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Tags terminal illness , hospice , dying , death

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Old 21st April 2007, 07:37 AM   #1
skepticdoc
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On Death and Dying, is there a "Rally" before Death?

It is a common belief/perception among Physicians and Nurses that in many terminally ill patients, there is a brief period of clinical, well being improvement shortly before death.

I just had an octogenarian with multiple problems (COPD, Cardiomyopathy, ESRD, PVD) that refused mechanical ventilation, hemodialysis and tube feedings. As expected, he continued to deteriorate, hung around until his only available relative came from a neighboring state. The day before expiring, he "perked up" slightly (smiled briefly, gestured he was not in pain).

I had started a thread in the Skepticalcommunity.com : http://skepticalcommunity.com/phpbb2...hlight=#242655 that has some bearing on this topic.

My question is: if Consciousness is just the product of neurons interacting, why would there be any improvement in consciousness as the body continues to deteriorate? My mechanistic interpretation would be that all bodily functions are directly related to the cellular milieu, as the machine slows down, everything should slow down.

Please post or PM any responses, opinions. I will post this in other forums to get opinions from other skeptics and also believers.
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Old 21st April 2007, 08:43 AM   #2
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Huh?

Ok, first, there needs to be some demonstration that there really is a common phenomena of an 'improvement before death' in contrast to preceding state of mind. Selective hear-say is kind of useless.

Secondly, even if it is demonstrated that an improvement in the state of mind occurs in a statistically significant number of patients in the 24 hours proceding death, why immediately think this would indicate some non-materialistic source of consciousness? Why wouldn't the body respond to some form of senescence with a change in neurochemistry?

I've got no answers here, but before you leap ahead in speculation, it pays to have some facts to work with first.

Athon
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Old 21st April 2007, 08:50 AM   #3
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In addition to Athon's comment - what counts as "rallying"? How much improvement? My friend that died last October, she slipped in unconsciousness late on a Monday night, then regained consciousness long enough on Tuesday to say "I don't want to die." Then she went under again and died a couple hours later. Does that count?
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Old 21st April 2007, 08:56 AM   #4
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Originally Posted by Lisa Simpson View Post
In addition to Athon's comment - what counts as "rallying"? How much improvement? My friend that died last October, she slipped in unconsciousness late on a Monday night, then regained consciousness long enough on Tuesday to say "I don't want to die." Then she went under again and died a couple hours later. Does that count?
What is your opinion? Does it count?

How do you explain your friend's course?
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Old 21st April 2007, 09:05 AM   #5
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No offence, doc, but do you have something to say on the matter? Excuse me for being somewhat cynical, but we get a fair share of people who express things that are 'interesting', stopping short of making a claim about something, yet doing their best to argue it nonetheless.

It's frustrating having a non-topic. Personally, I don't think there's anything to discuss here; you think that some people appear to be a little perkier in the hours leading up to their death. Without anything substantiating the apparent observation, it is meaningless speculation.

So, more importantly, what is your view?

Athon
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Old 21st April 2007, 09:41 AM   #6
Lisa Simpson
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Originally Posted by skepticdoc View Post
What is your opinion? Does it count?

How do you explain your friend's course?
You are the one who brought up the topic, not me. I think it is you who should be answering.
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Old 21st April 2007, 11:02 AM   #7
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Originally Posted by skepticdoc View Post
It is a common belief/perception among Physicians and Nurses that in many terminally ill patients, there is a brief period of clinical, well being improvement shortly before death.
Originally Posted by Lisa Simpson View Post
In addition to Athon's comment - what counts as "rallying"? How much improvement? My friend that died last October, she slipped in unconsciousness late on a Monday night, then regained consciousness long enough on Tuesday to say "I don't want to die." Then she went under again and died a couple hours later. Does that count?
Okay.

I feel sorry for your loss. My grandfather died this January. In his case, he bounced up and down for a long time. My question to skepticdoc...

Do you really expect them to rally after they die? If you honestly don't, then you are possibly guilty of 'selective reporting.' Before getting numbers and checking the facts (that is, the observations for the experiment), my conjecture is that there would be 'rallies' before death, possibly as part of a longer rally-degradation cycle. Even when the timing is short, I could conceive a one-off that uses the last strength a person has. (Of course, then we would have to discuss what, technically, I mean by 'having strength')
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Old 21st April 2007, 11:42 AM   #8
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How many of the respondents read the posts in the Skepticalcommunity thread?

The actual word "Rally" was used by the Social Worker and the Hospice Nurse that took care of my patient.

I am agnostic in every sense, like Darwin (according to Prof. Dawkins).

I am trying hard not to bring any bias, I am asking for comments, opinions.

I really don't know what is the correct scientific assessment, social issues, let alone spiritual concerns, are perhaps too complicated to analyze scientifically. I have read Shermer's trilogy, at the end it is only opinions, you pick and choose what you want to believe or not.

The issue in this segment of the Forum is medical-scientific, do some people really delay dying until some relevant family or social event is concluded? What would be the physico-chemical explanation?

The other parallel issues belong in the Religion section, one of our friendly moderators could copy the thread to that section and then let that discussion develop. In this section I am looking for facts, if any exist.
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Old 21st April 2007, 02:08 PM   #9
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Without any reliably gathered statistics to suggest otherwise, I am confident in answering this question
" do some people really delay dying until some relevant family or social event is concluded?"
with an emphatic NO. No need for a physico-chemical explanation.
What does happen is that sometimes people die after a relevant family or social event is concluded, some die before it starts and some die in the middle of it. Some don't die at all, before, during or after the social event.
Similarly when people survive some severe illness or trauma, credit is sometimes given to their being 'strong' or 'fighters'. It's a tautology: being a battler prevents death, failing to die means you are a battler.
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Old 21st April 2007, 02:10 PM   #10
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Everyone who has responded in this thread so far has asked you to give your opinion in the matter. Perhaps you have some sort of censorship on your web browser, and didn't notice that, or maybe you're not reading. We're not really interested in gathering the facts for you. My own opinion is that this idea of "rallying" in the sense of "consciousness in-itself trying to save the brain" is silly. I think the only observes "rallies" will be almost entirely because of physiological effects, which can probably be found to strongly correlate to the form of death involved.

Do you have any opinion at all? Or at least, where do you stand at the moment?

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Old 21st April 2007, 02:19 PM   #11
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It's widely believed that most serious skiing accidents occur on the last run of the day...

Why is something missing always in the last place you look?

Why do people rally just before they die?

Do these questions have something in common? I don't know if they do or not. The answer to the OP may be a simple misperception. It may be an urban myth.
If there truly is an effect, I suspect the answer is simply willpower- given a narrowing of horizons and an appreciation of imminent death, the sufferer concentrates all remaining resources on one task.
I suspect there are also genuine shutdown mechanisms in a failing body- similar to the chill reflex that shuts down peripheral circulation in a freezing person, shunting heat and oxygen to internal organs. It seems feasible some similar process might desensitise a dying person to organic pain, and such brief respite may allow an apparent last rally. Pure speculation without medical data.

ETA- I'm often perplexed by how calm an animal may appear while being literally torn apart by predators. I have seen a zebra with two lionesses hanging from haunch and throat , simply stand there, apparently calmly, without struggle or call, till it bled to death. Is this a similar effect? Is it perhaps a mechanism related to shock?

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Old 21st April 2007, 02:50 PM   #12
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Originally Posted by Lisa Simpson View Post
In addition to Athon's comment - what counts as "rallying"? How much improvement? My friend that died last October, she slipped in unconsciousness late on a Monday night, then regained consciousness long enough on Tuesday to say "I don't want to die." Then she went under again and died a couple hours later. Does that count?
My mum died of cancer. She had been in coma for a few days, she 'woke up' smiled to everyone in the room, said good-bye and then died.

Don't know if this counts as 'rallying'. At the time I saw it as a miracle, but I'm sure that there is a rational explanation. Hope you find it.
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Old 21st April 2007, 03:06 PM   #13
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Well hi Skepticdoc. Long time no silly unsupported claims to address.

I've never heard of this supposed "common belief/perception" and I spent more than a few years as an ICU nurse. My experience was just the opposite. Either people deteriorated until they were comatose for days to weeks before dying, or they never seemed to recover and remained depressed until dying. Seems those folks who just continued to feel as if something was wrong were the ones who soon died.

I believe there is some evidence people die more often just after a birthday or holiday which some have suggested is possibly due to 'hanging on' until a goal of some kind then giving up. But I'd have to check if the studies I read on this in the past have been confirmed or refuted. See below, further evidence refutes earlier results.

Either way, as usual, you make some claim with no evidence whatsoever to back up if your underlying premise is even true, let alone any reason the suggested mechanism is correct. You need to start there, not pondering the reasons when you haven't even established the phenomena or mechanisms exist.
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Old 21st April 2007, 03:08 PM   #14
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Originally Posted by simon dalton View Post
My mum died of cancer. She had been in coma for a few days, she 'woke up' smiled to everyone in the room, said good-bye and then died.

Don't know if this counts as 'rallying'. At the time I saw it as a miracle, but I'm sure that there is a rational explanation. Hope you find it.
That's a fascinating story. Have you ever looked into how common such events are?
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Old 21st April 2007, 03:12 PM   #15
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Originally Posted by Soapy Sam View Post
...
ETA- I'm often perplexed by how calm an animal may appear while being literally torn apart by predators. I have seen a zebra with two lionesses hanging from haunch and throat , simply stand there, apparently calmly, without struggle or call, till it bled to death. Is this a similar effect? Is it perhaps a mechanism related to shock?
I believe there are two possible things here. One is the animal may be in shock. And the other is what you perceive as calm may be some kind of feigned death as a mechanism of escape. Stopping struggling would seem like a logical thing to do if struggling isn't likely to be successful. Perhaps predators sometimes let go a second or two too early when an animal quits struggling.
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Old 21st April 2007, 03:16 PM   #16
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Originally Posted by kerikiwi View Post
Without any reliably gathered statistics to suggest otherwise, I am confident in answering this question
" do some people really delay dying until some relevant family or social event is concluded?"
with an emphatic NO. No need for a physico-chemical explanation.
What does happen is that sometimes people die after a relevant family or social event is concluded, some die before it starts and some die in the middle of it. Some don't die at all, before, during or after the social event.
....
Now I'm curious to see because I do know this concept was supported by statistics in at least one study.

Originally Posted by kerikiwi View Post
Similarly when people survive some severe illness or trauma, credit is sometimes given to their being 'strong' or 'fighters'. It's a tautology: being a battler prevents death, failing to die means you are a battler.
As contrary as this may seem, I think you dismiss it too readily. But I'll go with what ever the evidence supports.

Follow up:

And the evidence has it:

Holidays, special events have no proven effect on the timing of death
Quote:
RESULTS: Since the early 1970s, at least 18 studies have investigated whether death rates increase or decrease before, during, or after symbolically important occasions such as holidays and birthdays. Some studies but not others have found modest evidence of temporal effects. Methodological issues have raised questions about most of the positive findings. None of the studies provides any direct evidence that a psychophysiological mechanism enables people to postpone or hasten their own death.

CONCLUSION: Research over the past 3 decades has failed to provide convincing evidence that psychological phenomena such as "giving up" or "holding on" can influence the timing of death.


Willpower and survival is harder to study, that evidence will take more time to find/not find. But I suppose, on further pondering, those who had a will to live and died would go uncounted while those reporting the will to live who live would be one of those self selecting samples that skews the results. And prior to death, depressed affect probably does accompany heart failure. That could appear as giving up when it really was the result of deterioration.

I reverse my positions until some contradictory evidence surfaces.
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Old 21st April 2007, 03:21 PM   #17
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Originally Posted by skepticdoc View Post
My question is: if Consciousness is just the product of neurons interacting, why would there be any improvement in consciousness as the body continues to deteriorate? My mechanistic interpretation would be that all bodily functions are directly related to the cellular milieu, as the machine slows down, everything should slow down.
On average, we deteriorate. On a minute-to-minute basis, it's probably stochastic. Up and down.

There may be the occasional situation where the temporary upswing in neural consciouslness ironically leads to death by overexertion.

An example is my grandmother who had several strokes over many years, and therefore limited cognition. One day, she pulled it together enough to go for a long walk through her hospice, made several phone calls and I went to visit her. She died a few minutes after my visit, of a heart attack. She simpy overdid it that day. But she wouldn't have overdone it if she was still in that mental fog.

There are parallels in other fields of medicine: my wife is a psychiatrist, and one of the signs that a patient is planning a genuine suicide is that their attitude improves dramatically. This is not a paradox - they are 'happier' once they realize they see closure to their 'problems'.
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Old 21st April 2007, 03:39 PM   #18
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Originally Posted by skeptigirl View Post
I believe there are two possible things here. One is the animal may be in shock. And the other is what you perceive as calm may be some kind of feigned death as a mechanism of escape. Stopping struggling would seem like a logical thing to do if struggling isn't likely to be successful. Perhaps predators sometimes let go a second or two too early when an animal quits struggling.
To get a better grip you mean? Could be. As a defensive strategy though, just standing there while a pair of three hundred pound cats suffocate you seems to lack something to me. I'd be gouging their eyes out if that was the best I could do. Maybe it's a herbivore/ carnivore thing.
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Old 21st April 2007, 03:48 PM   #19
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Originally Posted by skeptigirl View Post
That's a fascinating story. Have you ever looked into how common such events are?
No I haven't, but I think skepticdoc is trying to find one

I have no experience in the medical field so I can't offer any opinions as to why it happened. I can just tell you what I saw.

I have a friend who is a nurse. I asked him about it once. He shrugged and said 'Happens sometimes. We don't enough about comas to be able to predict what is going to happen with a person when they are in one'
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Old 21st April 2007, 03:54 PM   #20
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Originally Posted by SoapySam
ETA- I'm often perplexed by how calm an animal may appear while being literally torn apart by predators. I have seen a zebra with two lionesses hanging from haunch and throat , simply stand there, apparently calmly, without struggle or call, till it bled to death. Is this a similar effect? Is it perhaps a mechanism related to shock?
Originally Posted by skeptigirl View Post
I believe there are two possible things here. One is the animal may be in shock. And the other is what you perceive as calm may be some kind of feigned death as a mechanism of escape. Stopping struggling would seem like a logical thing to do if struggling isn't likely to be successful. Perhaps predators sometimes let go a second or two too early when an animal quits struggling.
The calm of an animal being torn apart by predators arises from a different mechanism most likely -- though shock will definitely set in at some point. In the initial stages it is probably due to a huge endorphin surge.

I don't think many predators let go too early. Seems like they would learn not to almost immediately so that shouldn't serve as much of an advantage. When you're hungry, you're hungry and nothing says lovin' like an antelope in the ..............well, you know.


As to the original post we must be careful. It is far too easy to fall prey to biases (remembering the hits and not the misses, so to speak). I can recall some patients who rallied for a short period before death. Most never regained consciousness once the coma began. It could be ascertainment bias on my part as well, though.

As to the mechanism, who knows? My guess would be that in the act of dying there may well be a surge of hormone release -- particularly norepinephrine, dopamine, and epinephrine in the body as a whole and probably everything in the brain. For someone in a light coma or state of minimal consciousness this would probably "wake" them for a brief period. Especially if the process were slow, and the forebrain not too badly injured, this would seem to be a normal state if everything were shutting down. One of the proposed mechanisms for neuronal death in many conditions is glutamate induced cytotoxicity (neurons die, release their neurotransmitters as they die and the cell swells and bursts, glutamate opens NMDA channels, calcium rushes in and kills the cell), but if the glutamate release is short of allowing too much calcium into the cells it would probably "awaken" people briefly. This would be especially common in folks with enough of an electrolyte disturbance to partially depolarize their neurons. But, and this is a big but (not Jennifer Lopez, get your minds out of the gutter), this is all speculation. It makes some sense, but beware explanations that make some sense. The devil is often in the details.
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Old 21st April 2007, 03:55 PM   #21
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Originally Posted by blutoski View Post
There are parallels in other fields of medicine: my wife is a psychiatrist, and one of the signs that a patient is planning a genuine suicide is that their attitude improves dramatically. This is not a paradox - they are 'happier' once they realize they see closure to their 'problems'.
Yes - I have experienced this one. I wish I knew what it was before-hand

Originally Posted by Soapy Sam View Post
To get a better grip you mean? Could be. As a defensive strategy though, just standing there while a pair of three hundred pound cats suffocate you seems to lack something to me. I'd be gouging their eyes out if that was the best I could do. Maybe it's a herbivore/ carnivore thing.
Perhaps it knew it was going to die(?) Struggling may have caused it more pain(?) Perhaps I'm placing human values on an animal.

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Old 21st April 2007, 03:59 PM   #22
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Originally Posted by skepticdoc View Post
I really don't know what is the correct scientific assessment, social issues, let alone spiritual concerns, are perhaps too complicated to analyze scientifically. I have read Shermer's trilogy, at the end it is only opinions, you pick and choose what you want to believe or not.
The phrase in bold makes no sense to me. Do some people have some sort of mental denial mechanism (MDM - new acronym alert)?
I don't think I have one of those, and I suspect that for people that do have those, evidence and reality are never going to count for much.
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Old 21st April 2007, 04:01 PM   #23
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Originally Posted by skeptigirl View Post
Well hi Skepticdoc. Long time no silly unsupported claims to address.

I've never heard of this supposed "common belief/perception" and I spent more than a few years as an ICU nurse. My experience was just the opposite. Either people deteriorated until they were comatose for days to weeks before dying, or they never seemed to recover and remained depressed until dying. Seems those folks who just continued to feel as if something was wrong were the ones who soon died.

I believe there is some evidence people die more often just after a birthday or holiday which some have suggested is possibly due to 'hanging on' until a goal of some kind then giving up. But I'd have to check if the studies I read on this in the past have been confirmed or refuted. See below, further evidence refutes earlier results.

Either way, as usual, you make some claim with no evidence whatsoever to back up if your underlying premise is even true, let alone any reason the suggested mechanism is correct. You need to start there, not pondering the reasons when you haven't even established the phenomena or mechanisms exist.
It is a common belief/perception among Physicians and Nurses that in many terminally ill patients, there is a brief period of clinical, well being improvement shortly before death.
I could have stated that in my community, among the nurses in the Oncology/Hospice ward, this is a common belief. If you handle the Last Step by considering it "silly", I will regard that as your coping strategy, it is your prerogative, you are entitled to your opinion.

Blutoski posted an insightful comment, why would acceptance of the inevitable bring together the last remaining resources of consciousness in the terminally ill? The suicidal individual is not a good model because even if the person has a medical illness, they have to be strong enough to directly take their own life. My question refers to the terminally ill person that was very weak to even speak for several days, then subjectively perks up briefly before dying.
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Old 21st April 2007, 04:02 PM   #24
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I suspect there's also confirmation bias at work. All the times the course is a general deterioration up to death are unremarkable. When, once in a great while, you have a "rally", you tell everyone about it.

(Also, as mentioned, if "rally" isn't properly defined, nearly anything can count. A couple of seconds of consciousness? Sounds like a pretty broad net.)
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Old 21st April 2007, 04:27 PM   #25
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Originally Posted by skepticdoc View Post
It is a common belief/perception among Physicians and Nurses that in many terminally ill patients, there is a brief period of clinical, well being improvement shortly before death.
I could have stated that in my community, among the nurses in the Oncology/Hospice ward, this is a common belief. If you handle the Last Step by considering it "silly", I will regard that as your coping strategy, it is your prerogative, you are entitled to your opinion.

...
My coping strategy?

Skepticdoc, suffice it to say, I don't yet have reason to believe anything you say. As disgusting as your condescending attitude toward nurses is and as poor as you've demonstrated your capacity to understand evidence based medicine to be, I'm still not convinced you are a doctor.

Provide some evidence this 'rally' before death even occurs. I suspect that regardless of who or what some health care providers believe, it's based on anecdotal evidence which typically in cases like these, the evidence doesn't support the belief.

BTW, for anyone wondering why I make such comments about this guy, he believes nurses are only capable of following medical orders and incapable of any independent decision making and SD believes nurse practitioners should not be allowed to practice at all, because they are incompetent. SD has no clue that, despite the fact one can get a doctorate degree in nursing, there actually is such a profession. To him, everything nurses do is merely carrying out doctors' orders. His attitude was so backward, several of us could not tell if he was a troll. I'm still not sure he isn't one. At a minimum if he isn't a fake doctor, he's a least a poor one.
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Old 21st April 2007, 04:33 PM   #26
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Originally Posted by skeptigirl View Post

Provide some evidence this 'rally' before death even occurs. I suspect that regardless of who or what some health care providers believe, it's based on anecdotal evidence which typically in cases like these, the evidence doesn't support the belief.
While I can agree with much of the rest of your post, I can vouch for the reality of the phenomenon. It isn't very common, but it occurs.
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Old 21st April 2007, 04:34 PM   #27
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S'girl, count to ten, take a deep breath, relax.....
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Old 21st April 2007, 04:41 PM   #28
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Grow up, SD, I'm just letting people know what you have posted before. You could be a troll, maybe they'd like to know before wasting time in this thread. I'm not the least bit upset. You lost the respect of everyone reading the other thread, I didn't. Remember?

Medical and Healthcare phishing
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Old 21st April 2007, 04:43 PM   #29
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Sorry I hit your button
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Old 21st April 2007, 04:55 PM   #30
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As to what I believe, it is not very important.

I am getting acquainted with the work of Joseph Campbell, so far I agree with everything he had published.

I also agree with the Dawkins/Adams "puddle of water" analogy.
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Old 21st April 2007, 04:55 PM   #31
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Originally Posted by simon dalton View Post
Yes - I have experienced this one. I wish I knew what it was before-hand
I'm sorry to hear that.

I have another anecdote about this. When my wife and I were first dating, she was still an undergrad but already knew she wanted to go into psychiatry and had a good grasp of mood disorder indicators. One of the other signs of genuine suicidal intentions (as opposed to what are called 'gestures') is that the patient starts to give away his possessions, particularly sentimental ones.

Now, we didn't know each other very well at the time, so she didn't know about my strange personality trait: I hate clutter. I mean: I'm the opposite of a packrat. I used to move often, and made regular 'purges' of my stuff with an eye to having everything fit in one car trip.

This was the mid-90s and I started copying my LPs, tapes, and CDs to .aiff and .mp3 format and storing them on hard-drives. I started giving away all my plastic copies, because there is pretty much no real aftermarket. I had also just bought a new apartment and was planning a move, so I recruited her to help me schlep all of my 'student' furniture to the Salvation Army depot. My aparment was pretty empty within a few days.

I had three camera bodies at the time - two Pentax and one Olympus that my dad gave me when he lost interest in photography. I never knew what to do with the Olympus, because it didn't take the m55 or bayonet lenses I had invested in for my Pentaxes. When I learned she had just lost her own Olympus, I handed it to her as a keeper. "Here: my dad gave me this. I want you to have it." Bad wording on my part.

She burst into tears. We had a long talk. There was a happy ending.



So: the lesson is that usually there's a perfectly normal explanation for these 'signs'. Don't kick yourself for not recognizing or acting on them.
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Old 21st April 2007, 05:29 PM   #32
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Originally Posted by skeptigirl View Post
Follow up:

And the evidence has it:

Holidays, special events have no proven effect on the timing of death



Willpower and survival is harder to study, that evidence will take more time to find/not find. But I suppose, on further pondering, those who had a will to live and died would go uncounted while those reporting the will to live who live would be one of those self selecting samples that skews the results. And prior to death, depressed affect probably does accompany heart failure. That could appear as giving up when it really was the result of deterioration.

I reverse my positions until some contradictory evidence surfaces.
Wow, thanks for this, skeptigirl. I'd wondered before if there had ever been a study in this field.

It really does strike me as sad that a person can be medically trained, as skepticdoc claims, and yet completely lack any science skills such as basic research and opinion support.

Athon

Last edited by athon; 21st April 2007 at 05:34 PM.
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Old 21st April 2007, 05:33 PM   #33
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Originally Posted by skepticdoc View Post
It is a common belief/perception among Physicians and Nurses that in many terminally ill patients, there is a brief period of clinical, well being improvement shortly before death.
How common? Again, are you referring to your personal experience, or has somebody surveyed this? I must admit, I'm with skeptigirl; in my ICU experience most nurses and clinical staff tended to see patients decline until they just died.

You're not getting the fact that personal experience is a narrow window which doesn't show much. I'm happy to say my experience was a rather narrow view; that's why I'd need to see some survey on the claim before I have a valid opinion.

Quote:
I could have stated that in my community, among the nurses in the Oncology/Hospice ward, this is a common belief. If you handle the Last Step by considering it "silly", I will regard that as your coping strategy, it is your prerogative, you are entitled to your opinion.
You're not getting how this works.

Quote:
Blutoski posted an insightful comment, why would acceptance of the inevitable bring together the last remaining resources of consciousness in the terminally ill? The suicidal individual is not a good model because even if the person has a medical illness, they have to be strong enough to directly take their own life. My question refers to the terminally ill person that was very weak to even speak for several days, then subjectively perks up briefly before dying.
You need facts before you can speculate upon any form of mechanism!!! How is that so hard to fathom?

ETA:

Originally Posted by skepticdoc
As to what I believe, it is not very important.
Then what is it you're trying to say? You come in with a narrow perception you personally have made from your own situation and ask us to form an opinion? You've given nothing for anybody to form an opinion on. Sure, you can inspire some anecdotes, which are always touching to read, but there's no discussion as such.

Athon

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Old 21st April 2007, 05:42 PM   #34
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Originally Posted by athon View Post
It really does strike me as sad that a person can be medically trained... yet completely lack any science skills such as basic research and opinion support.

Athon
I'd like to note that doctors, like engineers, while relying on science, are not necessarily scientists themselves.
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Old 21st April 2007, 05:48 PM   #35
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Originally Posted by Jimbo07 View Post
I'd like to note that doctors, like engineers, while relying on science, are not necessarily scientists themselves.
As far as I know, medicine is classified as a technology profession, rather than a scientific profession.

However, there is a difference - many MDs are conducting scientific research, whereas that's rare with PEngs. So yes, "not necesarily scientists" is accurate. But many are.
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Old 21st April 2007, 05:49 PM   #36
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Originally Posted by Jimbo07 View Post
I'd like to note that doctors, like engineers, while relying on science, are not necessarily scientists themselves.
You know, I'd love to agree, however I can only take it one step further and say in my experience there are a lot of scientists who don't quite grasp science philosophy either. They 'know' a lot, but don't understand how the scientific process works. The scary thing is a lot of science teachers are in that boat.

Science illiteracy has a wide demographic spread, unfortunately.

Athon
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Old 21st April 2007, 06:03 PM   #37
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Originally Posted by skeptigirl View Post
BTW, for anyone wondering why I make such comments about this guy, he believes nurses are only capable of following medical orders and incapable of any independent decision making and SD believes nurse practitioners should not be allowed to practice at all, because they are incompetent. SD has no clue that, despite the fact one can get a doctorate degree in nursing, there actually is such a profession. To him, everything nurses do is merely carrying out doctors' orders. His attitude was so backward, several of us could not tell if he was a troll. I'm still not sure he isn't one. At a minimum if he isn't a fake doctor, he's a least a poor one.
Skepticdoc - I really hope this is not true.

As I said above my friend is a nurse and some of stories he has told me about doctors are quite scarry. He has saved more then one life from a doctors mistake. If he had done what the doctor had told him to do they would be dead.

It's been my experience that nurses are over worked and under paid. You would fail in your duty of care if it was not for the nursing staff.

It is very important what you think. Your a doctor and your thinking may effect the outcome of someone's life.

This is probably for another thread though.

ETA - Big fan of Joseph Campbell myself

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Old 21st April 2007, 06:09 PM   #38
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Originally Posted by skepticdoc View Post
It is a common belief/perception among Physicians and Nurses that in many terminally ill patients, there is a brief period of clinical, well being improvement shortly before death.

I just had an octogenarian with multiple problems (COPD, Cardiomyopathy, ESRD, PVD) that refused mechanical ventilation, hemodialysis and tube feedings. As expected, he continued to deteriorate, hung around until his only available relative came from a neighboring state. The day before expiring, he "perked up" slightly (smiled briefly, gestured he was not in pain).

I had started a thread in the Skepticalcommunity.com : http://skepticalcommunity.com/phpbb2...hlight=#242655 that has some bearing on this topic.

My question is: if Consciousness is just the product of neurons interacting, why would there be any improvement in consciousness as the body continues to deteriorate? My mechanistic interpretation would be that all bodily functions are directly related to the cellular milieu, as the machine slows down, everything should slow down.

Please post or PM any responses, opinions. I will post this in other forums to get opinions from other skeptics and also believers.
Much of the human system is controlled by the brain. QED.

Nothing odd here, in my opinion.
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Old 21st April 2007, 06:30 PM   #39
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Originally Posted by blutoski View Post
However, there is a difference - many MDs are conducting scientific research, whereas that's rare with PEngs. So yes, "not necesarily scientists" is accurate. But many are.
Heh... can you imagine the hue and cry if you dared to suggest that some of them aren't even practicing engineering?

There are MDs who do not conduct scientific research. I don't know what the entry requirements are in the U.S. but here, people who get accepted into Med School often have degrees already. It wouldn't surprise me if some doctors had more education than 'just' their medical degree. In fact, I know guys from my department who have gone into Med School. It may be that they want to do research in radiation therapy.

Originally Posted by athon View Post
You know, I'd love to agree, however I can only take it one step further and say in my experience there are a lot of scientists who don't quite grasp science philosophy either. They 'know' a lot, but don't understand how the scientific process works.
I've heard this.

Quote:
The scary thing is a lot of science teachers are in that boat.
In our department (physics), education students need only study up to mostly 2nd year classes with a small smattering of 3rd year classes.

Quote:
Science illiteracy has a wide demographic spread, unfortunately.

Athon
Agreed.
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Old 21st April 2007, 08:11 PM   #40
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Originally Posted by skeptigirl View Post
My coping strategy?

Skepticdoc, suffice it to say, I don't yet have reason to believe anything you say. As disgusting as your condescending attitude toward nurses is and as poor as you've demonstrated your capacity to understand evidence based medicine to be, I'm still not convinced you are a doctor.
Nominated.

I have nothing personal against skeptidoc and don't know the history behind this, but I know several nurses , physios and radiographers and I know they're going to love this quote. I laughed aloud as I read it.

That "still not convinced" cuts like a teflon coated scalpel.
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