Stuff You Should Know - SYSK Selects: How Dying Works

Episode Date: May 18, 2019

Chuck and Josh have covered just about every aspect of death except dying itself. Here, they fulfill the death suite of podcasts with an in-depth look at just how people die, what happens to the body ...during the dying process and how people accept death -- and what they regret not having done while they lived. Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.

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Starting point is 00:00:00 On the podcast, Hey Dude, the 90s called, David Lasher and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses and choker necklaces. We're gonna use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s.
Starting point is 00:00:17 We lived it, and now we're calling on all of our friends to come back and relive it. Listen to Hey Dude, the 90s called on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new iHeart podcast, Frosted Tips with Lance Bass. Do you ever think to yourself, what advice would Lance Bass
Starting point is 00:00:37 and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help. And a different hot, sexy teen crush boy bander each week to guide you through life. Tell everybody, ya everybody, about my new podcast and make sure to listen so we'll never, ever have to say. Bye, bye, bye.
Starting point is 00:00:57 Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple Podcasts, or wherever you listen to podcasts. Hi everyone, hope you're having a good weekend. Here's a podcast about dying. From September 9th, 2013, it is my stuff you should know, select, pick for the week, how dying works.
Starting point is 00:01:14 This is a tough one, but necessary. And this may be as much or more so than any other show we've ever done. We got a lot of feedback on just understanding the process of dying, literally, physiologically, has helped so many people over the years, over the past five or six years, when their own relatives are going through
Starting point is 00:01:31 this kind of thing. So, I'm glad it's helped people out in the past and hopefully it will in the future. So, enjoy may be the wrong word, but hope you learned something today with how dying works. Welcome to Step You Should Know, a production of iHeart Radio's How Stuff Works. Hey and welcome to the podcast, I'm Josh Clark.
Starting point is 00:01:55 There's Charles W. Chuck Bryant. How you doing? Hey, and Jerry's over there. Jerry, for the first time, just saw a meme that's been out for a couple of years. Yeah, that's like when you rolled me like two years after it was popular. You were like, isn't that the best?
Starting point is 00:02:12 Well, I was lying in wait. Yeah, I thought that happened so. And there's nothing more obnoxious in sending someone something and be like, I saw that two years ago. Well, I'm so sorry I tried to show you something funny. Right, right. You know, but yeah, Jerry just saw the, do we even say?
Starting point is 00:02:28 The mumble mouthed reporter, maybe? Yeah. The lady who supposedly had a migraine, but appeared to have had a stroke. Right. Reporting from the Grammys in Los Angeles a couple of years ago. Yeah, I still don't know whether it's okay to laugh
Starting point is 00:02:40 at that, cause I don't know really what happened to her. Well, we didn't laugh. We very solemnly showed Jerry. Yeah, yeah. And she laughed. Terrible, Jerry. Terror station. I've got one for you.
Starting point is 00:02:53 Okay. I've got a bit of an intro. It's not much, so don't get your hopes up. All right. Have you ever heard of the Population Reference Bureau? No. You have because I've mentioned it before. I've mentioned this article before.
Starting point is 00:03:08 It's on prb.org. It's called, how many people have ever lived on earth? Oh, okay. And I don't know what we mentioned in it. Maybe the population episode or something, but it's a really cool little article by this demographer named Carl Hobb, H-A-U-B. And he, there's even a video of him explaining it
Starting point is 00:03:25 if you couldn't get what he was going with. But Hobb, he reckons that modern humans, people who are virtually indistinguishable from you or me, aside from the fact that they're not wearing like any clothes really, Sure. showed up about 50,000, 52,000 years ago. Okay.
Starting point is 00:03:45 So Hobb puts the population of humanity at two in 50,000 BCE. Oh. Okay. So from that point to 2011, he extrapolates, does the math, does this little demography thing. And Hobb comes up with the number that 107,602,707,791 people have ever lived between 50,000 BCE and 2011 CE.
Starting point is 00:04:17 That's pretty neat. It is. That's a lot of people. He says that means about 6.5% of that are alive right now or were in 2011. All right. So we're dying off. Yeah.
Starting point is 00:04:30 That's the point. All 107,602,707,791 of those people had one thing in common, one thing aside from being humans. Taxes. No, not even, not even. Pre-tax. Yeah. Yeah.
Starting point is 00:04:47 They didn't have tax in 50,000 BCE. They had running from, say, were two tigers. And death. Death. It was death. That's the one thing. All 107,602,707,791 of those people had in common. You know, when I was thinking of your intro,
Starting point is 00:05:04 driving here today, I thought that'd be funny if Josh was like, how long people been dying, Chuck? And you know what? This wasn't that far off. Nice. I was like, he wouldn't do that. You were like, that'd be way too boring. What a stupid way to do it.
Starting point is 00:05:17 No, that's a good number. I like that, 107,602 million, 701,000. 7,000. 791. Yeah, wow. Yeah, and that includes you and me, pal. You know what that means? You're gonna die.
Starting point is 00:05:34 I'm gonna die. Jerry's gonna die at least two or three times. We're all gonna die. Yeah, this is our dying podcast. And we have covered just about every aspect of dying. Can you die from a broken heart? How rigor mortis works? What's the worst way to die?
Starting point is 00:05:54 Is there a best way to die? Did we do that? That was kind of in the, is there a worst way to die? Yeah, we've covered everything from autopsies. Peak oil. What can be done with the dead body? Ninjas. Yeah, or ninja at least.
Starting point is 00:06:09 You should know better than that. Yeah, we really have danced around everything except just how dying works. And this is gonna be a sad podcast in many ways and gruesome in some ways. Cause we're gonna touch on some of the stuff we hit on in like rigor mortis and autopsies and the actual dying process.
Starting point is 00:06:27 Right, but I mean. So brace yourselves. And I've mentioned this guy, scores of times at least, but as the great, no, it's Charles Mann, you're thinking of. Oh, okay. The great psychologist, Ernest Becker. Oh yeah. Shout out to our pal, Joe Randazzo,
Starting point is 00:06:44 who's like in the Becker now. Isn't it Ernst? Or is it Ernest? Ernest, you're thinking of Max Ernst. Okay. Ernest Becker wrote the denial of death. Right. The seminal work that basically says,
Starting point is 00:06:56 we're all just doing everything we can to think about our own demise. Yeah. And there is some sort of health, whether it's spiritual, emotional, there's some sort of health or wellbeing. I think from facing the fact that you're going to die. Sure.
Starting point is 00:07:12 And talking about it. Yeah. So let's talk about death, baby. Let's talk about you and me. Let's do it. Okay. So Molly Edmonds, who used to be on Sminty, Stuff Mom Never Told You, we call it Sminty.
Starting point is 00:07:27 Sure. Wrote this one. And I think it is interesting, and I usually don't like it when articles stay like, the definition of blah, blah, blah. But it's kind of interesting that in the first encyclopedia, it was just the separation of the soul from the body. And now it's 30 times that long in the encyclopedia.
Starting point is 00:07:44 Right. And that's just sort of indicative of how we used to think of it, and how, I don't know if it's ironic or not, but how medical science has complicated that over the years. Well, it's definitely ironic, because I mean, we used to be confident
Starting point is 00:07:58 that we understood death. It's like, that person isn't moving anymore. If you ask him what he wants to eat, he's not going to respond. If you choose something for him to eat like a block of cheese, it's not going to be swallowed. Like that's death. And since there was perhaps a lot more religiousness
Starting point is 00:08:15 associated with death and dying than there is today, that kind of underscored the belief in death. It's the soul departing from the body. That's right. What more do you want to know, egghead? It's death. Well, yeah. And way back, you know, a few hundred years ago,
Starting point is 00:08:31 you'd call in a priest and they'd check the body. See if it's breathing and say, yep, they're dead. And that was pretty much it. The doctor wasn't even involved at that point. Well, there may not have even been such a thing as doctors. And if there were, they were wearing like masks that made them look like crows to protect them from the plague. So they weren't any better at ascertaining death
Starting point is 00:08:51 than a priest was. That's true. When doctors did come along and they invented things like the stethoscope, they could actually check and see if there was a heartbeat. Before that, there was Balfour's test, which I couldn't find out a lot about this other than you stick needles into the heart
Starting point is 00:09:08 with little flags on it and see if the flags move. I think that's pretty straightforward. Really? Yeah, I think that's about it. I mean, that's the test. I'll buy that. And there were other tests that like a priest who may have come to say whether you were dead or not
Starting point is 00:09:22 would use like placing a feather above the mouth or around the mouth or nose to see if it moves. The old mirror check. Mirror trick. That's still, you know, useful. It is, but only if the mouth is still moist. If it's a dried mouth, it's probably not going to fog up a mirror.
Starting point is 00:09:40 Well, if it's not breathing, it's not going to fog up a mirror. Right, exactly. So I said that medical science has complicated it. And that's exactly what's happened over the years because as we progressed with medicine, we discovered a lot of ways to actually reverse death, like bring people back from the dead,
Starting point is 00:10:01 whether it's something as easy as CPR or as complicated as, you know, machines that help you breathe and feed you. Right, and not only that, we've entered this really awkward period in human medical history where the machines that can tell us whether someone is alive or not
Starting point is 00:10:21 are more advanced than our machines that can bring a person back from death. Yeah. So we have ways to sustain the body. Yeah, yeah, that's what you mean. But not necessarily the person depending on your definition of death. Yeah, like the faintest trace of a brain wave maybe.
Starting point is 00:10:41 Right, yeah, so we went from holding a feather under somebody's nose to see if they're alive to using the MRIs to see whether there's electrical activity. And we're finding that all of these old signs, these old outward signs of death, don't necessarily mean that the person's dead. And even if the person is dead, we have technology like you were saying
Starting point is 00:11:03 to resuscitate them. The question is, if we resuscitate them and they're still not talking, they still don't tell you what they want to eat, are they alive? Well, yeah, and this hasn't been that long, you know, I mean, in the 52,000 years or whatever that people have been dying,
Starting point is 00:11:20 it's only been the past, you know, 60 something that we've had to come up with terms like persistent vegetative state and irreversible coma. Yeah, because of those machines that can resuscitate or sustain a body. And in 1958, that was when the French neurologist described the coma de passe, which was a state beyond coma,
Starting point is 00:11:42 basically brain death, although that didn't come along until, technically until 1968 when Harvard Medical School did basically defined it for the first time. Yeah. Although they didn't even call it brain death at the time. What'd they call it? Just irreversible coma, like you're not coming back.
Starting point is 00:12:02 Gotcha. Brain death was kind of tagged on later. So yeah, so coma de passe, persistent vegetative state, brain death. All of these things would indicate, again, that you're dead. The problem is, is we have these machines that can keep your body warm
Starting point is 00:12:19 and keep your chest rising and falling, can keep your body going indefinitely. But the thing is, there's something that's not there. And does that mean you're dead? There's been a lot of talk about exactly what constitutes death. Defining death is a very, very difficult thing to do, especially through the advancement of medical technology.
Starting point is 00:12:43 It's kind of changed every time you come with it. Okay, I got it. This is the definition of death. Medical technology can provide some picture of a state of consciousness or life that throws a wrench in the works, you know? Yeah, and it's, actually, after 1968, it took until 1981, a presidential commission
Starting point is 00:13:05 is when they finally, in the United States, wrote a paper called Defining Death, Medical Legal and Ethical Issues and the Determination of Death. That was the basis for the Uniform Determination of Death Act, which basically rejected the Harvard idea that of the higher brain, which is like when your personality
Starting point is 00:13:25 and your memories are gone, the cortical brain, that means you're dead. And they rejected that in favor of the whole brain, which includes the brain stem, which is what keeps you breathing and functioning. They rejected it in favor of that. So Harvard was like, meh. Right, I don't know.
Starting point is 00:13:45 I think I subscribed to the higher brain death. The definition of death. The brain stem, yeah, it's pretty significant. You can be born with just a brain stem. We talked about Mike the Headless Chicken before. He had his head cut off, which included his brain, but his brain stem was still there and he's a chicken, so it didn't really matter.
Starting point is 00:14:07 But there's a huge division between the two because there's a big difference between breathing and being able to swallow for yourself and making a conscious decision whether, again, what you want to eat right then. Or having memories or just reacting to people aside from like physical reaction to a stimulus. Yes, and that's one of the,
Starting point is 00:14:31 there's a whole article on brain death. Maybe we'll do that one. I thought we did that now. I think we did it in the Oregon Donation Procurement episode. We talked about brain death and testing for brain death. Like they shoot ice cold water in your ear canal. I definitely remember covering it at some point. Yeah, I think it was in the Oregon Donation Procurement.
Starting point is 00:14:49 Or maybe Living Wills, obviously. We might've touched on it then. Did we do that one? We did Wills. We did Wills, but we hit on Living Wills in that. But you mentioned organs. I don't think we said that that was a big kind of a quandary in the 1960s and the late, I'm sorry, mid 1950s.
Starting point is 00:15:05 And then really in the 1960s is when we went organ transplant crazy, actually kind of not just the United States, all over the world. Doctors said, hey, we can actually give people a shot at life because we can now transplant kidneys and lungs and hearts. The problem was, and this is sort of one of the sad things that Molly points out is that the definition of death
Starting point is 00:15:31 kind of came about was hurried along maybe because we needed organs from these bodies that were still technically alive. Which is a very ghoulish proposition. I mean, it makes sense from a very utilitarian standpoint. It's like, this guy doesn't even know he's laying there. Yeah, and he's got a great kidney that could go to his sister.
Starting point is 00:15:49 Who knows that she needs a kidney if she's gonna die and she's got kids that she wants to hang out with and can put this kidney to good use. So let's figure this out. But as Molly says, most developed countries have signed on to the brainstem where it's like, your brain can no longer keep you alive on your own. You can't swallow, you can't take a breath for yourself.
Starting point is 00:16:13 So you're dead. The problem is that's just different. That's a much more, it's a narrower definition of death. I guess. And I think that that probably rules out a lot of people who might otherwise be used to harvest organs. Yeah, harvest. I know.
Starting point is 00:16:34 All right, so let's talk about death itself. It's funny that you, well, it's not funny, but out of all the different ways people can die, I thought it seemed simplified to break it down into three ways, but that's really kind of the three ways. Yeah, I think we talked about that in autopsy too, right? Yeah, it can be an accident, obviously. That's called the Upsie mode of death.
Starting point is 00:16:54 Yeah, the violent death, which is also an Upsie, I guess. Well, not an Upsie. No. It's tragic. Yeah. Homicide or suicide. So Chuck, let's talk about what it's like to die from different types of death.
Starting point is 00:17:07 You dug this up, you ghoul. Yeah, because I really wanted to know, like what is it like to drown or to be burned alive? Yeah, and people have survived some of these things and come back to tell the tale. That's obviously the only way we're gonna find this stuff out are from lucky people. Drowning, I've always heard drowning is a good way to go
Starting point is 00:17:28 because it's not so painful. Yeah, and the brain supposedly releases endorphins at the end? Yeah. Same with freezing, I've heard too. Maybe true, although drowning victims have reported, aside from the panic, a tearing and burning sensation when your water starts filling with lungs. Yeah.
Starting point is 00:17:47 And quickly, hopefully really quickly after that is the feeling of calmness that overcomes you. Yes, and tranquility. Yeah. Heart attack, you've got the squeezing pain in your chest or your left arm. Yeah, like a weight on your chest. Right, what I didn't know is that,
Starting point is 00:18:04 because of the heart not delivering oxygen to the brain any longer, you can lose consciousness within like 10 seconds. Uh-huh. I didn't realize that. Yeah. I thought like it was, there was a lot more to it. Well, it depends, you know.
Starting point is 00:18:19 Everyone has their own signature heart attack as well. Sure. If you bleed out, I imagine this is not one of the best ways to go. After about a liter and a half of blood, you're going to be thirsty and weak and anxious. Anything over two, you're going to be pretty confused and dizzy and probably lose consciousness pretty soon after.
Starting point is 00:18:41 And all of that would relate to how fast you're losing blood. Sure. And it would probably be very unpleasant depending on how you're losing blood, like why? Because you would imagine that if you're stabbed in the gut or something like that. Yeah. You got the attendant pain,
Starting point is 00:18:55 in addition to this dying from loss of blood. Yeah, or like man reservoir dogs? Yeah. That was like one of the most hardcore ways to open a movie. Yeah. Or not open, but they cut right to that scene after the diner scene. Right, after the walk.
Starting point is 00:19:09 Yeah. Electricution, if you're in your house and you get electrocuted, could stop your heart right then and there. And if you're in an electric chair, you may have actually heated your brain up to the point where you die or suffocated to death. Right, but there's indications
Starting point is 00:19:30 that being electrocuted with enough voltage knocks you out. That instantly you lose consciousness. Right, that's the idea probably. With the quote unquote humane. I'm sorry, quote humane, end quote. I'm gonna stop doing that. I'm going back to quote unquote.
Starting point is 00:19:47 Yeah. What if you fall from a height? If you fall from a height, supposedly time slows, which is awful. Yeah. It's like, well, you're gonna experience all of this. Yeah. That's the idea that you really can take it all in.
Starting point is 00:20:07 That's really awful. So they did a study of jumpers from the Golden Gate Bridge, which is 75 meters. What is that, 230, 40 feet? It's high enough, that's how high it is. And they found evidence that a lot of them died from exploded lungs, exploded hearts. Their organs were all cut up from their ribs,
Starting point is 00:20:33 which would indicate death was pretty much instantaneous. Yeah, we talked about that on something too recently, I think, or maybe I heard it someone else talking about it. That's pretty bad way to go. What, the Golden Gate Bridge? Or just dying from a height? Yeah, I can't remember who I was talking to
Starting point is 00:20:47 about jumping in the water. I was like, what actually kills you when you jump in the water from the eye? And it was like your organs smash into each other and explode. Yeah, I guess from any height, when you die from that, it'd be from organ explosion or whatever.
Starting point is 00:21:01 Yeah, or the brain obviously, if you go ahead first. Yeah, that's the long drop back in the day would, although they still, you can get hung in certain states if you choose. Really? Yeah, Washington State, I know you can. You can choose that as your method and they'll build you the gallows.
Starting point is 00:21:21 And the idea there is you want your neck to snap, otherwise you'd die slower and suffocate. The problem is there is a study of 34 prisoners that found four fifths of them died partly from asphyxiation. Really? That's the wrong way to hang somebody. Yeah.
Starting point is 00:21:40 If you don't snap their neck or they don't lose consciousness immediately, they sit there and hang and die of asphyxiation. That's a bad way to go. Wow, and speaking of bad, I think being burned to death may be one of the worst. Isn't that what we came up with on the worst way to die? I think so because you feel it
Starting point is 00:22:02 and you think like your nerve endings, that's what I thought like, oh, your nerve endings are probably like, stop responding quickly, but apparently that's not the case. No, not only is that not the case, apparently your fire further sensitizes your nerve ending. So you feel even more pain. Wow.
Starting point is 00:22:18 Yeah, but luckily most people, I think the vast majority of people who die in fires actually die from smoke inhalation before they ever feel pain from fire. Yeah, that are well. I don't know about before they feel pain, but hopefully quick enough. Well, carbon monoxide sinks.
Starting point is 00:22:36 So like, there's a lot of smoke, you are down low to the ground and that's where the carbon monoxide is. So you're inhaling mostly that. So it's possible it's before. That's true. And then the natural death, which is passing of old age or disease.
Starting point is 00:22:53 And here in this country, we have kind of whipped up a lot of the disease over the years into, they've sniffed them off the case. Right. Well, it depends. Like some of the ones that like kill undeveloped countries like diarrheal diseases, like dying from diarrhea,
Starting point is 00:23:09 you don't have that much in the US, but we have chronic disease like obesity and diabetes and cardiopulmonary disease. We have that down pat. I've got the top five here actually. I think they're all in there, aren't they? Heart is number one, cancer is number two, lower respiratory is number three,
Starting point is 00:23:29 stroke is four and accidents are five. And it's a huge drop. Cancer and heart are close to 600,000. And then number three, lower respiratory is only 138,000. So that shows you what cancer and heart disease are doing in the United States at least. When the upshot of all this is that most of us
Starting point is 00:23:48 are not going to die suddenly either by accident or by violent death. Yeah, dying of old age didn't used to be a thing. No, it was like. It was like a lot of ways to die, but that wasn't one of them. You ticked off some traveling night or there was a dispute over grazing rights.
Starting point is 00:24:06 Yeah, or plague. Yeah, you walked into a bear cave. Yeah. Yeah, the plague's another one. But yeah, old age is, it's kind of a new thing, but it's one of the most prevalent forms of death in developed countries. It actually has its own name, frailty.
Starting point is 00:24:25 Yeah, which is great, it's sad, but it's great that now we can live out our lives and we're about to talk about it, but sometimes the body, just like any other machine, just stops working. It's not designed to keep going indefinitely. And ultimately the system shuts down as its subsystems shut down.
Starting point is 00:24:43 Dude, it's shutting down every second. Right. Right now, our bodies are shutting down very slowly. And for that reason, because you and I are both dying, I guess once you're born, you start dying. Yeah. After you stop growing, you start dying, right? Is that just the positive outlook?
Starting point is 00:25:01 But I mean, like you're shutting cells and like this is like the dye, we're in the midst of the dyeing process. Just this natural system is in the winding down, although it takes decades and we still have plenty to do. Like you said, you're dying, I'm dying. That's why they have a more specific definition of death, which is called active dying.
Starting point is 00:25:22 Like you and I are not actively dying right now. No. No. Instead, if we are actively dying, we're in the midst of the dyeing process. Yeah, it is started, the dyeing process is started, the descent, if you will, has started. Right, so all this kind of happens
Starting point is 00:25:41 since different types of cells die at different speeds. That's what it is, it's cell death. Right, I don't wanna let the cat out of the bag, but oxygen doesn't happen to different parts of the body, your cells are gonna die. Exactly. And so as the cells die at different speeds, different systems are gonna shut down,
Starting point is 00:26:01 but just from watching frail people die of old age, they kind of have like the order in which it happens kind of down pat. So there's the preactive dying phase, which can take about three weeks, starts about three weeks before death, two or three weeks. And then there's the active dying phase, which can take a few days.
Starting point is 00:26:27 And obviously that's not set in stone, none of this is set in stone, but this is all just kind of accumulative knowledge from observations of people dying in like hospice and things like that. So you get the preactive phase of dying. And like I said, it starts a couple of weeks ahead of the actual death.
Starting point is 00:26:46 Because we have, this is a big deal right now, what we're talking about. Like it's becoming very clear in our modern age that death is not an instant, it's not a moment, there's a process. Yeah, well, unless it is in an instant, but yeah, old age dying. Yes.
Starting point is 00:27:05 Or like other kinds of dying, but how about non-accidental dying? Okay, we'll call it that. Because that's like the instantaneous thing. Right. And even sometimes in a very short scale, that can follow some of these, you know. Oh, are we gonna?
Starting point is 00:27:20 Yeah, forgot it's audio. Yes, I was nodding my head. ["The Dying Man"] On the podcast, Hey Dude, the 90s called, David Lashher and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses and choker necklaces.
Starting point is 00:27:49 We're gonna use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s. We lived it, and now we're calling on all of our friends to come back and relive it. It's a podcast packed with interviews, co-stars, friends, and non-stop references to the best decade ever.
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Starting point is 00:29:39 or wherever you listen to podcasts. So the preactive phase of dying, Chuck, what do we got? Well, you're going to start, you're going to get sleepy. You're not going to have much energy. You're going to start sleeping more and more. Your skin might become cooler to the touch. It might turn a little blue, but you're not going to have to do that.
Starting point is 00:30:04 If you're not going to have much energy, you're going to start sleeping more and more. Your skin might become cooler to the touch, It might turn a little bluish gray. Yeah, cyanosis is what that's called. Oh, is that what that's called? It's just becoming oxygen deprived. Like apparently your body's like,
Starting point is 00:30:20 okay, don't really need to use the legs anymore because we're bedridden. So I'm going to start focusing more of the circulation on the inner organs. Okay, that makes sense. Yeah. Well, that probably causes the modeling too, which is your skin can become sort of reddish,
Starting point is 00:30:35 like splotchy with reddish blue splotches as well. Right. You're going to be a little restless probably. Yeah. You're going to possibly come off as confused. You're not going to be hungry. No, you're going to probably withdraw from social activities.
Starting point is 00:30:52 Yeah. You're going to become a little withdrawn. You might want to settle unfinished business with family. You might request family come visit you for that kind of thing. Oh, sure. The non-physical parts, that's definitely something you'd be interested in doing.
Starting point is 00:31:07 Right. That's apparently something that people intuitively know. Like they need to, apparently, patients know when they're dying. I've seen that happen. And one of the signs from that's mentioned in hospice care, palliative care, is that the patient may even state, I'm dying.
Starting point is 00:31:31 Like I started, it's coming. That's pretty common. Yeah. Yeah, and that's sad that when you realize, like, all right, this is it. Like I feel myself, I'm going to be gone soon. But that's neat though, especially if you are-
Starting point is 00:31:47 If you have that time, yeah. Yeah. If you're like, okay, I'm going to put everything in order. Sure. And die happy or peacefully. Yeah. That's neat that you have that time to take care of that. Yeah.
Starting point is 00:32:01 If you're fortunate enough to go that way for sure. Back to physically, you won't be able to heal from a wound or an infection any longer. Yeah, you might lose control of your bladder and your bowels over the course of some time. You might be in pain, but chances are, here in the modern world, they're going to take care of you in that respect.
Starting point is 00:32:23 Right, and again, that's called palliative care, where at some point it's very obvious that you're going to die. And a lot of it can be based on what you want. But even without your wishes, there's probably a point in time where medical science says there's nothing we can do for you. Yeah.
Starting point is 00:32:43 We just want to make you comfortable. Exactly. So we're going to give you pain meds. We're going to like, your care is being transferred over from a physician who wants to save your life and keep you going to hospice workers, healthcare professionals who are trained to just keep you as comfortable as possible for the duration of your life.
Starting point is 00:33:04 Man hats off to those people. Yes. Like all healthcare professionals, of course, but man, hospice nurses, that is tough stuff. You got to be made of the right qualities as a human to be able to tackle something like that and still get up and go to work every day. Like they're literally in the business of dying.
Starting point is 00:33:22 Yeah, I mean, it's very valuable service people provide. So that's the pre-active phase. That's the, I'm getting ready to die. I got a couple of weeks and all of my systems are starting to wind down. In the active phase, the systems are starting to shut down. You may not have consciousness. And if you do, you may, if you are able to be aroused
Starting point is 00:33:48 from unconsciousness, you're going to slip right back into it again, possibly. You are probably, and apparently families find this very disconcerting, you're probably going to talk about people who are dead as if they're in the room or you can see them or hear them. Yeah, is this just the mind slipping? They don't know.
Starting point is 00:34:09 Hospice workers from what I can tell tend to just treat it like it's real, treat it on its own terms. Yeah. They're not saying it's real or it's a hallucination or something like that. And they advise families not to treat it like a hallucination, just to. Not to correct them.
Starting point is 00:34:27 Yeah, that makes sense, because you're there to provide comfort, not say, no grandpa, grandma's been gone for years. Exactly. Why would you want to do that? There is an exception to that. You would want to do that if they're fearful from their visions, then you can say, it's not real.
Starting point is 00:34:43 It's just you're brain, that's not real or whatever. Again, all about comfort. Yes. But you don't want to contradict them if they're happy or even saying it in a neutral tone. It's only if they're fearful that you want to say that. But apparently families are kind of like, oh God, they're going crazy.
Starting point is 00:35:01 But it's a natural part of the active dying process. Breathing's going to become really weird. The patient's going to stop breathing for disconcertingly long periods of time. Yeah, this is called Chaney Strokes Respiration Stokes. Sorry. Chaney Stokes, name for John Chaney and William Stokes. Obviously the first dudes who've described it.
Starting point is 00:35:24 Sure. Deep breath, quick, deep breaths, sometimes very slow ones, like you said, sometimes stopping all together. And that is caused by receptors in the heart and brainstem basically being too sluggish to respond to different amounts of oxygen and CO2. And it's just kind of lagging behind.
Starting point is 00:35:46 Again, think of it as a machine that's just slowing down. And those receptors can't pick up on it in time. So it doesn't know how to tell you to breathe, basically. Like at a steady rate. We should say that there isn't evidence that that is physically painful. True. Again, it's awful for the healthy person in the room, yeah.
Starting point is 00:36:05 Yeah, for the family watching it, you think that the person's suffering. There's not evidence that they are in fact suffering. But it seems like it. And that, from what I understand with palliative care, not only making the patient comfortable is one of the priorities, making the family comfortable is a priority as well.
Starting point is 00:36:23 Because how you die has a very lasting impact on the people who are there to witness your death. Yeah, for sure. For family. So explaining that they're not suffering is helpful, but not necessarily enough. Yeah, and I think actually this podcast itself could help like some people.
Starting point is 00:36:44 Cause I don't think a lot of people do this sort of research when they go into a hospital room in the last hours of a loved one's life. Yeah, and they may not be told. They may, even if it is explained to them, might not sink in what they're being told. Because seeing somebody gasping for breath and then being told that they're not really suffering,
Starting point is 00:37:03 those two things might not jibe. Well, yeah, your instinct is to probably try and get help. Like they can't breathe. Clearly let's get a nurse in here. And the nurse is like, no, that's... That's part of it. Another one that's very disconcerting, another sign of active dying is the death rattle.
Starting point is 00:37:18 And I did a, I guess a don't be dumb on death rattles. Oh really? And basically either you have fluid in the lungs or like, you know, when you clear your throat like I just did, that's a normal ability you have until you start dying, you can't clear your throat anymore. Those are your laryngeal muscles, basically spasming. What, clearing your throat?
Starting point is 00:37:43 No, the death rattle. No, the death rattle is just breathing through the mire. It's both, it's either liquid or it's the muscle spasms. Is that right? Yeah. Okay, so did you find that that's painful? Cause I found that it doesn't cause pain. It's just, it sounds terrible again
Starting point is 00:38:01 to the people in the room. Exactly. And this is, I don't think we pointed out this is the agonal phase of death and it's Greek for struggle and... Agony? Yeah, that sort of just encapsulates it. I think that's probably why they call it
Starting point is 00:38:15 the active phase of death now rather than agonal. Oh, they don't even call it that anymore. I mean, I think some people do, but I think that active and agonal are the same, one and the same. Gotcha. It's just, you know, they're in the agony phase. Right.
Starting point is 00:38:30 Or they're in the active phase. Your muscles, aside from your vocal cords, might start convulsing and spasming. You can get all, you know, perky jerky and do things that wouldn't seem like you should be able to do in your state. Like, card tricks. I don't know if you could do card tricks.
Starting point is 00:38:52 Shuffling card tricks from one hand to the other. And grandpa never could before. Yeah. I knew he'd get some humor in here somehow. What else? Well, let's see. Your blood pressure's gonna drop. Your jaw is gonna drop.
Starting point is 00:39:07 You might end up in a really weird, rigid position. Yeah. And I think we said your extremities are gonna be cold to the touch. Yeah, actually the death rattle as a result of the spasming of your laryngeal muscles, that can also produce what was described in what I read as a barking sound.
Starting point is 00:39:30 Oh, yeah. Yeah, and I've never, I didn't search that out to see if that was recorded anywhere, but I'm curious what that sounds like. I've heard everything from gurgling, like gurgle, to it sounds like there's marbles in your throat. Right. Barking, that's a new one,
Starting point is 00:39:46 but I think everybody has their own signature death rattle, you know? But the rule of thumb apparently among hospice workers is once the death rattle comes, it's a sign that they got about 48 hours or less left to live. Yeah, and all of these are tells really. And all of them, and we'll talk about what happens
Starting point is 00:40:04 after the body is dead too. And that helps with finding out, in forensics, I think we pointed out plenty of times, the time of death, depending on the various things that happen when they find you. But all of these are almost like markers on a clock. Yeah. And if you're in hospice care, you know these things,
Starting point is 00:40:24 like, oh, this means this. Well, there are signs and symptoms of the system shut down that the person's body is going through, you know? Yeah. So the senses apparently also are lost in a healthy person or a person who has all five senses. Yeah. They're lost in a certain order.
Starting point is 00:40:45 And touch and hearing are the last to go. Oh, really? And another... That's kind of nice. Another very important point that hospice workers make is never ever talk about the patient like they're not there because they can hear you up until the end. Like hearing is kept so long as the person could hear
Starting point is 00:41:03 before then and there's not any damage from, you know, during the act of dying period, they can hear you until the moment they die and you need to be careful what you say. Yeah. And I think that's a really nice thing that the last things that you can experience are the touch of a loved one or the voice of a loved one.
Starting point is 00:41:23 Right. You know? Because you need to see him. You may not even be able to respond to that. Yeah. But you can still hear. That's true. Yeah.
Starting point is 00:41:31 I would definitely pick that over sight. I'd rather hear someone's words as I pass rather than having silence and just seeing their faces staring at me. So long as the words are, wait, one more thing. I think it would be almost cruel to be able to see and not hear at the end, you know? Yeah.
Starting point is 00:41:49 Like he wants to see your family upset. You want to hear, feel them hold your hand and say everything's gonna be all right. So you raise a good issue. Like there's, if you have a dying family member, especially if they're dying of frailty or they're just dying, like they're in the dying process or they're about to enter the dying process.
Starting point is 00:42:08 Yeah. You could do worse things than to go online and educate yourself on how to be around them. I think people don't intuitively know how to be around a dying person. And there's certain things that you should do, certain things you shouldn't do. Like for example, they say that you should talk
Starting point is 00:42:25 to the person, not the condition. Yeah. So don't treat them like they're frail or dying. Like treat them like they're your old friend, who they are. It's extremely important to make sure that they're in a peaceful, calm environment. Sure. So like maybe yelling at somebody over the will
Starting point is 00:42:43 is a really bad idea. These seem like no brainers, but I guess some people need to be told this stuff. Yeah, but I mean, think about it. Like it can put you on edge being around a dying person. Like do you mention the fact that they're gonna die? Or do you, you know, I mean, like do you dance around it? If they make a joke or something, like can you laugh?
Starting point is 00:43:01 Or do you laugh too hard? Do you not laugh enough? Like there's, I think it's not necessarily like. Yeah. I think it's just put you on edge. Not everyone is as sensitive to. So I'm gonna add one. Don't bring your laptop in there
Starting point is 00:43:14 and watch reruns of the office. No, yeah. Are you speaking from experience? No, I'm just gonna add that. Okay. That's on my list. Okay. Get off your cell phone.
Starting point is 00:43:24 Yeah. Pay attention to them. Sure, yeah, I mean, that's what you're there for. That as hospice workers put it, you're giving them a very heartfelt gift by being there with them while they're dying. And maybe receiving a gift, you know? Sure.
Starting point is 00:43:39 And many religions and cultures, it's very much an honor to like be a part of this whole thing. And even if you're not religious, you could just feel that way spiritually as a human, you know? Okay. Well, let's pause here because Chuck, it's time for a message break. Let's go.
Starting point is 00:43:56 Stuff is should go. On the podcast, HeyDude the 90s called David Lasher and Christine Taylor, stars of the cult classic show, HeyDude, bring you back to the days of slip dresses and choker necklaces. We're gonna use HeyDude as our jumping off point, but we are going to unpack and dive back
Starting point is 00:44:18 into the decade of the 90s. We lived it and now we're calling on all of our friends to come back and relive it. It's a podcast packed with interviews, co-stars, friends and non-stop references to the best decade ever. Do you remember going to Blockbuster? Do you remember Nintendo 64?
Starting point is 00:44:35 Do you remember getting frosted tips? Was that a cereal? No, it was hair. Do you remember AOL instant messenger and the dial-up sound like poltergeist? So leave a code on your best friend's beeper because you'll want to be there when the nostalgia starts flowing.
Starting point is 00:44:47 Each episode will rival the feeling of taking out the cartridge from your Game Boy, blowing on it and popping it back in as we take you back to the 90s. Listen to HeyDude, the 90s, called on the iHeart radio app, Apple Podcasts or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new iHeart podcast,
Starting point is 00:45:05 Frosted Tips with Lance Bass. The hardest thing can be knowing who to turn to when questions arise or times get tough or you're at the end of the road. Ah, okay, I see what you're doing. Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation?
Starting point is 00:45:20 If you do, you've come to the right place because I'm here to help. This, I promise you. Oh, God. Seriously, I swear. And you won't have to send an SOS because I'll be there for you. Oh, man.
Starting point is 00:45:32 And so my husband, Michael. Um, hey, that's me. Yep, we know that, Michael. And a different hot, sexy teen crush boy bander each week to guide you through life, step by step. Oh, not another one. Kids, relationships, life in general can get messy. You may be thinking, this is the story of my life.
Starting point is 00:45:48 Oh, just stop now. If so, tell everybody, yeah, everybody about my new podcast and make sure to listen. So we'll never, ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart Radio app, Apple podcast, or wherever you listen to podcasts. And we're back.
Starting point is 00:46:20 Okay, so are we dead yet? Are we at that point? Yeah, the, the, the person has passed. You just sounded very cheery. Yeah, yeah, yeah. Well, I mean, like, we've rattled off some pretty, what seems like suffering, but now the suffering is over if there was any,
Starting point is 00:46:35 the person is dead. So once you immediately, immediately after you die, your pupils are gonna dilate because the muscles controlling the IRS are, you know, gonna have their final rest. So your pupils are gonna dilate. And then have you heard of the terminal tear or the lacryma mortis?
Starting point is 00:46:55 No. This is a, usually in the right eye and there's no real explanation for it, but it is a final tear that you shed. Wow. And it doesn't always happen right after you die, although it can. They did a study in the early nineties in New Zealand
Starting point is 00:47:14 and out of a hundred deaths, 14 of them, right at the time of death had the lacryma mortis tear and 13 of them in the final 10 hours. And they say to look out for that if you're the family, because it can be a sign. And also they try to talk you into the fact that it's a comforting thing to see that tear being shed.
Starting point is 00:47:35 Wow. Yeah. And since we're on eyes, you know the old thing where you close someone's eyes after they die? Oh yeah, or you put silver dollars on. If it's the old west. I guess people do that to,
Starting point is 00:47:49 so you're not having someone, a dead body staring at you. Cause if they're looking dead forward, straightforward, they're like following you all throughout the year. And it's definitely a movie trope, but if you don't close the eyes, and I never knew this, something called T-A-C-H-E noir, I don't know if it's Tash or Tash noir. Okay.
Starting point is 00:48:10 That is a black, a dark reddish brown strip that forms horizontally over your eyeball. And I guess it's just, you know, your eyeballs dry out and has that air. So if you don't close the eyes and I looked it up, you're going to see this weird horizontal stripe across your eye. There's a plus the effect it has on the living,
Starting point is 00:48:27 the difference between seeing a dead body with their eyes closed and a dead body with their eyes open. And it's like a galaxy between the two as far as discomfort goes. Yeah. Somebody should edit together the, like every time that's ever been done in a movie.
Starting point is 00:48:40 Yeah. There's like super fast. Shh, shh, shh, shh, shh, shh, shh, shh, shh, shh, shh, shh. All right. So that's all I got on the eyes. So Chuck, I want to alarm you right now. Oh boy. You have living in your guts right now,
Starting point is 00:48:56 the very organisms that are going to decompose your body when you die. They're just sitting around waiting, waiting for action. Waiting for the signal. Yep. When you die, there's a lot of stuff that's still alive, that's still going on. Even though your brain dead, whole brain, higher brain,
Starting point is 00:49:15 heart dead, your heart stops. You're dead. That's another definition of death. I don't know if we mentioned your heart's not beating anymore. Right. You're dead, yes. There's no bringing you back.
Starting point is 00:49:26 You've been in, your brain hasn't had oxygen for a while. You died of hypothermia and they warmed you up. So now you're officially dead. You're gone. Right. But there's still a lot of stuff. Remember the poop shake episode? Yeah, who can forget?
Starting point is 00:49:43 We talked about the microbiome. We have this whole other part of our life, our living organism that's still around, that's still operating and a lot of stuff living within us, including part of our microbiome, they're still carrying on processes. Like apparently you can harvest skin cells for 24 hours and they're still alive.
Starting point is 00:50:04 Just use them. Yeah, for all sorts of stuff. Yeah, you can harvest them. And then of course, inside your intestines, there's little tiny organisms that are still living and are going to help do the work that comes next. Starting a couple of days after death, like if you just fell over in the woods and no one was around.
Starting point is 00:50:22 I always love the setting. And you're just left there. Within about three days, these organisms, the micro flora, is going to go to work on you, starting in your intestines. Yeah, and this is after the various mortises, correct? Yes, I guess we should kind of go over it,
Starting point is 00:50:41 but I would recommend everybody go listen to What Causes Rigor Mortise. Yeah, for sure. It's on the website. You can go to stuffyshouldknow.com slash podcasts slash what-causes-rigor-mortise. We'll just run through the mortises real quick then. Algor mortise or the death chill,
Starting point is 00:51:03 that's the first thing that's going to happen. That's where your body starts dropping in temperature, about a degree and a half Fahrenheit per hour until you are just like a nice red wine at room temperature. Yeah. Actually, that's not quite true. Red wine is like 64 degrees Fahrenheit. I guess it depends what kind of room you're in.
Starting point is 00:51:20 Yeah, if you're in a 64 degree. It's perfect. All right, what else? Well, after algor mortise, you get rigor mortise. A couple hours after death, where the body settles into a stiff state. Yeah. And that lasts for what, like 24 hours?
Starting point is 00:51:37 I don't remember. We talked about it. Yeah, yeah, I think so. And then between those, you have liver mortise or a sedulation. That's where all the blood coagulates at the body. Yeah, basically, your red blood cells are pretty heavy and they just sink.
Starting point is 00:51:53 And it's about 20 minutes to three hours after death is when you're going to be in live remortise. Yeah. And then after that is rigor. That's right. Okay. So now back to putrification. Right.
Starting point is 00:52:06 Because that's the best thing to talk about. Yeah, that's basically like these organisms go into work breaking down your body and they do it pretty quick. Yeah. The pancreas apparently has so many in there that it just eats itself. The pancreas consumes itself.
Starting point is 00:52:21 That's pretty efficient. Your other organs are going to eventually be consumed in turned into liquid. You're liquefied from the inside out. Yeah, you're going to turn colors in this order, green, then purple, then black, which is just like a black eye, I guess. Yeah.
Starting point is 00:52:39 In the same stage? Yeah, except it never fully heals. Yeah. It explodes. You, within a couple of weeks, you're going to be liquid inside. Yeah. The organisms that are eating you produce a gas
Starting point is 00:52:56 as a byproduct from their consumption. So you're going to be bloated. Your tongue's going to stick out. It's going to turn dark too, your tongue. Yeah. And that gas really stinks. Your eyes are going to protrude. Yeah.
Starting point is 00:53:07 There's something called purge fluid. That is a putrid reddish brown fluid that can be expelled through just everywhere you've got an opening. Right. It can come out of your mouth, your nose, your vagina. It can be mixed with feces and come out of your rectum. Another, there's something else that can come out
Starting point is 00:53:27 of your vagina too. Yeah, this is maybe the worst thing I've ever heard. I just, I had no idea. Yeah. I had no idea. You know, I know all about death and all that, and it's like interests me. I had never heard of this before.
Starting point is 00:53:41 I don't even want to talk about it. You don't either. Maybe we should type it into the computer and make the computer say it. Do we have that ability? Coffin birth. Oh, wow. That was pretty good.
Starting point is 00:53:51 That was a good computer impression. So wait, that's what you do when you don't want to say something yourself. You pretend you're a computer. Yeah. That Emily and I, most of our fights are like that. Really? Yeah.
Starting point is 00:54:04 That's pretty cute. I go into a war games mode. What was it again, computer? Coffin birth. Coffin birth. So basically those gases that, this is a real thing. We're not making this up.
Starting point is 00:54:18 Yeah, but post-mortal fetal extrusion is another name for it. So the gases that build up in the body before the body ruptures, which comes a little later, can become so pressurized that a pregnant woman who has died with the fetus still in utero, can actually, the gases can push the fetus out
Starting point is 00:54:38 of the vagina, which is Coffin birth. Yeah. And this doesn't happen much anymore. No. Thankfully, because we take care of dead bodies pretty quickly, although they did find evidence of it in a case in 2008 where this woman was found
Starting point is 00:54:53 like in the woods. But it was described a lot in like 16th to 18th century medical literature. Oh, you know, it just drove them crazy. Oh, sure. She was obviously alive for weeks afterward. Yeah. Archeologists apparently too, or have to rethink
Starting point is 00:55:11 sometimes when they find, because sometimes you would die during childbirth, but they would bury the baby with the mother. And so you would find the bones like cradling each other almost, but then they've had to go back and look at some where they find the, between the legs, the bones of the baby,
Starting point is 00:55:30 and they think that might be the case of Coffin birth. Right, boy. So there's the worst thing in the world. Yeah. There's probably a death metal band with that name. If there's not, there is now. Yeah. So the gas is ultimately, eventually,
Starting point is 00:55:44 once they start, once they really get down to business and they're no longer just, what's it called where the fluid's coming out of little orifices here or there? Purge fluid. Okay, so once it's like enough with the purge fluid, we're just gonna tear the sucker open. Your body ultimately ruptures.
Starting point is 00:56:02 Yeah. And this is, you know, your skin is already blistered at this point. Your hair, nails, and teeth have fallen out. They don't keep growing. No, it's your skin receding from drying out, from desiccating. Yeah, so pass that around in school, kids.
Starting point is 00:56:16 When someone says that your fingernails keep growing after death, you set them straight. Tell them Josh's thinking. Oh, God, I just realized there's kids listening to this. And then the old de-gloving, which we've talked about before. Oh, yeah, I forgot about that. Remember that?
Starting point is 00:56:31 Yeah, where the, that can happen to you if you drive at 10 and two and you have an airbag, the gases that expand the airbag out of your steering wheel are very hot. And if you're not driving at nine and three and you have your hands at like 10 and two or something, like you're going to be de-gloved.
Starting point is 00:56:50 Really? Alive. Yeah. But yeah. Your skin is just burned right off your hands, or it's burned and separated, and then eventually comes off. So 10 and two is not how you should drive it on?
Starting point is 00:57:00 No, I'm not. Really? That's what I've learned. Yeah, I drive it either just a straight up six o'clock with one hand. Yeah. Or a noon or just a straight up noon. Noon.
Starting point is 00:57:10 I rarely have two hands on the wheel. You don't drive with like your knees with your hands behind your head relaxing? Occasionally, if I'm, you know. Relaxing? Yeah, or playing the guitar or something. Okay, so de-gloving. Yeah, de-gloving is,
Starting point is 00:57:24 I know we talked about this in probably rigor mortis, but that's when you're- Or body farms, maybe. Yeah. That's when basically your skin is removed, still attached to things like fingernails and things like that. And it's, they call it de-gloving
Starting point is 00:57:39 for a reason I don't think we'd need to explain. No, that makes perfect sense. Or de-socking, sometimes, you know, can happen to your feet. Well, I hadn't heard of that one. Did you just make that up? Well, they said gloves or socks if it's your feet, but I did make it de-socking.
Starting point is 00:57:53 De-socking. Well, I'm gonna have to use that from now on. Yeah, that's good stuff. That might be a new thing. So the body, once it ruptures, your organs are already liquid. And all that's left is a skeleton, which we'll eventually turn to dust, too.
Starting point is 00:58:10 Can we be done? No, wait, we can't be done because we do need to talk a little bit about assisted suicide. Yeah. I just teed that up for you. Boy, you sure did. That's quite a controversial subject.
Starting point is 00:58:23 Like we said, I don't know if I said or not. Like this has just been such a huge whirlwind of input of information in my head in the last like 36 hours studying for this, that I don't know what I've said yet or not, or what we talked about in another podcast. But so we talked about dying of frailty of old age and that it's increasing.
Starting point is 00:58:44 Supposedly five out of 10 people in the United States will die in the intensive care unit. And I saw this TED talk from Newcastle, Australia with this guy, I can't remember what his name is, but it's about dying. I think it's called, can we talk about dying or something? And his point was you're going to die in the ICU
Starting point is 00:59:06 whether you want to or not, if you die of a degenerative disease or frailty, unless you say you don't want to die there because the way medical science is currently set up, you are going to be treated most of the time up until the bitter end with life-saving measures. And you're going to die in the ICU with tubes hooked up and things beeping and like other people
Starting point is 00:59:34 having crash carts taken in and out of their room and people making a big ruckus up until the point you die, unless they give you palliative care or you say, I don't want to be sustained like that. I don't want to go to the ICU. And his point was if half of Americans are going to die in the ICU, you have to assume that maybe not all of them
Starting point is 00:59:56 would want to die in the ICU. And therefore they need to think of things like, I want an advanced directive, a living will. I want a living power of attorney to somebody to say, no, no, do not put them on a ventilator. Do not put them on feeding tubes. Like they don't want that. They just want to die or they want to go to hospice.
Starting point is 01:00:15 They want to go back home. That's another big one. Like they don't let you go back home, especially if you can't speak for yourself. Like to medical science these days, that's crazy. You don't leave the hospital when you know you're dying. You stay in the hospital and we keep doing stuff until you die.
Starting point is 01:00:34 That's not the way it jobs with a lot of people. But if you don't stop and think about it and then write it down or tell somebody who can speak for you, you're not going to go home. You're not going to go to hospice. You have to do this ahead of time. And part of that that's kind of come out of this idea is, okay, well, if we have autonomy to say,
Starting point is 01:00:53 I don't want you to intubate me, why don't we have the autonomy to say, I want you to give me some stuff that's going to painlessly end my life. Because it's either that or facing a tremendous amount of pain and suffering through this degenerative disease. Yeah, basically saying, I'm ready. I am ready.
Starting point is 01:01:11 It is my life. It's like the Richard Dreyfuss movie from the 80s that covered us. Whose life it is anyway, I think. I have no idea what you're talking about. Yeah, I think so. It was a movie about assisted suicide. And do you, should you have the right to be able to,
Starting point is 01:01:28 you know, it's a hot button issue for sure. But apparently most Americans or the majority of Americans actually support it until you start using a word like suicide. Right, when you pull them and say, do you, are you in favor of doctors helping someone to painlessly end their life or something at the end of life?
Starting point is 01:01:46 They say, sure. Yeah, and then they're like, okay, so you're in favor of physician assisted suicide? No, no, no. Right. Yeah. What was that word, you know? And the doctors who are in favor of euthanasia
Starting point is 01:01:56 is another term for it. Say, look at palliative care. It's like half of a step away from physician is assisted suicide. Like you're keeping somebody if they request it and knock down on morphine for the rest of their life. So they're never gonna regain consciousness. There's this, you dug up this one article
Starting point is 01:02:16 by a British physician who argues that that agonal gasping reflex, apparently when part of the apnea is that your body has a reflex where you gasp for air and it's really disconcerting to family members, even though they don't think that you're suffering, it looks like you're suffering. And this doctor argued, well, we have drugs
Starting point is 01:02:39 that can block this response so that the person can't gasp for air and what it's gonna cost them their last couple of breaths. But these last couple of breaths make it appear like they're suffering and the family remembers that their kids suffered. So why wouldn't we do that? And there's this conversation that's taking place
Starting point is 01:02:58 more and more and more that ultimately it's kind of like, who is somebody to say that somebody can't choose to end their own life painlessly through the use of like drugs? Yeah, or like Hunter Thompson did. Well, I mean, that's another way to go and anybody can do that. But there are some people out there
Starting point is 01:03:17 who don't wanna die violently. They wanna die peacefully. Yeah, or at least that for their family. Like that's the part that I was upset about with that was his wife, like finding him and stuff. Yeah, his wife and his son. And it was like, not only that, he did it in his own basement,
Starting point is 01:03:30 which I can understand doing it at home, but he left quite a mess in his own basement for his family to clean up. But if he had other options these days, like Dr. Assisted Suicide, he might not have had to make a mess in his basement for his family, so. Yeah, and Chuck, we know that Hunter Thompson is far from the only person
Starting point is 01:03:49 to make his own exit his own way. Sure. Another very famous person, Sigmund Freud did too, huh? Oh yeah? Yeah, you know that. Assisted Suicide. Yeah, literally physician assisted suicide. He was diagnosed with cancer of the palate
Starting point is 01:04:06 because he smoked tons of cigars. Right. Which were sometimes just a cigar. That was about to say. And for 16 years, he lived with that diagnosis. And finally, toward the end, he asked his surgeon, his physician, go ahead and hit me up with, I think, five grams of morphine,
Starting point is 01:04:23 like just a ton of morphine. And he died three hours after the injection of it, but. Which was more than his usual two grams of morphine. Right, or cocaine, he loved cocaine. Yeah. But he had developed what was called Tottenangst. Tottenangst. That's German.
Starting point is 01:04:39 Which is a dread of death. Yeah. And so he lived with that for 16 years, but he finally, he decided along the way, like I fear this, but I'm gonna take it into my own hands. Physician assisted suicide in 1939. And there's definitely more than one side to this coin. Like there's a lot of people,
Starting point is 01:04:58 there's very strong opinions on either side, but I think it's a, at the very least, even if you remove emotion from it, it's an extremely interesting conversation in that it reveals so much about our attitudes toward death. Totally. Autonomy and like who has the right to decide whether they're going to die
Starting point is 01:05:14 or who has the right to tell somebody that they can't do that. Whose life is it anyway? Yeah. Richard Dreyfus. And then Chuck, one other thing that we wanna hit on is regret. Yeah, I actually saw this a few weeks ago just by chance
Starting point is 01:05:28 and then you sent it to me. I think it was an England hospice nurse spent a lot of time researching life regrets over the course of a certain amount of time and came up with the five most common life regrets. And I think this is like a good way to end it, you know? Number one, I wish I had the courage to live a life true to myself and not the life others expected of me.
Starting point is 01:05:55 Right. That was the number one regret. Yeah. Number two was I wish I didn't work so hard. It didn't surprise me at all. Yeah. Number three, I wish I had the courage to express my feelings.
Starting point is 01:06:06 Number four, I wish I'd stayed in touch with my friends. That's a very sad one. And I wish I'd let myself be happier is number five. Yeah, like she was saying that they didn't realize toward the end of their life that happiness is a choice. Right. That you make, it's not something that happens to you. It's something you go search out.
Starting point is 01:06:23 It's a state of mind that you strive for. Sure. And to figure that out, like at the end, that's a regret. Yeah. So call to action people. Yeah, really. Think about this stuff. You don't have to wish these things on your death bed
Starting point is 01:06:38 if you start doing something about it now. Exactly. Dying, Chuck. You know what we might have just done? We might have just witnessed the death of the death suite. I bet there's something else. Yeah, only time can tell, but I don't know how much more aspects of death we can cover.
Starting point is 01:06:55 And I'll tell you what, I'm gonna put all of them together in a blog post. Oh, nice. The death suite. So everybody can go listen to all things death via stuff you should know. What a gift. Yeah.
Starting point is 01:07:08 In the meantime, if you want to look at more about dying, just type dying into the search bar at How Stuff Works. I think it has its own channel. There's so much to it. And since I said search bar, it's time for Listener Mail. This is a nice one. We don't normally do shout outs, but this was a nice one. And I thought what better way to end such a depressing show.
Starting point is 01:07:30 Hey guys, and Jerry loved the podcast. Josh, I have to thank you for teaching my fiance Danny and me about the flashlight trick this he's spiderizing. Oh yeah. I still haven't done it, man. I never think about it at night. Jerry, you said you tried it, right? And it worked.
Starting point is 01:07:42 Yeah. I can't wait. I need to do it. I need to set a reminder. And my response to people who've been like, can you explain it again? Practice. That's my explanation.
Starting point is 01:07:50 Just practice. Just try it from a different angle. Just practice. It's a real thing. It's not a trick. It is completely amazing. And this is from Peachy, by the way. And it's wonderful and frightening at the same time.
Starting point is 01:08:02 But the problem now is that whenever we walk our dogs at night, I just can't have my normal fiance. I have this dude with a flashlight stuck through his forehead, stopping at every field to let me know just how many spiders our dogs are stepping on and how we are always surrounded. Thanks for the show. And now, for a shameless request, I know you don't often give shout-outs,
Starting point is 01:08:22 but it would be the most amazing thing ever if you could give a shout-out to Danny on the podcast. The air is sometime before our wedding on October 13th. Oh, nice. Let him know that I love him more than anything, and that I'm excited to share my life with him, even if he does have a flashlight stuck through his forehead for the rest of our lives, walking our dogs together.
Starting point is 01:08:41 I know this is a totally blown away, and I would even let him listen to that podcast first. So thanks to Jerry. Thanks, guys. That is from Peachy. Way to go, Peachy. And Thousand Oaks, California. I think Peachy just expressed it very nicely.
Starting point is 01:08:56 Yeah, so Danny, Peachy, congratulations. Best of luck, best wishes from us. I told her, listen up for it on that dying podcast, and she thought that was kind of funny, and it's like, great. Yeah, and Danny, maybe put down a flashlight once in a while. Yeah, Peachy. Wife. And Peachy, don't use the word fiance so much.
Starting point is 01:09:16 OK. That's a lifeless one from Chuck right there. No one likes to hear that. If you want to see if you can talk Chuck into a shout-out, take your best shot. You can tweet to us at S-Y-S-K podcast. You can talk to him directly on facebook.com slash Stuff You Should Know.
Starting point is 01:09:34 That's where you spend all of this time. You can send us an email to stuffpodcast at howstuffworks.com. And you can join us at our website, our very own website. It's called stuffyoushouldknow.com. Stuff You Should Know is a production of I Heart Radio's How Stuff Works. For more podcasts from I Heart Radio,
Starting point is 01:09:55 visit the I Heart Radio app. Apple podcasts are wherever you listen to your favorite shows. On the podcast, Hey Dude, the 90s called David Lacher and Christine Taylor, stars of the cult classic show Hey Dude, bring you back to the days of slipdresses and choker necklaces. We're going to use Hey Dude as our jumping off point, but we are going to unpack and dive back
Starting point is 01:10:20 into the decade of the 90s. We lived it, and now we're calling on all of our friends to come back and relive it. Listen to Hey Dude, the 90s called on the I Heart Radio app, Apple podcasts, or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new I Heart Podcast, Frosted Tips with Lance Bass. Do you ever think to yourself, what advice would Lance Bass
Starting point is 01:10:42 and my favorite boy bands give me in this situation? If you do, you've come to the right place, because I'm here to help. And a different hot, sexy teen crush a boy bander each week to guide you through life. Tell everybody, yeah, everybody about my new podcast and make sure to listen so we'll never, ever have to say bye, bye, bye.
Starting point is 01:11:02 Listen to Frosted Tips with Lance Bass on the I Heart Radio app, Apple podcast, or wherever you listen to podcasts.

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