The weird phenomenon of Terminal Lucidity

My God, it’s full of stars!

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Anecdote I know, but this happened to my grandfather who was dying from complications of an infection after 10 years of decline due to Alzheimer’s disease. To put his situation into perspective, as he was being admitted to the nursing home (prior to hospice) he was stopping to try to pick up the flowers off of the print on the tile. By that time even on his best days he had limited ability to communicate with anyone and could only do so regarding a few childhood or early-youth memories (having ridden a horse, having driven a blue car, his mother had red hair, etc). He remembered no one in his family save for a son in New York (this son never existed) whom he regretted never visited him anymore (he swore this son used to come regularly but stopped) up until the point where he lost all ability to communicate. As he was in the hospital, literally moments before he died, he woke up suddenly and called for my mom (his youngest daughter). Decades before he had had a heart attack and it had been very bad. He said to her “I’m in a hospital! Is it my heart? It must have been a bad one this time.”

Those were his last lucid words to anyone. He slipped back into a fog and died within a day or a couple days at most (hard to remember but it was shortly after) of the infection that he’d been brought there due to (owing to his long decline our family had made strict orders not to do any life saving measures, but just to do pain management). As a result we don’t really know exactly what killed him, likely pneumonia as there was some fluid/mass in his lung when he was admitted.

I didn’t know there was a term for this kind of thing. I assumed it was just one of those unusual things that can happen with a disease that primarily damages the brain. It’s a damned shame it can’t happen at a nicer time! He missed all the good things and woke up in a bed lucky any of his family was even there at the moment, and just long enough to realize he was really sick and probably dying.

If you want a creepy pasta take on it, he actually did have a son. Their first child died shortly after birth. It’s also (non creepy pasta and much more reasonable) possible that this memory triggered a set of comforting delusions of a son he’d not wanted to lose, and he likely patched together details of this imagined son from stories he remembered about his friends’ sons and from things he’d seen in movies/television/books.

At any rate though, one thing is certain, very briefly and not long before he died, my grandfather who had been unable to hold a cogent conversation for years and whose brain had shrunk severely from a nasty disease (the heritable kind) that all of us fear developing (his sister and mother also died from it), regained clear ability to communicate, was able to accurately interpret his surroundings, was able to surmise a reasonable and likely explanation for them, and was able to recognize his daughter who was by that time many years older than the last time he had been able to recognize her.

Other anecdote, his wife died many years later technically of a bleeding ulcer but only after many many long complications of physical illness. Up until her last year she remained sharp and alert. Once her memory started to go we knew it was getting to be the end. She had said, in no uncertain terms, that she would only live to be 95 and indeed at 95 she died. We think, in all honesty, this was partly her own decision as she stopped admitting to issues (hence the ulcer became more severe than it might have otherwise). Still, it’s likely it would have killed her anyway as her other health complications would have made surgery dangerous or even pointless (congestive heart failure, COPD, etc.) She was the last of any of her friends alive. Towards the end she was the opposite, rarely lucid, and often mistaking my mother for her youngest sister (adjusting the time relatively and sometimes asking about her own mother’s health. Her mother had died when she was young.) She seemed to be living in the past and often told us that she had talked to various dead family members that day. She slipped into a coma before death so there was no further communication, other than some slight groaning that the nurse said was because the position had likely become uncomfortable. The nurse shifted her in her bed to allow her back to be better supported. After that we held her hand and watched them pipe fluid from her throat (mainly for our benefit because the rattle-breath was causing a couple of my family members to experience a LOT of emotional stress). We petted her hands and told her we’d come back after lunch. We ate at the hospice not two rooms down from her, but while we were making sandwiches and trying to cheer up my cousin a little, the nurse came in to tell us she had passed. We came back in and the difference was obvious but hard to explain, considering she had regularly stopped breathing for up to a minute previously. My mother folded her hands up to look nicer, and we got out of the way so that the hospice staff could do what they needed to.

Of the two experience, I rather think this is a bit nicer. She died in a very comfortable hospice with her pain under management surrounded by living relatives that loved her and the memories of dead family she had loved. The last days were hard but she was out of it and likely didn’t ever experience the sense of panic or anxiety my grandfather did as his last lucid thoughts. If I had to choose I know which one I’d rather, though of course we just don’t get to choose these things.

At no point though did the delusions she’d experienced during her last few months or year change. For her time existed side by side, with the past and present completely overlapped.

  • Adding this one last note just because it STILL upsets the family. When her COPD was diagnosed the nurse callously asked “how many years did she smoke?” She never had. She was a passive victim of her era. Please, nurses and doctors, when dealing with people’s family don’t make assumptions like this? No one felt good about this. And while it’s a shame the smokers in the family never stopped to consider the impact on others, it sure doesn’t make for a good bedside manner when you make assumptions like that about the patient to their kids.
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I don’t think it’s an insight that will withstand rational scrutiny, but I’m one of those who doesn’t feel every insight has to.

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“Why do I have this weird feeling that this is an argument for consciousness beyond the Spirit’s attachment to the physical form?”

I don’t know… why? (Not being snarky)

I don’t believe in consciousness beyond the brain/body itself in any way that one would identify as the personality or even “spirit.” If anything I’m a hard determinist of the non-Religious variety. The human mind is functionally incapable of fully understanding consciousness because a system can’t observe itself, but that isn’t an argument for that consciousness being separate in any way from the mechanisms that produce the phenomena called “consciousness.” It also doesn’t mean that our own biases and inability to explain or understand data we collect about the way the brain functions, or the shortcomings of any current scientific or philosophic explanations necessarily justify the inherent duality implied in the language of “spirit” and “physical form” in the first place.

In short, there’s a lot we don’t know. But all that I can see that meaning is exactly that: there’s a lot we don’t know.

“Why do I have this weird feeling that this is an argument for consciousness beyond the Spirit’s attachment to the physical form?”

I don’t know… why? (Not being snarky)

It was rhetorical.

What a shame.

That song is instantly stuck in my head now… thanks. So very much.

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Diagnostic and Statistical Manual of Mental Disorders

Exactly! It’s like studying car crashes where people have survived. What’s the point? In addition to the preponderance of crashes where people died, there’s also those crashes where people died harder, so why study these outliers? Certainly nothing to be gained, here.

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Contrasted to within hours or months, which is also mentioned.

The plural of anecdote is not data.

But all data, in the first-person singular, is anecdote.

Thank you for sharing.

what song?

Or as Steven Wright would have it: Aren’t all deaths sudden? You’re not dead. You’re not dead. You’re not dead. You’re dead.

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Aaaaand… now it’s back. I didn’t even play it, and its back in my head. :-/

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