Read what happens when the body starts shutting down.
In 2005, I remember sitting next to my mother who reached the end of her metastatic breast cancer treatments. Just a month ago, she was able to take the dog for a walk and go to Australia with my father. Now, she was lying weak and exhausted from the chemo, pain medication, and the disease itself.
It was my mother who decided to stop the chemo treatments and ask for a hospice care, of course with doctor’s blessing. Her treatment lasted six and a half years, during which she saw 6 oncologists, 2 general practitioners, several nurses, radiation technicians, surgeons at 3 clinics and 2 chemotherapy facilities. However, no one had spoken to her about what would happen as she passes away.
The professor of nursing at Wayne State University, Margaret Campbell, has worked in palliative care for decades. She explains that in the last two weeks of their life, people become too drowsy, or too sick, or too unconscious to describe what they feel and experience. So far, death is perceived through the eyes of the family, medical professionals, and friends of the person dying, rather than of their own.
The palliative-care specialist at Stanford University James Hallenbeck, explains that death similar to black holes, allows seeing only the effects but not inside them. As they pull close objects, the laws of physics start to change. Although the medicine starts to peek beyond the horizon, the last moments of our life remain shrouded in mystery.
Modern medicine has advanced so much that it continuously prolongs the lives of many people. Today, most Americans have slow deaths of lingering diseases like dementia or diabetes complications, or most terminal cancers, as opposed to the quick deaths that were typical before 100 years, such as flu or a farm accident. The Centers for Disease Control statistics show that people in U.S. are most likely to die of cancer, heart disease, or chronic pulmonary lung disease.
“Active dying” refers to the phase of the last few days of life to those who die gradually when they experience a final, quick slide. Palliative Care Perspectives reports Hallenbeck explanation that during this period, people usually lose their desires and senses in a specific order. First, they lose their thirst and hunger. Then, their speech, and vision. The hearing and touch are usually the last senses they lose.
Campbell says that in some deaths, pain is inevitable. On the other hand, some people die without any distress, just from aging. Also, it doesn’t mean that a person with painful disease will have a painful death too. For most cancer patients, a comprehensive pain regimen can help them die peacefully. As far as doctors can tell, the noise that weak patients make in the back of their throats when having difficulties to swallow or cough is not painful for them. What’s more, medical researchers think that the death rattle phenomenon is probably painless.
However, the exact suffering of people in their last hours or days is not known, since most of them lose consciousness or awareness. The oncologist and palliative-care specialist David Hui, who analyzes the death signs, explains that people generally think that if a person is not really responsive, or has a brain in a comatose kind of situation, their perception and feeling of things is significantly reduced. The dying person might or might not be aware of what exactly is going on.
After one or two weeks since we spoke to the nurse, my mom begin to be rarely conscious. The only part of her that was here when she was awake, was the part that told her legs to get up and go to the bathroom, the automated movements during the teeth brushing, and then wiping the sink. For the first time, her mind turned away from my father and me.
I wanted to know what my mother was thinking about. Sitting next to a dying person is wondering where their mind is, whether they are sleeping, awake, dreaming, or experiencing something unnatural. You don’t even know if their mind is gone.
The director of the UCLA Brain Injury Research Center, David Hovda, explains that the brain of many dying people begins to sacrifice the less critical areas to survival. He compares this to aging. As people grow old, they start losing some abilities like learning motor skills, complex or executive planning, and the very important inhibition. Hovda explains that as the brain changes and begins to die, the visual system, like many other parts, becomes exited and the person starts to see light.
Latest research suggest that what we know as brain’s reaction to dying matches with sharpening of the senses reported by many people. In one animal research, the neuroscientist at the University of Michigan, Jimo Borjigin noticed that the neurons of the dying animals began to secret large amounts of new chemicals. Borjigin realized that the light seen by cardiac-arrest survivors while in unconscious state, described as extremely real, might be explained by the sudden release of neurochemicals.
The researcher and her team conducted an experiment on 8 rats. They first anesthetized them, and then they stopped their hearts. Borjigin explains that suddenly, all the regions of the rats’ brain became synchronized. Their brains showed coherence and higher power in different frequency rates.
The researcher explains that these features go up when one does high-level cognitive activity, like trying to remember a word, or a face, or in other words when one is focusing his/her attention on something specific. Researching human consciousness in awake people uses these parameters, so Borjigin and her team thought if one is aroused or alert, similar parameters should also increase in the brain of a dying person. And, it was true.
In the last few weeks of my mother’s life, when I felt like her mind is somewhere else, she was occasionally raising her arms in the air and removing some invisible items with her fingers. This half-waking, half-dreaming state is common in dying people. Christopher Kerr and his team conducted a study at a hospice center outside Buffalo, New York, analyzing the dreams of dying people. 88% of them had one vision or dream at a minimum, but they all described them as realer than the reality, carrying them into wakefulness.
72% said they had dreams about reuniting with their late close ones; 59% were preparing to travel somewhere; 28% about meaningful past experiences. These pre-death dreams often helped people reduce their fear of death, most of them being positive and comforting.
The Stanford palliative-care specialist, Hallenbeck, says that in the final hours, after patients have lost their urge for hunger and thirst, as well as their vision, they close their eyes which makes them look asleep. But, no one can tell what is actually happening from this point on. Hallenbeck’s belief is that they are in a dream state, and not in a state of unconsciousness, or coma. It’s hard to pinpoint the exact moment when a person starts dying or when entering a dream state.
This happened to my mother. I remember seeing her peaceful, and listening to her raspy breathing. There were no indications or dramatic movements that she was about to pass away. She didn’t sit up or open her eyes, but just took her last louder breath and left us.
Via The Atlantic
