What Romantic Comedies Get Wrong About Brain Damage

Isn’t It Romantic hit theaters just before Valentine’s Day—not even a year after Amy Schumer’s generally disliked I Feel Pretty—and it follows an all-too-familiar trajectory. Rebel Wilson’s character, Natalie, is mugged on the subway when she incorrectly assumes a man is flirting with her, runs into a pole while trying to get away, and wakes up in a romantic comedy.

What trope do these two flicks have in common besides blonde leads looking-but-not-looking for “the one”? It’s self-realization after a traumatic brain injury (TBI) resulting in zany situations and ultimately, a perfect new relationship.

The link between romance and brain damage is a strange motif in rom-com history. Back in 2004, 50 First Dates saw Adam Sandler trying to woo Drew Barrymore even though she would inevitably forget who he was by the next morning. Every day. Repeat ad nauseam. Add rock ‘n’ roll classics to the soundtrack and shove some Rob Schneider in there and it's a standard Happy Madison production with an aww-factor.

This, friends, is not exactly how it happens in real life. After my own traumatic brain injury in 2015 when I fell 25 feet out of a redwood tree, I had to relearn how to walk, swallow, and use the bathroom by myself. And that was before I even was allowed out of the spinal injury ward (where I remained for six weeks). In the following months, I completed physical, occupational, and speech/cognitive therapy in a 7-hour, 5-day-a-week program.

One problem with using a head injury as a plot device is the message it sends about how "easy" it is to recover from a TBI. In 2013 (the last year data was collected), there were about 2.8 million TBI-related emergency department visits, hospitalizations, and deaths in the United States. And 50 percent of non-fatal, severe TBIs—such as the ones these romantic comedy leads experience—result in permanent deficits that the movies totally ignore. This is an injury that comes with baggage which doesn't usually appear in the form of a perfect new boyfriend.

In Isn’t It Romantic (beware of the spoiler), Natalie doesn’t just have a traumatic brain injury—she was in a medically-induced coma and the entire movie plot ends up being a dream that her subconscious cooked up. When she emerges from her coma, Natalie does so in the same vein as most media representations: instantaneously and immediately able to perform well, physically and cognitively.

Yes, this is just a movie and, with a willing suspension of disbelief, we’re all okay with this concept. But it still sets up some audaciously unrealistic expectations for individuals who've had a TBI or were ever in a coma. Movies like this have to be at least part of the reason my mom decided to take me whale-watching a month after I was out of the hospital—even though I still had double-vision and an arm crutch because of my balance issues.

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People do get their perceptions of coma from films and television, whether they admit it or not. In 2006, a report about “the portrayal of coma in contemporary motion picture” found that 39 percent of people in the college-educated group they polled “would allow the scenes [of coma] to influence their decisions.” That may not seem like a high percentage to you, but considering the fact that a movie plot might dictate how these people might treat a recovering person, 39 percent is not ideal.

When a person endures a really severe brain injury and disturbance of consciousness, it’s not uncommon for their families to expect them to wake up and go straight home, back to regular life, after a little bit of therapy, says Joseph Giacino, director of rehabilitation neuropsychology at Spaulding Rehabilitation Hospital and professor of medicine at Harvard Medical School. But, just as there was for me, months of intense therapy usually follows. During that time, the type of support I needed warranted a real understanding of what happened to my body and mind.

In Isn't It Romantic, when Natalie wakes from her 18-hour, medically-induced coma, she bolts out of bed after her doctor gets a verbal agreement not to be sued if she injures herself—y’know, because she literally just regained consciousness.

To be fair, the “hit-your-head and madness ensues” trope isn’t completely fiction—far from it. Weird things that happen in movies do happen to people in real life. After Natalie’s coma, she’s imbued with unprecedented confidence and barges into her boss’s board meeting to present an idea she’s come up with. The movie may have gotten the recovery time wrong, but Giacino points out that uninhibitedness is indeed a common result of traumatic brain injuries.

“That confidence is not really confidence. It’s social disinhibition,” he says. Theoretically, Natalie's frontal lobe control has been dampened as a result of the injury. As a result, her “brakes” get applied less frequently or not as hard. “Her behavior is more apt to be expressed, and that can look like confidence. ‘I'm doing these things I never did before.’ This absolutely does happen. You hear this all the time,” he says.

In college, I used to take shots of whiskey before giving presentations for classes. Confidently speaking in front of an audience, even a small one, was an enormous source of anxiety. Post-injury, I actually stand up in front of a classroom and teach college composition to freshmen—I just don’t feel any strong emotions or sensations as I did before when it comes to public speaking. If enough damage is done to the frontal lobe, the way a person’s emotions are experienced can change drastically. For the record though, I definitely didn’t hop out of bed and start fearlessly lecturing to a roomful of people.

Another thing: I actually did wake up with a boyfriend. A casual partner of mine decided to tell doctors we were together, thinking everything would play out just fine. But five months of therapy, one eye surgery, and a permanent invisible disability later, he had major buyer’s remorse; he wasn’t so keen on continuing the relationship. Movies that pretend romance is a byproduct of brain damage are more concerned with entertainment than accuracy, which does make families—and in my case, potential partners—expect different outcomes.

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