Buried alive – at least nearly so

Forensic Prof. Klaus Puschel and court reporter Bettina Mittelacher review spectacular Hamburg criminal cases.

When a person who was thought dead suddenly wakes up again in the morgue. The story in the Crime Podcast.

Hamburg. Suddenly it moves. Quite discreetly only, hardly perceptible, after hours in which no sign of life could be discerned. As if dead, the body had lain there until just now, cold, pale, pupils fixed, no pulse to be felt. Breathing motion was also not seen.

And now this supposedly deceased regains consciousness, in that place where usually only the dead rest: in a morgue! "This sounds creepy and a bit like a horror movie. Apparently dead – and buried alive! For centuries, the fear of the prospect of ending up alive in a coffin, in cold storage or even in the ground has been going around," says Forensic pathologist Klaus Puschel in the Abendblatt podcast "On the trail of death" with court reporter Bettina Mittelacher. "But what to do when it’s dark around you and your cries for help go unheard?", Mittelacher asks.

How to determine if dead devices are really dead?

To ensure that anyone falsely declared dead could be resurrected from the presumed dead, Christoph Wilhelm Hufeland, later director of the Charite hospital, devised ways and means for a path back to life in anno 1791. The medic relied on heated morgues, a pulley at the foot and a saving bell. Others relied on holding a feather or a mirror in front of the mouth and nose of the deceased and observing whether something was still stirring.

The coffins were also tinkered with in those days; there were models with windows, air holes, bell pulls or even with folding spades as accessories. And some, wanting to remove any doubt, decreed in the will that the wrist be cut or even the "heart stab," in which a pointed instrument was thrust into the heart between the ribs. After such a procedure, no one was alive when buried. Death proof.

Apparent death is a rare phenomenon today

"In fact, in times when, for example, fear of epidemics and contagion was high, it certainly happened that a supposedly dead person was no longer really looked at up close or even examined," explains Puschel. "It is very conceivable that people were buried then who were still alive. Today, however, the apparent death is a highly rare phenomenon. At 800.000 deaths across Germany per year, the number of such cases is in the single digits. In the hospital, these supposedly deceased people are sometimes taken to the dead room or already to the morgue."

So-called apparent death is a state of deep unconsciousness in which the body appears completely lifeless. This state of limbo is also known as vita minima, or life at its lowest level. The author duo Puschel/Mittelacher has also described this topic in their book "Death gives no rest".

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Death for 17 minutes – and then not

"In 2002, I myself once witnessed a corresponding case," recalls the forensic pathologist. An 83-year-old lady collapsed at a bus stop in Hamburg-Lokstedt. Rescue workers tried to revive her. After 17 minutes, during which the emergency physician saw a zero line in the ECG, the measures were stopped.

Later, in the forensic medicine morgue, employees notice that the ribcage of the apparently dead person rises and falls very slightly. Now even a slow heartbeat can be detected. As a result, the rescue chain is immediately alerted. "And I, who was the doctor on duty nearby, did the chest compressions myself at times," says Puschel. The 83-year-old woman is taken to the hospital, but dies a short time later after irreversible cardiovascular failure.

Sure and uncertain signs of death

"There are several sure signs of death," Puschel explains. "These are rigor mortis and lividity, putrefactive changes, as well as injuries that are incompatible with life – that is, for example, when a person’s head was cut off in a traffic accident. Unsafe signs of death, on the other hand, include pupils that are fixed in light, cooling, and a pulse that cannot be measured. Such signals must not be relied upon under any circumstances." Even though Puschel has complete faith in science, he understands if there are still people who fear they might be buried alive.

"During my more than 40 years in forensic medicine, I have been asked a few times to personally make sure that people were really quite clearly deceased," he relates. "I remember cases where I opened the large artery at the wrist of old people and documented that it was certainly no longer pulsating.

The people in question had explicitly put this form of death determination in writing as their last will and testament. This last wish also touches me. There are situations in which I give in to the last will and testament against my own reason, because I believe that this person will find peace with it."

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