HBO Video has released Coma, the 2007 documentary by director Liz Garbus that chronicles four patients who have suffered traumatic brain injuries. Scrupulously inconspicuous and not at all exploitive, Coma still manages to chill the viewer when its central message finally sinks in: the majority of people who suffer a traumatic brain injury rarely go back to being the person they were before their accidents, and, more terrifying, doctors don't really know why.

Beginning in the summer of 2005, Garbus followed four patients admitted to the JFK Medical Center in Edison, New Jersey, one of the leading institutions in the world for the study and care of traumatic brain injuries. Al'Khan Edwards, 26-years-old, a father and restaurant worker; Roxy Guzman, 19-years-old, a college student; Sean Reilly, 20-years-old, a college student, and Tom Segars, 31-years-old sales manager, have all awoken from a comatose state. Edwards and Guzman were involved in car accidents; Reilly was assaulted and thrown from a bridge when in Europe; and Segars fell from a balcony. This is all the background information Garbus presents on the patients. Their past histories are unimportant - a perfect filmic metaphor for the loss of self that occurred when their brains were damaged.

I must confess I didn't have any previous knowledge of the aftereffects of a coma, other than the highly inaccurate presentations of the state that invariably pop up in films and on TV (someone in the documentary mentions the dichotomy between the "reel" comas and actual ones). I had the impression, as I suspect quite a few people have, that the majority of people who awake from a coma are functioning normally within a few days, if not hours; the soothing falsity that are "movies" usually presents comas like some deep sleep, from which suffers awake refreshed, or more grotesquely, imbibed with some special awareness or power. Nothing could be further from the truth, evidently.

As Coma matter-of-factly states, coma patients who awake can enter a minimally conscious state, which can either then progress to a more fully conscious state of awareness and functionality, or which can retreat into a permanent vegetative state. Although doctors are for the most part perplexed as to why the following occurs, most are in agreement that 95% of all minimally conscious patients have a one-year window to show improvement. If they don't progress within this period, the vast majority never will. And obviously, that's the time frame that director Garbus uses, with the viewer drawn in, watching the clock so to speak, to see if any of the patients will show even the smallest flicker of cognitive recognition, indicating that they're indeed "there" and that they therefore qualify for more therapy and effort to bring them back to some semblance of their former selves.

What Coma does quietly and with a detached yet not unsympathetic air - and without a trace of capitalizing on the suffering of its subjects - is present these patients' conditions and show exactly how these mystifying injuries not only frustrate and impede the few ones lucky enough to progress away from a vegetative state, but also show the dedication of the professionals who care for these people, and the tremendous well of caring and hope and heartbreak that consumes these patients' family members. "Pity" decidedly isn't Garbus' aim, although how anyone watching Coma would deny feeling this is beyond me. There are several heartbreaking scenes where parents and loved ones realize their child won't be recovering, or they won't be the person they used to be, and frankly, it's difficult to watch. Particularly because Garbus deliberately doesn't try to wring pathos out of the situations. Had she, we might have been able to cry, "Foul," and distance ourselves from the rather horrifying abyss she adeptly conveys. That void of cognitive functionality was what I found most terrifying about Coma, with the added horror that doctors really don't know yet - if they ever will - what is happening with these patients. The notion that someone may be "trapped" in a mind that has been permanently damaged, resulting in the loss of basic cognitive skills and a body that won't respond correctly, is a frightening prospect for anyone to contemplate. Coma doesn't shoot for this creeping discomfort deliberating or crudely; it's just there, matter-of-factly, and all the more disquieting for Garbus' detached style.

The DVD:

The Video:
The full-screen, 1.33:1 video transfer for Coma is fine, with a clear, sharp image and a correctly hued color range. No compression issues.

The Audio:
The English 2.0 stereo audio track cleanly delineates all dialogue. A Spanish audio track is optional, as are English close-captions.

The Extras:
There's a bonus segment of Coma, running 17:56, that looks at Willie Hicks, a patient at JFK who has a far more successful recovery than the four patients featured in the main film.

Final Thoughts:
Quietly harrowing, director Liz Garbus' detached yet essentially sympathetic Coma looks at four patients who have suffered traumatic brain injuries, and the unfathomable, inexplicable medical riddles that surround their various recoveries and regressions. Not at all exploitative, Coma is a most unusual medical documentary that mixes unquenchable hope with a deep, mystifying sense of dread, and of finality. I recommend Coma.