As Munira Abdulla saw the car racing towards her, she closed her arms protectively around her four-year-old son Omar. So he tells it years later the Arab daily newspaper "The National". Omar remained virtually unhurt in the 1991 Abu Dhabi clash. But his mother suffered a severe traumatic brain injury. The brain of the then 32-year-olds was so badly damaged that the doctors assumed that she would never wake up again.

The patient dawned in a state that doctors call minimal consciousness. Although she opened her eyes and could look at her son's face, further interactions were not possible. She also could not speak. One specialist after another treated the woman, including in Abu Dhabi and the UK. But only in a clinic in the Bavarian Bad Aibling she came back in the summer of 2018, 27 years after the accident. Her son is now as old as she was then. Throughout the years, he has taken great care of his mother and has traveled extensively to visit her.

How coma victims like Munira Abdulla survive for years https://t.co/fDeUBOh8If pic.twitter.com/NIGbQM1Lop

- The National (@TheNationalUAE) April 23, 2019

The story of Munira Abdulla has caused a sensation worldwide. In an interview with SPIEGEL ONLINE, the treating physician Friedemann Müller explains why the case is spectacular.

SPIEGEL ONLINE: The case of Munira Abdulla has caused a tremendous stir. The "Bild" headlines: "Mother wakes up after 27 years in a coma" and speaks of a "medical miracle". Is the assessment justified?

Friedemann Müller: In fact, the case is medically complex. Most recently, the patient was in a state of minimal consciousness, which could also be called a "wake coma" in this form. In other words, she was able to take a close look at something, especially when she reacted to her son's face. For relatives, the clinical picture can hardly be distinguished from a coma, in which patients show no awareness. But the difference is there and can be explained in a simplified way: Patients can open their eyes in the "coma", not in a coma. From a coma, no patient simply wakes up after 27 years.

SPIEGEL ONLINE: So is it wrong to say that the woman has awakened?

Müller: If you mean that the patient suddenly wakes up, as after a long sleep, as everyone does in the morning, then yes. The following description would be interesting: The physical and mental condition of the patient has improved enormously over a period of a few weeks. She can now consciously interact with her environment and return to family life.

SPIEGEL ONLINE : What did you do differently than the attending physicians before?

Müller: We had a holistic approach. The patient suffered from spasticity, ie strong muscle contractions. At first, we brought these under control so that the patient could develop a better feeling for her body again. In addition, we have changed the drugs against epilepsy so that fewer side effects occurred. Physiotherapy also enabled us to mobilize the woman so that she could leave the hospital room in a wheelchair and thus be confronted with other stimuli, such as birdsong.

SPIEGEL ONLINE: When did the decisive breakthrough come?

Müller: That's a slow process. The son noticed an improvement before we could detect it during the visit. It is often the case that relatives are the first to recognize progress because they often spend more time with patients, know them better and their voice is familiar. At some point she could open her mouth if we asked her. She was also able to pronounce her son's name, greet us and she quoted some verses from the Koran.

SPIEGEL ONLINE: Is the case unique?

Müller: The case is very unusual, but not unique. Another well-known patient is, for example, Terry Wallis from West Virginia, who started to talk again after 20 years in the wake coma. Such cases are very rare.

SPIEGEL ONLINE: Does your therapy mean hope for other patients?

Müller: The case raises hope, of course. Therefore, the son of the patient also decided to go public. We now have to find out which people we can help with our findings. In any case, I would advise relatives to stay in touch with the patients. Always talking to them, exposing them to new stimuli, mobilizing them and watching them closely. However, there is no guarantee for improvement, especially brain damage due to lack of oxygen rarely show improvements.