Is there pain after death?

A grandfather-father-husband-salesman-cook-gardener-hiker-gentleman, adored by many, is struck down by cancer.  His disease is particularly horrible, spreading quickly though his body causing damage not only to bone and organ, but to sinew and nerve. He suffers terrible pain for weeks, relieved poorly with inadequate doses of inferior medications, thrashing in misery witnessed by his kin, always at the bedside, ages seven to seventy.  Finally, uncomfortable and agitated until the end, he dies.  Does his pain continue after death?

Pain that is not relieved in a person’s life continues after they are gone, held as a sordid memory by loved ones.  Just as we retain treasured thoughts of joy, wisdom and warmth, we preserve images of pain.  Unrequited suffering contaminates memory, preventing healing, healthy grieving and closure. This pain in turn flows across our communities, touching many who may never have met the patient.

This does not have to be somatic discomfort to be treated with pain medication.  Shortness of breath, seizures, nausea, wounds and bleeding cast intense images that last more than one lifetime.  Uncontrolled anxiety or fear may contaminate a family and corrupt its fiber, as can loss of spiritual path, loneliness, or guilt.  Failure to settle past wrongs or mixed intentions results in a loss of opportunity, a psychic wound that will never heal.

A poorly managed end-of-life experience can transform families for generations.  I recently heard of a young man who suffered a miserable protracted death from cancer.  This resulted in his wife becoming chronically depressed and isolated from her family.   She committed suicide, leaving their son a life as an alcoholic and drug addict.  The ripples from that one cancer spread out and, through the network of that family, caused pain for many more.

When we think of end-of-life planning, we focus on those immediate moments for the patient and family, as well we should.  The opportunity to live one’s life well, even at its end, should not be denied, and must be the first goal of palliative medicine and hospice.  However, we cannot overstate the need and potential to protect and even nourish future generations by treating pain of all types in patients with terminal illness, and in families sharing that passage.

There is pain after death, and I suspect it is the cause of much waste, anger and tragedy in our society. We must strive to prevent that suffering.  Good things are possible, loved ones can be together, memories shared, and solid foundations laid. Patients, families, doctors and caregivers must protect and treasure even this difficult time of a person’s life, because as one life ends, others are beginning.

 

 

11 Comments

  • James you tackle many difficult subjects with a refreshing openness of heart. As an interconnected global society, I write from a rain splashed South of England, we need to address with all of our compassion and caring attention this issue of easing the end of life. It has been said many times..'I wouldn't let my dog suffer like that.' We need to really look at what this means and into how we can together, act with love and responsibility. Taboo and fears often pull us up short. Do not read into this that I advocate euthanasia..I don't. But we do need to come with fresh eyes and without fear to discuss this topic that you raise...when death is inevitable and distress and pain are not eased by palliative care.
    • James Salwitz, MD
      Your are so right; as an interconnected global society untreated pain eventually affects us all. Death is indeed unavoidable, but there is much more to be done to prevent suffering and improve life. jcs
  • ramamohan
    What a coincidence, I practised this exactly, for a very dear friend MY DOG, ! He lived a life of diginity, and I followed it, even when he died, a month ago, by searching for a decent burial place in this crowded city, I live. He died due to stage 4 cancer , without suffering, or make us, his family, humans to suffer. According to me someone GOD , listens to our intenionality , he listened to me and helped, I now have a feeling of fulfillment .I got a very decent burial done for him and kept up his diginity, of life , as a Dog, for 14years.
    • James Salwitz, MD
      That is really wonderful. I think it says great things about the soul of man when we show compassion to other creatures...especially those we love. jcs
  • [...] Posted by James Salwitz, MD on Oct 5, 2012 in Cancer Care, Featured, Life & Health | 4 comments [...]
  • I have reblogged your post. I hope you do not mind. I linked this post back to you. http://tersiaburger.com/2012/10/06/is-there-pain-after-death/
    • James Salwitz, MD
      I am flattered ... Thanks ... Jcs
  • [...] Pain continues after death.  Agony is remembered by friends and family long after the patient is gone; the ripples of suffering affect the future. [...]
  • IBS
    PAIN FOR THE PATIENT IS BOTH EMOTIONAL AND PHYSICAL. HIS OR HER BELOVED ONE DOESN'T SUFFER PHYSICAL PAIN AFTER DEATH. EVERYONE HAS DIFFERENT PAIN TOLERANCE AS A PATIENT. SOME ARE LUCKY ENOUGH TO CLOSE THEIR EYES AND THEY LEAVE THIS EARTH; WHILE OTHERS SUFFER. I AM A VERY SPIRITUAL PERSON, AND THERE IS NO MORE PAIN FOR THE PATIENT ONCE THEY'VE PASSED. THEY ARE HEALED AND SO ARE OUR ANIMALS. I HAVE HAD TOO MANY EXPERIENCES WITH PEOPLE THAT HAVE PASSED, AND THEY ALL SAY THEY'RE OKAY. I AM NOT A PHYSIC JUST VERY SENSITIVE AND EMOTIONAL. YOUR BELOVED ONES WILL THEN BE STANDING BY YOUR SIDE. I SWEAR TO YOU THIS IS TRUE. I HAVE BEEN UPSET LATELY WITH ONE DAUGHTER BEING OPERATED ON THE WEST COAST, AND MY YOUNGER DAUGHTER IS SUFFERING FROM PRECLAMSIA: HIGH BLOOD PRESSURE AND PROTEIN IN HER URINE. THE DANGER IS TO THE MOTHER AND NOT THE BABY. THIS MAY MAKE MY HEART BREAK. I DIDN'T HAVE MY CAREGIVER HERE LAST NIGHT, BUT ALL OF A SUDDEN ONE OF MY DOGS THAT HAD PASSED STARTED BARKING. SHE WAS TELLING ME SHE WAS STILL WITH ME. I WAS THEN ABLE TO SLEEP. FOR THE CAREGIVERS, PATIENTS WANT TO KNOW THEY WERE LOVED. I USUALLY HOLD THEM IN MY ARMS, PLAY SOFT MUSIC, AND TELL THEM ALL THEIR LOVED ONES ARE WAITING. YOU ALSO CAN TELL THEM THEY CAN LEAVE WHEN THEY FEEL THEY'RE READY. TELL THEM YOU LOVE THEM AGAIN, TOUCH THEIR HAIR AND WHISPER IN THEIR EAR IF YOU WANT TO SAY SOMETHING BEAUTIFUL AND PEACEFUL TO THE PATIENT.
    • James Salwitz, MD
      Thank you for your wonderful words, jcs
  • Shruti
    Sir Can u please provide me with evidence/research that shows "is death pain" thank you

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