A few years ago, I was working in the intensive-care unit when an elderly male, pale as chalk, was rushed into one of the empty rooms. He had recently been admitted to the hospital with a brain aneurysm so large that it was threatening to burst. But before he could get surgery, his heart stopped. After almost an hour of CPR failed, the man’s surgeon went to the waiting room to tell his family he didn’t make it.
Fifteen minutes later, as I was managing a patient with a serious infection, a nurse came up to me and said that there was a problem: The dead man had a pulse. I went back to the man’s room and saw a clear, regular rhythm on the heart monitor. His wrist had a thready beat.
The man had experienced something extremely rare: auto-resuscitation, also referred to as the Lazarus effect. Sometimes patients spontaneously recover a pulse after all resuscitative efforts have failed. It’s hypothesized this occurs because of some residual medications floating around in their sera, which provide a final push to their hearts to start beating. Whatever the cause, these patients’ resurrected heartbeats almost always fade again soon.
Humanity has always sought to draw a clear line between life and death. In the 1800s, physicians went to increasingly absurd lengths to determine if someone had died. One such test involved the insertion of long pins through cadavers’ chests all the way down to their hearts; tiny flags attached to the ends of these pins were supposed to signal beating if they flapped. Modern medicine developed tools to sharpen this line, but it achieved quite the contrary. Now that monitors can detect the faintest of activity in the heart and brain, and technology can sustain bodies in which the brain, heart, or lungs have failed, the distinction between life and death is blurrier than ever.