Dying 101

People don’t die like they do in the movies–alive one minute, saying something profound, and dead the next. There is a way the body is programed to die. Most of us don’t think about that, don’t know about it, and generally don’t want to know about it. We live in a death-denying society.

But as a nurse, I have spent most of my life talking about death, and now more than ever I want to explain the normal way the body dies.  

This is a time of great fear in our country, and the world, and a huge portion of the fear revolves around dying–probably the thing we fear the most (certainly that Americans fear the most).

Knowledge reduces fear, so here is “Dying 101.”

There are only two ways to die: Fast death, such as from a heart attack, suicide, or getting hit by a truck. Or gradual death, which comes about either due to old age (our body just wears out, and we die) or disease (we get a disease that the doctors can’t fix, that our body can’t fight, and we die).

Dying from the coronavirus is considered a gradual death (due to disease), but it can happen rapidly.

There is a process that occurs with gradual death. Certain things happen at certain times. The changes in gradual death occur on a timeline that ranges from months or weeks to sometimes only days, hours, or minutes.

With the coronavirus, the gradual dying signs begin days or hours before death. Up to that time, the patient will be very sick, will have difficulty breathing, but will not appear to be dying.

Most such people are isolated in a medical facility, surrounded by machines, but I think our fear stems not from the machines but from how we’re going to feel.

Think about a time when you were the sickest you’ve ever been. You likely don’t remember much, if anything, from that time. What you remember is when you were past the critical point and you heard what others told you had happened.

During the worst part of a severe illness, our mind just goes blank. I believe a dying person isn’t really aware of what is happening around them. Some people believe a dying person is thinking, feeling, and experiencing the world in the same way observers are. I don’t believe that is true. I have been with many people during their last hours and minutes and have consistently observed a lack of connection, lack of fear, and lack of awareness.

In this time of great fear and uncertainty, my wish for all of us–along with health, safety, and support–is knowledge. Knowledge of how to live in this crisis and knowledge of how to die in this crisis. We may be doing both.

Barbara Karnes
Vancouver, Washington


1 thought on “Dying 101”

  1. Dorothy Harsen

    Thank you for sharing your insights, Barbara. All very true from my experience as well. Families often find solace if we can tell them “at least he didn’t suffer.” Nevertheless, there is a period of time before the Covid-19 dying process sets in when patients and staff have pretty clear awareness of the anxiety, pain, breathlessness, and fear of taking the next breath. This is a hard thing to experience and a hard thing for staff to witness and a hard thing for family to witness over Skype. Lord have mercy. Our society doesn’t just deny death, it denies the reality of suffering as well.

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