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CAITLIN DOUGHTY

What If They Bury Me When I’m Just in a Coma?

Caitlin Doughty (b. 1984) is a writer, blogger, YouTube personality, and mortician. A native of Hawaii, Doughty graduated from the University of Chicago, where she majored in medieval history. After training at a crematory, Doughty studied mortuary science at Cypress College. In 2011, she founded the Order of the Good Death, which advocates for natural burial and open discussion of human mortality, and started her popular YouTube series, “Ask a Mortician.” Doughty is the author of Smoke Gets in Your Eyes (2014); From Here to Eternity (2017); and Will My Cat Eat My Eyeballs? (2019).

“What if they make a mistake and bury me when I’m just in a coma?” is one of 35 questions Doughty raises in her 2019 book. Her answer is not to worry: death professionals today are expert classifiers with strict scientific criteria for identifying different states of human mortality, such as merely being in a coma or being “good and dead.”

MLA CITATION: Doughty, Caitlin. “What If They Bury Me When I’m Just in a Coma?” Back to the Lake: A Reader and Guide for Writers, edited by Thomas Cooley, 5th ed., W. W. Norton, 2024, pp. 518–21.

KAY, SO TO BE CLEAR, you don’t want to be buried alive, is that correct? Got it.

Lucky for you, you don’t live in Ye Olden Times! During Ye Olden Times (before the twentieth century), doctors had a less-than-flawless track record when it came to declaring people dead. The tests they used to determine if someone was honest-to-God-really-dead were not just low-tech, they were horrifying.

For your enjoyment, here’s a fun sample of the death tests:

Shoving needles under the toenails, or into the heart or stomach. Slicing the feet with knives or burning them with red- hot pokers. Smoke enemas for drowning victims—someone would literally “blow smoke up your ass” to see if it would warm you up and make you breathe. Burning the hand or chopping off a finger.

And, my personal favorite:

Writing “I am really dead” in invisible ink (made from acetate of lead) on a piece of paper, then putting the paper over the corpse-in-question’s face. According to the inventor of this method, if the body was putrefying, sulfur dioxide would be emitted, thus revealing the message. Unfortunately, sulfur dioxide can also be emitted by living people, like those with decaying teeth. So, it’s possible there were a few false positives.

If you woke up, breathed, or visibly responded to these “tests”—hallelujah!—you weren’t dead. But you might be maimed. And that needle stuck in your heart could actually kill you.

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But what about the poor souls who weren’t put through the battery of stabs, slices, and enemas, but were just assumed to be 100 percent dead and sent to the grave?

Take the tale of Matthew Wall, a man living (yes, living) in Braughing, England, in the sixteenth century. Matthew was thought to be dead, but was lucky enough to have his pallbearers slip on wet leaves and drop the coffin on the way to his burial. As the story goes, when the coffin was dropped, Matthew awakened and knocked on the lid to be released. To this day, every October 2nd is celebrated as Old Man’s Day to commemorate Matthew’s revival. He lived, by the way, for twenty-four more years.

With stories like that, it’s no wonder that certain cultures had extreme taphophobia, or the fear of being buried alive. Matthew Wall was lucky that his “body” never reached his grave, but Angelo Hays was not.

In 1937—true, 1937 is not quite Ye Olden Times, but at least it’s way before you were born—Angelo Hays of France was in a motorcycle accident. When doctors couldn’t find his pulse, he was pronounced dead. He was buried quickly and his own parents were not allowed to see his disfigured body. Angelo would have remained buried if it wasn’t for the life insurance company’s suspicions of foul play.

Two days after Angelo was buried, he was exhumed for an investigation. Upon inspecting the “corpse,” examiners found that it was still warm, and that Angelo was alive.

The theory is that Angelo had been in a very deep coma which slowed his breathing way, way down. It was that slow breathing that allowed him to stay alive while buried. Angelo recovered, lived a full life, and even invented a “security coffin” with a radio transmitter and a toilet.

Luckily, if you fall into a coma today, in the twenty- first century, there are many, many ways to make sure that you are good and dead before you’re moved on to burial. But while the tests may show that you are technically alive, your new status may be small comfort to you and your kin.

Media and TV shows often throw around terms like “coma” and “brain-dead” interchangeably. “Chloe was my true love, and now she will never wake from her coma. I must decide whether to pull the plug.” This Hollywood version of medicine can make it seem like those conditions are the same, just one step away from death. Not true!

Of the two, the one you really don’t want to be is brain-dead. (I mean, neither is great, let’s be honest.) But once you’re brain-dead, there is no coming back. Not only have you lost all the upper brain functions that create your memories and behaviors and allow you to think and talk, but you have also lost all the involuntary stuff your lower brain does to keep you alive, like controlling your heart, respiration, nervous system, temperature, and reflexes. There are gobs of biological actions controlled by your brain so that you don’t have to constantly remind yourself, “Stay alive, stay alive . . .” If you are brain-dead, these functions are being performed by hospital equipment like ventilators and catheters.

You cannot recover from brain death. If you’re brain-dead, you’re dead. There is no gray area (brain matter joke): either you are brain-dead or you are not. If you are in a coma, on the other hand, you are legally very much alive. In a coma, you still have brain function, which doctors can measure by observing electrical activity and your

reactions to external stimuli. In other words, your body continues to breathe, your heart beats, etc. Even better, you can, potentially, recover from a coma and regain consciousness.

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This either-or condition is true of any

“binary” classification

system (p. 467).

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Okay, but what if I fall into a deep, deep coma? Will someone eventually pull the plug and send me off to the mortuary? Will I be trapped in both a casket and in the prison of my mind?

No. We now have a whole battery of scientific tests to confirm that someone is not just in a coma, but really, truly brain-dead.

These tests include but are not limited to:

Seeing if your pupils are reactive. When a bright light is shined into them, do they contract? Brain-dead people’s eyes don’t do anything. Dragging a cotton swab over your eyeball. If you blink, you’re alive! Testing your gag reflex. Your breathing tube might be moved in and out of your throat, to see if you gag. Dead people don’t gag. Injecting ice water into your ear canal. If doctors do this to you and your eyes don’t flick quickly from side to side, it’s not looking good. Checking for spontaneous respiration. If you are removed from a ventilator, CO builds up in your system, essentially suffocating you. When blood CO levels reach 55 mm Hg, a living brain will usually tell the body to spontaneously breathe. If that doesn’t happen, your brain stem is dead. An EEG, or electroencephalogram, which is an all-or- nothing test. Either there is electrical activity in your brain or there isn’t. Dead brains have zero electrical activity. A CBF, or cerebral blood flow, study. A radioactive isotope is injected into your bloodstream. After a period of time, a radioactive counter is held over your head to see if blood is flowing to your brain. If there is blood flow to the brain, the brain cannot be called dead. Administering atropine IV. A living patient’s heart rate will accelerate, but a brain-dead patient’s heartbeat will not change.

A person has to fail a lot of tests to be declared brain-dead. And more than one doctor has to confirm brain death. Only after countless tests and an in-depth physical exam will you go from “coma patient” to “brain-dead” patient. Nowadays, it’s not just some dude with a needle poised over your heart and “I am really dead” scrawled on a scrap of paper.

It is highly unlikely that your living brain will slip through the cracks and that you’ll be sent away from the hospital in a coma. Even if you were, there is no funeral director or medical examiner I know who can’t tell the difference between a living person and a corpse. Having seen thousands of dead bodies in my career, let me tell you—dead people are very dead in a

very predictable way. Not that my words sound all that comforting. Or scientific. But I feel confident saying that this is not going to happen to you. On your list of “Freaky Ways to Die” you can move “buried alive— coma” down to just below “terrible gopher accident.” ◆

FOR CLOSE READING

1. Is Caitlin Doughty right to say that the tests that even doctors

once used to determine whether or not a person was dead were “less-than-flawless” ones (2)? Why or why not?

2. What about the “battery of scientific tests” that doctors use today (15)? How reliable are they, according to Doughty; and

what, precisely, are they used to determine?

3. On anyone’s list of “Freaky Ways to Die,” just how far down is

“terrible gopher accident” likely to be: “not very,” “more than halfway,” “off the charts” (18)? Explain.

4. “I must decide whether to pull the plug” (11). Why does Doughty describe this as a “Hollywood version of medicine” (11)?

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18 As p. 462

explains, we classify

things in order to make

sense of the world around

us.

5. Do you think Doughty’s essay is in bad taste? Why or why not?

STRATEGIES AND STRUCTURES

1. “Okay, so to be clear, you don’t want to be buried alive, is that correct?” (1) Would this qualify as a RHETORICAL QUESTION? Is

it an effective way for Doughty to begin her essay? Explain.

2. Doughty presents her first list of dead-or-alive tests “for your

enjoyment” (3). To whom is she speaking here? What assumptions is she making about her intended audience,

especially about their capacity for IRONY?

3. Doughty studied history in college. Why does she tell the

ancient “tale” of Matthew Wall (5)? How about the more recent (but still “way before you were born”) story of the Frenchman

Angelo Hays (7–9)? Are they good historical EXAMPLES? Why

or why not?

4. In the first part of her essay, Doughty uses a binary

classification system (comatose or dead); what “new status” does she introduce in paragraph 10? What are the main

distinguishing features of this third category, as established by the second set of tests that Doughty outlines?

5. How would you describe the overall TONE of Doughty’s essay:

“sharp as a needle,” “lighthearted,” “heavy-handed,” “deadpan,”

all of these, or other? Explain.

6. Other Methods. According to Doughty, what is the most

important difference between being “in a coma” and being

“brain-dead” (13)? Doughty is an advocate of mortuary reform; what ARGUMENT is she implying here, especially when referring

to “equipment like ventilators and catheters” (12)?

THINKING ABOUT LANGUAGE

1. Doughty defines “Ye Olden Times” as the period “before the

twentieth century” (2). Did she likely learn this binary (then and now) system of classifying historical events in college, or is she

sharing a joke with her audience? Explain.

2. Doughty defines “taphophobia” as “the fear of being buried

alive” (6). The common suffix “-phobia” means “fear of.” What is the literal meaning of “taphos” in Greek?

3. With brain death, says Doughty, there is no “gray area” (13). Is

this an insufferable PUN—or welcome levity in a serious

discussion of a difficult topic? Explain.

4. “Will I be trapped in both a casket and in the prison of my mind?” (14) In addition to being buried alive, what other condition

would have to be met for a person to suffer from the second, more METAPHORICAL of these unlikely horrors?

FOR WRITING

1. Make a “Freaky Ways to Die” list that includes possibilities even more irrational and unlikely than being buried alive or killed in a

terrible gopher accident. List at least five possibilities.

2. “Ye Olden Times.” “Ye Olde Gifte Shoppe.” Do a little research on

spelling and printer’s conventions in early modern English, and

write a paragraph or two explaining the extra letters in words like these—and how “Y” came to be used at times for “Th.”

3. In college, Doughty wrote and directed a play based, in part, on the work of Edgar Allan Poe (1809–49). Read Poe’s late short

story “The Premature Burial,” and write a six-to-eight-paragraph CRITICAL ANALYSIS of it as a psychological tale of terror. You

can find the story online by googling the title.

4. Write an essay of 500 to 700 words defining “brain death” as a

medical condition and ARGUING that patients who meet all the

standard criteria for this condition should (or should not) be

taken off life support.

Check Your Understanding: 1 Of 5 INCOMPLETE

Question

Before the twentieth century, the tests for whether a person was dead or alive included

Select an Answer

A. smoke enemas and shoving needles up the nose.

B. smoke enemas and burning the feet with red-hot pokers.

C. burning the hand and shoving needles up the nose.

D. pounding the chest and chopping off a finger.

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Check Your Understanding: 2 Of 5 INCOMPLETE

Question

Doughty tells of an incident in sixteenth-century England. A man was declared dead and was about to be buried, until what happened?

Select an Answer

A. The pallbearers slipped on wet leaves and dropped the coffin, which woke the man up, and he knocked on the coffin lid to be released.

B. The priest heard the man in the coffin singing along with the hymn and opened the coffin to find him alive.

C. The man woke up during his funeral and thrashed around inside the coffin, knocking it off its platform.

D. The coffin slid out of the back of the wagon carrying it uphill, the impact broke the coffin open, and the man inside started yelling.

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Check Your Understanding: 3 Of 5 INCOMPLETE

Question

How does Doughty describe brain death?

Select an Answer

A. Upper brain functions cease, but lower brain functions may continue.

B. All memory is completely deleted, leaving a “blank disc.”

C. Lower brain functions cease, but upper brain functions continue involuntarily.

D. It is irreversible, and there is no possibility of recovery.

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Check Your Understanding: 4 Of 5 INCOMPLETE

Question

What is one of the differences between brain death and being in a coma?

Select an Answer

A. Brain-dead patients continue to be aware of their surroundings; coma patients don’t.

B. Coma patients can talk and answer questions; brain-dead patients can’t.

C. Coma patients can continue to breathe on their own; brain-dead patients can’t.

D. Brain-dead patients respond to external stimuli such as a bright light in the eyes; coma patients don’t.

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Check Your Understanding: 5 Of 5 INCOMPLETE

Question

According to Doughty, even if medical personnel declare someone dead by mistake, the error will still certainly be caught in time by

Select an Answer

A. a funeral director or medical examiner.

B. a family member.

C. a cemetery or crematorium worker.

D. a morgue worker.

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