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Is a person in coma aware of her surroundings?

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Practicing since : 2002
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I have a questions about my sister who was in a Coma bc of an overdose. Her pain doc prescribed oral Methodone (6 per day) and Xanax (BID) - she took her morning doses and was barely breathing when found. She was airlifted and on to ICU and later that night, she opened her eyes for a few secs and gripped our hands--the nurse said she "had improved" and was responding some but then went right back out when we stopped talking (and needed to bc a little later she pulled out a tube). They had to give her something to settle her down bc she was on a vent. She never came to again that we know of and her vitals worsened the next day and then she passed away the following morning bc her heart rate was insane, BP so low, and Glucose all over the map. She was on the highest lev drip possible or she'd have gone into arrest sooner. It hurts us to think she might have been aware all that time. Was she? And why was she coming in and out of being awake later on the day she overdosed? And why not the next day? She was motioning wanting us to come closer--I am sure to tell us to take out the tubes so she could try and talk, but it would have killed her since the vent was keeping her alive. I wish we just knew more about that state and why it worsened and again--how aware she prob was.
Posted Sat, 5 May 2012 in Drug Abuse
Answered by Dr. Robert Galamaga 3 hours later
Hello and thank you for your query.

First of all I am very sorry to hear about what happened to your sister. This is certainly a tragic event and I will do my best to try to give you some information and understanding regarding what happened.

Let me also say early on that I really feel that she was not fully conscious and aware of everything that was going on around her near the end of her life. The body has a tremendous tendency to want to fight artificial interventions and I'm sure that was what was going on when she was on the ventilator.

The waxing and waning tendency of her symptoms as she neared the end of her life was more so a physiologic response and stress response as her body was slowly giving away. I am confident that the overdose of fact really had a significant impact on her neurologic status and brain function such that the emotion of anxiety and pain were nearly completely wiped out near the end.

Let me reassure you again that I think that while your sister suffered a very tragic episode near the end of her life that her emotions of pain as well as anxiety or lay to rest before her body finally lets go.

I thank you very much for submitting your question and sharing with your sisters experience. I hope my answer has provided you with some good information as well as comfort. If you have any additional questions related to this concern. I would be happy to address them.


Dr. Galamaga
Above answer was peer-reviewed by
Follow-up: Is a person in coma aware of her surroundings? 1 hour later
Very helpful. We wondered if she was even in pain as she worsened? The nurse said that she was certainly "uncomfortable" but that was the 1st night when we got the "response" from her.

Do you think she was under far enough that she was not lying there in horrible pain all that time? Or at least was not aware of it?

And finally...You are saying that although she got so bad right before passing she more than likely was not aware of it?

Thank you so much for your insight.


PS--I am sorry I was throwing so much out there. It just seemed so unreal that she was pulling at us and grasping our hands and even had tears in her eyes. She was trying to tell us something--but it was so brief. Is that normal? And to not even do that again?
Follow-up: Is a person in coma aware of her surroundings? 11 minutes later
And do pts in this state normally hear what is going on around them? We talked to her and told her how much we love her--but in so many ways, we hoped she didn't hear anything since we couldn't be with her that much and we didn't want her to feel so alone if she was aware of what was being said by nurses and docs in our absence or even other family visitors.
Answered by Dr. Robert Galamaga 1 hour later
Thanks for the follow up.

I really think that she was not aware of everything that was going on around her. The brain sometimes let's go before the rest of the body does and in her case I really feel strongly that this was what was going on.

It's not uncommon for these periods of apparent lucency to punctuate the end of life but there really is no awareness on the part of the patient. It is part of the dying process.

Regarding hearing - this is impossible to prove really. We can assume however that auditory stimuli may still be processed. It is not likely however that these auditory stimuli translated into anything as the brain again was not functioning. The processing of sounds occurred in the ear and nerves near the ear but beyond that it would be by processed.

I thank you again for the query and followup. I am here for you should you have any additional concerns.


Dr. Galamaga
Above answer was peer-reviewed by
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