The disease or malady or stroke of misfortune that will ultimately kill you is likely different from the one that will kill me. But our final hours will likely be quite similar, or so says Dr. Sara Manning Peskin in a piece for the New York Times. Peskin, a neurology resident at the University of Pennsylvania, writes that "dying has its own biology and symptoms," and as far as symptoms go, she calls out three: the death rattle, air hunger, and terminal agitation. There's a good chance you'll experience at least one, though in a small bit of comfort she notes that while they "appear agonizing," they don't typically feel that way, particularly if medication is given. She explains each:
- The death rattle: The choice to take a dying patient off a ventilator brings with it the rattle, a sound Peskin likens to one "blowing air through a straw at the bottom of a cup of water." It's actually tied to swallowing, as the process to move our saliva out of our mouth but keep it out of our airway (via the epiglottis) misfires.
- Air hunger: Peskin defines this simply as "the uncomfortable feeling of breathing difficulty." She's less definitive about why it causes pain, but some research points to a hiccup between how fully our brain wants us to breathe and how well our lungs can actually inflate and deflate.
- Terminal agitation: This is a less typical occurrence and can make the body "appear tormented." Peskin writes that the dying patient's shouts or spasms can have physical causes (urine retention is one).
Read Peskin's full piece, which shares medication options for each symptom, here