by Unknown
Death could creep up much more slowly if a smaller vein or artery is nicked—even taking hours. Such victims would experience several stages of haemorrhagic shock. The average adult has 5 litres of blood. Losses of around 750 millilitres generally cause few symptoms. Anyone losing 1.5 litres feels weak, thirsty and anxious, and would be breathing fast. By 2 litres, people experience dizziness, confusion and then eventual unconsciousness.
‘Survivors of haemorrhagic shock describe many different experiences, ranging from fear to relative calm,’ Kortbeek said. ‘In large part this would depend on what and how extensive the associated injuries were. A single penetrating wound to the femoral artery in the leg might be less painful than multiple fractures sustained in a motor vehicle crash.’
Fire
Long the fate of witches and heretics, burning to death is torture. Hot smoke and flames singe eyebrows and hair and burn the throat and airways, making it hard to breathe. Burns inflict immediate and intense pain through stimulation of the nociceptors—the pain nerves in the skin. To make matters worse, burns also trigger a rapid inflammatory response, which boosts sensitivity to pain in the injured tissues and surrounding areas.
As burn intensities progress, some feeling is lost but not much, according to David Herndon, a burns-care specialist at University of Texas Medical Branch in Galveston. ‘Third-degree burns do not hurt as much as second-degree wounds, as superficial nerves are destroyed. But the difference is semantic; large burns are horrifically painful in any instance.’
Some victims of severe burns report not feeling their injuries while they are still in danger or intent on saving others. Once the adrenalin and shock wear off, however, the pain quickly sets in. Pain management remains one of the most challenging medical problems in the care of burns victims.
Most people who die in fires do not in fact die from burns. The most common cause of death is inhaling toxic gases—carbon monoxide, carbon dioxide and even hydrogen cyanide—together with the suffocating lack of oxygen. One study of fire deaths in Norway from 1996 found that almost 75 per cent of the 286 people autopsied had died from carbon monoxide poisoning.
Depending on the size of the fire and how close you are to it, concentrations of carbon monoxide could start to cause headache and drowsiness in minutes, eventually leading to unconsciousness. According to the US National Fire Protection Association, 40 per cent of the victims of fatal home fires are knocked out by fumes before they can even wake up.
Fall from a height
A high fall is certainly among the speediest ways to die: terminal velocity (no pun intended) is about 200 kilometres per hour, achieved from a height of about 145 metres or more. A study of deadly falls in Hamburg, Germany, found that 75 per cent of victims died in the first few seconds or minutes after landing.
The exact cause of death varies, depending on the landing surface and the person’s posture. People are especially unlikely to arrive at the hospital alive if they land on their head—more common for shorter (under 10 metres) and higher (over 25 metres) falls. A 1981 analysis of 100 suicidal jumps from the Golden Gate Bridge in San Francisco—height: 75 metres, velocity on impact with the water: 120 kilometres per hour—found numerous causes of instantaneous death including massive lung bruising, collapsed lungs, exploded hearts or damage to major blood vessels and lungs through broken ribs.
Survivors of great falls often report the sensation of time slowing down. The natural reaction is to struggle to maintain a feet-first landing, resulting in fractures to the leg bones, lower spinal column and life-threatening broken pelvises. The impact travelling up through the body can also burst the aorta and heart chambers. Yet this is probably still the safest way to land, despite the force being concentrated in a small area: the feet and legs form a ‘crumple zone’ which provides some protection to the major internal organs.
Some experienced climbers or skydivers who have survived a fall report feeling focused, alert and driven to ensure they land in the best way possible: relaxed, legs bent and, where possible, ready to roll. Certainly every little helps, but the top tip for fallers must be to aim for a soft landing. A paper from 1942 reported a woman falling 28 metres from her apartment building into freshly tilled soil. She walked away with just a fractured rib and broken wrist.
Explosive decompression
Death due to exposure to vacuum is a staple of science fiction plots, whether the unfortunate gets thrown from an airlock or ruptures their spacesuit. In real life there has been just one fatal space depressurisation accident. This occurred on the Russian Soyuz-11 mission in 1971, when a seal leaked upon re-entry into the Earth’s atmosphere; upon landing all three flight crew were found dead from asphyxiation.
When the external air pressure suddenly drops, the air in the lungs expands, tearing the fragile gas exchange tissues. This is especially damaging if the victim neglects to exhale prior to decompression or tries to hold their breath. Oxygen begins to escape from the blood and lungs. Up to 40 seconds after the pressure drops, bodies begin to swell as the water in tissues vaporises, though the tight seal of skin prevents them from ‘bursting’. The heart rate rises initially, then plummets. Bubbles of water vapour form in the blood and travel through the circulatory system, obstructing blood flow. After about a minute, blood effectively stops circulating.
Human survivors of rapid decompression accidents include pilots whose planes lost pressure, or in one case a NASA technician who accidentally depressurised his flight suit inside a vacuum chamber. They often report an initial pain, like being hit in the chest, and may remember feeling air escape from their lungs and the inability to inhale. Time to loss of consciousness was generally less than 15 seconds.
Surprisingly, in view of these apparently traumatic effects, animals that have been repressurised within 90 seconds have generally survived with no lasting damage.
Obviously some of the above must be hearsay, until it happens to us we won’t know—and we’re in no rush to find out. Some unfortunates, however, do find out before their time would otherwise be up, thanks to the human practice of execution. And other unfortunates have been, well, unfortunate enough to study them. In 1983, one brave New Scientist correspondent did just that.
An unnatural way to die
In 1983, the British parliament voted decisively against the reintroduction of the death penalty. But what were they voting against? What happens during an execution? Why does the person die? Is death instantaneous? Which is the most humane method?
If the death penalty had been reintroduced in the UK, hanging would probably have been the method. The blindfolded prisoner stands on a trapdoor with a rope around his or her neck. The door is opened suddenly and the weight of the prisoner’s falling body causes traction and tearing of the cervical muscles, skin and blood vessels. The upper cervical vertebrae are dislocated, and the spinal cord is separated from the brain: this is the lesion which causes death. The volume of blood in the skull and face quickly increases, but soon falls again. The respiratory and heart rates slow until they stop and death supervenes.
Initially during hanging the prisoner attempts to move, presumably reacting mainly to the pain of neck traction and dislocation. Later there is a series of reflex movements, as a result of spinal reflexes originating at the site of severance of the brain from the spinal cord, but these are not evidence that he or she can still feel. Hanging, however, does not immediately arrest respiration and heartbeat. They both start to slow immediately, but whereas breathing stops in seconds, the heart may beat for minutes. Blood loss plays little part in death due to hanging.
It is impossible to know for how long the condemned person feels pain, but in addition to cervical pain, the prisoner probably has an acute headache from the occlusion of veins and engorgement of cerebral blood vessels; this results from the rope closing off the veins of the neck before occluding the carotid and vertebral arteries. In experiments during the Second World War on human volunteers, the pressure at the lower end of the neck was raise
d to 600 millimetres of mercury and consciousness was lost in 6 to 7 seconds. This would have been sufficient time to feel pain.
Shooting is probably the second most widely used execution technique. Death is virtually instantaneous if the person is shot at close quarters through the skull; the bullet penetrates the medulla, which contains the vital respiratory and cardiac centres, among others.
But condemned prisoners are usually shot by firing squads aiming at the heart from some metres away and it is difficult to shoot a person dead with a single or few shots, except at very close range. The reason for this is that the cause of death in these cases is normally blood loss through rupture of the heart or a large blood vessel, or tearing of the lungs. Any lover of opera or westerns knows that death in these circumstances takes several minutes, quite enough for the victim to sing a powerful aria or almost describe the location of buried treasure.
Bullets, of course, cause a great deal of damage in tissues. High-velocity missiles, such as rifle bullets, have a tremendous amount of energy, which is partly released as heat within the tissues. This causes evaporation of tissues and water, forming a carrot-shaped space several hundred times the volume of the original bullet. When the bullet has passed through, this cavity collapses and sucks in dead tissue and contaminated air.
The guillotine was named after the French deputy who proposed its use in 1789 and introduced as a swift and painless device to extend to all citizens the advantages of a technique used only on noblemen in France. It was considered more humane because the blade was sharper and execution was more rapid than was normally accomplished with an axe. Death occurs due to separation of the brain and spinal cord, after transection of the surrounding tissues. This must cause acute and possibly severe pain. Consciousness is probably lost within 2 to 3 seconds, due to a rapid fall of intracranial perfusion of blood.
Some macabre historical reports from post-revolutionary France cited movements of the eyes and mouth for 15 to 30 seconds after the blade struck, although these may have been post-mortem twitches and reflexes.
Garrotting was used in the Iberian peninsula until the 1970s. It is a form of strangulation by a metal collar with a clamp. Those who use it believe that the resultant dislocation of the neck is rapid and death is instantaneous. Unfortunately, although the clamp is tightened quickly, the degree of compression of the neck sufficient to dislocate it takes some seconds to achieve. The neck tissues are tough and the application of the contraption is highly disagreeable. In addition to compressing the soft tissues, the clamp occludes the trachea. Therefore it kills by asphyxia, cerebral ischaemia and neck dislocation. Dying is painful, deeply distressing and may take several minutes.
Electrocution was first approved by the state of New York in 1888, and several hundred people a year were executed in the US for rape and armed robbery, as well as murder, until the end of the 1960s.
The prisoner is fastened to a chair by his chest, groin, arms and legs to prevent violent movements and to keep the electrodes in place. These are moistened copper terminals attached to one calf and a band round the head. Jolts of 4 to 8 amperes at levels between 500 and 2000 volts are applied for half a minute at a time, and a doctor inspects the condemned to decide if death has occurred or another jolt should be administered.
In 1982, John Louis Evans was shocked for half a minute. This broke the leg electrode, which was reattached. A second attempt failed to kill him and smoke was seen coming out of his mouth and left leg. He was given a third dose. It took ten minutes before the attending physician certified him as being dead.
The effects of accidental electrocution are burns, respiratory paralysis and cardiac arrest. The electric chair was introduced because it was believed it causes instant and painless death. Close observation has shown this is clearly not the case. There is no reason whatsoever to believe that the condemned person does not suffer severe and prolonged pain. The prisoner is so firmly fastened to the chair that he cannot move. The large amount of energy in the shock paralyses the muscles, presumably leading to the belief that the failure to move meant the prisoner was not suffering pain. However, a prisoner being electrocuted is paralysed and asphyxiated, but almost certainly fully conscious and sentient with a feeling of being burnt to death while conscious of the inability to breathe. It must feel very similar to the medieval trial by ordeal of being dropped into burning oil.
Two further techniques have been introduced in the US, examples of which are given below. The first is intravenous injection. In December 1982, Charlie Brooks of Texas had his vein cannulated by a physician. Then, from outside the execution chamber and unseen by the prisoner, a mixture was injected: this consisted of the rapidly acting anaesthetic Pentothal-curare to paralyse the muscles, and potassium chloride to stop the heart. The condemned man would have gone off to sleep in 10 to 15 seconds, never to wake again. The prisoner would have suffered no more pain than a patient being given Pentothal before an operation. However, the physician gave an overdose and the condemned man died under anaesthetic from central respiratory depression.
Other states have chosen gassing. In September 1983, Jimmy Lee Gray was strapped to a chair in an airtight room. Sodium cyanide crystals were dropped into a bath of sulphuric acid below his chair by depressing a lever from outside. This created hydrogen cyanide gas and the condemned man inhaled it. A sufficient concentration to constitute a lethal dose would take several seconds to accumulate, depending on how hard he tried to avoid inhaling. It would cause acute difficulty in breathing, asphyxia and, possibly, pain in the stomach. The prisoner would be severely distressed and in pain during the whole procedure. The resulting hypoxia would cause him to have spasms as in an epileptic fit, visible if he were not bound firmly. The prisoner would have died of inhibition of respiratory enzymes.
This article does not discuss the morality of capital punishment. A physician has no more expertise in general moral and ethical questions than does anyone else. These are simply the physiological facts of execution. They are inescapable if gruesome, but, if considered, may well help us to make appropriate moral decisions.
Nasty stuff indeed—and enough to make us determined prohibitionists on a subject that is still being debated today. To be honest though, given the choice, we’d go for the guillotine. Got to be better than an old axe, for sure. Apparently it took the axeman three attempts to sever the head of Mary Queen of Scots in 1587. He had to finish the job with a knife. Decades earlier in 1541, Margaret Pole, the Countess of Salisbury, was being executed at the Tower of London. She was dragged to the block but refused to lay her head down. The inexperienced axeman made a gash in her shoulder rather than her neck. According to some reports, she leapt from the block and was chased by the executioner, who struck 11 times before she died. Lovely. But although we now know what it’s like to die, what really does happen afterwards?
What happens after you die?
Many have tried to harness the rational horsepower of science to answer this most floaty question. Some were physicians, some physicists, some psychologists. Two were Nobel prizewinners. One was a sheep rancher. They have tackled it in labs, in hospital operating rooms, in barns behind their houses. Of them, only one landed an irrefutable proof—not a suggestive nugget or an inexplicable anomaly, but the sort of answer you could plant your flag into and say, ‘Victory! Now I know for certain.’ The man’s name was Thomas Lynn Bradford.
Though his background was in electrical engineering, Bradford’s afterlife experiment involved gas, not electricity. On 6 February 1921, Bradford sealed the doors and windows of his rented room in Detroit, Michigan, blew out the pilot on his heater, and turned on the gas.
Finding out is easy. Reporting back is the challenge. For this Bradford needed an accomplice. Some weeks back, he had placed a newspaper advertisement seeking a fellow spiritualist to help him with his quest. One Ruth Doran responded. The two met and agreed, as the New York Times put it, ‘that there was but one way to solve the mystery—two minds properly attuned, one
of which must shed its earthly mantle’. The protocol was sloppy at best, for regardless of whether or not our mantle-shucking engineer came through on the telepathic wireless, Mrs Doran, for the sake of spiritualism or publicity, could simply have told the reporters that he did. But she did not lie. The Times ran a follow-up under the headline ‘Dead Spiritualist Silent’.
A better-pedigreed variation of the Bradford experiment was undertaken by the physicist Oliver Lodge, once the principal of the University of Birmingham. Prior to his death in 1940, he devised the Oliver Lodge Posthumous Test. The goal, again, was to prove the existence of life after death. Lodge composed a secret message and sealed it in a packet (the Oliver Lodge Posthumous Packet) so that when, after his death, he told mediums (four of them, recruited by the Oliver Lodge Posthumous Test Committee) what the message was, their stories could be checked.
The packet itself was sealed inside seven envelopes, each envelope containing a clue the mediums could employ to jog the deceased physicist’s memory should he forget his own secret. Instead, the clues merely irritated the mediums. The contents of Envelope 3, for example, read: ‘If I give a number of 5 digits it may be correct, but I may say something about 2 801, and that will mean I am on the scent. It is not the real number…but it has some connection with it. In fact it is a factor of it.’ Eventually the mediums walked off the set and the Posthumous Packet was torn open, leaving the committee with nothing for their efforts but a slip of paper bearing an obscure musical fragment and a gnawing suspicion that Sir Oliver had been a few envelopes short of a stationery set. Of course, even had the mediums succeeded, one could never have been certain whether they might simply have—via some discreet Oliver Lodge Posthumous Envelope Steaming—peeked.
