Smiling or expressions of delight right before death?
August 29, 2013 1:03 PM   Subscribe

15 minutes before my mom died she suddenly opened her eyes, looked straight ahead (not at me) and smiled beautifully as if she was seeing the most wonderful thing imaginable. This gave us all a tremendous sense of peace. I once heard about a priest who was on his deathbed and he kept saying over and over "Its so beautiful, its so beautiful.." before he died. I understand his eyes were open and he was, also, looking straight ahead. We often hear about the body's processes shutting down at the time of death and the the lack of oxygen on the brain as its closing down but I'm referring to the hour or so before death - what are they seeing? Is the shutting down process starting early? Even so I don't think just seeing a light at the end of a tunnel was making the two cases mentioned so ecstatic. I always thought that my mother was seeing someone she knew and loved very much - it was that kind of smile - delight upon recognition. I have 2 elderly stage IV cancer patients in my family right now so death has been on my mind a lot lately.
posted by Tullyogallaghan to Science & Nature (28 answers total) 40 users marked this as a favorite
DMT, a powerful hallucinogen, is naturally produced by the brain. Some theorize that it is released in near-death and other mystical experiences, and causes the strange experiences that are sometimes had.
posted by shivohum at 1:09 PM on August 29, 2013 [9 favorites]

Or, another take on 'defying description':

...eye hath not seen, nor ear heard, neither hath it entered into the heart of man, what things God hath prepared for them that love him.
posted by jquinby at 1:22 PM on August 29, 2013 [19 favorites]

Is the shutting down process starting early?

A few days before she died, my grandmother's hospice worker, who I was regularly in touch with, told me that there was good news and that my grandmother was looking very "relaxed." She mentioned a smoothing of the face from a tight grimace, an un-tightening of clenched muscles, a lack of struggling. This was all very notable, as grandma had to be heavily restrained for her own safety even a week prior.

According to the hospice worker, this sort of "relaxation" was an almost guaranteed sign of impending death, and she had seen it many times before. She legally wasn't allowed to tell me that I should expect death soon based on this (she was only allowed to tell me what was happening,) and even apologized for it during our last conversation.

Unfortunately, I can't recall what sort of medical professional this particular hospice worker was.
posted by griphus at 1:37 PM on August 29, 2013

As a hospice volunteer and as a family member, I've been at the bedside of a number of people as they died, and each one was quite different.

I was with a number of people who were dying from conditions that inhibited oxygen uptake and, while the first reaction when oxygen becomes impaired is to become quite anxious, over the course of time it apparently becomes more pleasant. I can think of three people who embodied this over the course of days and weeks. Toward the end, one woman asked me, "Is there an angel over the fireplace there or am I hallucinating?" I said, "I don't see it myself." But you know, her experience was her experience, and she was comforted by what she was seeing.

It is also not unusual for people at the moment of death to appear to be gasping for breath or choking. Some practitioners call this "fish mouth" because it looks the a fish out of water. My mother was quite disturbed when she was at her sister's bedside and her sister did this, and my mother was sure that my aunt was trying to say something. Years later, when my mother died, she had been comatose with little brain function for a week, and then at the moment of death she opened her eyes and appeared to be gasping for breath. I held her hand and said, you're safe, you're loved, you are not alone. Happily, because I knew about this and knew that it might happen, I wasn't disturbed the way my mother was. On the one hand, I often think that family members who will be at the bedside should know that this is a possibility; on the other hand, in all of the deaths I've witnessed, hers was the only one with "fish mouth" so I don't know if it happens often enough to freak out family members in advance.

Okay, anyway, I'm kind of rambling now, I'll stop.
posted by janey47 at 1:38 PM on August 29, 2013 [35 favorites]

Gosh, I said I would stop rambling and now I remembered something else I wanted to add. The folks who appeared least peaceful up to and at the time of death were the ones whose illness deeply affected their liver, so that it was impaired before the body began the final process of shutting down. When the liver isn't working properly, toxins remain in the system and that can cause agitation. At the end of the day, the thing I feared most as a child -- suffocating, drowning, etc. -- turns out to be the way I hope to go out, in some form or other.
posted by janey47 at 1:42 PM on August 29, 2013 [1 favorite]

I just heard something in the last week or so about a study that showed a spike in a certain kind of brain activity just as rats were dying that could explain the near death experience.
posted by COD at 1:48 PM on August 29, 2013 [1 favorite]

A close relative died after she happily cried "mom" - and my gran died with a peaceful sigh, like a baby in my arms. Some people go into death gracefully. I am not really certain what to think of it. My dad died with a weird hiss. My granddad died in agony.

Incidentally, my gran died with a cancer originating in the colon that had violently attacked her liver, so I'm not certain janey47's theory holds in all cases. If one can even speak of it this way, she had a beautiful death, totally in accordance with her life. I miss her terribly, and those last hours will for ever remain a special moment for me, I know she was there and resolved.

My working theory is that people die like they live - my warrior granddad died fighting - not a war, but cancer. My best friend recently died suddenly, in the middle of something, in the same impulsive way she lived.

The grief we live with afterwards is suffocating. But for me it somehow helps to think that this was not different from who they were, just a terrifying extension. Does this make any sense at all?
posted by mumimor at 2:01 PM on August 29, 2013 [20 favorites]

I worked with elderly people in nursing homes a few years ago. Dying patients talking about seeing long-gone relatives happened enough that the care staff saw it as a sign that death was probably quite close, even if not imminent.

There was one patient who told me about seeing someone (she didn't say who, just said "her" and "she", but it was clearly someone she recognised) in her room a couple of days before she died. It was obviously someone she was really happy to see, and at one point she told me "she says she might be here to take me to heaven!", in such a delighted, overjoyed way that it was clear she didn't see this as frightening at all, that whatever she was experiencing was a wonderfully happy and peaceful thing for her. So yes, I could absolutely believe that your mother was seeing someone she recognised and was very happy to see, whatever the actual brain processes underneath that experience were.
posted by Catseye at 2:03 PM on August 29, 2013 [6 favorites]

I don't think this is an answerable question. Either they are hallucinating as their brain and body shut down or they are seeing the moment when (as Tolkien phrased it) "the grey rain-curtain turned all to silver glass and was rolled back, and [they] beheld white shores and beyond them a far green country under a swift sunrise."

Possibly alone among all questions, no one is in a position to answer definitively and we are all going to find out sooner or later.
posted by ricochet biscuit at 2:45 PM on August 29, 2013 [16 favorites]

My grandmother was in a coma for a day before she died and was wearing a nasal cannula for oxygen. When the time came her shoulders and upper body lifted a bit from the bed, and a beautiful and joyful smile crossed her face, even though her eyes did not open. She looked like she had seen someone she hadn't in years.

It was one of the most beautiful (sacred?) things I've ever seen.
posted by kimberussell at 2:49 PM on August 29, 2013 [4 favorites]

Seeing those who've gone before seems fairly common, but I don't see that there's been much study about what's chemically going on in the brain at the time. Maybe I just don't know where to look.

Grandma's esophageal cancer diagnosis was particularly hard for her to hear because she had been her father’s sole caregiver when he died from it fifty years earlier. She was one of those tough-as-nails, take-charge sort of people, and the only things that really haunted her were that and the baby daughter who died of some kind of fever because she couldn’t get the doctor in time. Needless to say, medical science had advanced in fifty years, and she had remissions and palliative care her father couldn’t have dreamed of. But we all knew it was close the night she said a tall man with a flower in his hat came through the wall with a beautiful girl baby in his arms. She started plucking at the blankets soon after that, and died with a smile on her face.
posted by The Underpants Monster at 2:55 PM on August 29, 2013 [7 favorites]

You might find this book helpful: Final Gifts: Understanding the Special Awareness, Needs, and Communications of the Dying by Maggie Callanan and Patricia Kelley. It was one of my favorite books recommended from my hospice training.
posted by nanook at 3:25 PM on August 29, 2013 [1 favorite]

My grandmother died of Alzheimer's and had a very difficult last year - she was terrified, angry, and impossibly disoriented: by the end, I remember once I was resting my hand on her leg and she found it uncomfortable; not only did she not know my name, or who I was, she couldn't even express the concept of "leg" or "touch" in any meaningful way. This was true, without exception, whenever I saw her that year. Which is only to emphasize how astonishing it was when, an hour or so before she died, she looked my aunt in the eye said, "I'm sorry I was always so hard on you."

I'm not religious, but I do think we know very little compared to all there is yet to know, and there are sometimes comforts where we don't expect them. I wish you the best in getting through this time.
posted by pretentious illiterate at 3:46 PM on August 29, 2013 [5 favorites]

It's not possible to know whether people can perceive the next world from this one. Of course, it's also not possible to know whether there is a next world, but these are two separate questions.

I believe there is a next world, whether or not we can perceive it from here. That events in the brain affect perceptions of it doesn't validate or invalidate anything - how are we supposed to perceive things, if not with our brains? You can simulate humour by poking someone's brain in a particular spot, but that doesn't prove that there's no such thing as humour, for example.

All I can say is that we need to think about heaven as a real place to which we expect to actually go, in the end - not as "pie in the sky when you die" - and think carefully about how we live our lives now in light of that expectation.

I will tell you something from my own experience. When my father died he emitted a terrible groan. I worried for a long time afterwards what he might have been seeing or experiencing. Late one night I was praying for understanding, wishing I could know that he hadn't died in fear or distress. And then I heard something terrifying and froze. It was that same groaning sound. Then gradually I realized what I was hearing - it was a sound I hadn't heard in many months... Not since we got our boiler serviced. It was the sound of air going through the pipes under my bedroom floor. The horrible groan I'd heard was just air being forced out of his lungs, nothing more. I went to sleep content and never worried about it again.

Conversely, I don't know that your mother didn't see the welcome awaiting her on the other side, there's no reason to assume she didn't. I can only leave you with this old Russian riddle: which arrow flies forever? The one which has hit its mark.
posted by tel3path at 3:58 PM on August 29, 2013 [12 favorites]

In her eulogy for him, Steve Jobs' sister said that his last words were, "Oh wow. Oh wow. Oh wow."
posted by kat518 at 5:14 PM on August 29, 2013 [3 favorites]

When my friend died over a decade ago, my other friend was there (she was a very good friend of the family.) He came out of his confusion long enough to have a lucid conversation with his mother on the phone-then when a family member took the phone and went into the next room with it, my friend who was there said he looked up, as if startled by what he saw, and then went peacefully.

(In his case there was a lot of liver disfunction from the cancer, so yeah, that theory might not be always the case.)
posted by St. Alia of the Bunnies at 5:26 PM on August 29, 2013

It's not really the same thing, but in the week before her death, at 101 years old, my grandmother dreamed every single night about her siblings and parents. She would wake up shocked and somewhat disappointed that she was still alive.
posted by brookeb at 6:16 PM on August 29, 2013 [3 favorites]

It may depend on what, if any, painkillers they are on.
posted by gjc at 6:51 PM on August 29, 2013

My father died while seated. My mother was with him and, as she bent over into his face trying to bring him around, he kept moving his face away and looking up and over her shoulder as if he were seeing something up in the corner of the room. It was a bob-and-weave contest between him and mom for eye contact.

As we are Christian, we go with jquinby's quote: ...eye hath not seen, nor ear heard, neither hath it entered into the heart of man, what things God hath prepared for them that love him.
posted by michellenoel at 7:21 PM on August 29, 2013 [2 favorites]

It's quite possible that it is a "spiritual" experience. Scientifically ineffable.
posted by rmmcclay at 7:31 PM on August 29, 2013

I can't believe nobody posted Jobs' final words:

Oh wow, oh wow, oh wow.
posted by Sphinx at 7:43 PM on August 29, 2013

Someone did, Sphinx. It's upthread.
posted by michellenoel at 7:50 PM on August 29, 2013

Tangentially, if I may (and if not, Mods, please take it down), is the true story of a man in Mary Roach's book, Ghost. I don't recall all of the details, but he wanted to know definitively if the body had a spirit and whether it could be measured. He build the most sensitive scale he could and put the dying person on it to see if a change in weight was measured at the instant of death.

I don't recall exactly what happened, but his experiment was inconclusive. That is a fascinating book.
posted by michellenoel at 7:54 PM on August 29, 2013

You might be interested to read Elizabeth Kubler-Ross' memoir. It gets a little "woo" at times, but read with a grain of salt, it does give you quite a perspective on dying. I read it a while ago and a few things stayed with me, maybe you can get something out of it too.
posted by CrazyLemonade at 8:53 PM on August 29, 2013

michellenoel: You can find Mary Roach's chapter on it from Spook here. (Short answer: The man's findings were totally unverifiable.)
posted by greenland at 9:03 PM on August 29, 2013

I was with my grandfather the day before he died; he was the last of his family alive at 96. He had always talked about how much I favored his sister Maggie, who he had been very close to as a child. As adults they had been an ocean apart. Anyway, his last words to me were that he'd be awfully glad to see Maggie again. He said it so familiarly as if the three of us were planning something together (she died before I was born). He was very wistful. This struck me because it was not in keeping with his regular demeanor at all.

He died the next morning, his heart just suddenly stopped. I take great comfort in this because I think it made him happy.
posted by readery at 1:20 PM on August 30, 2013 [2 favorites]

Thank you for the title correction and link, greenland.
posted by michellenoel at 2:41 PM on August 30, 2013

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