Cold Comfort?

Cold Comfort? – True cases of ‘reanimation of the dead’

Recently I was asked by The Guardian newspaper to write a short post in response to the story of the Polish woman who woke up in a mortuary. I wouldn’t say that cases are common, but they do happen. You can see the version of my article on The Guardian website, or read on for my version.

“In Poland, a 91-year-old woman shocked her family – and the public at large – by waking up in a morgue after being refrigerated, having been previously declared dead. Despite 11 hours of cold storage, Janina Kolkiewicz was discovered to be alive and well after mortuary staff detected movements in her body bag. Speaking as an Anatomical Pathology Technologist (or mortuary technician) I can thankfully say that has never happened to me when I’ve been on duty.

But, it does happen.

In January this year a 24 year old Kenyan man, Paul Mutora, was pronounced dead after swallowing insecticide. 15 hours later he woke up in a morgue, causing staff to “take to their heels, screaming.”  In March, a 78 year old man, Walter Williams, was found alive and literally kicking in a body bag at a funeral home in Mississippi. The discovery came as staff were preparing to embalm his body, so he was just spared the gruesome fate of having an artery sliced open and his blood replaced with formaldehyde to preserve his tissues. He’d been declared dead on Wednesday at 9:30pm as he had ‘no pulse’ and it was a few hours  later that he began kicking in the embalming room, causing staff to immediately call an ambulance. These two are only stories from this year but there are many others [1] and whole books have been written on the subject.

So how does it happen?

In the case of Mr Mutora it was theorised that the atropine he was given by medical staff to counteract the insecticide may have made him appear dead (it slows heart rate for example, in smaller doses under 0.5mg.) In the case of Walter Williams, much has been made of the fact that the Coroner who pronounced him dead, Dexter Howard, was an elected official without a medical degree, as is the case in many US states. In the UK we too have a Coroner, appointed by the local authority (the UK Coroner is different to the US version – it comes from the word ‘Crowner’ and is a position that has been held here since around 1194). They have a different function here and may have a medical or law degree but the difference is our Coroners don’t have the power to pronounce people dead.  That is left to medically trained staff – and for good reason. Even within the medical community there is debate over what really constitutes ‘death’ and it is seen not so much as a stand-alone occurrence but more as a process. It involves several different mechanisms ceasing, not just  one, which is why there can be ethical arguments around brain-stem death; when the person is in fact deceased but their tissues can be artificially kept alive.

When the heart, for whatever reason, stops beating, the tissues it services are deprived of both oxygen and glucose and subject to a build-up of toxic waste products. This gradually kills the cells and when enough of them die there is major organ failure and the body as a whole is said to be dead.

The delicate cells of the brain are particularly susceptible to a lack of oxygen (anoxia) and they will usually begin to die in around 4-6 minutes. However, certain environmental circumstances can extend this period considerably – and one of them is a reduction in temperature. The cold decreases the cells’ need for oxygen and glucose and they go into a type of hibernation state. Many examples of this preservation and recovery exist, from people drowning in icy water, to people becoming suffocated beneath an avalanche, or simply becoming unconscious and hypothermic until they are found and revived. (This is being used in trials for suspended animation of trauma victims by Dr Samuel Tisherman. The technique involves replacing all of a patient’s blood with a cold saline solution, which rapidly cools the body and stops almost all cellular activity for hours at a time. The patient can then be transported to specialist units for surgery, the injury repaired and blood slowly re-introduced). For the most part it seems that people in this ‘apparent death’ state will either spontaneously wake up or be woken up by sounds or movement. This was taken to extremes in Romania in 1992 when an 18 year old ‘dead’ female was brought back to life as she was being raped by a necrophile mortuary worker. He was arrested, but the parents were too grateful to him for ‘resurrecting’ their daughter they refused to press charges saying she “owed him her life!”

(However it doesn’t always work that way: in Los Angeles in 2010 a pathologist ruled that 80 year old Maria de Jesus Arroyo did not die due to a heart attack, as was declared by doctors, but died from asphyxiation and severe hypothermia after being placed in a mortuary freezer. Injuries indicated she’d tried to claw her way out…)

Conversely the cells of the skin, for example, can remain alive for 24 hours after the heart has stopped beating, although the idea that nails and hair continue to grow after death is myth. (The below is also, of course, myth but I think the effects in this clip are fantastic!)

Now it’s becoming clear how the unfortunate Polish woman was able to wake up after 11 hours in this hibernation state with no severe physical damage and nothing but a craving for hot tea and pancakes. And the fact is she’s not a modern day Lazarus who ‘came back from the dead’ as many headlines scream – she quite simply wasn’t dead in the first place but probably had a very weak pulse and was unconscious due to a medical issue. Some people have a condition called Catalepsy, for example, a nervous disorder which replicates the stiff muscles of rigor mortis, slows breathing, and decreases sensitivity to pain. This means that gruesome archaic tests for death such as shoving needles beneath fingernails, pouring in onion juice and slicing nostrils may not even work on the cataleptic patient. Catalepsy was written about extensively by Edgar Allen Poe who was terrified of being buried prematurely – a very real fear during the 19^th Century. The Association for the Prevention of Premature Burial, for example, was formed in 1896 by William Tebb [2] and one of their recommendations was that the deceased be left unburied and unrefrigerated for 6 days, until the indisputable signs of putrefaction appear. This had been a custom in some European countries where ‘waiting mortuaries’ were built for this very purpose.

So people can be mistaken for dead but it is very rare and for the most part our sophisticated medical tests and equipment ensure that it doesn’t happen. For example no-one in the UK is cremated without having been certified dead by two different doctors. And, as illustrated by the above cases, those unlucky people tend to wake up in mortuaries anyway and certainly don’t reach the stage where they’d be buried alive.

Although that information may be cold comfort as we wouldn’t really know about those people, would we…?”

[1] Many others such as Maureen Jones, 1996 and Agnes Tomblin, 1987 in England;  3 year old girl in the Philippines who awoke in her own coffin; a man in Zimbabwe, an Egyptian waiter who woke up at his own funeral and more topically video footage of a man assumed dead from Ebola ‘waking up’ during a news report. There are 7 more tales here.

[2] In 1896 he co-founded the London Association for the Prevention of Premature Burial (LAPPB) and co-wrote Premature Burial and How It May Be Prevented, giving voice to widely held fears about the safety of the body in the hands of ambitious but not necessarily competent, conscientious, or even careful, medical professionals. Concerned that doctors did not possess the appropriate tools to verify death, that they were unable to distinguish it from a state of trance, and that the government was paying little heed to the thousands of cases of premature burial that were coming to light each year, Tebb began to lobby for burial reforms. The LAPPB demanded that each corpse be thoroughly inspected for signs of life, that greater care be taken in the administration of anaesthesia, and that the process of death certification be revised. The association guaranteed its members that LAPPB physicians, armed with all the necessary instruments, would carefully verify that they were indeed dead before consigning their bodies to the earth.