The Romeo Error
Page 7
At the moment a fall begins, the first response is to try to avert the danger, to fight back against the inevitable. Part of this is a purely physical reflex of the kind that pulls a hand away from a hot stove, but there also seems to be a fierce psychological battle against a strange longing to surrender to the danger. We shall see later that this is not destructive, but has survival value. The second stage begins as soon as the faller recognizes the futility of struggling and accepts the fact that death is certain. This brings on a mood of detachment in which the subject becomes engrossed in oddly irrelevant thoughts. One climber described "sensations of petty annoyance and even of speculative interest." [65] A student who was thrown from a car moving at high speed and went rolling head over heels down a highway said that his immediate concerns were for his new coat, which he could see ripping as he rolled, and for his school football team, which, according to the car radio, was losing its latest game. In another case, a child who fell from a cliff was afraid only that he would lose his new pocket knife.
Soon these stray thoughts crystallize into the classic life review. In 1972 a nineteen-year-old sky diver in Arizona fell from over three thousand feet and broke nothing but his nose. He described how he started screaming as he fell and then "I knew I was dead and that my life was ended. All my past life flashed before my eyes. It really did. I saw my mother's face, all the houses I've lived in, the military academy I attended, the faces of friends, everything." [305] Heim reported that "I saw myself as a seven year old boy going to school, then in the fourth grade classroom with my beloved teacher Weisz. I acted out my life as though I were on a stage upon which I looked down from the highest gallery in the theatre." A thirty-four-year-old nurse in a near fatal coma, induced by an allergic reaction to penicillin, spoke of vivid colors and of how she saw a doll she once owned and was struck by the bright blue of its glass eyes.
One psychiatrist explains this visual review as "an emotional defense against the thought of extinction" and suggests that, deprived of his future, a dying person concentrates his last vital energy on recapturing what was precious to him in the past. [208] Another describes the pictures as "screen memories" and thinks that the ones chosen to be reviewed at this time would prove on analysis to be connected with an unpleasant experience. [124] The most comprehensive survey of responses among those reprieved at the last moment lists over three hundred cases and finds flashback experiences in only 12 per cent, but it is obvious from the data that all of these were sudden death situations like falling or drowning in which the time span was very short. [139] When life was threatened in a more leisurely fashion by illness or by a situation such as being locked in an airtight freezer, there were invariably no life reviews.
Finally, and remember we are dealing with a sequence of reactions condensed into a few seconds, the flashbacks stop and are replaced by an extraordinary mystical state. The drugged nurse had an experience of ecstasy in which she was "idyllically absorbed in contemplating a picture of the Taj Mahal." A climber who fell from the Dolomites recalls, "My body was in the process of being injured, crushed and pulped, and my consciousness was not associated with these physical injuries, and was completely uninterested in them." [65] Heim's survey of Alpine accidents ends with the comment that death through falling is very pleasant and that "those who have died in the mountains have, in their last moments, reviewed their individual pasts in states of transfiguration. Elevated above corporeal grief, they were under the sway of noble and profound thoughts, heavenly music, and a feeling of peace and reconciliation. They fell through a blue and roseate, magnificent heaven; then everything was suddenly still."
This transcendent state is so powerful and so pleasant that those who experience it are unwilling to leave. Recalling her rescue from drowning as a child, one woman says, "I saw the efforts to bring me back to life and I tried not to come back. I was only seven, a carefree child, yet that moment in all my life has never been equaled for pure happiness." [305] It is possible that failed suicides who get as far as having this experience might be tempted to go back and try again -- perhaps with more success on the next occasion.
The marked similarity between transcendence under the threat of death and transcendence under the influence of drugs shows that dying is intricately involved in living. The stages of resistance, flashback, and transcendence are experienced in the brief period that precedes sudden unexpected death, but there are direct parallels in the very much longer phases that occur when dying takes place as a result of illness or old age.
Elizabeth Kübler-Ross interviewed over two hundred dying patients and found five distinct stages in their approach to death. [155] The first reaction to learning of a terminal illness is usually "No, not me, it cannot be true." This initial denial is very much like the first desperate attempts of the climber to negate the act of falling. Then as soon as the patient admits that it must be true, denial is followed by anger and frustration. "Why me, when I still have so much to do?" Or this stage may be replaced by bargaining in which patients make promises to themselves or others in return for extra time. Then, when the full implications of the illness are realized, comes a time of fear and depression. This stage has no parallel in sudden death experiences and seems to arise only out of situations in which the person facing death has time for dwelling on the circumstances. A tremendous amount of research has been done on the fear of death and dying, and most of this seems to assume that everybody is naturally afraid of death, but skimming through the vast literature on psychological responses to death, I am impressed by one fact. This fear is manifest only in adults and older children, and then only when they have time to think about it. There is absolutely no evidence to suggest that such fear is a natural and inevitable part of our dying behavior. On the contrary, in cultures where death is dealt with more openly and seen as a part of the living process, there is no fear of dying. In other species there is nothing to show that death is one of the stimuli that release instinctive avoidance or distress responses. When young chimpanzees reach a certain age, they will, without instruction or training, avoid contact with snake-like objects. They have a built-in tendency to react fearfully to stimuli that could be associated with danger, but I do not know of a single organism that manifests a natural fear of death itself.
The final stages of the cycle that precede clinical death are the same for sudden or slow death patterns. When terminal patients have had enough time, or been given enough of the right kind of help to conquer their fears and accept the inevitability of dying, they often experience feelings of peace and contentment.
So it seems that the dying process comprises a distinct phase of human development with its own sequence of orderly, definable experiences and behavior patterns. The fact that these stages are not peculiar to people dying only of accident or illness is shown by the presence of the same steps in dying that has been artificially induced in people who are in perfect physical health. A study of eighteen convicted murderers awaiting capital punishment in Sing Sing prison showed that their waiting periods on death row began with denial (in which they minimized their predicament), followed by anger and fear, and ended finally (for those who had sufficient time) in easy meditative detachment. [22]
It may be a little far-fetched, but it seems even to be possible to identify the stages of dying by tracing their parallels through our historical attitudes to death. There is a time of death denial in our history, a time when we refused to believe that death was a natural occurrence and preferred to blame it on someone or something else. This is clearly manifest in the death rituals of the river-valley civilizations. Then comes a time of death acceptance, as shown by the Judeo-Hellenic civilizations, when death was very real and final. Then a stage of death defiance in which we tried to overcome the reality. St. Paul voiced this Christian attitude with his brave cry of "O death, where is thy sting?" And finally, as with falling, we arrive at today's point where civilization is so close to the brink that its only defense against death is transcendence.
Our bodies store energy in the form of glycogen which is kept in the liver and the long muscles until it may be needed. In emergencies adrenaline raises the blood pressure and promotes the rapid conversion of glycogen back into blood sugar for immediate use. In a matter of seconds the brain is receiving an enriched supply of food and begins to work overtime. This biochemical stage corresponds directly to the mood of mental detachment and flashback that follows the climber's first reflex struggle to avoid falling.
The second stage, which the Russians call preagonal, is marked by dramatic chemical changes in the brain. [87] Activity in the cortex reaches fever pitch, and sugar is consumed faster than it can be provided. This activity in the human brain is largely confined to the higher frequencies, with fast beta rhythms interrupted by irregular spikes of prolonged alpha activity. This is exactly the state of mind that is known to occur in meditation, and it obviously corresponds to the experience of bliss and transcendence reported by those who have almost died.
The third stage in the Russian sequence is called agony, and for a faller it would take place only after he has hit the ground. Respiration stops, eye reflexes disappear, and the activity of the brain dwindles almost to vanishing point. In the dogs, agony began when the organic acid waste products of glucose accumulated in the brain and poisoned it. When the brain stops altogether, the Russians recognize this as clinical death, but even at this late stage resuscitation is still possible if the full flow of blood can be restored. But if nothing happens to redress the imbalance in the brain within a certain period of time, which in man seems to be about six minutes, the fourth stage of dying becomes irrevocable by present techniques and the organism is considered as dead.
The Russian studies also contribute one further vital clue. [99] They have discovered that a prolonged period of dying, such as that caused by a lung disease, leads to severe depletion of the energy reserves in the early stages and that the brain in such an organism can survive only a very short period of clinical death. In cases where death is sudden or accidental, reserves are high and the organism has the stamina necessary to survive longer periods of total brain incapacitation. The ability to recover following such a stoppage depends entirely on the metabolic state of the organism prior to dying. In experiments with dogs it was found that if the animals were in a state of high excitement before dying, their chances of recovery were very small; but if they were already quiet or asleep when dying began, their rate of recovery was enormously increased. So the detachment and the transcendent states in which an individual relaxes and contemplates the Taj Mahal or reviews past events have high survival value. The faller who goes into these states has more chance of pulling through a serious injury, or even of surviving clinical death, than one who screams and fights all the way down.
The series of changes that take place in dying therefore follow a fixed sequence for very good reasons, but the sequence can be interrupted at almost any stage. It can also be short-circuited by pain or by fear. It is even possible for the early fear stage to lead directly to terminal clinical death if it is sufficiently intense. We talk about being "frightened to death" or "scared out of our lives." These things do happen.
In Australia aboriginal sorcerers carry pointing bones made of giant lizard femurs with a thong of human hair attached. When one of these bones is pointed at a man while the death spell is chanted, the victim soon sickens and dies and all the skill and resources of modern medicine cannot save him. [81] African witch doctors use knuckle bones, European witches make wooden dolls or wax models, Caribbean voodoo priests sacrifice white cockerels, and in Greece it is enough just to squint an evil eye. The methods seem to be relatively unimportant, but the effects on the victim who sees the charms, or even knows that they have been used, are well documented.
Several clinical studies have been made on people dying, apparently in perfect physical health, from the effects of black magic. In none of these cases was it possible for the doctors to isolate an organism or injury that might have brought about the obvious physical decline of their patients -- all they could do was record the symptoms. In a case of voodoo enchantment, the victim began to breathe very rapidly and his heart beat faster and faster until it was in constant contraction and he died of cardiac arrest. [40] Hematocrit readings taken during dying showed that there was a rapid increase in the concentration of the blood caused by fluids passing out of circulation into the tissue spaces. It was almost as though someone were operating on the victim with an invisible knife, because these are exactly the symptoms produced in cases of severe surgical shock.
In other instances of voodoo death, doctors have returned verdicts of "sudden haemodynamic alternation" [29] and "paroxysmal ventricular tachycardia [109]," which are merely different ways of saying that the heart stopped. Yet others put the blame on "an over-exuberant oxygen conserving reflex [295]" or "cataleptic death due to oxygen starvation." [183] These diagnoses are unimportant. The ultimate cause of death in every case was brain damage due to lack of sufficient oxygen following failure of the blood to reach its destination; but this tells us nothing about what produced the malfunctions to begin with. There is little doubt that changes in the body, even ones as severe as these, can be produced psychosomatically. Stephen Black tells of a skin cancer, definitely diagnosed by biopsy at the Lagos General Hospital, which was cured by an ointment provided by a local witch doctor. When the ointment was analyzed in London, it was found to contain nothing but soap and wood ash." And yet all too often the term "psychosomatic" is used as a rationalization to cover failure by the physician to find out what was wrong. In the final analysis, no condition can be assumed to be purely psychosomatic until it can be proved that the symptoms are curable by psychotherapeutic methods alone, but in advanced cases of bewitching there is seldom time for therapy. It is very easy to dismiss the phenomena by saying that they are "all in the mind," as though this were sufficient explanation for what happened, but this evasion merely sidesteps the astonishing fact that the brain is able to kill the body bearing it.
In cases of enchantment, where people seem to be literally scared to death, the victims usually know that the spell has been cast and that they are supposed to die -- so they do." The possibility still exists, however, that some external force is being brought to bear on them. In Czechoslovakia a series of tests was made between a pair of practicing telepaths situated miles apart." [237] The receiver was not told when transmissions were to be attempted, and yet at the precise instant that the sender was asked to imagine that he had been buried alive, the receiver had a crippling attack of asthma. When the sender imagined being short of breath, his unwitting friend, with no previous medical history of this kind, became short of breath. It looks as though it is possible for someone to control another's physiology even from a distance. In 1959 Stepan Figar, of Prague, found that intense mental concentration in one man could produce a measurable change in the blood pressure of a second one lying at rest at a distance. [75] Douglas Dean, of the Newark College of Engineering, recently discovered that when someone thinks
hard about a close friend, no matter where he may be, that person registers a measurable change in blood pressure and volume. [147] Using this response as a means of communication, Dean has managed to send simple Morse code messages from New Jersey to Florida, entirely without the knowledge of the receiver, who just lay quietly attached to a plethysmograph.
Whether heart failure is produced by the victim's own brain or by the malevolent thoughts or actions of another, the results are the same. He dies of shock. Sudden deaths of this kind are common in animals that have been captured in the wild or restrained for some reason in captivity. Hares and mice die from rough handling, shrews can even be killed by a loud noise. Disturbances due to building operations, or even to the proximity of unfamiliar animals in adjoining cages, have killed large numbers of sensitive zoo animals. Wild birds often die while being banded. Humans have died of fright while being given a hypodermic injection or simply at the sight of someone else's blood. The fact that all these deaths are due to the same cause has been demonstrated in a series of grim experiments performed at the Johns Hopkins Medical School in Baltimore. [226]
At Johns Hopkins, Curt Richter has an unpleasant piece of apparatus in which he tests the effects of stress on rats by forcing them to swim in narrow-mouthed jars from which there is no possibility of escape. He prevents them from resting or floating by jets of water that produce a constant turmoil, and he keeps them there until they die. Under normal circumstances domestic white rats survive in this machine for days, while freshly captured wild brown rats die in a matter of minutes. Postmortem examinations show that the brown rats die of shock produced by overstimulation of the vagus nerve, which leads from the brain to the heart. The same symptoms can be produced in white rats by the trauma of snipping off their whiskers before giving them the water torture, but the undamaged white rats eventually die for entirely different reasons. After more than two days in the jars, from which they cannot escape by fighting or fleeing, they simply give up and die of hopelessness.