If you’ve ever wondered how, precisely, people die, we can tell you the one place you should not look for answers: television. On TV, sometimes folks die an agonizing death from the slightest case of sniffles. Other times, the helicopter slams into the bridge and the whole A-Team emerges unscathed.

“It’s hard to answer the question of whether death itself hurts because nobody really knows,” Dr. Iserson says. There can be pain and discomfort at the initial onset of a fatal event, especially with trauma or where a heart attack or a terminal illness is involved. “But it’s not likely that the final moments are very painful since the brain is shutting down. In fact, some dying processes, like drowning, can actually be quite peaceful,” says Dr. Iserson, a near-drowning victim himself. Here’s a quick look at how we die.

The big three. The three top causes of death-heart disease, cancer, and stroke-are also the easiest to understand. They cause death by shutting down vital organs. Most heart attacks occur because the heart is not getting enough oxygen through plaque-constricted coronary arteries. The heart stops, and the lights go out. Stroke is similar but occurs when the brain, not the heart, fails to get enough blood (which is why some doctors now refer to stroke as brain attack). And cancer kills by impairing the functions of the organs it invades.

Bang! You’re dead. Fatal events such as car crashes, falling from high places, or being shot cause trauma. More than half of the time, death in trauma cases is actually the result of injury to the heart, a major blood vessel, the brain, or the spinal cord, which causes blood loss and shock or massive injury to the brain or other vital organs. “That’s why the Safety Council folks are so adamant about people wearing seat belts, helmets, and other protective gear,” says Dr. Wecht. “Often if you can protect your head, you can stay alive.”

Bleeding to death. We tend to think of bleeding as something we do on the outside. But internal organs such as the spleen, liver, and lungs are like miniature blood banks. Rupturing such organs can cause massive internal bleeding, which takes precious amounts of blood out of circulation. A quick loss of 40 to 50 percent of your blood, which is approximately five to six pints in a 170-pound man or four to five pints in a 130-pound woman, is enough to cause coma and death. When too much blood is taken out of circulation, the heart speeds up to try to compensate for the loss. But once the pressure and volume get too low, the person falls into a coma, and the oxygen-deprived heart stops.

From gallows to swallows. Finally, there’s asphyxiation. One sure way to put your heart to rest and your brain to sleep for good is to cut off your air supply. When you can’t breathe, whether a chicken bone is lodged in your throat or cement shoes tied to your feet haul you down to drown, you experience asphyxia. During asphyxia, the pulse quickens, the blood pressure rises, and the amount of carbon dioxide in your blood shoots up due to the lack of new air coming in, or of old air being expelled. In a few minutes, the heartbeat becomes irregular from lack of oxygen and then stops.

Though death accounts are predictably grim, experts say that your final moments, if you are dying from a chronic, natural illness, probably aren’t all that bad-even if they aren’t exactly pretty. “In many cases, it’s just a slip out of consciousness,” Dr. Iserson says.

*25/36/5*

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