Tag Archives: clinical death

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Plumbing the Depths of Grief

american somme cemetary Bony

american somme cemetary Bony (Photo credit: Wikipedia)

The death of a loved one is an impossibly agonizing, soul-crushing experience that never completely heals and only lessened by time. When my brother died in a car accident at the age of 25, I thought my tears would never stop.  From the moment I first heard the news, until the moment we lowered his body into the ground, I cried with a ferocity and singleness of purpose I didn’t know I possessed.  All the awful details of death, going to the hospital to get his personal possessions, cleaning out his apartment, picking out a coffin and the clothes he was to be buried in, were done with eyes blurred by tears and a voice hoarse from crying.  The procession of people bearing food and flowers seemed never ending, but I only hungered for alcohol and cigarettes.

After he was buried, the dreams started. Dreams of the two of us on a subterranean train system, the only illumination strobes of light that made him and the other passengers appear and disappear to the background sound of a speeding train racing over wooden tracks.  I was the only one who spoke in the dreams. He sat quietly, attentively, listening. I started out by speaking slowly, normally, and as the train raced along my words hastened to match its speed. I’d talk faster and faster, cognizant in my dream that the time to talk was soon coming to an end, and then he’d disappear.

I’d wake up crying, thinking I would pay any price for him to still be alive. Eventually my grief ebbed to where I could say his name without crying, and then to where I could look at his picture without my eyes growing teary, and now I survive without him. Still, 28 years later, I mist up whenever I hear the lines from “White Christmas” that promise “I’ll be home for Christmas, if only in my dreams”  because my dreams are the only place I can hope to see him.

Was I depressed during the grieving period? Yes. Did my doctor put me on antidepressants to numb the pain of my loss? No, and I’m glad he didn’t. My brother’s death was something I had to work through and plumbing the depths of my grief informed how I have dealt with the deaths of all of the loved ones that have followed him.

The American Psychiatric Manual has traditionally warned against diagnosing depression during bereavement, but now psychiatrists with ties to drug companies have helped to remove that warning and the makers of antidepressants stand to benefit from the change. If grief equals depression, grief is a treatable condition. A treatable condition is billable and amenable to interventions, in this case, prescription medications. Instead of providing a shoulder to cry on, doctors will provide a prescription pad to write on. And where does that leave the patient? Once again a normal part of life is medicalized, this time because drug companies want to take advantage of a market that increases every day, with every death.

Recently I heard the story of a mother who stood up at her son’s funeral and apologized because she had nothing to say to eulogize her son. She stood dry-eyed, unable to cry, and said she was on too many medications to feel anything but numb.  I wonder about her now, many  months after her son’s death, and whether she’s allowed herself to experience the pain of grief in all of its snot-drenching messiness. I hope so. I can’t imagine any crueler prison than not being able to let go of that pain.

In mourning death, we open our heart and let it bleed. Even though a scab may form, for a long time every memory rips it open and starts the bleeding again. It’s an unpleasant, unpredictable process, but as Henry Rollins says, “Scar tissue is stronger than regular tissue. Realize the strength; move on.”

The grieving process helps us to do that far more than any chemical ever will.

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Zombies Wanted, But Are They Dead or Alive?

One of my favorite lines in the Wizard of Oz goes like this:  “As Coroner I must aver, I thoroughly examined her, and she’s not only merely dead, she’s really most sincerely dead.”  It has a measure of decisiveness and finality. If someone is dead, we’d like assurances that they’re really and truly dead.
In order to determine the relative deadness of a person, there are two different criteria that may be used.  There’s the always popular clinically dead, the medical term for when the heart stops pumping and the lungs stop breathing. Then there’s brain dead, based on neurological criteria, that allows for a beating heart and working lungs (many times artificially maintained by a ventilator or respirator), but a nonfunctioning brain. Brain death determination looks at cessation of cerebral and brainstem functions and demonstration that the changes are irreversible.
Some definitions of death include all three markers, meaning death is defined as the cessation of all vital functions of the body including the heartbeat, brain activity (including the brain stem) and breathing.
And that makes me think of zombies.
Unfortunately, most definitions of zombies include some reference to the supernatural or witchcraft. The Centers for Disease Control Preparedness 101 Zombie Apocalypse home page states: “Although its meaning has changed slightly over the years, it refers to a human corpse mysteriously reanimated to serve the undead.” New theories support the notion that zombies are merely humans infected with a parasite that spreads through saliva. No matter what definition is chosen, a zombie is a human form that has lost the ability to reason and is no longer reliant on a heartbeat or breathing to survive. He or she retains the ability to move, but their movements are slow and awkward (unless one believes in zoombies).  Zombies have brain function, and that is the trait that causes most of us to fear the Zombocalypse.  Luckily their brain function is very limited. Enough for them to stagger around. Enough for them to capture people. Enough to remember that brains are their choice of food. Mobility, lack of brain function, and a hunger for brains is a terrifying combination.
But traditionally zombies are not considered alive or undead.  They are categorized as dead, and though they fit the criteria because of their lack of breathing and circulation, what about their brain function?
Dr. Steven C. Schlozman, an assistant profession of psychiatry at Harvard Medical School, postulates that zombies suffer from Ataxic Neurodegenerative Satiety Deficiency Syndrome or ANSD. He contends that zombie brains have some function, as well as dysfunction, in their cerebellar and basal ganglia. He likens the amount of brain function in zombies to that of a crocodile. Their unpleasant behaviors, including their insatiable appetites, derive from the lack of activity in the parts of the brain that modulate behavior.  But does this make them dead?
Since, at this point in time, medical technology has not created a need for zombie organ donation, devising new definitions of dead are not at the forefront of medical science. If, in the future, a method to safely use zombie organs is developed, I have no doubt that a new definition will arise and it will include the presence of limited brain function in the absence of respiration and circulation. The process will follow the same path to definition and acceptable use that occurred when human organ transplantation became viable. Prior to the need of organs, one definition of death, absence of heart beat and breathing, sufficed. After organ transplantation, a new definition of death, brain death, arose. When the need for zombie organs is great enough, medical science will become interested in ensuring that the answer to the question, are zombies dead or alive,  will become “really most sincerely dead.”
Interested in reading more about zombies? Check out:
http://www.cdc.gov/phpr/zombies.htm
http://io9.com/5286145/a-harvard-psychiatrist-explains-zombie-neurobiology