Science and death: Why do some patients seem to get well hours before they die

It is not uncommon for people and health workers to witness a seriously ill person suddenly becoming active and showing signs of recovery.

Many experts call it a heartbreaking phase of ‘terminal lucidity’, a fleeting episode of increased brain activity and clarity before death. The phenomenon, though observed globally, is being studied to understand the changes causing it to occur.

Scientists often cite the case study of Anna Katharina Ehmer, a 26-year old woman with severe mental disabilities and who never spoke a word in life. The patient was reported to sing a song before she died. 

Many healthcare workers, particularly those working in intensive care units or ICU often report patients, especially those with dementia, schizophrenia, meningitis, neurological injuries and some kinds of cancer, to get into a lucid state (one with clarity of thoughts) where they start to think correctly, hold meaningful conversations or engage in small activities like having water or food, right before they begin to sink.

Importantly, most of these patients are usually impaired in their physical or cognitive abilities, with some having brain damage from stroke or cancer. Some of them are in unresponsive states and the sudden surge in energy causes the caretakers to be confused and sometimes relieved.

While loved ones often see this lucidity as a sign of recovery, patients often die after the episode ends.

As per a report, it is estimated that about 43 percent of people who experience this brief episode die within 24 hours and about 84 percent die within a week.

What causes it to happen?

Terminal lucidity is understood as a final surge of neurochemical activity or the dying brain temporarily overcoming damage, said the Cleveland Clinic.

Some researchers believe a lack of oxygen causes the starving brain cells to behave differently and enter this lucid state.

An expert speaking to Psychology Today said that the exhaustion of the over inhibitory cells or the sudden surge of brain activity can temporarily re-wire the circuits of memory or speech to come back to normal. More like a final raise before a car breaks down.

Some even suggest it could be the last push by the body for survival.

The phenomenon also closely ties with near death experiences which is also associated with lucidity and out-of-body experiences.

However, these are independent speculations into the mysterious phenomenon and there is no consensus among scientists on what exactly might be causing it to happen.

Why is it important to know?

As per experts, many of the terminal lucidity episodes happen in front of the loved ones.

Seeing a terminally, unresponsive sick person talking, sharing memories or asking for food can stir heavy emotions in the caretakers.

Many of them might rush to take them back home, thinking they are reviving.

However, some experts say it would be good for caretakers to be around them and remain present in this unusual moment. 

Scientists still don’t know who may get terminal lucidity, when it can get triggered or how long it could last in a person.

Though understudied, some suspect it could open doors to understanding the science behind biological death.