Sometimes, people just go catatonic and freeze up. In such a case, hopefully, it's not a hardware problem and there's no actual brain damage. This How To does not address such issues; look into neurosurgery or something.

Other times, it's entirely a software problem. Yes, people can become so paralyzed by mental illness that they go comatose. Luckily, homo sapiens comes equipped with a reset button, though it really resembles the Mac's paperclip disk ejection system more than a button. Simply obtain the following items.

  • A needle-less syringe
  • A bucket
  • Absolutely frigid ice cold water

The catatonic victim should be lying on a bed/cot/some flat surface. Fill the syringe with ice cold water. Put the bucket near their head. Now squirt the syringe-full of water into one of their ears.

If it's a mental illness problem, your coma victim will come to life vomiting profusely. Don't ask me why, it's something about the brainstem. Just one of those involuntary responses. Even someone with severe brain damage (but not brain death) will grimace or show some sign of discomfort, but someone whose coma is psychologically induced will probably go through the full response. While the patient will probably go back into the coma over time, now trained therapists can have a crack at helping the patient regain mental balance, and hopefully the cycle of coma->woken->therapy->return to coma will end in time.

Note: I am not a trained medical professional, though alex.tan appears to be one. For God's sake, don't try this at home. This knowledge should be used for good, not evil... though the temptation to try this out on my drunken roommate was almost overpowering sometimes, to be honest.

dragoon, what you have described (icy cold water squirted in the ear) is a good test for brainstem function. Also known as the caloric test, it's also used as one of the tests for brain death.

I once watched some doctors in the Intensive Care Unit do this test on a patient who seemed dead - no pupillary response to light, doll's eyes, no response to noise and painful stimuli (nipple pinch - ouch!), no response to intravenous atropine (the heart rate should increase). Someone got a cup of cold water, the consultant dipped his finger in and said "that's not cold enough. empty that cup, fill it to the brim with ice and then put some water in." - sure enough, there was no response to the icy cold water either and the patient was disconnected from the respirator and left to die.

So ... the water should be ICY cold. The way to do this is to fill a large cup with ice cubes and pour water over it, stirring to form a icy cold mixture (aka a freezing mixture). DO NOT DO THIS FOR FUN. It is a horribly unpleasant feeling to get icy cold water squirted into your ear.

A less cruel (and more practical - I often don't have ice water on me) method for awakening someone unconscious or asleep, is to rub your knuckles in a rough way on the chestplate of the incapacitated person. This is very unpleasant, and will make the victim wake up (if not in a coma).

The reason all these methods work is that the body experiences discomfort, and seeks to change its current state, which often requires using the brain.

Note that this will often not work in a physically induced coma. However, the icy water in ear method will, as it works through the autonomous nervous system.

(thanks for the extra info, alex.tan :)

There is a test for psychological vs. physical coma that may not awaken the victim, and which does not cause vomiting, unlike the ice water method. It may be useful in certain circumstances.

Assuming the victim is lying on their back, raise their hand directly above their face and drop it. A physically comatose victim will permit the hand to fall directly on the face, and you need to get a doctor involved to prevent any further resemblance to a rag doll. A psychologically comatose victim will sense the threat and just manage to pull the hand to one side.

Side effects may include a broken nose—the victim's, if the coma was physical, or yours, if the victim finds your intrusion upsetting enough. Use with caution.

This writeup was brought to you today by my Physiology prof Bruce Woolley, my EMT friends Erika and Sterling, and the indefinite 'they'.

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