And I Must Scream/Real Life

Warning: This page contains Nightmare Fuel. Preparation of Brain Bleach is recommended.

"I did some volunteer work in a children's hospital. There was only one polio patient: one of the last cases, then a teenager, in an iron lung. By then there were no more specialty polio centers, no more polio wards, in which at least the inhabitants could talk to someone who understood. In a ward for children, where the other patients were kids who'd had some other treatable illness or injuries, there was his iron lung. He wanted no part of the cheerfulness we tried to bring to the ward. And no wonder. Unless he could adapt to one of the smaller respiratory assists that came later, he was stuck for life in a huge, unwieldy, scary case... immobile, having to be tended by people who reached in through portholes on the side to clean him up, change his diaper... and who, increasingly, would not have a clue what his life was like because people like him were so few now. He could not see his body, engulfed in the machine that kept him alive. He could see only what was directly above him or reflected in the mirror over his head. None of the electronic aids for the disabled existed then... or for another decade or two. There were, and are, more lethal diseases than polio: those with a higher mortality, and greater infectivity as well. But polio had a special horror to it."
 * One of the most common forms of this is Amyotrophic Lateral Sclerosis, also known as Motor Neurone Disease or Lou Gehrig's Disease. If you have Lou Gehrig's Disease, your motor neurons, which are responsible for triggering actions, gradually decay away while the rest of your nervous system (including your brain) remains perfectly intact. You can still feel pain and boredom but cannot move to avoid it. Clumsiness is one of the first symptoms. Poor Stephen Hawking got more of a taste of this than anyone ever wants, living like this for years, though he at least had sight, hearing and enough eye movement to control his computer (which did the communicating for him), along with retaining his incredible mind.
 * The fact that Hawking was not only able to maintain a positive attitude, but still focus his brilliant mind was a testament to his sheer willpower.
 * Fibrodysplasia ossificans progressiva (FOP). A horrible, horrible genetic disease where, if your muscles are damaged in any way at all, your body decides to replace the damaged muscle- not with more muscle, but with bone. By the time you're thirty, most, if not all of your joints have been locked into place by newly-grown bones and you die of starvation/suffocation because you can't move your jaw or ribs.
 * Fortunately, it's extremely rare.
 * A bad experience with the psychoactive herb salvia divinorum can cause horrifying sensations of being trapped in an eternal loop or transformed into an inanimate object.
 * You mean like that guy who OD'd on Acid and spent the rest of his life believing he was a glass of OJ and trying not to spill himself? Read here.
 * Not just salvia, but almost any psychedelic drug. Time dilation plus ego death equals this trope becoming very, very real.
 * During surgery, hospital patients are supposed to receive neuromuscular blocking agents (which keep them paralyzed so they don't twitch and mess up the surgery), sedatives (to keep them asleep and give them amnesia), and an anesthetic (to numb them so they don't feel anything). There are numerous reports of patients who have had the sedatives and anesthetics wear off during/after surgery but KEPT ON the neuromuscular blocking agent. So essentially they are completely paralyzed and wide awake and have no possible way to give the doctors a sign that they are in excruciating pain. Luckily, the autonomous systems keep functioning and react to the pain as normal (quickened breathing and pace, heightened blood pressure, sweat), so a good doctor would probably be able to tell and administer more anesthetic. Hopefully.
 * Modern anesthesia machines include an "entropy sensor" to make sure the patient is unconscious. The problem is that quite often it is removed for being in the way
 * Polio often caused paralysis. Sometimes of limbs. Sometimes of the various breathing mechanisms. Iron lungs, for a very long time, meant lying down in a sort of cylinder, with only the head outside. That's a nonintrusive way to keep someone breathing, and it's fine and dandy as a temporary thing. Most people who needed them only needed them for a week or two. But some polio patients were never able to breathe on their own again, and it was years before smaller long-term breathing machines were invented. Why We Immunize has a good article on that.
 * There's Elizabeth Moon's essay on polio. Put your chin on your chest.

"Many people tell me that I am bewitched... and I believe them, such is the life I suffer."
 * This is the gist of Locked in syndrome, wherein you appear comatose, but are actually 100% aware of everything going on. This can go undiagnosed, everyone thinking they're just plain comatose.
 * When former editor of Elle magazine Jean-Dominique Bauby was struck by locked-in syndrome after a stroke, he managed to communicate through a system of eyeblinks, and wrote a book about his experiences called The Diving-Bell and the Butterfly, later made into a film.
 * Severe cases of cerebral palsy or otherwise brain injury can result in a person being in a state like this.
 * Exhibit A: Christopher Nolan (not that one, the Irish author), whose only way to communicate is typing with an "unicorn stick" after taking anti-spasmodics so that he can have some voluntary control of his muscles.
 * See the references to Johnny Got His Gun in Film and Literature? One unfortunate Gulf War II veteran is living the nightmare. (Link to mentioned article)
 * Empress Dowager Lüi of the Han Dynasty, after having the young prince Ruyi murdered as a perceived threat to her son Hui's throne, tortured his mother, Consort Qi, by hacking off her hands and feet, putting out her eyes, deafening her, and tossing her in a pig pen to live out the rest of her life. Emperor Hui was so traumatized by his mother's unspeakable and pointless cruelty that he took to drink and died.
 * Carlos II of Spain.

"But his journal entries consisted, essentially, of the statements "I am awake" or "I am conscious," entered again and again every few minutes. He would write, "2.10 pm: this time properly awake... 2.14 pm: this time finally awake... 2.35 pm: this time completely awake," along with negations of these statements: "At 9.40 pm I awoke for the first time, despite my previous claims." This in turn was crossed out, followed by "I was fully conscious at 10.35 pm, and awake for the first time in many, many weeks." This in turn was canceled out by the next entry. This dreadful journal, almost void of any other content but these passionate assertions and denials, intending to affirm existence and continuity but forever contradicting them, was filled anew each day, and soon mounted to hundreds of almost identical pages." (pp. 203-204) Wearing has been keeping this diary for more than twenty years."
 * In the book "Musicophilia", Oliver Sacks describes the sad case of conductor Clive Wearing, who suffers from an acute case of both retrograde and anterograde amnesia (i.e. he has lost almost all memories of his past, and is also unable to form new long-term memories, like the protagonist in the film Memento). Wearing is aware that something is terribly wrong with him, but he has no way to learn what has happened or come to terms with it, and is left only with a constantly recurring realization of having been robbed of all past experience. At one point, Wearing's therapist suggested that he might try keeping a diary...


 * Heartwarmingly, one of the few things Wearing can always recognize and remember is his wife.
 * This experiment involving MRIs implies that people in persisted vegetative states may be completely aware of their surroundings, even going so far as to answer complicated questions. What's worse, the BBC broadcast talking about this implied the moral and legal obligations of such a claim, that someone stuck in this state and capable of asking for it would not be legally allowed assisted suicide.
 * However, several other methods of determining if someone in this state is aware are prone to problems. To wit, facilitated communication (where allegedly the comatose is able to communicate through another person "guiding" his hand to a keyboard) does not work (tests where different facilitators are used and where a test object is hidden from the facilitator, but not the PVS). The most prominent case of this is Rom Houben, a man who was thought to be completely aware for his 23 years in a coma, but was determined to still be out when the facilitated communication used to stake the claim failed.
 * Sleep paralysis is a condition in which the normal REM atonia that normally prevents the body from moving during REM sleep persists after one regains consciousness. Though generally this is experienced for only a few minutes at a time, the body is generally unable to accurately perceive the passage of time, and it can feel like hours. If it's not bad enough you're in a state of panic because you can't move, the subject can also experience terrifying hallucinations.
 * Thankfully, it's possible to learn to recognize what's going on and teach oneself ways to stay calm. Some sufferers are also able to break out of it faster by wiggling their toes, gradually regaining the ability to move at a somewhat quicker rate than if one stayed perfectly still. For some people, sleep paralysis can be triggered by various environmental factors (this troper is more likely to experience it if she sleeps in a hot room, for example), so figuring out and avoiding these factors may reduce the chances of it happening.
 * Some people experience sleep paralysis mostly as a result of sleep deprivation. That means that whenever you try to go to sleep, you get paralyzed, and once you escape, you're exhausted and have to try to go asleep again, which leads to more sleep paralysis... The saddest part about this phenomenon is that it is not uncommon. It is where the word for nightmare originated from.
 * The leukodystrophies, a family of disorders in which the fatty sheath covering the nerves slowly dissolves, oftentimes lead to the sufferer becoming paralyzed, blind and deaf.
 * The WNYC program Radiolab reported the story of Emilie Gossiaux, who suffered a traumatic brain injury that left her unable to communicate with the outside world. Or was she? It was unusually hard to tell, since . You can listen to it here; it's absolutely riveting.
 * Spider wasps. Googling them will result in Nightmare Fuel, Nausea Fuel, and Paranoia Fuel, in that order.
 * Similar and just as horrifying, the Emerald Wasp. You'll want to scream for its victims who have lost any drive to do so themselves.
 * Tetrodotoxin, a potent neurotoxin found in puffer fish, can induce muscular paralysis and a comatose stupor that lasts for several days--while leaving you fully conscious. It's believed by some to be the active ingredient in real-life zombie powder.
 * For people who fall over from exhaustion near the summit of Mt. Everest, in the "death zone" where acclimatization is impossible, this is tragically their fate. Due to the extreme sub-zero temperatures, the lack of oxygen in the air, and the physical maladies and mental delirium brought on by the altitudes, it is essentially impossible once down to get back up, or for other climbers to attempt a rescue if not in situ immediately. What follows is a slow death, which reportedly can take well over 12 hours as the extremities gradually freeze solid, while the victim remains partially conscious as the conditions of the death zone also make sleep next to impossible. Many of the bodies of those who have died in the death zone remain where they fell to this day, as there are no scavengers at that altitude and the cold dry air has a mummifying effect on exposed bodies - at least one unfortunate traveller, nicknamed "Greenboots" for the bright green shoes he wears, has become a landmark since his death in 1996 as climbers on the north face must step over his frozen carcass on the ascent.
 * In the infamous 2006 case of David Sharp, the intensity of the situation is magnified. After completing a solo ascent in mid-afternoon, Sharp became disoriented on the way down and fell into a sitting position several feet away from Greenboots' corpse. At 1 AM, by which time he was too weak to stand up or speak, he was passed by a group of almost 40 hikers bound for the summit - including a documentary crew, there to film a double-amputee's attempt to climb the mountain. Most of the hikers ignored him, assuming he was already dead or that he was Greenboots, and those that took notice made no effort to save him. Sharp was still alive nearly 12 hours later when the same group descended, and a Sherpa made an unsuccessful attempt to get him on his feet before abandoning him again, where he died sometime that evening. For nearly a day, Sharp was completely aware that he was going to die and that the people several feet away from him weren't going to help him - and he couldn't scream or say so much as "help me".
 * When a person falls victim to decapitation, the brain stays alive for a period of time up to 15 seconds. 15 seconds during which you are detached from your lungs, and unable to make a sound even if you wanted to.
 * Genie a sad case of someone intentionally inflicting this fate upon a child. Be warned, this story is horrific.
 * Catatonic stupor.
 * This is essentially the fear freeze response turned Up To Eleven.
 * The 'freeze response' theory also explains why this state commonly occurs in mental disorders involving intense fear or other extreme emotions, such as mood disorders, PTSD or schizophrenia.
 * Since full-blown catatonia is uncommon and the victims are not actually paralyzed (in a neurological sense), their condition is often not taken serious. "He's just making a scene/playing possum!"
 * Autistic shutdowns can be similar (though usually less extreme and more short-lived). Plus accusations of being "unresponsive", "cold" or even "passive aggressive".
 * Also they are more often caused by Sensory Overload rather than fear.
 * Severe chronic fatigue syndrome can also lead to someone being nearly unable to move without actually being paralyzed. And unlike catatonic stupor and autism shutdowns, this is a chronic condition that usually lasts for years if not life-long.
 * Akinetic mutism may qualify as well. Although sufferers are said to have no ambition to move, we don't know what really goes on in their head.
 * Akinetic mutism basically means loss of volition or will power. This is not the same as losing one's motivation to do anything (as can happen e.g. in severe depression). So sufferers can still have dreams about their future life but they are unable to actually get themselves up.
 * High spinal cord injury can be this, depending on the level and completeness of the injury. And especially at the moment when you first realize it.
 * A complete injury above the third cervical vertebra results in paralysis of all limbs as well as all essential breathing muscles (especially the diaphragm). In the absence of other injuries (like brainstem injury or obstruction of major cervical arteries), this means suffocating while essentially fully aware.
 * A complete injury between C3 and C5 leaves the diaphragm innervated to a variable extent. You may or may not be able to breathe effectively, but you still won't be able to shout "HELP!" when you need it, because your vital capacity is too low for that.
 * Even lower cervical injuries can still qualify, as the diaphragm stays innervated but important expiratory muscles are still paralyzed or weak, rendering you unable to vocalize loudly (although that can usually be restored with training). You'll also be able to move your arms but not in a really functional way. Plus if autonomic nerves are involved, neurogenic shock ensues right after the injury. In a situation where you've just acquired this, and there's nobody around for first aid, this can still mean a slow and very distressing death over hours.
 * Sometimes this trope is averted - kind of - when the neurological injury extends to the brainstem, which can lead to either death by reflex cardiac arrest, or destruction of the centers responsible for respiratory drive. The latter still results in suffocation, but due to loss of respiratory drive there's no more urge to breathe, and hence no panic response when breathing is not possible.
 * Can you remember one of these scenes in films where somebody is lying on the ground injured and weeping in pain (usually after some kind of accident), and his fellow breaks his neck in order to quickly end his suffering? Well, after reading the last examples, you know how this might end for the poor guy in Real Life...
 * Also consider that a fractured/dislocated vertebra does not automatically mean spinal cord injury, a spinal cord injury does not automatically mean it's a complete one, etc. And a broken neck can also result in injured cervical arteries leading to strokes, and compression of the airways by displaced bone fragments.
 * And don't forget that severed sensory nerves can still be a source of pain, even severe pain.
 * Generalized Tetanus causes body-wide muscle cramping and sensory oversensitivity resulting in excruciating pain. Due to cramping of the muscles in the face, tongue, larynx and ribcage, it becomes impossible to make any voluntary sound, and if not treated with muscle relaxants, this often results in death by suffocation.
 * Strychnine poisoning is similar.
 * Many progressive neurological disorders - including common ones like Alzheimer's disease - often have features of this trope in the later disease stages.
 * Before modern medicine, it could happen to people that they get buried alive because everybody thinks they're dead.
 * Especially if they already had conditions that qualify for this trope on their own - Locked in syndrome, tetraplegia, even psychological issues like catatonia or psychogenic paralysis, or temporary deep unconciousness... Creepy.
 * Usually people were declared dead when there was no detectable breathing any more. But shallow breathing can be hard to detect for a layperson.
 * Let's not even go to cremation. (Although survival instincts will kick in here and hopefully demonstrate that they're still alive, at least if there's any muscle left that they can move.)
 * Unless they are being entombed before combustion.
 * A girl with a genetic defect involving deletion of the "language gene" FOXP2 and several adjacent genes has been described in the literature. At the time she came to medical attention, she could neither speak, nor cough, sneeze or laugh spontaneously.
 * This trope is what is expected to happen to anyone who crosses the event horizon of a black hole. Given that the black hole is massive enough, its gravity at the event horizon is not lethal, and a human could theoretically cross it while staying alive. (This is because of the special mass-radius relationship of black holes; as seen from the falling observer, tidal forces get weaker as the black hole's mass increases due to the linear expansion of the event horizon with mass.) So what are the consequences of passing through the event horizon alive? You are completely and irreversibly cut off from any communication with the world outside the black hole. And of course, you will keep falling towards the center and ultimately get "spaghettified" some time later.
 * Akathisia, a movement disorder characterized by restlessness and a painful urge to move. Jack Henry Abbott described it:
 * "You ache with restlessness, so you feel you have to walk, to pace. And then as soon as you start pacing, the opposite occurs to you; you must sit and rest. Back and forth, up and down you go … you cannot get relief …"
 * The case of Lacey Fletcher who was found "fused" into a sofa in her parents' house. (WARNING DISTURBING!)
 * Unfortunately, there is a lot of low-quality information out there about this case. From what is known, Lacey was a friendly but shy and socially awkward girl who gradually started avoiding other people and going outside from puberty on. On a doctor visit at age 16 or 17, she got a diagnosis of social anxiety disorder and a debatable diagnosis of Asperger Syndrome. After occassionally going out and meeting a neighbor boy until around age 21, she was no longer seen outside her house. Around 2010, when she was 24, her parents reported to a doctor that she would no longer leave the sofa in her living room and become incontinent. (Or at least so they said.) Apparently, this didn't have any consequences. From then on, she was confined to that place (watching Disney movies all day or what?), with all her body's waste accumulating on the sofa under her and gradually corroding both the furniture and her body. She ultimately died around new year of 2022, in such a state of Body Horror that even the pathologists were sick for several days following her autopsy (Don't search the internet for pictures, please!). Later it was reported that Lacey would have suffered from Locked-in syndrome, but that theory fits poorly with the details of the crime scene, and it seems more likely that a mental disorder (or perhaps akinetic mutism) was responsible for her progressive seclusion and self-neglect. Anyways, she was obviously ill, and whether or not the initial cause was a physical one, she would have been immobilized by contractures after the first one or two years at maximum. Despite this, her parents stated that she "always had a sound mind and made her own decisions", which probably kinda explains why they neglected her more and more. (If they weren't outright intentionally abusive; as of 2023 this case is still open.)
 * Disregarding the possibility that her parents somehow restrained her on purpose, this all sounds a lot like an extreme form of a Hikikomori. (Well, combined with caregivers who are either Jerkasses bordering on Complete Monster territory, or morbidly stupid.)
 * Whatever exactly happened (we may never know), this case is really an abomination. And it seems it's not even the first time such a thing happens. A couple of similar cases are known from the last decades, the dark figure is unknown (in case of Lacey nothing outside her house looked in any way suspicious), and it's probably a lot more common to happen with animals...