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Season 12 | Episode 5

Dead Reckoning

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From a duel with the world's deadliest disease to a surprising peek into the way doctors think about death, in this hour Radiolab tries to reckon with the grim reaper. And, in the end, we confront the question at the heart of it all — when the time comes to finally leave, how do we want to go?   

Guests:

George Church, Sean Cole, Dr. Amy Gilbert, Tim Howard, Monica Murphy, Dr. Sergio Recuenco, Bill Wasik and Dr. Rodney Willoughby

Rodney Versus Death

What do you do in the face of a monstrous disease with a 100% fatality rate? In this short, a Milwaukee doctor tries to knock death incarnate off its throne.

Comments [7]

Stayin' Alive

A look at four unconventional ways to stay alive.

Comments [2]

The Bitter End

We turn to doctors to save our lives -- to heal us, repair us, and keep us healthy. But when it comes to the critical question of what to do when death is at hand, there seems to be a gap between what we want doctors to do for us, and what doctors want done for themselves.

Comments [8]

Comments [24]

I accidentally started to listening to this one recently and found it even more infuriating than the first time. Were the parents charged with child neglect? Was the daughter taken away? It doesn't matter how low your level of education is, how could someone know that their child was bitten by a bat and do NOTHING?! It's really depressing to know that there are people out in this country that display this level of neglect and are still present in normal society and not imprisoned. HORRIBLE parents, that poor girl!

Apr. 23 2014 11:21 AM
Stephen Magan from Honolulu, HI

There was a song you played about 40mins into the show. I had heard it before in the documentary "Fog of War". Can you tell me the name of the song?

Mar. 13 2014 03:20 PM
Chris Ruppe

What would doctors do if it wasn't brain damage or dementia.? If it was not life threatening? Would doctors do chemo if they had cancer? Would they not do major surgery, dialysis, CPR etc. under any circumstances or just when dementia or brain damage was involved?

Mar. 10 2014 01:16 PM
m

transcript please or a "print" button. Many I know need this info.

Mar. 04 2014 04:15 PM
Dr. Qian Xinzhong from Portland, OR

Prayer does not conflict with science. Scientism is far more dangerous for the advancement of science than any parent doing their best with what they know. Accepting doctor or scientist advice simply because they are an "authority" and not having ones own process or questions leaves one too many things in the hands of those who may not have the right answer for the individual. I'm glad Radiolab was respectful to the parents of the young girl who survived.

Also here in Oregon, we're allowed to privately bury our loved ones. Of course there are rules that apply, but so far no "chronically ill" buried people have poisoned our water or spread their mutated genes into our precious artisan crafted small batch bacon flavored beer.

Feb. 25 2014 08:23 PM
Sara from Foxfield Preserve from Canton, Ohio

I always enjoy your show, and was particularly thrilled to hear such a beautiful description of a natural burial, or 'Abbey burial', in your recent episode, Dead Reckoning.

I operate the Foxfield Preserve nature preserve cemetery in Ohio (foxfieldpreserve.org), one of the many places in the country where this type of burial is being encouraged. Our burials encourage the body's return to the earth, without the use of any embalming fluid, concrete vaults or steel casket. Burials take place in a nature preserve, either in a prairie of wildflowers or in a hardwood forest, and all proceeds benefit nature education and conservation in our community.

This movement is gaining ground across the country, as more people are searching for a more environmental alternative to our modern burial traditions (greenburialcouncil.org). Though natural burials are simple, they are incredibly meaningful. As you tapped into in your description, there is a spiritual element at play in knowing that your personal loss will provide life for many other organisms. It is a scientific equivalent to 'life everlasting.'

Thank you for all your great work!

Feb. 25 2014 03:30 PM
John from Pennsylvania

Thank you for exploring this topic. I have a 23-year old brother who suffered a severe traumatic brain injury three years ago. For several months, he was in a coma, and kept alive by a ventilator. It took us two years of agonizing trips to the hospital and establishing home healthcare accommodations before we learned that he was unable to recover, and that within several years he would die from this stressful and deteriorating condition. My brother now has limited consciousness and is bedridden, but can still laugh and smile. My family and I are grateful for the bright moments that are left for us to share, even if it is difficult to see him in so much pain.

The past few months, he has been having seizures. Standard protocol was to take him to the hospital after these episodes. He would be stuck full of IVs and put on machines if necessary. The stays typically lasted several days, and were clearly trying and uncomfortable for him. So, several weeks ago my parents made the decision that, in the future, they would avoid hospital visits. Instead, to fight seizures they have enlisted a hospice care provider to give my brother sedatives. If he goes into a coma and dies, he will do so at home. This was an extremely difficult decision, but my parents did what they thought was best. Healthcare providers disagreed; doctors were very curt with my parents when informed of their decision, and our home nursing agency actually refused to service us any further, causing my parents to switch providers.

Listening to this episode gave me a good deal of reassurance. There is no quality of life on a ventilator, especially if it's not going to save you in the first place. My brother has been off machines for a while now, and we have every reason to believe that we have a few more years to share that wonderful smile. But when the time comes and he's going to go, he will do so naturally, in a comfortable place, surrounded by people who love him. Thank you again, I am grateful for listening.

Feb. 24 2014 08:52 PM
raffy from Aruba

The molecule discussion is very cute indeed. Would you ever wander the thought that we are more than just that? Just consider the immense infinity of things we yet don't know. The probability that we are more than molecules and cells is astounding. Just take the whole evolution of the knowledge about rabies...goes to show that we don't know enough about what exactly we are composed off to so strictly limit our being to our molecular manifestation.

Your dad understands what it is to sustain life! Superdad! And I think more of us have to understand this bit. And I realize it's easier written then done. Thanks for all the planning advice.

Feb. 23 2014 11:46 PM
Henry Thompson from KSUT, Pagosa Springs, CO

Dear Radiolab,
I am extremly pleased that my NPR station that I support has brought your program on.
After listen to the broadcast "Dead Reconing" I made a bucket list...

1. Get a rabies shot.
2. Speak with my laywer about an "Abby burial" ( I cannot suffer being contained either)
3. Tatooing "DNR" on my chest or having a card in my wallet stating so (hope they read it first)
4. Leaving half of my retirement to NPR for what I will never hear anywhere else.
5. Great job gentlemen!

Henry Thompson

Feb. 23 2014 05:30 PM
Tova from Everett, WA

How could a modern day, middle class family not know to see a doctor immediately after their child was bitten by a wild animal? Her illness and fight to live was a failure born of poor parenting. Perhaps if they spent more time in a biology book and less time in church they could have avoided the whole thing. Her survival was not an act of god, her disease was.

Feb. 23 2014 03:47 PM
Dave from Mahanoy City

I would first like to acknowledge what a wonderfully informative, thought-provoking, and entertaining program you have. However, like a prior commentator, I too must say something about not so much the mention of prayer in your story about the girl with rabies, but your lack of response.

I could see not seeking to engage in discourse with the parents as perhaps a kind of sensibility, but when the physician mentioned that he had prayed, and you didn't respond - that was truly remiss.

If the physician had said that he had sacrificed a goat, burned incense, or prayed to Odin, would you not have inquired as why? The equally improbable, and irrational Judeo-Christian god should have evoked the same type of response.

By not responding you lent tacit validity to the myth, and the ritual of invoking a deity to alter the outcome of human events. If it did in fact work, then all the data from every study, or experiment ever done, where someone, anyone prayed to affect the outcome, must be discarded, and the study run all over again.

Feb. 23 2014 02:38 PM
Pat from sinsinawa wi

Excellent information. I wish I could get a printed form of Dead Reckoning

Feb. 23 2014 01:27 AM
Lara Barringer from San Diego, CA

This just tickled me to death,loved this episode, made my heart skip a beat. Thank you!

Feb. 23 2014 12:36 AM
Gretchen Brauer-Rieke from Oregon

As an Advance Care Planning Facilitator, I hear stories all of time of the trauma families go through when a loved one has a health care crisis that brings them to the end of life, but have not left clear wishes about what medical interventions that they would or wouldn't want in that situation. Without your wishes clearly documented (and backed up with discussion with your loved ones), you are likely to get aggressive, but futile medical care that prolongs your dying while seldom prolonging life with any quality. Please, please - find your state's Advance Directives (and, if appropriate, a POLST or MOSLT) and fill them out. Talk about them with your loved ones and your health care professionals. Listen to the doctors in the study who understand the burdens that go along with aggressive medical treatment at the end of life. If you want to die peacefully at home, you'll need to plan in advance - don't wait until you can no longer speak for yourself and place your family in the difficult, stressful position of withholding or withdrawing treatment.

Feb. 22 2014 10:29 PM
Don Gateley from Santa Cruz, CA

It may be here somewhere and I have missed it but how can I get a copy of Jad's father's last medical will and testament?

I want to put this on a medical alert USB bracelet with directions where to find the signed copy so that I can be sure it is seen should whatever happen. I'm older and without family so it is especially important that I be able to wear it.

Feb. 22 2014 07:04 PM
Lynn from San Francisco Bay Area

Thank you, a million times thank you! Yes! to Green burials, what a lovely description for how and why that makes beautiful sense..
And even more,much more, Thank you a billion times over for your piece on doctors' almost categorical preferences to NOT be treated in the event of brain tumor (and by implication, dementia.)

So few people, as your man-on-the-street questions revealed, have any clue how end of life treatments are, indeed, worse than what we do to terrorists.
Ten of my family members died within the last 10 years, and those who did not die suddenly, had miserable horrible drawn out suffering because of medical interventions.

In summary, after multiple family members were put into the hands of the medical industrial complex they all died horrific science experiment deaths - all to benefit the industrial medical complex and play off of the ignorance and guilt of their family members, who are tasked with making decisions that they don't have the experience and/or knowledge to be making. And what's worse, those family members who can't handle the psychological and spiritual reckonings of death would probably make the same stupid ass decisions to over-treat, again.

One thing I would like to specifically include, is that, even the choice for "palliative" care can cause undo suffering if one isn't very sophisticated and assertive as to the details. E.g., choosing a hospice provider that uses high quality pain meds, instead of cheaper methadone, for example, is extremely important. And choosing a hospice provider that doesn't stingily parse out the pain meds is also important. Once you sign over your health care payments, to a hospice agency, it is very difficult to reverse.

Your show is so very important, not just this spectacular episode, but in general.
I will be recommending this episode to everyone on Facebook and emailing it to all and sundry.

Best regards,
Lynn

Feb. 22 2014 06:31 PM
Mareck Scott from Minnesota

Terribly dissapointed to hear prayer given any validity in a scientific setting. What a slap in the face to those who pray every day for a cure for disease or a regrown limb. Did these people simply not pray hard enough? The supernatural did not save Gina, guide Rodney nor "heal" anyone.

Feb. 22 2014 05:55 PM
Rose

The story about Gina getting rabies completely stunned me when I heard that she was bitten by a bat, then simply washed it off and went on with her daily life. When I hear about bats and the rare occasion of being bitten, I immediately think of rabies. How could she NOT have gone to the hospital straight away and get checked?!!

Feb. 22 2014 05:11 PM
anne fitzmaurice from Berkeley, ca

You didn't do your homework about burial without a coffin. There is a widely supported and well-known movement in the U.S. that advocates for "green burial." Seven cemeteries in the U.S. offer this service, and I have purchased a 'green bueial' gravesite at Fernwood Cemetery in Mill Valley, CA. I will be buried in a shroud, not a coffin. I will not be embalmed, and there will not be a cement lining in my grave. I will have a simple rock, not a carved stone to mark grave. The bulk of the acreage at Fernwood is devoted to green burials. I would guess that if you Google on 'green burial' that you'll get a great deal of informaiton.

Feb. 22 2014 04:46 PM
Kin Ellentuck from Baltimore, MD

I always find myself scratching my head when I hear talk of "green" funerals or an Abbey burial as being different and abnormal. Jews and Muslims bury their dead this way everyday as they have been doing for thousands of years. Because there is no embalming funerals are usually held within a day or two of death. Jews are wrapped in a shroud and placed in a wooden coffin. Whether the coffin is an expensive mahogany casket or a plain pine box, there is never metal, it is made entirely of wood so that it will breakdown and become part of the earth again. Muslims do not embalm their dead either, most often the body of the deceased is wrapped only in a cloth shroud for burial. Ashes to ashes, dust to dust.

Feb. 22 2014 03:20 PM
Sandra Lindsay from Umatilla, FL

Hello, I am listening to the Dead Reckoning episode of Radio Lab. I am a 20 year critical care nurse. I would like to comment on the person who wanted to have a burial without a coffin. I was intrigued with the idea of returning the body back to nature. Then I thought about when I visited the Catacombs in Paris. All of the corpses were gathered from the graves and gathered in the catacombs out of fear of diseases.

The idea of returning the body to nature is fine if the body was truly all natural. However, our bodies are not just our own. We share them with millions of microbes, living out their whole lives on our skin and inside us such as in our GI tract. Many of us have had antibiotics to wipe out many of these microbes at one time or another. The microbes that regrow are the ones that are more resistant. Chronically ill people are often colonized with several types of these mutated bacteria. An all natural return to nature could harmfully alter nature if the person had chronic illness or lived in a nursing home where mutated bacteria and pathogens are shared.

By the way,

Feb. 22 2014 02:03 PM
Kris Klosin from New York

I heard on your show a few days ago a Harvard professor saying that death may be reversible. More specifically he said that if we could record the position of all atoms in a human body, we could then potentially recreate this configuration at a later time even after the death of the person and thus bring the person back to life. However, to do this we would not only need to record the positions of all atoms but also their velocities (i.e., possess full information about the dynamical system which is human body). But at an atom level (in truth, at any level) this is impossible due to the Heisenberg uncertainty principle. Because of it we can never gain full information about a dynamical system, hence we will never be able to fully recreate the same system.

Feb. 21 2014 10:31 PM
Erik from Columbus

I want to say something about CPR.

Yes, you could crack ribs and even damage organs with the use CPR. But let's be serious. If you suffer total cardiac arrest, your chances of survival already collapse. CPR is not meant to be a thing that will cure you of your cardiac arrest and you end up being fine. If you suffer cardiac arrest (which is when you need CPR) your long term chances of survival completely drop off the map. This episode really makes it sound like CPR is futile, dangerous, or both. Effectively encouraging people to not to do CPR. This kind of logic would also suggest that defibrillators are worthless.

Look, if I suffer a total cardiac arrest, I know that the grim reaper is knocking on the door. But that doesn't mean I want someone to look down at me and say, "eh, f--- it, he's dead in a month anyway." If I suffer cardiac arrest I'll probably get very little warning, and if I get a few minutes to be awake to say my goodbyes, then I want those minutes. I just want those couple minutes are enough if I can get them. After that you can toss me in the freezer.

Also, CPR in a hospital room is different from CPR in your house. If you require CPR at the hospital, you're probably on your way to the pearly gates by then. But if I'm in the grocery store, do not step over me and continue to shop. I'm not a Monty Python skit.

Feb. 20 2014 06:22 PM
Steve from Bloomington, IL

We wait so long for new episodes and get so few in each season and then you spend a third of this latest episode covering a 10 year old story that is pretty widely known. It's kind of a big deal when someone survives rabies.

Feb. 20 2014 10:16 AM

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