Death, resurrection, and rebirth: observations in cardiac surgery.

The fantasy of life after death is universal, and every culture attempts to deal with concepts of resurrection and rebirth. In the past, these fantasies have dealt with religious and symbolic meanings, but cardiac resuscitation and cardiac surgery have introduced a new dimension: the patients' concept that they die in reality and are reborn or resurrected. This study, which was based on pre- and postoperative psychiatric interviews with cardiac patients, has focused on the problems such patients face. Their defensive immortality-formations appear to confirm Freud's speculations in Thoughts for the Times on War and Death concerning the human being's difficulty in accepting death as an end to life. Case history vignettes were presented, showing how these fantasies of death and resurrection can influence patients' ability to undergo necessary surgery. It was suggested that the idea of rebirth indicates starting life anew without blemish, whereas resurrection fantasies involve having another chance to live but with the same defective body.