Noelia Serna was rushed to a hospital in Cali, Colombia after suffering a heart attack. She was 45 years old and also suffered from multiple sclerosis. She was admitted to the intensive care unit in critical condition but survived for only 10 hours. She was pronounced dead and transported to the funeral home for burial preparation. So far so good.
Approximately two hours later, attendant Jaime Aullon was preparing to inject the embalming fluid when he noticed Noelia move her right arm. I would suspect that freaked him out. It turns out that she was indeed still alive. I’m not sure what ultimately happened to Noelia since I could not find any more information on the story but it does raise an interesting question as to how does one go about determining the presence of death.
This has been a problem throughout history. Prior to the advent of the EKG, which is a method of determining whether there is cardiac electrical activity or not, determining death was not always straightforward. Any disease process, such as the heart attack that Noelia suffered, where the heart rate and blood pressure are very low, can be mistaken for death. The victim’s breathing is shallow and weak, the pulse is slow and virtually undetectable, and the skin takes on a dusky hue. Under these circumstances the victim indeed appears dead. This can happen with all forms of shock such as after a heart attack, a serious infection, or a drug overdose.
An EKG can help determine death but not uncommonly the heart continues to have some electrical activity after death and this can sometimes linger for many minutes if not hours. It’s odd to see an intensive care unit patient who is essentially dead with no pulse, no blood pressure, no heart sounds through a stethoscope, and no brain activity but still with electrical impulses bouncing across the screen. It happens. We call this electro-mechanical dissociation. There is electrical activity but no resultant mechanical beating of the heart.
Back in the 16th and 17th centuries, there were no EKGs, no stethoscopes to listen for heart beats, and no real method for determining death. So situations such as arose with Noelia were not uncommon. Several unique and bizarre techniques were devised. Tobacco smoke enemas, vigorous nipple pinching either manually or with pliers, hot pokers shoved into various bodily orifices, and aggressive tongue pulling were all used to determine if the “corpse” was truly dead. Tongue pulling was so popular that a device was developed that clamped the tongue and yanked it in and out when a crank was turned. This continued for several hours and, when the victim didn’t complain, a pronouncement of death occurred. As you would guess, the occasional “corpse” rose from the dead during such procedures.
Many physicians of that era felt that the only true way to ascertain death was to await the appearance of putrefaction. Since families preferred not having rotting corpses in the house, a system of “vitae dubiae asylums” or “waiting mortuaries,” was established. The suspected dead person would be placed in a warm spot (to hasten the decomposition) in these institutions until decay appeared, after which they could be buried. If they were indeed alive, they could signal this by pulling on a string, which was attached to a bell. Since corpses can manifest twitches and jerks from involuntary contractions of the decomposing muscles, false alarms were not uncommon. A disconcerting event to the person charged with overseeing the mortuary, I would suspect.