Inspired by the real-life "right-to-die" court case of Karen Ann Quinlan, a young woman who lapsed into a coma under uncertain circumstances, "Inacoma" can be described as a collaboratively and improvisationally developed musical fantasy about a comatose teenage girl who has fallen from the speaker towers at a rock concert. The play was built upon the synthesis of music and language. Called a work in progress, a group of eight local actors, including Sam's wife Olan, along with 8 musicians (San Francisco Theatre Jazz Ensemble) brought the piece to life. Sam directed and wrote the lyrics for the songs. He led the actors and musicians in a series of sound and movement exercises and then primed their improvisational impulses with various ideas and readings. The improvisations became the de fact script for the production.

John J. Winters (Sam Shepard: A Life);
"Critics thought the production was a mixed bag, with its share of compelling sections but too often falling back on easy satire. At three hours, it was too long. One critic complained that 'Inacoma' lacked the things that made other Shepard productions stand out, namely his singular use of language and images. The short life of 'Inacoma' ended with its final performance at the Magic. If nothing else, Shepard's experience taught him that he could effectively embroider true events with touches of the gothic and magical. Put another way, he could mix realism with the imaginative flights that marked his best early work."

Don Shewey (Sam Shepard):
"Even as a work-in-progress, it seemed to wobble somewhere between documentary and satire, but as an experiment, it was an opportunity for Shepard to try his hand at engaging actors in creative collaboration, though not one he would repeat again soon. The next time he did it was under more manageable circumstances - with one actor, Joseph Chaikin."