In 1880, a middle-aged woman paid a visit to the French neurologist, Jules Cotard (pictured below), complaining of an unusual predicament. She believed she had ‘no brain, no nerves, no chest, no stomach, no intestines’. Mademoiselle X, as Cotard dubbed her in his notes, told the physician she was ‘nothing more than a decomposing body’. She believed neither God nor Satan existed, and that she had no soul. As she could not die a natural death, she had ‘no need to eat’.
Mademoiselle X later died of starvation. [1]
Although this peculiar condition eventually became known as ‘Cotard’s Delusion’ the French neurologist was not the first to describe it. In 1788—nearly 100 years earlier—Charles Bonnet reported the case of an elderly woman who was preparing a meal in her kitchen when a draught ‘struck her forcefully on the neck’ paralyzing her one side ‘as if hit by a stroke’. When she regained the ability to speak, she demanded that her daughters ‘dress her in a shroud and place her in her coffin’ since she was, in fact, dead.
[T]he ‘dead woman’ became agitated and began to scold her friends vigorously for their negligence in not offering her this last service; and as they hesitated even longer, she became extremely impatient, and began to press her maid with threats to dress her as a dead person. Eventually everybody thought it was necessary to dress her like a corpse and to lay her out in order to calm her down. The old lady tried to make herself look as neat as possible, rearranging tucks and pins, inspecting the seam of her shroud, and was expressing dissatisfaction with the whiteness of her linen. In the end she fell asleep, and was then undressed and put into bed.
Hoping to break her spell, a physician attended her bedside and administered a ‘powder of precious stones mixed with opium’. Eventually, the woman did awake from her delusional state; however, she continuously redeveloped her paroxysm every three months for the rest of her life. During the periods when she thought that she was dead ‘she talked to people who had long been dead, preparing dinners for them and hosting the occasion somberly and constantly’. [2]
Today, the condition is sometimes referred to as ‘Walking Corpse Syndrome’. Although rare, people are still diagnosed as suffering from nihilistic delusional beliefs that they are dead and no longer exist. Occasionally, the condition is characterized by a belief that one is missing essential body parts or organs, as in the a case of a 28-year-old pregnant woman who thought her liver was ‘putrefying’ and that her heart was ‘altogether missing.’
In 2013, New Scientist interviewed a man named Graham Harrison, who had attempted suicide 9 years earlier by taking an electrical appliance with him into the bath, and awoke in the hospital believing he was dead. He said:
When I was in hospital I kept on telling them that the tablets weren’t going to do me any good ’cause my brain was dead. I lost my sense of smell and taste. I didn’t need to eat, or speak, or do anything. I ended up spending time in the graveyard because that was the closest I could get to death.
It was his brain which had died. He had fried it, or so he thought. Doctors tried to rationalize with him, but to no avail. Eventually, Graham was referred to Dr Adam Zeman, a neurologist at the University of Exeter, and Dr Steven Laureys, a neurologist at University of Liège. They used positron emission tomography (PET) to monitor his metabolism. What they found was unsettling.
‘Graham’s brain function resembles that of someone during anaesthesia or sleep. Seeing this pattern in someone who is awake is quite unique to my knowledge’, Dr Laureys told New Scientist. ‘I’ve been analysing PET scans for 15 years and I’ve never seen anyone who was on his feet, who was interacting with people, with such an abnormal scan result’. The below image shows the areas of Graham’s brain which are underactive (coloured in blue) in comparison with a healthy person.
Graham is the only patient with Cotard’s Delusion to have undergone a PET scan, and therefore scientists can draw few conclusions about the results since they have no basis for comparison. The condition has been tentatively linked to bipolar disorder in young people, as well as severe depression and schizophrenia in older patients. Treatment of the condition is varied. Typically, those suffering from it are put on a combination of anti-depressants and anti-psychotic drugs, although electroconvulsive therapy has also been known to be successful.
For Graham, psychotherapy and drug treatment has helped ebbed the symptoms of Cotard’s Delusion, though it’s been a long, hard journey. Over the past decade, he could often be found sitting in local graveyards in an attempt to get closer to death. ‘The police would come and get me, though, and take me home’, he said. [3]
Graham is one of the lucky ones. Many who have suffered from the condition in the past have died from starvation, and some have even resorted to pouring acid on themselves in an effort to stop being one of the ‘walking dead’. One thing is for certain: Cotard’s Delusion, or ‘Walking Corpse Syndrome,’ illustrates just how little we still know about the human brain in the 21st century.
