It is believed that life to the last is fighting a battle with death. But scientists have suggested that the approach of death triggers the production of endorphins, especially in the absence of pain relievers. The author of the article in Conversation writes that a special process begins two weeks before the death.
For the first time after death, people often look as if they are asleep, a neutral expression freezes on their faces. But one of my relatives, who suffered from severe pain during his death hours and did not have access to medical care, had a radiant, ecstatic expression on his face. Could dying trigger the production of endorphins, especially in the absence of pain relievers? Goran, 77 years old, Helsingborg, Sweden.
The poet Dylan Thomas had a lot to say about death, particularly in one of his most famous poems:
Father, from the heights of curses and sorrows
Bless with all your fury -
Do not go resignedly into the darkness!
Don't let your light go out!
(translated by Vasily Betaki)
It is often assumed that life to the last is fighting death. But is it possible, as you suppose, to negotiate with death?
As an expert in palliative care, I believe there is a process leading up to dying two weeks before our death. During this time, people usually start to feel worse. As a rule, it becomes difficult for them to walk, they become more sleepy: periods of wakefulness are rapidly shortened. Towards the end of their lives, they lose the ability to swallow pills and take food and drinks.
During this period, we say that people "actively die", meaning that they have two or three days to live. Some, however, go through this entire stage in one day. Some people manage to hold out on the brink of death for almost a week, which, as a rule, is extremely painful for their relatives. Therefore, different processes occur with different people, and we cannot predict them.
The very moment of death can be difficult to recognize. But another unpublished study suggests that the closer people get to death, the more stress-related substances are released by the body. Cancer patients, and possibly other people too, have increased inflammatory rates. There are substances that rise as the body fights infection.
You suspect that there may also be an increased release of endorphins before death. But we do not know this yet, because no one has explored such a possibility before. A 2011 study, however, found that six rats had a three-fold increase in levels of serotonin, another brain chemical thought to be associated with feelings of happiness, at the time of death. We cannot rule out that something similar happens in people.
The technology for tracking endorphin and serotonin levels in humans does exist. Nevertheless, constantly taking tests, especially blood samples, is technically difficult in the last hours of someone's life. Moreover, it would be difficult to obtain funding for such a study. In the United Kingdom, £ 580 million was allocated for cancer research in 2015-2016, while less than £ 2 million for palliative medicine research.
There is no evidence that pain medications such as morphine interfere with the production of endorphins. Even the pain itself does not always draw attention to itself at the moment of dying. Based on my own observations and discussions with colleagues, I believe that if pain was not a problem for a person in the earlier stages, then it will rarely become so at the time of death. In general, it seems that in the process of dying, the pain is dulled. We don't know why this is happening - it could be related to endorphins. And again, no research has yet been conducted on this topic.
There are a number of processes in the brain that help us deal with excruciating pain. This is why soldiers on the battlefield often feel no pain when their focus is on something else. A study by Irene Tracy of the University of Oxford demonstrates the amazing power of placebo, persuasion, and religious belief in overcoming pain. Meditation is also helpful.
But what can cause the feeling of euphoria during death, if not endorphins and some other neurotransmitters? The slowing down of metabolic processes in the body affects the brain. Perhaps the way this happens somehow influences what we experience at the moment of death. American neuroanatomist Jill Bolte-Taylor described on a TED talk show that she experienced euphoria and even "nirvana" near death when her left hemisphere, which is the focus of numerous rational abilities, such as speech, turned off after stroke.
Interestingly, even though the Bolt-Taylor damage was on the left side of the brain, damage to the right side of the brain can also increase your feelings of being closer to a higher power.
In my opinion, there is a possibility that your relative had a deep spiritual experience or realization. I know that my grandfather, dying, raised his hand and finger, as if pointing at someone. My father, a devout Catholic, believes that my grandfather saw his mother and my grandmother. He died with a smile on his face, and this was a deep consolation for my father.
Buddhists regard the process of dying as sacred, believing that the moment of death creates a tremendous potential for consciousness. They regard the transition from existence to dying as the most important event in life, as the point when you transfer Karma from this life to others.
This does not mean that religious people in general have happier death experiences. I have witnessed an extreme state of anxiety among priests and nuns on their deathbed, perhaps overwhelmed by anxiety about their moral character and fear of condemnation.
In the end, everyone dies in their own way - and it is impossible to predict who will die in peace. In my opinion, those whose death I saw did not feel the production of an increased amount of substances that ensure good health. I think of younger people in my department, for example, who found it difficult to come to terms with the fact that they were dying. They had young families, and they never put up with the process of dying.
Of the patients I have observed, those who have somehow rejoiced at death and peacefully accepted its inevitability have experienced an ecstatic experience towards the end of their lives. Medical care in such cases can be important: a study of lung cancer patients who received palliative care early on showed that they were happier and lived longer.
I remember one woman who was IV fed. She had ovarian cancer and could not eat. People who eat this way run the risk of contracting serious infections. After the second or third case of contracting a life-threatening infection, the patient changed. A sense of peace emanated from her physically. She managed to leave the hospital for a while and drive home, and I still remember how she talked about the beauty of sunsets. I always remember these people, they always push me to think about my own life.
After all, we know very little about what happens when someone dies. After 5,000 years of studying medicine, we can tell you how people die from drowning or heart attack, but we don't know how people die from cancer or pneumonia. As a last resort, we can only describe this process.
My research focuses on trying to demystify the process of dying, understand its biological basis, and develop models that predict the last weeks and days of life. Over time, we can also move on to the study of the role of endorphins in the last hours of life and give a final and complete answer to your question.
It is possible that we are experiencing the deepest experience in the confused depths of the space between life and death. But this does not mean that we should stop feeling angry about the extinction of the light. As Swedish diplomat Dag Hammarskjöld said: “Don't look for death. She will find you herself. Look for the path that turns death into achievement."