In the face of the great mystery it would be thought that those who have returned to life after having been, for an appreciable time, apparently dead might have gained some insight into the unknown that lies beyond. Cases of such recovery are not uncommon, and not a few must have come within the experience of most medical men of large practice. I have watched certain of such cases with much interest. Among them the most pronounced example of apparent lifelessness was afforded by the following occasion.
A middle-aged man, in good general health, was brought into the theatre of the London Hospital to undergo an operation of a moderate degree of severity. The administration of an anæsthetic was commenced, but long before the moment for operating arrived the man collapsed and appeared to be dead. His pulse had stopped, or at least no pulse could be detected, the heartbeat could not be felt, he had ceased to breathe, all traces of sensation had vanished, and his countenance was the countenance of the dead. Artificial respiration was at once employed, injections of various kinds were given, electricity was made extended use of, while the heat of the body was maintained by hot bottles liberally disposed.
The man remained without evidence of life for a period so long that it seemed to be impossible that he could be other than dead. In the intense anxiety that prevailed, and in the excitement aroused, I have no doubt that this period of time was exaggerated and that seconds might have been counted as minutes; but it represented, in my own experience, the longest stretch of time during which a patient has remained apparently without life. Feeble indications of respiration returned and a flutter at the wrist could again be felt, but it was long before the man was well enough to be moved back to the ward, the operation having been, of course, abandoned.
I determined to watch the recovery of consciousness in this instance, for here was a man who had been so far dead that, for a period almost incredible to believe, he had been without the signs and evidences of life. If life be indicated by certain manifestations, he had ceased to live. He was, without question, apparently dead. It seemed to me that this man must have penetrated so far into the Valley of the Shadow of Death that he should have seen something of what was beyond, some part, at least, of the way, some trace of a path, some sight of a country. The door that separates life from death was in his case surely opening. Had he no glimpse as it stood ajar?
He became conscious very slowly. He looked at me, but I evidently conveyed no meaning to his mind. He seemed gradually to take in the details of the ward, and at last his eye fell upon the nurse. He recognized her, and after some little time said, with a smile, “Nurse, you never told me what you heard at the music hall last night.” I questioned him later as to any experience he may have had while in the operating theatre. He replied that, except for the first unpleasantness of breathing chloroform, he remembered nothing. He had dreamed nothing.
At a recent meeting (1922) of the British Medical Association at Glasgow Sir William MacEwen reports an even more remarkable case of a man who was brought into the hospital as “dead.” He had ceased to breathe before admission. An operation upon the brain was performed without the use of an anæsthetic of any kind. During the procedure artificial respiration was maintained. The man recovered consciousness and, looking round with amazement at the operating theatre and the strange gathering of surgeons, dressers and nurses, broke his death-like silence by exclaiming, “What’s all this fuss about?” It is evident from cases such as these that no light upon the mystery is likely to be shed by the testimony of those who have even advanced so far as to reach at least the borderland of the “undiscovered country.”
I might conclude this fragment with some comment on the Fear of Death. The dread of death is an instinct common to all humanity. Its counterpart is the instinct of self-preservation, the resolve to live. It is not concerned with the question of physical pain or distress, but is the fear of extinction, a dread of leaving the world, with its loves, its friendships and its cherished individual affairs, with perhaps hopes unrealized and projects incomplete. It is a dread of which the young know little. To them life is eternal.
The adventure is before them. Death and old age are as far away as the blue haze of the horizon. It is about middle age that the realization dawns upon men that life does not last for ever and that things must come to an end. As the past grows vaster and more distant and the future lessens to a mere span, the dread of death diminishes, so that in extreme old age it may be actually welcomed.
Quite apart from this natural and instinctive attitude of mind there is with many a poignant fear of death itself, of the actual act of dying and of the terror and suffering that may be thereby involved. This fear is ill-founded. The last moments of life are more distressing to witness than to endure. What is termed “the agony of death” concerns the watcher by the bedside rather than the being who is the subject of pity. A last illness may be long, wearisome and painful, but the closing moments of it are, as a rule, free from suffering. There may appear to be a terrible struggle at the end, but of this struggle the subject is unconscious. It is the onlooker who bears the misery of it. To the subject there is merely a moment—
“When something like a white wave of the sea