No RIP for fear of being buried alive

MEDICAL MATTERS:Nightmare haunts sufferers of Taphephobia

DEATH AND medicine are inevitable bedfellows: despite a doctor’s best efforts, some of his patients are going to die. Junior hospital doctors probably have the most substantial exposure to death and dying, given their 24-hour presence in hospitals. Death is an everyday fact for hospice doctors, too. In general, it is seen as part of your professional life, although I still remember one January weekend when I was the duty doctor in the geriatric department of a large hospital. It coincided with a flu epidemic; by the time I had certified the eighth old person dead, I was feeling somewhat frayed around the edges.

Confirming a person dead is normally a straightforward process. Listening for breath sounds, heart sounds and confirming the absence of a pulse before finally examining the person’s eyes to establish the pupils are not reacting to light is the usual drill. Very occasionally, however, things don’t quite go according to plan.

Listening to a conversation on Today FM's The Last Wordprogramme recently reminded me why many of us harbour a fear of being buried alive. Presenter Matt Cooper and guests were somewhat tickled by reports of an elderly Polish bee-keeper, who "died" following an allergic reaction to a bee sting. Following removal by a Katowice undertaker, Josef Guzy's body was placed in a coffin in the store room of a local funeral parlour. However, a loud banging emanated from the room some hours later. Staff were startled to discover a very much alive Mr Guzy who, having regained consciousness, had been banging on the coffin lid in an effort to avoid being buried alive.

Such occurrences were more frequent in medieval times. Coffins were routinely equipped with a rope which was attached to a bell positioned in the reposing room, so that any unexpected resurrection could be dealt with to the satisfaction of both the “deceased” and the undertaker. Papal deaths were confirmed by firmly applying a silver hammer to the late pontiff’s cranium; a practice presumably designed to ensure a recently deceased pope had a one-way ticket only to heaven.

Taphephobia – the fear of being buried alive – was a major concern during the 19th century. In her book, The Dying Game, Melanie King describes how the phenomenon attracted a certain tabloid prurience. Readers were informed of how exhumed bodies often showed signs of struggle, with arms and fingers gnawed to the bone.

Things got so bad that people made specific requests in their wills. It was common to request a six-day delay before burial; others left money for doctors to be engaged to open a major artery before they were placed in a coffin.

Even today, failsafe gadgets are marketed to reassure modern taphephobics. King describes the work of an Italian inventor in the mid-1990s: “Fabrizio Caselli became so disturbed by reports of premature burial that he turned his hand to the invention of what he patented as the bara salvavita or ‘lifesaver coffin’. This hi-tech contrivance seems to have more in common with an ICU [intensive care unit] bed or the cockpit of an aeroplane than a conventional pine box. It comes equipped with a computer, close-circuit TV cameras, an alarm, microphones, motion sensors and also monitors to detect a heartbeat. Casselli advertises his product with the alarming slogan: ‘Cases of apparent death are much more common than you think!’.”

Perhaps the ultimate modern "weapon" against premature burial is magnetic resonance imaging. A paper in the current issue of the New England Journal of Medicinedescribes how MRI scans were used to check for "preserved cognition" in ostensibly unconscious patients. Using functional MRI, researchers activated the cerebrum in five of 54 unresponsive (vegetative) patients, using verbal instructions. The findings could help reassure those afraid of being " locked in" while in a coma.

Somerset Maugham wrote: “Death is a very dull, dreary affair, and my advice to you is to have nothing whatever to do with it.” Good advice for taphephobics?

mhouston@irishtimes.com