Note from Emma Balmer: I am a licensed funeral director and embalmer and I write about matters concerning death and the funeral service industry. I like to look at the lighter side of mortality. Even though my articles are often written in a tongue-in-cheek manner, it is not my intention to make fun of the dying, bereavement, or funerary processes. I take death seriously when I have to, but I'm also able to laugh about it at times. Like most morticians, this helps to keep my sanity intact.

The fear of being buried alive has the ability to chill you to the bone and rattle your soul. How terrifying would that be!? It's hard to even think about. As a mortician, I have a different but related concern... what if one of my client bodies ended up being alive! I've been asked what I'd do in that situation, and the answer is simple, run. Run hard and run fast. There would probably be some screaming in there too.

My boss and I just returned from a burial at the city cemetery. We got to talking to the gravedigger. One thing lead to another and we ended up conversing about premature burials and what we'd do if we heard a knock from inside the casket. We took a moment to ponder that scenario and we stared at the shiny pink casket next to us as we imagined in silence. Shaking our heads after a minute, we decided that it wasn't something we really wanted to creep ourselves out over.

Sitting in the hearse on the way back to the funeral home, I wondered, are the urban legends true or false? We hear those stories ever once in awhile, but no mortician I have ever known has seen it. This primal fear dates back a long long time. To better understand the theory and fear of premature burial, it's best to know the history.

For as long as there have been humans, there has probably been the fear of being buried alive. I mean, death is pretty final and it happens to us all. Back in the day, it was a serious concern.

First of all, physicians in Medieval times (and later) didn't have the education that today's doctors do. Those physicians just started studying as an apprentice under someone and got on-the-job-training so to speak. Also, they were reported to have relied heavily on potions, concoctions, spells, and even witchcraft. Misdiagnosis was a common thing back then and some people were sent to their graves accidentally when they were actually still alive.

Secondly, various fatal diseases (like the plague) were a huge concern and great effort was taken to dispose of contagious dead bodies as quickly as possible. They made haste in order to avoid infecting the living. It seems like a great idea, but unfortunately some sick people could have been mistaken for dead and buried alive. Writing about this reminds me of that funny scene in Monty Python and The Holy Grail :) The "I'm not dead yet" scene. Hilarious by today's standards, but extremely serious business back then.

Different cultures have their own ways of preventing premature burial, and some are better than others. Let's look at some of those practices from around the world.

"All I desire for my own burial is not to be buried alive." - Lord Chesterfield, 1769

Many customary acts were performed by different cultures to test for death in order to avoid premature burial. Most of them seem rational while others probably didn't work.

The Roman Test of Death

Roman mythology states that the soul can rest in peace only when the body does. Until the body is at rest, the spirit of the decedent is said to haunt because it's angry. To make certain that the body was dead before burial, a male family member (usually the oldest son) would yell out to the body and call its name. This was called conclamatio. If after calling out the decedent's name the body did not respond, the eyes were then closed and the body was washed with warm water, anointed, and positioned.

The Greek Test of Death

In Mediterranean countries the dead have always been buried very soon after death. The people of Ancient Greece simply washed the dead body with warm water to see if it produced a reaction of some sort. Perhaps they thought that the temperature of the water would arouse some sort of physical reaction. If nothing happened after the ceremonial washing, the casket was (still is) left open during the funeral service just to make absolutely certain that the body didn't come to life.

The Hebrew Test of Death

The Hebrew people didn't embalm their dead (still don't) so to ensure that the body was dead, they would hold long wakes, or watches, in a sepulcher (tomb). By watching over the body, the living can be certain that it didn't move and they could watch for the early signs of decomposition (abdomen turns green).

Most cultures use the "wake" method of preventing premature burial. It's probably the most practical way to go to make absolutely certain. In fact, we still use this method; only today the ceremony is usually called a Vigil or Viewing.

"Swear to make them cut me open, so that I won't be buried alive."- Said to have been Frederic Chopin's last words

Even if all of the measures were taken to ensure that the dead person really was dead, people were sometimes still concerned that the body was buried alive. Marketing toward this concern, unique burial receptacles were created that were able to indicate to the living whether life still existed in the grave.

One of these coffins was even marketed by inventor Christian Eisenbrandt from Baltimore, MD. He claimed to have "new and useful improvements in coffins" and he called them "life-preserving coffins in case of doubtful death".

These coffins were made with things like lids, flaps, air holes, signaling bells, and even electrical alarms. Most of them were created to save lives before burial took place, but other were designed to operate even after the body was interred.

These coffins stirred some interest within the death care industry, but evidence of them actually being marketed hasn't been found. But as you can see by the number of inventions imagined, there was a great concern about being buried alive. Stories of people being buried prematurely are legendary and they always attract a lot of attention because everyone dies. That means that everyone has the same risk of being buried alive. (Rest assured that it is a very distant possibility!)

These stories have been around forever. Some of the stories are frightening and others are just embarrassing. Like the magician, Simon Magnus (Simon the Sorcerer), who tried to prove that he was a God and flew around in the air and also buried himself alive to prove that a miracle would happen (it never did).

Or how about those stories of bodies being dug up after burial and scratch marks being found inside the coffin lids. Pretty creepy stuff. The internet is riddled with these tales, and I like to think that premature burial doesn't happen nowadays. At least, I hope it doesn't.

Here are some websites that contain detailed urban folklore (and actual events):

http://www.snopes.com/horrors/gruesome/buried.asp

http://urbanlegends.about.com/od/horrors/a/buried_alive.htm

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/08/28/waids128.xml

Advanced medicine. That's the reason we don't have so many accounts of premature burial today. Great measures are taken to ensure that the dead are indeed deceased. Doctors, nurses, and other certifiers can check things like pulse, blood pressure, pupil dilation, and heartbeat. Instruments like stethoscopes, 3-lead EKG monitors, and cuffs help do this efficiently and accurately.

State laws usually have a time period that has to elapse before a body is cremated or buried. Even though this may not be to prevent premature cremation/burial, it helps make sure the person is dead.

A sure-fire way to make sure a body is dead is to have it embalmed. Nobody can live through that process because harsh chemicals replace the body's blood in the circulatory system.

Like I said at the beginning, my boss and I were talking to the gravedigger this morning about people being buried alive. When my boss started telling the story in the hearse on the way back to the funeral home, I realized why he wanted to wait until we were alone to tell me this tale. It probably would have creeped out the gravedigger too much.

He was driving and I occupied the only other seat suitable for a live body. He said, "You know, my brother-in-law is an embalmer for one of those big firms on the Bay Area outside of San Francisco. And there was one time that he started to embalm a living body."

He said it without exclamation. He was completely serious and I was silently waiting to hear the rest. He had my full attention.

"Yeah... the removal company picked up this dead lady from a nursing home and brought her to the embalming facility. When my brother-in-law made the incision in her neck to raise the carotid artery, he noticed a slight pulse in the artery! Good thing he didn't cut it. Instead of freaking out like I would, he called 9-1-1 and the medics showed up. After taking her to hospital and treating her, they took her back to the nursing home. Then like 2 days later, she died for real and ended right back up an an embalming table at that facility. It really unsettled my brother-in-law so he had a different embalmer take care of her. He didn't want to cut into her again!"

That is an honest-to-God true story. And can you believe it, the guy still works as an embalmer! I would have run out of that room with my mask and gown on and everything, screaming and running for miles, I think. It's hard to know exactly what I'd do. What would you do in that situation?