Explore: The Journal of Science and Healing
Volume 3, Issue 4 , Pages 347-354, July 2007

The Undead: Botched Burials, Safety Coffins, and the Fear of the Grave

Article Outline

 

Taphephobia, n: fear of the grave, or fear of being interred while still alive. From the Greek taphos, grave, and phobos, fear.

Thanatomimesis, n: the state of apparent death; the resemblance of death while still alive. From the Greek thanatos, death, and mimesis, to imitate.1

When George Washington died at 10 pm on December 14, 1799, his final words to Tobias Lear, his secretary, were, “I am just going. Have me decently buried and do not let my body be put into the vault in less than three days after I am dead. Do you understand? ‘Tis well.”2 America’s first president and the Father of His Country was buried according to his instructions.

During this period, well-informed individuals in Europe and America, such as Washington, were well aware of the possibility of being buried before being completely dead. Lord Chesterfield (1694-1773) expressed this widespread anxiety when in 1769 he wrote to his daughter-in-law, “All I desire for my own burial is not to be buried alive.” The final words of Frédéric Chopin (1810-1849), succumbing to tuberculosis, were also typical: “The earth is suffocating. … Swear to make them cut me open, so that I won’t be buried alive.”3

A several-day waiting period prior to interment was the most common precaution against premature burial. The deceased could be left lying in the caskets for days or weeks, just to make sure they were dead. When the Duke of Wellington died in 1858, burial postponement reached a macabre extreme; he was not buried until two months after he expired.4

When extended deferment of burial was not practical, individuals would sometimes be buried with accessories that might come in handy—crowbars and shovels that could be used to dig one’s way out in case one revived. Or vertical pipes might be installed through the ground into the casket, for communication with the outside world. Wealthy families often hired servants to wait by the pipes the first few days, just in case the “deceased” called for help. Those whose fear of premature burial was extreme might specify in their wills that they wanted their heart punctured prior to interment. Families who could afford fancier measures sometimes had coffins fitted with special nails that, when driven, punctured vials that liberated poison gas.4

During this period, there were no electrocardiograms, electroencephalograms, or brain scans to determine whether death had occurred. The pronouncement of death often depended largely on whether the individual looked dead. But looks were often deceiving. A feeble, undetectable pulse or shallow, invisible respirations might return after a person was pronounced dead. Mistakes were made, and they horrified people.

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The Romeo Error 

In his enchanting book The Romeo Error, biologist Lyall Watson describes how the 18th and 19th centuries were peppered with gruesome instances of premature burials that fed the fears of everyone.5 Watson calls the diagnosis of premature death the Romeo Error, after the mistaken assumption by Shakespeare’s impetuous character that his beloved Juliet was dead, when she was only in a deep, temporary sleep resulting from the potion given her.

The Romeo Error isn’t restricted to impulsive Latin lovers. Plato, Pliny the Elder, Plutarch, and Asclepiades the physician recorded stories of people believed dead, but who returned to life prior to interment.

Far more gruesome were reports of people buried alive. One of the most famous concerned Franciscan theologian John Duns Scotus (1266-1308). He lapsed into a coma and apparently died—the condition called thanatomimesis, literally the imitation of death. When he was eventually exhumed, as saintly individuals often were, he was reportedly found outside his coffin with torn and bloody hands, having failed to escape his grave.6

Although there is an unbroken chain of these accounts across two millennia, most of those on record date to the last three centuries. In 1856, knocking sounds were heard from the grave of a man, but it took the priest and police so long to grant permission to disinter the individual that he was dead by the time his coffin was opened. The wounds he inflicted on himself—bites on his shoulders and arms—were proof he had been buried alive.7 Noises from the grave were also heard in an 1893 case of a woman who died late in pregnancy. By the time she could be dug up, her body was torn and bleeding from her struggle to free herself, and from the birth of her baby. Both mother and infant had died from suffocation.

William Tebb (1830-1917), the English merchant and social reformer best known for his criticism of compulsory vaccination, and his colleague Edward Vollum compiled 219 cases of narrow escape from premature burial, 149 instances of actual premature burial, 10 cases in which bodies were mistakenly dissected before death, and two cases in which embalming was begun on a living person.8

Fear of infectious disease contributed to premature burial. In the 1850s, a young girl died of diphtheria while visiting Edisto Island, South Carolina. Because it was feared the disease might spread, she was hurriedly buried in the local family’s mausoleum. The next time the tomb was opened was around a decade later, to inter one of the family’s sons who died during the Civil War. The girl’s skeleton was found outside her casket on the floor just behind the door.9

Watson has collected numerous examples of premature funerals. The Reverend Schwartz, an early missionary to India, was roused by his favorite hymn as it was being sung at his funeral in Delhi. The gathered mourners became aware of the error when they heard a voice from the coffin joining in the chorus.10 Nicephorus Glycas, the Greek Orthodox bishop of Lesbos in the late 1800s, lay in state for two days, decked out in his vestments in the church at Methymni, when he suddenly sat bolt upright, glared at the passing mourners, and demanded to know what they were staring at.11

One of the most famous examples of thanatomimesis involved Dr Thomas Willis (1621-1675), the legendary physician and anatomist who described a number of diseases and the intracranial arteries at the base of the brain that came to be known as the Circle of Willis. Anne Green, a 22-year-old single woman employed as a housemaid by Sir Thomas Read in Oxfordshire, became pregnant and gave birth to a premature infant. The baby died and Green concealed the body. When the corpse was found, she was accused of murdering her own child and was sentenced to hang.

The execution took place on December 14, 1650. After Green climbed the ladder up to the gallows, a rope was placed around her neck and she was pushed off. As her body was hanging, people came forward to pinch her breasts or to amuse themselves by hanging onto her legs. This was the custom of the day and was tolerated because it was believed that tugging on the condemned hastened his or her death. Fearing the rope would break, the attendant urged spectators to leave the body alone. After 30 minutes, Anne Green was presumed dead.

Her body was placed in a coffin and taken to the home of Dr William Petty, a university lecturer in anatomy, as corpses for dissection were difficult to come by. When the physicians, among whom was Dr Thomas Willis, opened the coffin, the “corpse” visibly inhaled and a rattling was heard in the throat. Resuscitation was begun immediately, including keeping the body in an upright posture, tickling the neck to induce coughing, pouring hot drinks down her, and rubbing the hands and feet. When, after 15 minutes, they again tickled Anne Green’s throat with a feather, she opened her eyes for a moment. Other measures were instituted, including bloodletting. Eventually she was put to bed beside a woman for the purpose of keeping her warm. Green recovered dramatically. Within 12 hours she could vocalize, and two days later was sent home. After four days she was able to eat solid food. A month later she was back to normal except for amnesia for the execution and resuscitation.

The authorities reprieved Anne Green. She moved to the countryside with friends, bringing along with her the coffin in which she had been laid as a corpse. She married, had three children, and lived another 15 years after her failed execution. This apparent resurrection helped make Dr Thomas Willis famous and became a source of envy to his physician colleagues. His contributions to medicine were so numerous and his fame so great, he was buried with honor in Westminster Abbey.12, 13, 14

Those who authorized a premature burial were sometimes punished for doing do. In a case reported in the British Medical Journal in 1877, the grave of a woman, buried some days earlier, was opened for the reception of another body. “It was found that the clothes which covered the unfortunate woman were torn to pieces, and that she had even broken her limbs in attempting to extricate herself from the living tomb.” A court sentenced the doctor who had signed the death certificate, along with the person authorizing the interment, to three months imprisonment for involuntary manslaughter.15

Those who survive premature burial are not always welcomed back. In 1993, Sipho William Mdletshe, 24, was pronounced dead following a traffic accident in Johannesburg, South Africa. After spending two days in a metal box in a mortuary, workers heard his cries and rescued him. His joy turned to sorrow, however, when his fiancée, who was also injured in the crash, refused to believe his story. She was certain he was a zombie who had come back to haunt her, and she refused to see him.9

There have been lighter moments. In 1674, a sexton buried Marjorie Halcrow Erskine of Chirnside, Scotland, in a shallow grave, intending to return later to rob her jewelry. While he was cutting off her finger to remove a ring, Marjorie woke up. She lived several more years, giving birth to and raising two sons. The fate of the sexton is unrecorded.9

In the late 1500s in Braughing, England, while the body of Matthew Wall was being carried to his grave, one of the pallbearers tripped, causing the coffin to be dropped. This revived Wall, who thereafter celebrated his “resurrection” every year, until he died several years later in 1595.9

In the early 1800s, M. Chevalier, a Paris surgeon, contracted a sleeping sickness, lapsed into coma, and was apparently dead. Those in charge moved and shook him violently, with no success. They shouted his name in a loud voice, again to no avail. Then someone who knew him remembered that he was an enthusiastic player of piquet, a popular card game. So he shouted the words quint, 14, point!—whereupon the man suddenly awakened from his lethargy.16

The Romeo Error continues to be made today, in spite of our more precise ways of diagnosing death. In December 1963, 35-year-old Elsie Waring was certified dead by three physicians at Willesden General Hospital in London. As she was being lifted into her coffin 10 hours later at Kilburn Public mortuary, she began to breathe again.17

As a pathologist was making the first incision at autopsy in New York in 1964, the “corpse” suddenly leaped up and seized the poor man by the throat. The corpse lived, but the pathologist suffered a cardiac arrest and died on the spot.17

A recent case resembles that of Shakespeare’s Juliet. In 2001, the Boston Globe reported the case of a woman found apparently lifeless in her bathtub, with a suicide note and evidence of a drug overdose nearby. The emergency medical technicians and the police could detect no vital signs or any evidence of neurological responsiveness, so she was taken to a nearby mortuary. On his way out, the funeral director heard the faint sound of someone breathing, unzipped her body bag, held open her mouth to assist her breathing, and had her removed to a hospital. Like Juliet, she had awakened when her “potion” wore off.18

A Juliet-like moment involving a potion that mimics death, but with a happier ending, occurs in the 2006 movie The Illusionist.19

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How Frequent? 

In 1892, the U.S. Army cemetery at Fort Randall, South Dakota, was officially abandoned and the remains of 67 individuals, including 63 soldiers and four children, were removed and interred in the Fort Leavenworth National Cemetery in Kansas. T.M. Montgomery, who supervised the disinterment and removal of the remains, reported “nearly 2% of those exhumed were no doubt victims of suspended animation”—a polite way of saying they were buried prematurely.9

This is consistent with other estimates. Rodney Davies, author of The Lazarus Syndrome: Burial Alive and Other Horrors of the Undead, reports that the frequency of premature burials has been variously estimated to be from 0.1% to 1% or 2% of all total burials in the United States and Europe. Davies describes how premature burials increase in periods of pestilence and war. During World War II and the Vietnam War, he reports that premature burials were estimated to be as high as 4%.20

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Contributing Conditions 

Biologist Watson examined medical conditions that may have been involved in premature burial.5 Among these are cataplexy and catalepsy, medical terms one doesn’t often hear these days.

In cataplexy, the individual sinks to the ground with closed eyes and is unable to move a muscle or utter a sound. The condition is precipitated by strong emotion such as hearty laughter, excitement, surprise, or anger. During the episode the individual remains fully conscious, and the event may persist for a couple of minutes or so. Cataplexy occurs in around 70% of cases of narcolepsy, a condition characterized by profound, uncontrollable somnolence.

Catalepsy, a similar condition, occurs in psychotic patients. It is characterized by a trancelike, unresponsive state and a waxy rigidity of the limbs.21 It can also be induced in normal individuals by hypnosis.

“Perhaps,” suggests Watson, “today we simply bury our cataleptics alive. It could be significant that one of the earliest discussions of this problem occurs in a paper ‘On the Signs That Distinguish Real from Apparent Death’ that was published in the Transylvania Journal of Medicine in 1835.22 The author was prompted to explore the subject by the number of vampire scares to which his part of the world is subject. He and others have suggested that the destruction in tombs, the broken coffins, torn shrouds, and twisted, bloody corpses were not so much evidence of vampirism as of the last desperate struggles of cataleptics to free themselves from their premature graves.”5, 23

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Safety Coffins 

To prevent being buried alive, many people during the past three centuries specified in their wills that special tests were to be done prior to burial, such as a candle or mirror being held up to their mouth and nostrils to detect respiration. Occasionally, to make sure they were dead, they demanded they be decapitated, exsanguinated, or stabbed through the heart. Some required that boiling liquids be applied to their skin, surgical incisions be made, or red-hot irons be touched to their flesh to see if they could be aroused. Others requested a way of killing themselves should they wake up in their coffin and were thus buried with guns, knives, or poison.9

Eventually technology was tapped as a way of thwarting premature burial. In the 1890s, a young Belgian girl came out of a trance as the earth was being tossed onto her coffin. This so troubled Count Karnice-Karnicki, chamberlain to the Czar of Russia and Doctor of the Law Faculty at the University of Louvain, that he invented a device that enabled a person trapped in a coffin to summon help. A spring-loaded device sitting on the corpse’s chest would be triggered if the chest began to move. The spring would open a box on the surface, admitting air through a tube into the coffin. To summon help, a flag would also spring up, a bell would ring for 30 minutes, and a lamp would burn after sunset. His invention was patented in 1897.9 Inventors of safety coffins were also busy in the United States. Between 1868 and 1925, Americans applied for 22 patents for “life-signaling” coffins.24

One of the most popular safety devices in Victorian England was the Bateson Revival Device, invented by George Bateson, who made a fortune in sales. The gadget came to be known as Bateson’s Belfry. It consisted of an iron bell mounted on the coffin lid just above the deceased’s head, with a cord connected to the hand “such that the least tremor shall directly sound the alarm.” Ironically, his invention did nothing to relieve his own all-consuming fear of premature burial. In 1886, driven mad by his dread, he committed suicide by dousing himself with linseed oil and setting himself on fire.25

Today one occasionally hears that the idioms “saved by the bell” and “dead ringer” are derived from the bell-ringing feature in safety coffins popular in the 19th century. There is no evidence for this. “Saved by the bell” arose in the sport of boxing in the 1890s.26 “Dead ringer” has its origin in horse racing, meaning a horse that is substituted for another of nearly identical appearance in order to fool the bookies.27

An example of a bell that could be rung when the interred person pulled a cord is featured in the 1979 movie The First Great Train Robbery.

Refinements in safety coffins flourished, including pyrotechnics, escape hatches, ladders, and even feeding tubes. Netting was installed over the air tubes to prevent the entry of insects into the coffin. Housing was placed over the air tube to prevent wind from ringing the bell in a false alarm and to eliminate the entry of rain. In some designs, if the bell rang, the watchman was instructed to insert a second air tube and pump air continually inside the casket with a bellows until the occupant was dug up. However, many safety coffins were too cute by half; the designer simply forgot a method for providing fresh air, without which the elaborate gadgetry was destined to fail.6

Not so the coffin of Duke Ferdinand of Brunswick, who gave orders for the first safety coffin on record prior to his death in 1792. It featured a window and an air tube to admit light and air. The lid was not nailed down, but was fitted with a lock that could be opened from the inside. In a pocket in the Duke’s shroud were two keys—one for the coffin lid and one for the tomb door.6

Some inventors went to great lengths to demonstrate the superiority of their safety coffin. Dr Adolf Gutsmuth, a German designer, had himself buried alive several times in his invention, and in 1822—while interred—ate soup, sausages and beer delivered to him though the coffin’s feeding tube.6

In the 1820s, “portable death chambers” appeared in Germany. These consisted of a small chamber for the corpse that was constructed over the grave. The chamber was outfitted with a bell for signaling and a viewing window that permitted the watchman to check for signs of life or decomposition. If putrefaction was detected, a trap door in the bottom of the chamber could be triggered and the body would drop into the grave below. A panel was then slid into place, covering the grave, and the chamber could be removed and reused.6

There is no historical evidence that any person was ever buried alive in a safety coffin. But a few bells were rung and coffins were dug up in response, when the cords attached to the corpse’s limbs were tugged on as a result of the body’s natural movements as it putrefied and bloated.3

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The Fear Continues 

The old horror remains. In a 1985 Italian study of patients recovering from myocardial infarction, 50% were found to suffer from phobias that included being buried alive.28

So, it’s not surprising that safety coffins are still available today. A 1983 U.S. patent (No. 4,367,461) was issued for an electronic alarm system inside coffins that was triggered by a movement of the body.18 In 1995, Italian inventor Fabrizio Caselli introduced a sophisticated safety coffin costing $5,000. It comes with an emergency alarm, two-way microphones and speakers, a flashlight, a small oxygen tank, a heart monitor, and a defibrillator.6

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Cremation 

Cremation has long been touted as a surefire method of preventing premature burial and its associated horrors. A pamphlet was circulated in Australia in the late 1800s assuring people that “Cremation eliminates all danger of being buried alive.”9 This advice ignores the risk of being burned alive. Pliny the Elder (23-79 ce) cites the case of a man placed upon a funeral pyre who awakened as the flames were lit. The flames were too high for anyone to save him, and the man was burned alive.18

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Modern Assurances 

Barbara Mickelson, in her review of premature burial, says, “These days, getting accidentally buried alive in the United States or Canada borders on the impossible. Embalming procedures will finish off anyone not quite all the way through the Pearly Gates, and the families of deceased citizens of both those countries overwhelmingly opt to have their loved ones embalmed.”9 These assurances may be excessive, because there are many instances in which the problem of premature burial is replaced by premature embalming.

In 1830 in Rome, Cardinal Somaglia became ill, passed out, and was believed dead. Preparations for this high official began abruptly. When the embalmer cut into his chest to instill embalming fluid, he could see the cardinal’s heart still beating. At this point the cardinal awoke and pushed the scalpel away from his chest, only to die from the chest incision.9

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Listening for Life 

The history of the stethoscope is interwoven with that of taphephobia. René Laennec, the French physician who was the first to recognize cirrhosis of the liver as a disease entity and who made important contributions to our understanding of melanoma and tuberculosis, invented the first stethoscope in 1819. Although his original version was a crude affair made of wood, with only one earpiece, it nonetheless enabled physicians to detect a heartbeat more accurately.

Laennec’s device was accepted gradually and grudgingly by many physicians. An exception was Dr Eugene Bouchut, who won a prize in 1846 from the Academy of Sciences in Paris for “the best work on the signs of death and the means of preventing premature burials.” Bouchut’s method relied heavily on Laennec’s stethoscope in determining whether death had occurred.

Bouchut’s earliest conclusions seem as if they might have contributed to premature burials rather than prevent them. After experimenting on sedated and dead animals, he believed that if a heartbeat were absent for longer than two minutes, an individual could be considered dead. In the face of opposition from colleagues, he extended the period to five minutes.

Several physicians vied for the prize Bouchut won. They had wildly different approaches to diagnosing death and preventing premature burial. One suggested introducing leeches near the anus. Another recommended applying specially designed pincers to the nipples. A particularly bold suggestion involved piercing the heart with a long needle with a little flag at the end; if the heart were still beating, the flag would wave.29

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Legal Measures 

In 1899, a bill designed to prevent premature burial was introduced before the New York State Legislature.30 The sponsor of the bill said it would “preclude all danger of burying a live person. We have a number of authenticated cases of this. . . . ” This legislative act made it illegal to bury, cremate, or otherwise dispose of a body until 12 hours had elapsed from the time of death specified by the physician or coroner on the death certificate, and before unequivocal signs of decomposition such as rigor mortis had occurred. The proposal reflected ongoing, widespread concern about being buried alive, not just in America but also in Europe. In fact, the New York proposal was modeled on a German law, and it embodied concerns that were being forcefully voiced by London’s Society for the Prevention of Premature Burial.

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Poetry and Literature 

Taphephobia became the subject of poets. Shortly after the New York legislation was introduced, followers of the poet Percy Russell shuddered as they read his poem “Premature Burial,” which contained these lines:

To find a coffin stifling their last breath,

Surpasses every horror underneath. . .

How many have been smothered in their shroud!

How many have sustained this awful woe!

Humanity would shudder could we know

How many have cried to God in anguish loud,

Accusing those whose haste a wrong had wrought

Beyond the worst that ever devil thought.31

Edgar Allen Poe, America’s master of the macabre, was obsessed with premature burial, and he fanned America’s fears of being buried alive. In his 1846 story “The Cask of Amontillado,” the narrator exacts revenge by luring his enemy into a wine cellar and walling him in. In 1850, Poe scared the nation witless with his widely read short story “The Premature Burial.” Published posthumously, the story dealt with “sepulchral terrors” that Poe considered “the most terrific of these extremes which has ever fallen to the lot of mere mortality.”32

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Death: Gradual or Instantaneous? 

Implicit in funeral practices worldwide, says biologist Watson, is a central theme that death is not the end, but is a transition. “But in our society,” he continues, “the generally accepted opinion is that death is instantaneous.”5 One moment you are alive, the next moment you are dead. In movies, people die in an instant. Movie cameras don’t linger; they don’t capture the process of dying, but a faked, abrupt event called death.

The cultural belief that death is instantaneous has practical implications. It means there need be no waiting period or intermediary stage for the soul to begin its journey to the beyond. Indeed, modern science assures us that there is no journey to be taken, because nothing survives that might require a waiting period to complete its transit. “The only reason [in our society],” says Watson, “for the delay of two or three days between death and disposal is to allow preparations to be made and to give time for friends and relatives to gather. . . . [We] are almost alone in this view. . . .”5

By the late 19th century, physicians’ views had solidified: death was not a long-drawn-out process, but was sudden. It was as if some on-off switch existed; you were either dead or you weren’t. As Phillippe Ariès explains in his landmark work, The Hour of Our Death, “[Physicians] rejected the idea that apparent death [thanatomimesis or look-alike death] represented a real danger, seeing it as a superstition without experimental foundation or scientific validity. They did so with a passion that surprises us. This is because the debate over apparent death raised the possibility that death could be, at least for a time, an ambiguous condition. They did not accept the idea that there could be a state that partook of both life and death; it had to be one or the other. It was no more possible for death to have duration than it was for a geometric point to have density or thickness. Death was a vague expression that must be eliminated from the precise language of science in order to designate accurately the arrest of the machine, a concept of pure negativity. The concept of death as a state was intolerable.”33

Today we generally assume that physicians have always considered life and death to be an abrupt, either/or condition. But as Ariès makes clear, this is not so. During the 16th, 17th, and 18th centuries, “the time of death” was widely considered by physicians to be a state that partook simultaneously of both life and death. Death was not considered final until decomposition and putrefaction set in. For doctors of the 16th and 17th centuries, Ariès says, a period of uncertainty began with apparent death or thanatomimesis, and continued in the cadaver or mummy. They saw evidence for this—the fact that cadavers “bled, bit, or perspired, and. . . hair, nails, and teeth continued to grow.”33

What subverted this view? Watson traces the origins of the death-in-an-instant view to the 14th century, when life was indescribably horrible for Europeans. Into this period “were crowded more disasters, plagues, wars, and pestilences than have ever been known at any other place or time. Bubonic plague swept across the Continent, bringing repulsive torment, delirium, and death to one fourth of the earth’s population; famine strewed the roads with dead and forced those forgotten in prison dungeons to devour one another; the Tartars and the Crusaders ravaged communities already weakened by the epidemics, and fire, earthquakes, measles, smallpox, and the Inquisition took care of the rest. During that century the subject of death was central, vivid, intense, and all-pervading. Nobody could ignore death and its associated terrors. . . .”5 It was necessary in this situation to dispose of the dead as quickly and unceremoniously as possible. This was a matter of survival, because festering, decomposing corpses threatened the living.

The urgency for burial must have made premature burial common. Evidence for this comes from the above-mentioned 1905 survey of premature burial in England by Tebb and Vollum.34 As part of this investigation, the researchers interviewed an old woman who was in charge of the cholera wards during an 1849 epidemic that killed 199 people. She stated that as soon as the patients died, they were placed without delay or further observation in wooden coffins, the lids were screwed down, and they were moved to a small shed so they’d be out of the way. “Sometimes,” she revealed, “they’d come to afterwards and we did hear them kicking in their coffins, but we never unscrewed them, because we knew they had to die.”34

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Burial Customs 

Burial customs play a role in premature burial. Societies that bury their dead below the surface in coffins or seal them in vaults are more likely to bury them alive. In contrast, many native tribes of the American West sewed their dead into a deer or buffalo hide and placed them on elevated platforms or in trees. Certain African tribes shut their dead up in their own houses and abandon them, or build special death houses. Other tribes around the world place their dead in caves or leave them on exposed rock ledges. Even if the moment of death is miscalculated in these societies, if the individual awakens, he or she is not trapped inside a coffin with six feet of earth above.

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Other Views 

I am amused when I hear people say in casual conversation, “If I die. . . .” Where does the if come in? So far, the statistics are impressive: everyone dies, no exceptions.

For some people, as we’ve seen, the inevitability of death and the fear of a botched burial are such an obsession, they crowd out an appreciation of the uniqueness and preciousness of life itself. It should be the other way around. As Lewis Thomas (1913-1993), director of research at Memorial Sloan-Kettering Cancer Center said, “Statistically, the probability of any one of us being here is so small that you’d think the mere fact of existing would keep us all in a contented dazzlement of surprise.”35 Or, as poet Emily Dickinson put it, “To live is so startling it leaves little time for anything else.”36 Nobel novelist J.M. Coetzee is on Dickinson’s side. In his book The Age of Iron, he exults, “Such a good thing, life! Such a wonderful idea for God to have had! The best idea there had ever been. A gift, the most generous of all gifts, renewing itself endlessly through the generations.”37

The cure for taphephobia is not safety coffins or high-tech methods of diagnosing death. It lies, rather, in cultivating a perspective that celebrates life, accepts physical death as a natural transition, and, in my view, acknowledges that “something else” survives the dissolution of the body, whatever that may prove to be. Some have regarded this something else as obvious and axiomatic. As the Greek philosopher Epictetus (circa 55-circa 135) assured his followers, “You are a little soul carrying a corpse.”38

In our materialistic age, the idea that something survives death is difficult for many people to accept, because of the morbid declaration of science that death represents the final annihilation of all that we are. Truth be told, many scientists who take this view are indulging in willful ignorance.39 As philosopher David Ray Griffin says, “[P]robably not one intellectual in a thousand, including college and university professors, is conversant with the kinds of evidence [relevant to the question of survival of bodily death].”40

In considering the possibility of life after death, some philosophers have essentially said, what’s the big deal? The supreme example may be Voltaire, who, in appraising reincarnation, stated flatly, “It is not more surprising to be born twice than once.”41 The shocker is not reincarnation or some other form of survival, but this life, and the fact that life exists at all.

Many wisdom traditions advocate preparation for death. Buddhism is the prime example, where we find this Zen aphorism: “If you die before you die, then when you die you will not die.”42 Dying before you die means dying to the notion of self or ego. The inevitability of physical death is a great incentive toward cultivating this understanding. As the late Harvard psychiatrist and Pulitzer winner John E. Mack said, “Human beings grow when, in the confrontation with death, they are enabled to discover a new personal perspective, sacrificing their egoism before it is the body’s time to die. This is what Eastern religions refer to as ego death.”43

Buddhist teacher Thich Nhat Hanh emphasizes how to live, not how to die, and comes to the same conclusion: “If we know how to live, we will also know how to die. Living in beauty means dying in beauty. The deepest way to be alive and the deepest way to die are the same—doing so in harmony with everyone and everything, in the true spirit of inter-being. The moment we do this, ideas of self and non-self, life and death, vanish, and we experience joy, equanimity, and non-fear.”44

Secular methods exist as well. In 1905, physician J.L. Corning described on the pages of the Journal of the American Medical Association the method he used to help a patient who was morbidly afraid of death: “By. . . saying to himself when about to sleep, ‘I die now,’ I have sought, by autosuggestion, to make him feel that he already knew the worst that death could inflict on him; that, in short, he had died, to all intents and purposes, every twenty-four hours.”45

For some, the solution to taphephobia is to focus on the here-and-now. As philosopher George Santayana concluded, “There is no cure for birth and death save to enjoy the interval.”46

Some Western philosophers have sought to defang the inevitability of death by transforming our view of time. At issue is our common-sense idea that time is a river that flows irreversibly in one direction, sweeping all living things inexorably toward death. Wittgenstein, for example, said, “If we take eternity to mean not infinite temporal duration but timelessness, then eternal life belongs to those who live in the present.”47

The eminent physicist David Bohm found in modern physics an affirmation of Wittgenstein’s view: “Ultimately all the moments are really one. . . therefore now is eternity. . . . [E]verything, including me, is dying every moment into eternity and being born again. . . .”48

In other words, the future is now. As St. Teresa of Àvila said in a religious context, “The path to heaven is heaven.”

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Practical Solutions 

Today, a great many end-of-life options are available that can allay the fear of death and provide comfort to dying persons and their families.

One of the most effective and elegant is the Chalice of Repose Project, which for over three decades has provided harps and harpists in thousands of vigils for dying persons and their loved ones. Therese Schroeder-Sheker, who founded the field of music-thanatology and the Chalice of Repose Project (http://www.chaliceofrepose.org), has worked tirelessly for more than three decades to ease the passage of the sick and dying around the world. Shroeder-Sheker contributes the Transitus column in EXPLORE and is the author of the superb monograph “Transitus: A Blessed Death in the Modern World.”49

Another exemplary end-of-life program is that of Upaya Zen Center in Santa Fe, New Mexico. Upaya was founded by Buddhist priest, educator, and social activist Roshi Joan Halifax, who has worked with dying persons since 1970. In its Being with Dying programs, Upaya trains healthcare professionals and caregivers from around the world to deliver compassionate care during life’s final period (http://www.upaya.org).

The international hospice movement has been enormously effective in reducing the pain, suffering, and fear experienced by dying people since the founding of St. Christopher’s Hospice by Dr Cicely Saunders in the United Kingdom in 1967.

A parallel development is the field of palliative care, which embraces many of hospice’s key elements. Palliative care (from the Latin palliare, to cloak) is any form of medical care or treatment that focuses on reducing the severity of symptoms or slowing the progress of a disease, rather than finding a cure.50 In 2006, hospice and palliative medicine was approved by the American Board of Medical Specialties as a subspecialty of internal medicine.51 A bridging organization, the International Association for Hospice and Palliative Care, seeks to increase the access to these services for patients and families around the world (http://www.hospicecare.com).

Hospice and palliative care seek neither to hasten nor to postpone death, but to offer symptom relief and to promote general well-being and spiritual, psychological, and social comfort for the person with a life-threatening or life-limiting illness. Toward these ends, a team approach is employed, featuring physicians, nurses, hospice chaplains, social workers, physiotherapists, occupational therapists, complementary therapists, volunteers, and, importantly, family members, who are guided when necessary by the professional healthcare team.50

Would taphephobia have been lessened if these services had been available to our ancestors in centuries past? Surely the answer is yes. But the old terrors would not have been completely eradicated, for they are as primordial as our genes and mitochondria. So it is not surprising that these primal fears remain widespread today, in spite of the extensive accessibility of these magnificent end-of-life options.

As long as medicine remains an inexact science, the diagnosis of death will remain imprecise. And as long as individuals remain unable always to choose the place and time of their death, examples of near- and actual premature burial will occur, though hopefully with decreasing frequency. But even if premature burial could be eradicated completely, the sorrow evoked by death itself will remain for many, because it seems always to come too soon. For them, any burial is premature, because life, they feel, should always have been stretched a little further.

In the literature dealing with premature burial, there are more than a few jokes and cynical asides about those anxious Victorians who were suckers for all those safety coffins and gizmos. This criticism is unfair. At least the Victorians were honest about their fears. We seem largely in denial of ours, and our nervous joking gives us away.52 It is wrong to trivialize the human fear of death, including the fear of premature burial. We should empathize with those for whom taphephobia is real and remind them that paths exist to pacify their quaking souls. And offer them, perhaps, the assurance of Buddhist teacher Sogyal Rinpoche, “Not to worry. We will all die successfully.”53

If conjectures of survival of bodily death are unconvincing to taphephobes, perhaps Socrates’ perspective might be consoling: “If it is true that in the Great Beyond lie all the great minds that have gone before, then what delight it would be to engage with them in every manner of discussion till the end of time. And if there is nothing it is just as well because I am tired and in much need of the rest.”54

No matter how empathic we try to be, gallows humor inevitably creeps into gruesome situations, including taphephobia. So in the spirit of lighthearted empathy, I offer the following suggestion, particularly to those in academia. As an anonymous instructor said, “If you plan to die, do it in a faculty meeting. That way, no one will notice the transition.” Your colleagues probably won’t notice you for at least a week, which is a safe waiting period to prevent premature burial. And if you ever wanted to raise a stink in a faculty meeting but never had the courage, by seven days your wish will have been granted.

Not a bad way to go.

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PII: S1550-8307(07)00147-4

doi:10.1016/j.explore.2007.05.001

Explore: The Journal of Science and Healing
Volume 3, Issue 4 , Pages 347-354, July 2007

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