Digging deeper into the process of dying

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It is Halloween and, once again, gruesome images of death and the dead haunt the scene.

Coffins open, Dracula bares his vampire fangs, jangly-boned skeletons, ghosts and zombies rise from the ground.

"People think death is a scary process," says Kathy Kalbacken. "I don't see dying like that."



Death, in the public mind, is often violent and dark, spooky and fearful, hallmarks of Halloween night fright. But people like Kalbacken, a hospice nurse who deals with death daily, aren't frightened by death or the process of dying. Death, for them, is as meaningful as life.

While the Halloweenish aspect of death is creepy and ghoulish, Jon Austin, director of the Museum of Funeral Customs in Springfield, Ill., points out many cultures honor the dead in one way or another. For instance, Mexican Day of the Dead, "Dia de los Muertos," represents the continuity of life by celebrating the dead on the first two days of November.

Michael Wiant, director of Dickson Mounds Museum in Lewistown, Ill., sees death from the point of view of an archaeologist and anthropologist.

"Death, in many societies, means new life," he says. For an archaeologist, death means the life of knowledge for an individual or a culture.

"We have an opportunity to learn, not only about the form of life, but how it came to pass. Hopefully that informs us about how human beings have persisted for so long."

Kalbacken says people focus on the mysterious, enigmatic aspects of death. "But we forget, we start to die as soon as we're born."

She acknowledges tragic, accidental, or unexpected instantaneous deaths. However, in terminal illness or the natural aging process, the body starts to slow down months before a person actually dies.

A person may become weaker, sleep more and eat less, Kalbacken says. Eventually, they lose the desire for fluids, then one by one, the organs start to shut down.

"It's like going in slow motion," she says. "When you think about it, you need energy to talk, energy to chew, energy to smile. When the body is slowing down, it isn't making energy for all those processes."

Loved ones may try to force the person to eat, thinking they're starving to death. But the body is actually turning off the need for food and fluid on its own. It's a natural protective mechanism, Kalbacken says.

"The body is shutting down, and if you put a lot of food and fluid in it, where's it going to go?"

Common signs, such as the marbly-sounding "death rattle" or skin mottling are actually signs of the slowdown, rather than signs of pain or distress.

Predicting death, that is, giving terminally ill patients an estimate of how long they will live, is one of the most challenging estimates for doctors to determine. But Kalbacken has been in hospice long enough to recognize the small hints when death is near.

Pets will draw closer or pace around the bed, she says. Often, the patient himself will give clues that he knows death is imminent. The senses become more acute, the person might start reviewing his life, either in words or actions. Kalbacken says she's heard people talk to deceased relatives or speak knowingly of events that occurred before they were born.

"And, I can't explain it, but death has a smell all its own," she says. "In some patients, it's casual; in some, it's omnipotent, but you know it."

Fear of death is coupled with fears of what happens to the body - and the soul - after death.

Human remains are organic matter. Like all organic matter - plant, pet or human - bacteria and microorganisms activate decomposition. As soon as the heart stops, the cells lose oxygen and start to die off.

Myths that nails and hair keep growing after death are the result of misunderstandings of the decomposition process, Austin says.

For instance, as skin tissue shrinks, the follicles of facial hair become exposed. What looks like growth is actually shrinking tissue.

Depending on environmental conditions, noticeable changes begin to occur nine to 14 hours after death. Both Austin and Tim Krosse, of Carl Sandburg College's Mortuary Science Program in Galesburg, Ill., point out that modern embalming methods are for disinfection and sanitation rather than preservation.

"Embalming remains makes viewing pleasant for the living but it can't be interpreted as a permanent preservative technique," Austin says.

Bones, however, under the right soil and climate conditions, can be close to permanently preserved. That's why skeletons play such a large role in images of death.

Human bone has characteristics that make it very durable in life and death, Wiant says. Under certain conditions, over hundreds of thousands of years, bone fossilizes into mineralized stone.

Teeth enamel may be more durable than bone.

"There are studies that look at the deterioration of corpse to skeleton," Wiant says. "Often the teeth are the last to disappear because they are so hard."

But point-by-point scientific explorations of death belie death's strong connections to the emotional and spiritual realms of life.

"Death can be peaceful," Kalbacken says. "To me, people look younger when they die," she adds, which leads back to what Wiant says about death representing new life.
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