Let me out of my coffin . . . I’m alive!

Happy Halloween. It being a bank holiday weekend, in time honoured tradition this column will look at the lighter side of medicine. And, in a nod to the season, I thought a loosely scary theme would be appropriate.

Bess Lovejoy is the author of a book, Rest in Pieces, which takes a look at the horror of premature burial. It was an understandable fear in centuries past, she notes in a recent article in the online journal "Atlas Obscura". After all, doctors had few reliable means of determining death.

Nowadays, before pronouncing someone dead we look for a pulse at the carotid artery in the neck. We use a stethoscope to check carefully for breath sounds and we use a penlight to examine the light reflexes in the person’s pupils to see if they are fixed and unresponsive to the light. And, of course, we auscultate the chest for heart sounds.

The moment of death is quite peaceful; the phrase “passed away” is an apt description of the process. But death is a biological process – the deceased doesn’t immediately stiffen and go cold.

As Lovejoy notes, we die in stages: “Death is a biological process that moves throughout the body, and signs of life can remain long after the apparent end.” After a beheading eyes sometimes flicker for a number of seconds. Morticians learn not to be alarmed by the sound of corpses passing wind.

Two of the earliest methods for determining whether life was still present, the feather and the mirror, were hardly foolproof. As a result, in the 18th and 19th centuries, the fear of being buried alive terrified some people. The media didn’t help with a steady diet of gruesome news stories: tales of bodies exhumed with scrape marks on the roofs of their coffins; skeletons found near the doors of their tombs; and babies born to women who had been left for dead.

Lovejoy writes about the inevitable response to these horror stories. "The Victorian novelist and politician Edward Bulwer-Lytton asked for his heart to be punctured before he was buried, to make sure he was truly dead. George Washington requested that his body be watched for two days after his apparent demise." And the Danish author and poet Hans Christian Andersen was so frightened of premature burial that he often slept with a sign that read: "I am not really dead."

Safety gadgets

Lovejoy describes how inventors devised a number of gadgets to safeguard against premature burial. In 1752,

Antoine Louis

proposed blowing tobacco smoke up the rears of the apparently deceased to awaken them. In 1854, another Frenchman invented the pince-mamelon, or “Nipple Pincher”, a particularly strong pair of giant tweezers designed to shock the supposedly dead back to life.

Then there were the “safety” coffins. An 1897 patent involved placing a spring-loaded ball on the chest of the apparently deceased. If the chest moved, the ball’s spring would release, triggering the delivery of light and air into the coffin through a tube that extended to the surface of the grave. A system of bells and flags also allowed for the summoning of help. However, there is no record of how successful such contraptions were in practice.

It seems the practice of arterial embalming at the end of the 19th century helped put our fears of premature burial largely to rest. As Lovejoy somewhat pithily concludes: “If you weren’t dead when the embalmer started, you certainly were by the time he was finished.”

Irish Heart Foundation

On a completely separate note I would like to tell you about an important initiative by the Irish Heart Foundation (IHF). Dr

Brian Maurer

, a friend, mentor and a superb cardiologist, died three years ago this month. The IHF has established a memorial fund to prevent sudden cardiac death, in his name. A worthy cause, you will find more details at irishheart.ie

mhouston@irishtimes.com