December 11, 2023

What happens when you die: Palliative care doctor speaks out to ‘tackle the fear’

The retired doctor said she wanted to tackle the fear that many of us have around death and dying. Photo / 123RF

A retired palliative care doctor has spoken out about what really happens to us when we die, saying she hopes to “tackle the fear” many of us have about the end of life.

64-year-old Dr Kathryn Mannix joined host Emma Barnett on the BBC’s popular Woman’s Hour show to break down the process, which she has explained in her new short Dying for Beginners animation.

Mannix likened the process to an “old mobile phone” that was getting harder to charge.

Discussing the fear that many have of experiencing death, Mannix explained that most of us won’t realise it is happening.

“It’s not a frightening mental state to be in,” she said. “It’s a state of not knowing anything.

“The first thing that’s noticeable is just that the body starts to run out of energy, almost like when you’ve got an old mobile phone and the battery won’t stay charged.

“And the charger is sleep. More than food, more than drink. In fact, a lot of dying people don’t feel very hungry and that’s fine. They’re not dying because they’re not eating. They’re not eating because their body is dying.

“So as time goes by people gradually need more sleep to give them intervals of enough energy to think and do what they can. And gradually people become not just asleep, but unconscious,” she said, noting that, at that stage, we won’t recognise the difference.

Addressing the high drama often ascribed to our final moments by Hollywood, Mannix told the BBC that, although some aspects of the process might be disconcerting for friends and whānau, it was all part of the body shutting down.

She said that the laboured breathing, sometimes known as the death rattle, that accompanies our last hours is just a bodily reflex.

“The brain runs reflex breathing patterns that move backwards and forwards between quite deep breathing that gradually becomes more shallow,” she explained.

“And then back to the beginning again, and backwards and forwards between periods of quite slow breathing, more rapid breathing, back to slow breathing again.

“Now if you haven’t seen that before, you might think that the person who is breathing, perhaps fast but shallow, is struggling to breathe or is panting or is uncomfortable. This person is quite safe,” she noted.

“And then at the very end of somebody’s life, there will usually be one of those slow breathing phases.

“There will be a breath out that just doesn’t have another breath in after it, which is not at all what Hollywood has led us all to expect.”

She said she hoped to alleviate some of the fears around what she calls “ordinary dying”.

“We can’t make it not be sad, but to take away the fear, I think, is the mission that I’m on.”

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