Fillers A memorable patient

Postmortem movements

BMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7180.393 (Published 06 February 1999) Cite this as: BMJ 1999;318:393
  1. John Parry, retired general practitioner
  1. Stafford

    One Saturday afternoon I was in the pit under the second hand Austin 10, our only transport at the mission hospital, tinkering with the transmission.

    Being the only doctor I was always on call so I was not surprised to see brown legs and hear polite coughs. “Ba Kantwa has died,” they told me. Puzzled because I was not usually called out to the village when someone had died, I gave my condolences. “But we are not sure she has died.”

    Hurriedly checking both statements, for my knowledge of the vernacular was still not too good, I got out and cycled down to the village to find a thatched hut full of people round a large hardwood bed on which lay a body under a snow white sheet, clothed as for burial. I soon established that she was indeed dead, and seeing some of our Christians there offered a short prayer for the departed and the relatives.

    To my further surprise agitated conversation broke out, and I gathered that some doubted that she was dead. Turning back the sheet I demonstrated all the points that led me to say that she was dead, and expected that that would quieten the murmurings. But no. “Tell him! Tell the doctor!” Timidly one said, “Doctor she is still moving her toes.” I pulled the sheet right off this time and there the right middle toe was gently moving up and down. The hair on the back of my neck followed suit. Once more I went over the signs of death as I wondered what to say, eventually giving my opinion that it was the result of the blood draining back to the heart in an irregular fashion.

    To my great relief one said to another, “Didn't I say it was that? I knew it wasn't anything to worry about. Fancy bothering the doctor with a thing like that.” Such was their relief I left them more in a party mood than that of a funeral. Later I worked out that irregular onset of rigor in the leg had probably caused the rhythmic movement. I wrote to my nearest colleague 80 plus miles away, a senior mission doctor. He said that he had heard of postmortem movement and thought that the rigor theory was probably correct. It also struck me how sensible the villagers were, looking for a rational explanation rather than fearing witchcraft. For my part I resolved to make a complete examination of the next corpse, toes and all.

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