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Scientifically speaking: the most unpleasant ways to die

In our society, dying has become a taboo subject that is only too gladly suppressed. However, that doesn't change the fact that the Grim Reaper doesn't give a damn about our ignorance and sooner or later knocks on everyone's door with his bony hand. So it is worthwhile to think about which kind of death we should rather avoid because of its horror.

Those of us with a penchant for morbid things may have succeeded in answering this question. Perhaps you are particularly uncomfortable with drowning, or the unsightly method of being burned alive. When we think about death, we often think about how it might overtake us under most strange circumstances. As if it were a long outdated relic from an unpredictable time, before doctors found out about germs. Dying is usually only an issue when the grandma starts planning her own funeral or in a funny group with a bit of black humor and a few drinks. Then life goes on as usual.

Yet the deaths that populate our nightmares have common characteristics. And although science is still far from a consensus, we can puzzle together some scientifically sound perspectives, read between the lines and answer the question about "the most terrible way of death." The answer I have found is not easy to bear, however .

Before we get down to the nitty-gritty, however, we should first define what "types of death" actually mean.

When a person dies, the doctor fills out a death certificate. Among other things, the cause, classification and type of death are stated on this certificate. These harmless sounding sections can be quite unsavory and I will limit myself to the cause of death here.

"The cause of death is the illness or injury that causes a physical collapse that ends in death, such as a gunshot wound in the chest," explains Kevin Henderson, Ontario, New York gravedigger. These causes trigger our deep-seated fears. It distinguishes between the fear of drowning, the fear of deprivation of oxygen, the inhaled water, and the fact that you cannot swim.

Eugène Delacroix. 1798-1863. Paris. La mort d'Ophélie. 1838. New Pinakothek Munich. Image: Wikimedia | Public domain

The thought of a cause of death often shakes us humans because we anticipate a certain pain. Pain is generally defined as an "uncomfortable feeling" in the body, but the sensation is subjective and can be lessened or exacerbated depending on the context.

"Context is very important in the sensation of pain," said Randy Curtis, director of the Center for Palliative Care at Washington University Hospital. "Birth is a good example of this. It's a pretty bad pain, but the woman knows it will pass. She knows why she is feeling this pain and it's exciting. In this context, people can tolerate a much higher level of pain than, for example, pain caused by cancer, because the prevailing idea here is that the disease will shorten your life and keep getting worse will be."

Although pain is very subjective, it can be objectively categorized. This will help doctors make a decision about treatment. They look at how long you've been suffering from the pain: acute (short-term) or chronic (long-term). Both can be terrible, says Curtis. However, pain also feels different depending on its origin. Nociceptive or somatic pain is the feeling of feeling your nerves as a direct result of injury, whereas neuropathic pain has no apparent origin and can include pain from alcoholism, phantom pain, or multiple sclerosis.

Few people exploited the power of pain as thoroughly as the early modern inquisitors, who created what we now commonly refer to as "medieval torture." These terrible torments spread relatively quickly around 1520, after the Reformation in Western Europe explains Larissa Tracy, professor of medieval literature at Longwood University in Farmville, Virginia.

Take, for example, hanging, the most common death penalty in the late Middle Ages. “It wasn't a very sophisticated way of killing someone. The criminal was pulled up to suffocate, which could take six to ten minutes, "said Tracy. Torture sentences were very rarely used, and only on the worst criminals such as traitors and murderers. What they had in common, however, was brutality and slowness occurring, redeeming death.

Other terrifying methods, including being gutted and quartered, were reserved for the worst criminals in early modern England. A person was first hanged until near death, then cut down and then castrated. The executioners then tore his entrails out in front of his eyes with a hot poker that was stabbed in the lower abdomen of the convict. Eventually the villain was beheaded and, as if that weren't enough, chopped into four pieces, which were then prominently displayed on stakes in the end. Some traditions also speak of the tearing of the body by four horses, but according to Tracy the evidence for this is rather thin.

Another particularly nasty punishment was being broken over the wheel. This method was also reserved for the worst criminals in Europe and revolting slaves in the USA. The convict was tied to a large wooden wheel and beaten until all of his bones were broken. According to some reports, the victims continued to languish in this state for up to three days.

The beheading was often reserved for the nobility, as it was quick and, in comparison, almost painless. Image: Wikimedia | Public domain

As medieval and horrific as the methods are, Tracy says we are much more likely to use the death penalty these days, and our methods are far from gracious, either. Studies have shown that the deadly poison cocktail in lethal syringes is unlikely to have the numbing effect it is supposed to have. The improvement over the electric chair is therefore rather questionable.

"Thousands of volts are chased through a human body, the brains begin to boil, sometimes flames lick through the skin," says Tracy, shuddering. "And during the whole process the convicts are fully conscious."

Although these methods are extremely painful, they only take a few minutes (usually). The average American today is more likely to die of an illness and suffer from it for much longer. The leading causes of death are heart disease and cancer, which together account for 63 percent of all deaths in the United States. People who suffer from these or other diseases may live longer than their ancestors, but these last stages of life are often painful.

"We pretend we're all going to die of heart attacks overnight, but it's not."

“People think they know exactly when their last hour will strike. But most of us are slowly approaching the end of our lives, "says Joanne Lynn, a doctor and palliative specialist." We pretend we're all going to die of heart attacks overnight, but it's not like that. "

When our time draws to a close, suddenly many people have to live out their fear of dying. "Decline is bitter, which is why people fear loss all the more," says Lynn. "They fear suffering, physical and psychological isolation. They fear loss of control, impoverishment. And of course, behind this is ultimately the fear of." Nonexistence, the fear of being dead. "

It is not uncommon to struggle with all of these fears at the same time. People who make it into the old age of 85 or 90 find this fear less crippling, as many of their friends may have left this planet before they did. As a result, death is often "harrowing but not unexpected," adds Lynn.

So the bad news is that death tends to be delayed these days, making it seem pretty scary. The good news is that our pain management is much better than it was in the Middle Ages. Depending on the source of pain and stress, doctors can treat you with all kinds of healing methods, from non-steroids like Tylenol to opioids like morphine. Here again, the individual perception of pain plays the greatest role.

“The first step before any treatment is to investigate the cause. If we know where the pain is, maybe there is something we can do about it, "says Dr. Curtis of Washington. Cancer metastases that eat into the bone, for example, can cause particularly bad pain.

"Some types of cancer are very sensitive to radiation, which makes the suffering a lot easier," said Curtis. "Others are not sensitive to radiation. If doctors apply too much radiation, complications such as burns and injuries can result, which make them even more painful. "

We will probably die here. Image: Dan Cox / Flickr | CC BY-2.0

Pain, adds Curtis, is just one of many symptoms that can traumatize a patient at the end of life. "Nausea, vomiting, tiredness, depression, anxiety and shortness of breath - all of these can be enormously debilitating and frightening," says the doctor. However, this points to something else, the mother of all fears: the fear that nobody will control one's own fear understands so that one is forced to endure it alone.

Doctors are often a little better at articulating this because of their work experience. "I'm afraid of great pain and at the same time not having access to a doctor who takes me seriously and can treat me effectively," explains Curtis.

Lynn also fears inadequate treatment. “I would like a system that I can rely on. That is trustworthy where everyone involved knows how to respond to my needs and is honest about my prospects, "she said.

After all of the discussions with experts, it seems that scientifically speaking the worst way to die is the one most of us face: on a hospital bed after a long illness. Maybe then we will feel the approaching end, but maybe not. We may be surrounded by doctors who can treat our pain. Or family members who respect your wishes. But we don't know any of that.

But not everything is black and white. Whether a convicted criminal is gutted with a poker or an average person with cancer, the psychological state still determines how bad "bad" really is. Researchers are sure to develop even more sophisticated methods of treating pain and understanding pain and death. But our psyche has an infinite number of faces - and each and every one of us has it largely up to us to control their state.

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