THE STUDY OF DEATH
WE have very strong sympathy with the demand of the writer in a medical paper for a better and more systematic study of the physiology, and still more of the psychology, of death. The general public, never averse from muddling its mind on a great issue, apparently thinks that the prime object of the writer was to put the fear of death out of men's minds. That, we feel sure, was not the mother thought of the writer in the newspaper, though, no doubt, it would have its place in the investigation. Meanwhile we have been assured by hundreds' of writers in the Press of a fact, which is unquestionable : when men really come to die, the fear of death departs. That is the experience of every doctor and nurse. This is merely another way of saying that what men fear is not being dead, but the act of dying.
This act they associate with great sufferings, and they also fancy that what the poets call "the rending of body and soul," and also the physical convulsions of those who do not die in their sleep, must be moments of terrible pain. Indeed, it was this idea that made the old physicians call the act of dying "the agony." (One of the very few medical books specially devoted to the subject is, we believe, a work of about a hundred years ago entitled The Treatment of the Agony.) But, though we are convinced that it is not, as we have said, being dead but dying which alarms the patient, we feel that a good deal might be done to deliver the soul and body, or perhaps, we should say, the sub-conscious mind, from its dread of the pains of dissolution. If patients knew that the subject had been carefully studied and that there were methods by which, without impairing the patient's chance of life, " the agony " might be smoothed over, or even abolished altogether, they would face the moment between the certainty of death and actual death with far greater fortitude.
Although we desire to see every facet of what, after all, must always remain the most interesting thing in Physiology or psychology pass under thorough and most scientific investigation, what we attach most importance to is the psychological side of the proposed study. Partly owing to the inevitability of death, Partly owing to the very human desire of the doctor and the nurse to exhaust every possibility of victory in the struggle with death, and partly also through fear of giving pain to the relations, there has been very mule systematic attempt to record and to weigh the ften very remarkable and significant things said by eople on their deathbeds—things which, though they ay sometimes seem like mere delirium, or arc without any significance to the untrained mind, may, after all, be of great psychological importance. Therefore it should be the business of every doctor and every nurse who is an observer of the dying hour to record—but always, of course, with the greatest care and sympathy for the relatives—what was said as the flame of life gave its last flickers.
We can best illustrate what we mean by giving a concrete example. It will, we think, be admitted by the medical profession that it is by no means uncommon for dying people—people, that is, actually in " the agony "—to use some such words as " I'm not dead yet." The words are often pronounced in the patient's true voice breaking through the inco- herence of delirium. The present writer can recall an instance of how the character of the true man broke through the mood of the physical brain when mastered by delirium, which exactly illustrates our meaning. A patient in or closely approaching " the agony " was raving incoherently in various languages, sometimes intelligibly, sometimes quite without meaning. Then suddenly the ravings stopped and the man's own voice broke through in some such words as these : " I hope that person on the bed is not worrying you as much as he is worrying me. I don't know what he is talking about any more than you do." And then followed some words which seemed to show that the real man was neither distracted nor in pain. Death followed not long after.
Needless to say, the chief interest here was the fact that the true man seemed, as he came actually within the sphere of death, to be able temporarily to overcome the delirium which had held him for many weeks. He was not, as he approached "the agony," getting away from his true self but nearer to it. But to write like this on one or two examples is anything but scientific. What are wanted are a great many examples of words and phrases dropped in the hour of death, and then a serious effort made to co-ordinate them, or, at any rate, to say in what direction, if any, they point. There is no fear of any misuse being made of such observations. In the first place, the idea that people let out terrible family secrets in the hour of death is recognized as largely a delusion. No doctor of experience would impute any sinister meaning to the self-accusations of a delirious man. What we want is a collection such as Lord Bacon, that great pioneer of science, made in his essay "Of Death." He gives a list to show how some of the greatest figures in the world had remained " the same Men, till the last Instant." " Augustus Caesar died in a Complement ; Tiberius in dis- simulation ; Vespasian in a Jest ; Septimius Severus in dispatch."
Of the physical symptoms of death no record is better than that of Hippocrates ; with an uncanny instinct Shakespeare put the same observations into time mouth of Mrs. Quickly as the sure and certain signs of dissolution. For example, the nose sharp as a pen, and the plucking at the sheets. On this last point Hippocrates lays great stress. It is a very curious fact, because, though the majority of men die with bedclothes round them, there are thousands who cannot give this universal signal. Once more, the study of the act of dying, physiological and still more psychological, is well worth the closest attention of the whole medical profession.
Previous page
