In medicine, a coma (from the Greek koma, meaning deep sleep) is a state of unconsciousness, lasting more than 6 hours A person in a state of coma is described as comatose.

Coma may result from a variety of conditions, including intoxication (such as illicit drug abuse, overdose or misuse of over the counter medications, prescribed medication, or controlled substances), metabolic abnormalities, central nervous system diseases, acute neurologic injuries such as strokes or herniations, hypoxia, hypothermia, hypoglycemia or traumatic injuries such as head trauma caused by falls or vehicle collisions. It may also be deliberately induced by pharmaceutical agents in order to preserve higher brain functions following brain trauma, or to save the patient from extreme pain during healing of injuries or diseases.

In order for a patient to maintain consciousness, two important neurological components must function impeccably. The first is the cerebral cortex which is the gray matter covering the outer layer of the brain, and the other is a structure located in the brainstem, called reticular activating system (RAS or ARAS). Injury to either, or both of these components is sufficient to cause a patient to experience a coma. The human cortex is a group of tightly dense, "gray matter" composed of the nucleus of the neurons whose axons then form the "white matter", and is responsible for the perception of the universe, relay of the sensory input (sensation) via the thalamic pathway, and most importantly directly or indirectly in charge of all the neurological functions, from simple reflexes to complex thinking. Reticular activating system (RAS) on the other hand is a more primitive structure in the brainstem that is tightly in connection with reticular formation (RF), a critical anatomical structure needed for maintenance of arousal. Reticular activating system (RAS) takes its name from the effect it has on the reticular formation, which is via its stimulation. It is therefore necessary to investigate in a comatose patient, the integrity of the bilateral cerebral cortices, and the reticular activating system (RAS).

Signs and symptoms

Generally, a patient who is unable to voluntarily open the eyes, does not have a sleep-wake cycle, is unresponsive in spite of strong tactile (painful), or verbal stimuli and who generally scores between 3 to 8 on the Glasgow Coma Scale is considered to be in coma.

The outcome for coma and vegetative state depends on the cause, location, severity and extent of neurological damage. A deeper coma alone does not necessarily mean a slimmer chance of recovery, because some people in deep coma recover well while others in a so-called milder coma sometimes fail to improve.

People may emerge from a coma with a combination of physical, intellectual and psychological difficulties that need special attention. Recovery usually occurs gradually—patients acquire more and more ability to respond. Some patients never progress beyond very basic responses, but many recover full awareness. Regaining consciousness is not instant: in the first days, patients are only awake for a few minutes, and duration of time awake gradually increases. This is unlike the situation in many movies where people who awake from comas are instantly able to continue their normal lives. In reality, the coma patient awakes sometimes in a profound state of confusion, not knowing how they got there and sometimes suffering from dysarthria, the inability to articulate any speech, and with many other disabilities.

Predicted chances of recovery are variable owing to different techniques used to measure the extent of neurological damage. All the predictions are based on statistical rates with some level of chance for recovery present: a person with a low chance of recovery may still awaken. Time is the best general predictor of a chance of recovery: after 4 months of coma caused by brain damage, the chance of partial recovery is less than 15%, and the chance of full recovery is very low.

The most common cause of death for a person in a vegetative state is secondary infection such as pneumonia which can occur in patients who lie still for extended periods.

Occasionally people come out of coma after long periods of time. After 19 years in a minimally conscious state, Terry Wallis spontaneously began speaking and regained awareness of his surroundings. Similarly, Polish railroad worker Jan Grzebski woke up from a 19-year coma in 2007.

A brain-damaged man, trapped in a coma-like state for six years, was brought back to consciousness in 2003 by doctors who planted electrodes deep inside his brain. The method, called deep brain stimulation (DBS) successfully roused communication, complex movement and eating ability in the 38-year-old American man who suffered a traumatic brain injury. His injuries left him in a minimally conscious state (MCS), a condition akin to a coma but characterized by occasional, but brief, evidence of environmental and self-awareness that coma patients lack. Comas however can range from hours to weeks. The shortest time period of a coma has never been recorded, with the longest being 37 years and 111 days.

Coma lasting seconds to minutes results in post-traumatic amnesia (PTA) that lasts hours to days; recovery plateau occurs over days to weeks. Coma that lasts hours to days results in PTA lasting days to weeks; recovery plateau occurs over months. Coma lasting weeks results in PTA that lasts months; recovery plateau occurs over months to years.

Treatment and recovery

Medical treatment

Coma is a medical emergency, and attention must first be directed to maintaining the patient's respiration and circulation, using intubation and ventilation, administration of intravenous fluids or blood and other supportive care as needed. Once a patient is stable and no longer in immediate danger, the medical staff may concentrate on maintaining the health of patient’s physical state. The concentration will be directed on preventing infections such as pneumonias, bedsores (decubitus ulcers) and providing a balanced nutrition.

Emotional challenges

Coma has a wide variety of emotional reactions from the family members of the affected patients, as well as the primary care givers taking care of the patients. Common reactions, such as desperation, anger, frustration, and denial are possible. The focus of the patient care should be on creating an amicable relationship with the family members or dependents of a comatose patient as well as creating rapport with the medical staff. Emotional support, and continuous "emotional stimuli" by close family members and figures familiar to the patient, are believed by some to have a positive impact on improvement of the comatose patients, however supportive literature is not extensive.

Society and culture

Research by Dr. Eelco Wijdicks on the depiction of comas in movies was published in Neurology in May 2006. Dr. Wijdicks studied 30 films (made between 1970 and 2004) that portrayed actors in prolonged comas, and he concluded that only two films accurately depicted the state of a coma victim and the agony of waiting for a patient to awaken: Reversal of Fortune (1990) and The Dreamlife of Angels (1998). The remaining 28 were criticized for portraying miraculous awakenings with no lasting side effects, unrealistic depictions of treatments and equipment required, and comatose patients remaining muscular and tanned.

See also

Brain death Lack of activity in both cortex, and lack of brainstem function.

Coma scale, a system to assess the severity of coma

Locked-in syndrome Paralysis of most muscles, except ocular muscles of the eyes, while patient is conscious.

Persistent vegetative state (vegetative coma), deep coma without detectable awareness. Damage to the cortex, with an intact brainstem.

Process Oriented Coma Work, for an approach to working with residual consciousness in comatose patients

References

Category:Intensive care medicine Category:Emergency medicine Category:Symptoms and signs: Cognition, perception, emotional state and behaviour

Name	Marilyn Manson
Landscape	Yes
Background	solo_singer
Genre	Rock
Birth name	Brian Hugh Warner
Born	January 05, 1969Canton, Ohio, U.S.
Instrument	Vocals, guitar, bass, keyboards, drums, pan flute, percussion
Occupation	Singer-songwriter, musician, artist, poet, film director, actor
Years active	1989–present
Label	Cooking Vinyl, Nothing, Interscope
Associated acts	Marilyn Manson, Satan on Fire, Nine Inch Nails, Mrs. Scabtree, Jack Off Jill
Signature	Signature of Marilyn Manson.png
Signature alt	Cursive signature in ink

Brian Hugh Warner (born January 5, 1969), better known by his stage name Marilyn Manson, is an American musician and artist known for his controversial stage persona and image as the lead singer of the eponymous band, Marilyn Manson. His stage name was formed from juxtaposing the names of two 1960's American cultural icons, namely, actress Marilyn Monroe and convicted multiple murder mastermind Charles Manson as a critical and, simultaneously, laudatory appraisal of America and its peculiar culture. He has a long legacy of being depicted in the media as a detrimental influence on children. The seemingly outrageous styles for which he models and the controversy surrounding his lyrics have led to his very pronounced public appeal.

Early life

Marilyn Manson was born as Brian Hugh Warner in Canton, Ohio, the only child of Barb (née Wyer) and Hugh Warner. As a child, he attended his mother's Episcopalian church, though his father was Catholic. Warner attended Heritage Christian School from first grade to tenth grade. He later transferred to Cardinal Gibbons High School in Fort Lauderdale, Florida. Manson graduated from high school in 1987, and became a student at Broward Community College in 1990. He was working towards a degree in journalism, and was gaining experience in the field by writing music articles for a South Florida lifestyle magazine, 25th Parallel. He would soon meet several of the musicians to whom his own band would later be compared, including My Life With the Thrill Kill Kult and Trent Reznor of Nine Inch Nails.

Career

Music

Manson formed Marilyn Manson & the Spooky Kids in Florida in 1989 (the name was shortened to Marilyn Manson in 1992). While with The Spooky Kids, he was involved with Jeordie White (also known as Twiggy Ramirez) and Stephen Gregory Bier Jr. (also known as Madonna Wayne Gacy) in two side-projects: Satan on Fire, a faux-Christian metal ensemble where he played bass guitar, and drums in Mrs. Scabtree, a collaborative band formed with White and then girlfriend Jessicka (vocalist with the band Jack Off Jill) as a way to combat contractual agreements that prohibited Marilyn Manson from playing in certain clubs. In the summer of 1993, the band drew the attention of Trent Reznor. Reznor produced their 1994 debut album, Portrait of an American Family and released it on his Nothing Records label. The band began to develop a cult following, which grew larger with the release of Smells Like Children in 1995. That EP yielded the band's first big MTV hit with "Sweet Dreams (Are Made Of This)", a cover of the 1983 Eurythmics hit. Antichrist Superstar (co-produced by Trent Reznor) was an even greater success.

In the US alone, three of the band's albums have been awarded platinum certification, three more gold, and the band has had three releases debut in the top ten, including two number-one albums. Manson first worked as a producer with the band Jack Off Jill. He helped name the band and produce most of the band's early recordings, and also played guitar on the song "My Cat" and had the band open most of his South Florida shows. Manson later wrote the liner notes to the band's album Humid Teenage Mediocrity 1992-1995, a collection of early Jack Off Jill recordings. Manson has appeared as a guest performer on DMX's album Flesh of My Flesh, Blood of My Blood and on Godhead's 2000 Years of Human Error album — the only album released on his vanity label Posthuman.

In 2010 Manson was featured in the Motionless in White song, "London in Terror".

Film and television

.]] Manson made his film debut in 1997, as an actor in David Lynch's Lost Highway. Since then he has appeared in a variety of minor roles and cameos, including Party Monster; then-girlfriend Rose McGowan's 1998 film Jawbreaker; Asia Argento's 2004 film The Heart Is Deceitful Above All Things; ; and , the sixth installment in the BMW Films series. He was interviewed in Michael Moore's political documentary Bowling for Columbine discussing possible motivations for the Columbine massacre and allegations that his music was somehow a factor. He has appeared in animated form in Clone High and participated in several episodes of the MTV series Celebrity Deathmatch, becoming the show's unofficial champion and mascot; he often performed the voice for his claymated puppet, and contributed the song "Astonishing Panorama of the Endtimes" to the soundtrack album. In July 2005, Manson told Rolling Stone that he was shifting his focus from music to filmmaking - "I just don't think the world is worth putting music into right now. I no longer want to make art that other people — particularly record companies — are turning into a product. I just want to make art."

Johnny Depp reportedly used Manson as his inspiration for his performance as Willy Wonka in the film Charlie and the Chocolate Factory. Manson himself expressed interest in playing the role of Willy Wonka in the film.

He has been working on his directorial debut, , In the film, he plays Lewis Carroll, author of Alice's Adventures in Wonderland. Rather than a web-only release, he decided to give the estimated $4.2 million budget film a conventional cinema release, originally slated for mid-2007. The film was to have an original music soundtrack with previously unreleased songs. Production of the film had been postponed until an undefined period following the Eat Me, Drink Me tour, and were consqeuently cancelled due to its violent contents. Manson will portray metalband frontman Lars in the upcoming Slasher Splatter Sisters.

Art

Manson claimed in a 2004 interview with i-D magazine to have begun his career as a watercolor painter in 1999 when he made five-minute concept pieces and sold them to drug dealers. On September 13–14, 2002, his first show, The Golden Age of Grotesque, was held at the Los Angeles Contemporary Exhibitions Centre. Art in America's Max Henry likened them to the works of a "psychiatric patient given materials to use as therapy" and said his work would never be taken seriously in a fine-art context, writing that the value was "in their celebrity, not the work". On September 14–15, 2004, Manson held a second exhibition on the first night in Paris and the second in Berlin. The show was named ‘Trismegistus’ which was also the title of the center piece of the exhibit – a large, three-headed Christ painted onto an antique wood panel from a portable embalmers table.

Manson named his self-proclaimed art movement Celebritarian Corporation. He has coined a slogan for the movement: “We will sell our shadow to those who stand within it.” In 2005 he said that the Celebritarian Corporation has been "incubating for seven years" which if correct would indicate that Celebritarian Corporation, in some form, started in 1998.

Celebritarian Corporation is also the namesake of an art gallery owned by Manson, called the Celebritarian Corporation Gallery of Fine Art in Los Angeles for which his third exhibition was the inaugural show. From April 2–17, 2007, his recent works were on show at the Space 39 Modern & Contemporary in Florida. 40 pieces from this show traveled to Germany's Gallery Brigitte Schenk in Cologne to be publicly exhibited from June 28 - July 28, 2007. Manson was refused admittance to Kölner Dom (Cologne Cathedral), when he was in the city to attend the opening night. This was, according to Manson, due to his makeup.

Manson revealed a series of twenty paintings in 2010 entitled Genealogies of Pain, an exhibition the artist collaborated on with David Lynch. The series is being showcased in Vienna's Kunsthalle gallery.

Personal life

Manson made an appearance in the video game Area 51 as Edgar, a Grey Alien. His song "Cruci-Fiction In Space" is featured in a commercial for a video game, The Darkness. His likeness is also featured on the Celebrity Deathmatch video game for which he recorded a song for the soundtrack (2003). The song "Use your fist and not your mouth" was the credits score of the game Cold Fear as well as . Manson launched "Mansinthe," his own brand of Swiss made absinthe, which has received mixed reviews ranging from critics who compared the drink's odor to sewage water and described the taste as being "as bad as piss" to coming second to Versinthe in an Absinthe top 5 and winning a Gold medal at the 2008 San Francisco World Spirits Competition. Prior to his relationship with Dita Von Teese, he was in a relationship with Michele Greenberg. He then was engaged to actress Rose McGowan. In 2007, attention was brought to Manson's love life again when a relationship with True Blood actress Evan Rachel Wood was made public. Manson and Wood reportedly maintained an on-again off-again relationship for several years. Manson proposed to Wood during a Paris stage performance in January 2010, but the couple broke off the engagement later that year. After media comments from Manson that he wears his signature black leather pants 24/7, animal rights group PETA added Manson to PETA’s ‘Worst-Dressed Celebrities of 2008’.

Marriage to Dita Von Teese

Manson and Dita Von Teese first met when he asked her to dance in one of his music videos. Though she was unable to, the two kept in contact. On his 32nd birthday they became a couple. He proposed on March 22, 2004 and gave her a 1930s-era, , European round-cut diamond engagement ring. On November 28, 2005, Manson and von Teese were married in a private, non-denominational ceremony in their home. A larger ceremony was held on December 3, at Gurteen Castle, in Kilsheelan, County Tipperary, Ireland, the home of their friend, Gottfried Helnwein. The wedding was officiated by surrealist film director and comic book writer Alejandro Jodorowsky.

On December 30, 2006 Von Teese filed for divorce due to "irreconcilable differences." ET.com and People claimed that Manson was having an extramarital affair with then 19-year-old actress Evan Rachel Wood, who is to co-star in his horror film , and features in the video for his 2007 single, "Heart-Shaped Glasses." The relationship was confirmed by Von Teese in an interview with the Sunday Telegraph, "I get the impression he thinks I was unsupportive, but the truth is I wasn't supportive of his lifestyle, and someone else came along who was." Manson's alcohol abuse and distant behavior were also cited as cause for the split. A judgement of divorce was entered in Los Angeles Superior Court on December 27, 2007.

Lawsuits

In a civil battery suit, David Diaz, a security officer from a concert in Minneapolis, Minnesota, on October 27, 2000, sued for $75,000 in a Minneapolis federal court. The federal court jury found in Manson's favor.

In a civil suit presented by Oakland County, Michigan, Manson was charged with sexual misconduct against another security officer, Joshua Keasler, during a concert in Clarkston, Michigan, on July 30, 2001. Oakland County originally filed assault and battery and criminal sexual misconduct charges, but the judge reduced the latter charge to misdemeanor disorderly conduct. Manson pleaded no contest to the reduced charges, paid a $4,000 fine, and later settled the lawsuit under undisclosed terms.

On April 3, 2002, Maria St. John filed in Los Angeles Superior Court accusing Manson of providing her adult daughter, Jennifer Syme, with cocaine and instructing her to drive while under the influence. After attending a party at Manson's house, Syme was given a lift home; Manson claims she was taken home by a designated driver.

On August 2, 2007, former band member Stephen "Pogo/Madonna Wayne Gacy" Bier filed a lawsuit against Manson for unpaid "partnership proceeds," seeking $20 million in back pay. Several details from the lawsuit leaked to the press. In November 2007, additional papers were filed saying that Manson purchased a child's skeleton and masks made of human skin. He also allegedly bought stuffed animals, such as a grizzly bear and two baboons and a collection of Nazi memorabilia. In December 2007, Manson countersued, claiming that Bier failed to fulfill his duties as a bandmember to play for recordings and to promote the band.

Discography

Portrait of an American Family (1994)

Antichrist Superstar (1996)

Mechanical Animals (1998)

Holy Wood (In the Shadow of the Valley of Death) (2000)

The Golden Age of Grotesque (2003)

Eat Me, Drink Me (2007)

The High End of Low (2009)

Filmography

S.F.W. ("Get Your Gunn" featured on soundtrack)

Lost Highway (as Porno Star #1, "Apple of Sodom" & "I Put a Spell on You" included on soundtrack) (1997)

Spawn ("Long Hard Road out of Hell" included on soundtrack) (1997)

Private Parts ("Suck for Your Solution" included on soundtrack) (1997)

Nowhere ("Kiddie Grinder (Remix)" included on soundtrack) (1997)

Dead Man on Campus ("Golden Years" included on soundtrack) (1998)

The Matrix ("Rock is Dead" included on soundtrack) (1999)

Jawbreaker (as The Stranger) (1999)

Detroit Rock City ("Highway to Hell" included on soundtrack) (1999)

("Suicide is Painless" included on soundtrack) (2000)

Valentine ("Valentine's Day" included on soundtrack) (2001)

From Hell ("The Nobodies (Wormwood Remix)" included on soundtrack) (2001)

Not Another Teen Movie ("Tainted Love" included on soundtrack) (2001)

Resident Evil (Composer, 2002)

Bowling for Columbine (interview, 2002)

Queen of the Damned (Vocals on "Redeemer" included on soundtrack) (2002)

(as Himself) (2003)

Party Monster (as Christina) (2003)

Doppelherz (Director, Composer) 2003)

The Heart Is Deceitful Above All Things (as Jackson) (2004)

Area 51 (as voice of Edgar) (2005)

Saw II ("Irresponsible Hate Anthem (Venus Head Trap Mix)" included on soundtrack) (2005)

House of Wax ("Dried Up, Tied and Dead to the World" included on soundtrack) (2005)

Living Neon Dreams (2006)

Rise: Blood Hunter (as Bartender) (2006)

King Shot (2009)

Gamer ("Sweet Dreams (Are Made of This)" included on soundtrack) (2009)

(as Lewis Carroll, Director, Writer, Composer) (2010)

Tim and Eric Awesome Show, Great Job! (as The Dark Man) (2010)

Splatter Sisters (Actor, Composer) (2011)

Vampires Suck ("If I Was Your Vampire" included on soundtrack) (2010)

Books

The Long Hard Road Out of Hell (1998)

Holy Wood Unreleased

Appearances in other media

In an episode of Metalocalypse called Regionklok, Manson was featured as the priest of a Satanist church, telling the fellow satanists not to forget to pick their trash up and to not park by the neighbors house, due to towing.

Season 2, Episode 18 of South Park features Trey Parker doing a parody of Marilyn Manson singing "Stinky Britches"

Episode 2 of Clone High portrays Marilyn Manson singing a song about the Food Pyramid

Season 5, Episode 4 of Family Guy portrays Marilyn Manson informing Chris Griffin of nutrition

In the final episode of the fourth season of Mr. Show David Cross portrays the character "Marilyn Monster" in a sketch.

In The X-Files Season 8, Episode 17 the characters Detective Potter and Agent Reyes discuss Marilyn Manson after finding his cd at the desk of a suspect.

Andy Dick created the character "Marilyn Poppins" for The Andy Dick Show as a satirical homage to Marilyn Manson

Manson was characterized in the British TV Series Bo' Selecta! during Series 4, Bo! in the USA.

During Season 4 of Madtv Pat Kilbane portrayed Marilyn Manson in episodes 406 & 407 for a Kenny Rogers sketch and Lowered Expectations sketch respectively.

MTV's Cartoon Sushi featured a clip of Marilyn Manson and Charles Manson in a celebrity fight to the death. This later spawned the series Celebrity Deathmatch in which Marilyn Manson continued his appearances crashing the fight between Hanson vs. The Spice Girls in the "Deathbowl '98", as well as his deathmatch with Garth Brooks in Season 1, Episode 6. His final match against Ricky Martin occurred when Martin interrupted a performance by Manson's band. Celebrity Deathmatch was made into a video game in 2003 featuring Marilyn Manson as a playable character.

Marilyn Manson is mentioned in Method Man's song "Well All Rite Cha", Outkast's song "Y'all Scared", Shop Boyz' song "Party Like a Rockstar", Dead Celebrity Status' song "In My Backyard", Wyclef Jean's song "Where Fugees At?", D12's songs "These Drugs" & "Blow My Buzz", Xzibit's song "3 Card Molly", Bizzy Bone's song "Social Studios", Slaughterhouse's song "The One", Nicki Minaj's song "Higher Than a Kite", Big & Rich's song "Comin' to Your City", Lonestar's song "Don't Let's Talk About Lisa", Princess Superstar's song "I Love You (Or at Least I Like You)", The Ataris' song "The Radio Still Sucks", Bowling for Soup's song "Luckiest Loser", Thousand Foot Krutch's song "Unbelievable", Relient K's song "My Girlfriend", Eminem's songs "When the Music Stops," "Still Don't Give a Fuck" & "The Way I Am" as well as New Radicals' song "You Get What You Give". Both latter songs generated interest from Manson.

References

External links

Official website

NACHTKABARETT

Category:1969 births Category:1980s singers Category:1990s singers Category:2000s singers Category:2010s singers Category:Marilyn Manson (band) members Category:Musical groups from Fort Lauderdale, Florida Category:Musical groups established in 1989 Category:American actors of German descent Category:American film actors Category:American male singers Category:American painters Category:American rock singers Category:American singer-songwriters Category:American musicians of German descent Category:American musicians of Polish descent Category:American autobiographers Category:Broward College alumni Category:Living people Category:Musicians from Florida Category:Musicians from Ohio Category:People from Canton, Ohio Category:Resident Evil composers