Real coma is not like 'Heaven'

The trailers and TV ads for Just Like Heaven, the new No. 1 film starring Reese Witherspoon, might lead you to believe it's just like ... well, just like Ghost.

With the poster bearing the tagline "It's a wonderful afterlife," the DreamWorks romantic comedy appears to be a supernatural love story about two people co-existing in different dimensions.

But the film crosses into less whimsical terrain in its second half when it's revealed that Witherspoon, a workaholic E.R. doctor hurt in a head-on crash, actually has been in a coma for the past three months. Meanwhile, her spunky spirit is seen and heard only by Mark Ruffalo's landscape architect, who sublets her apartment.

The movie's approach to medical issues is more storybook fanciful than textbook factual.

No coma patient after that length of time would look as Snow White-fresh as Witherspoon does, says Susan Tolle, an internist and director of the Center for Ethics in Health Care at the Oregon Health & Science University in Portland. Her muscles, including those in her face, would atrophy. Her eyes probably wouldn't be shut all the time.

While Witherspoon is connected to a breathing machine, few other details are offered about the extent of her injuries. And that's exactly as co-writer Leslie Dixon (Freaky Friday) intended.

"Whatever the medical reality is was completely ignored," she says of the screenplay based on the French novel If Only It Were True. "The film was meant to entertain. People aren't arguing the pros and cons of plug-pulling. They wipe away tears or smile as they walk out. It's pleasurable for them, not preachy at all."

Still, with its talk of living wills and final wishes, Heaven easily could summon echoes of spring's national obsession over the fate of Terri Schiavo. Ruffalo says that reporters at a press junket brought up the question.

"They're like, 'Um, what do you think is this movie's position?' For anyone to politicize this movie that way would be a real stretch and sad to see." Besides, what ultimately happens "is medically impossible."

Shooting was completed long before the family battle over Schiavo's guardianship monopolized headlines. After all the media coverage, Dixon says, "I was concerned initially. But when I saw it with an audience, I relaxed. Bottom line is, out of 600 test cards, only one mentioned it."

Adds director Mark Waters (Mean Girls), "It's clearly not inspired by the Schiavo case." He doubts those on either side of the right-to-die issue could co-opt what is essentially a fantasy. "It's not like there is a political or religious agenda to the movie. Everyone wants her to wake up."

But just as Million Dollar Baby caused a ruckus over its depiction of assisted suicide, Heaven could raise concern over its Hollywood-ized picture of a young and healthy-looking coma patient. Especially since a life force in the form of Witherspoon's somewhat vaporous presence clearly hovers outside her prone body.

The danger, Tolle says, is that the film might give false hope. "It's so hard for parents of young people who are profoundly brain injured," she says. "When they are brain dead, they look like they are asleep. Their chests rise and fall. But nothing is functioning. Body functions are all artificially maintained."

Even if someone were to miraculously awaken, "no one leaps out of bed," Tolle says. "There is an extremely prolonged rehabilitation."

That Witherspoon's character is on a ventilator and in intensive care for such a long period would make any recovery highly unlikely. "That is the stuff of dreams," Tolle says.

But Heaven might encourage even the young and healthy to obtain a living will and avoid the legal mess that Schiavo's family faced.

"Advanced directives are useful for selecting the best person to decide," Tolle says. "You don't want Congress or the courts choosing for you."

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