Somehow despite decreased levels of consciousness and clouded thinking patients can still sense what the date is. People may hang on for significant dates such as Christmas and New Year’s Day. These particular days may be times for a traditional family gathering. A chance to catch up with family and friends. To spend time together. FOMO – Fear of missing out may even apply to dying people. They don’t want to miss out on special occasions.

On the other hand, other people may die prior to the significant dates. They don’t want to impact the usual celebrations of birthdays or other events such as wedding anniversaries. Some years I have seen a higher number of deaths prior to Christmas. Others may hold on for Christmas but then let go before the New Year arrives. In the past, I used to work during the New Year’s break and there would often be a high number of deaths during the holiday period. People held on through Christmas, made it into the next year and then let go.

How can people who are dying and have become comatose know what the date is? How can they know when to hold on and when to let go? Does the internal biological clock work well even at the end of life? Are people still aware of their environment and what is happening around them? Studies of people under general anaesthesia in which people have been rendered unconscious have demonstrated that they can still hear and understand what is being said to them despite the brain being put to sleep.

What other mysteries are there at the end of life? We’ll all find out the answers for ourselves at some time in the future. Some people seem to know that something is about to happen. I met a patient the other week who had suddenly felt the urge to prepare their will and their enduring power of attorney. This occurred some weeks prior to them becoming unwell. Somehow they knew that things needed to be sorted out. When they became unwell it meant at least some of the practicalities of dying had already been taken care of which was a great relief to the patient and their family.

Listen to that gut feeling, it may be trying to tell you something. Especially after the festive season when most of our guts have become bigger after feasting.

I hope you had a decent Christmas and I wish you all the best for 2023.