How do broken people go on

Not even death could separate them. Two elderly spouses died of natural causes in Syria within one day. The couple from a small village in the Idlib province had been married for more than 70 years, since their 90-year-old wife passed away last Sunday.

Her 95-year-old husband was supposed to live less than 24 hours. He too died while preparing for his wife's funeral. 66 grandchildren mourn their grandparents.

"He just didn't want to live anymore", in this case, as in many comparable cases, the relatives, the neighbors and friends have said. Nevertheless, the cause of death "broken heart" is not on any death certificate.

Doctors call this phenomenon "sudden cardiac death" which they cannot explain. But often people who die suddenly in special situations and with no signs of physical symptoms do not suffer from heart problems at all.

"Such deaths are of an emotional nature," says Zurich psychotherapist and physicist Gary Bruno Schmid, who a few years ago published a book in the scientific Springer publishing house on the phenomenon of psychogenic death, on "death through imagination".

The reason for his research were his own painful experiences with the elusive phenomenon. Schmid's father passed away at the age of 66 shortly after his retirement. "He was vital and in good spirits," remembers Schmid. "But overnight he died in the middle of the night."

"Sudden cardiac death", diagnosed the family doctor at the time, and Schmid was amazed "how easily he dealt with the death certificate". The psychotherapist believes that his father lost his will to live with the job and has been collecting similar cases ever since.

One in ten deaths with no explanation

"It happens again and again that adults in their prime die out of full health," says Wolfgang Eisenmenger, head of forensic medicine at the University of Munich. Pathologists found no explanation for ten percent of all deaths - as in the case of the middle-aged mother who stabbed her own son in the thigh with a knife. "Although the wound was not deep, she still died in the ambulance," says Eisenmenger.

The doctors remained equally perplexed with the unmarried twin brothers William and John Bloomfield, who were sitting together at their daily dinner in a restaurant in May 1996 when one of the two 61-year-olds suddenly collapsed dead. While the restaurant visitors were still taking care of him, the other took his last breath as well - less than two minutes later.

Even sections according to all the arts of pathology do not give a cause of death in such cases. There were no changes in the brain, heart, or lungs that came close to explaining why people died. Death from the soul seems likely: "Freud called it" letting oneself die, "says Horst K├Ąchele, head of psychosomatic medicine at Ulm University.

Despite their sometimes unsuccessful search for clues, not all forensic scientists and pathologists accept the power of the soul over life. They often look compulsively for a physiological trigger - and usually attribute it to the heart. Pulmonary embolism, circulatory failure or "cause unknown" are further notes that appear in the death certificates of the "AGs", the "extraordinary deaths".

One study found that among widowers who were older than 54 years, the mortality rate was 40 percent higher in the first six months after the death of the wife than in the normal population of the same age. Three quarters of these men died of "heart failure".