read horror stories about people who were severely injured (like, severely burned), and placed into a state of artificial “medically-induced coma”, sometimes for extended periods of time. When they are finally aroused from the coma, they sometimes report that they had horrific hellish non-stop nightmare-like experiences the whole time. ---
**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\ **Post date:** [May 12, 2016, 7:02pm UTC](https://boards.straightdope.com/t/why-dont-they-wake-people-in-a-coma-through-pain/754609/12 "2016-05-12T19:02:25Z")
(Missed edit window) ETA: Just spent a few minutes “researching” medically-induced comas. TL;DR: They are very different from natural comas, so any comparisons probably don’t mean much. ---
**Author:** ![lost4life](https://avatars.discourse-cdn.com/v4/letter/l/c4cdca/32.png) [@lost4life](https://boards.straightdope.com/u/lost4life)\ **Post date:** [May 12, 2016, 7:16pm UTC](https://boards.straightdope.com/t/why-dont-they-wake-people-in-a-coma-through-pain/754609/13 "2016-05-12T19:16:42Z")
> [@WhyNot](#): > > …We don’t set them on fire. We press on the nail bed of a finger or rub their sternum (breastbone) firmly. These are painful enough to wake a sleeping person and to make a faking person respond in some way. Had this experience with a family member. They never “woke up” after a major surgery. To demonstrate that they were mostly gone, they laid a pen across the base of the thumbnail and pressed real hard. There was no change to any of the monitors. So, maybe we could take people in a coma and rent them out as stunt doubles for movies. ---
**Author:** ![Boyo\_Jim](https://avatars.discourse-cdn.com/v4/letter/b/87869e/32.png) [@Boyo\_Jim](https://boards.straightdope.com/u/Boyo_Jim)\ **Post date:** [May 12, 2016, 8:52pm UTC](https://boards.straightdope.com/t/why-dont-they-wake-people-in-a-coma-through-pain/754609/14 "2016-05-12T20:52:47Z")
> [@lost4life](#): > > … So, maybe we could take people in a coma and rent them out as stunt doubles for movies. Better as crash test dummies. ---
**Author:** ![cochrane](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cochrane/32/10441_2.png) [@cochrane](https://boards.straightdope.com/u/cochrane)\ **Post date:** [May 12, 2016, 9:08pm UTC](https://boards.straightdope.com/t/why-dont-they-wake-people-in-a-coma-through-pain/754609/15 "2016-05-12T21:08:47Z")
Need answer fast? 😃 ---
**Author:** ![Derleth](https://avatars.discourse-cdn.com/v4/letter/d/b9e5f3/32.png) [@Derleth](https://boards.straightdope.com/u/Derleth)\ **Post date:** [May 12, 2016, 9:13pm UTC](https://boards.straightdope.com/t/why-dont-they-wake-people-in-a-coma-through-pain/754609/16 "2016-05-12T21:13:04Z")
> [@Boyo\_Jim](#): > > Better as crash test dummies. And if they begin to wake up, the most they’ll be able to say is “Mmm Mmm Mmm Mmm”. ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [May 12, 2016, 9:58pm UTC](https://boards.straightdope.com/t/why-dont-they-wake-people-in-a-coma-through-pain/754609/17 "2016-05-12T21:58:27Z")
> [@Azeotrope](#): > > Hands up if you’re also squeezing your fingertips and rubbing your sternum to see how bad it hurts… Right?! The weird thing is, I can’t press my own fingernail hard enough to really hurt. But boy does it make people jump! I think it’s like trying to tickle yourself. ---
**Author:** ![Miller](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/miller/32/481_2.png) [@Miller](https://boards.straightdope.com/u/Miller)\ **Post date:** [May 13, 2016, 1:00am UTC](https://boards.straightdope.com/t/why-dont-they-wake-people-in-a-coma-through-pain/754609/18 "2016-05-13T01:00:32Z")
> [@pianodave](#): > > I can’t imagine this comatose person just lying there and letting themselves be burned to death. Wouldn’t the body automatically make itself aware to defend against a threat to life? So, you know about anesthetic, right? Drugs we give to people so that they’ll sleep through things like having their torso sliced open, their rib cage cracked, and their major internal organs re-arranged? Comas are kind of like that, except (usually) without the drugs. ---
**Author:** ![Gedd](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gedd/32/4938_2.png) [@Gedd](https://boards.straightdope.com/u/Gedd)\ **Post date:** [May 13, 2016, 1:25pm UTC](https://boards.straightdope.com/t/why-dont-they-wake-people-in-a-coma-through-pain/754609/19 "2016-05-13T13:25:24Z")
> [@Miller](#): > > So, you know about anesthetic, right? Drugs we give to people so that they’ll sleep through things like having their torso sliced open, their rib cage cracked, and their major internal organs re-arranged? > > Comas are kind of like that, except (usually) without the drugs. That’s a good point. I would hope if I was asleep and someone re-arranged my organs it would wake me up. On the note of anesthetics, when my wife had surgery they gave her the IV and started the drugs. As they wheeled her into the room the doctors and nurses and whoever said “Oh! You’re still awake?” It kinda freaked her out. ---
**Author:** ![Hermitian](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hermitian/32/470_2.png) [@Hermitian](https://boards.straightdope.com/u/Hermitian)\ **Post date:** [May 13, 2016, 2:03pm UTC](https://boards.straightdope.com/t/why-dont-they-wake-people-in-a-coma-through-pain/754609/20 "2016-05-13T14:03:51Z")
> [@pianodave](#): > > I mean, I can see a situation with a person in a vegetative state for years being woken up by setting their legs on fire, and then treating them for burns. Have there been any studies published in peer reviewed journals that have tested this technique? No? Then it sounds like an area ripe for research. [Next page](https://boards.straightdope.com/t/why-dont-they-wake-people-in-a-coma-through-pain/754609.md?page=2)