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Sept 2, 1968


JAMA. 1968;205(10):697-698. doi:10.1001/jama.1968.03140360057017

Electrical failure of the heart provides a favorable background for cardiac neurosis, especially in the setting of an intensive care coronary unit. Druss and Kornfeld1 recently described a frequent occurrence of nightmares in resuscitated patients after cardiac arrest. Bearing a remarkable resemblance to dreams of violence which often haunt soldiers wounded in battle, these nightmares were the only psychiatric disturbances specific to survivors of cardiac arrest as distinct from other patients with grave heart disease. Whether the nightmares are the result of an organic disturbance or of a psychological adaptive process which helps patients adjust to an extremely traumatic experience is not known, but their occurrence should not be too surprising. Existential philosophers have for a long time emphasized the "dread" that accompanies confrontation with sudden death—an encounter not easily forgotten in the science-fiction setting of an intensive-coronary-care unit. Surrounded by weird electronic equipment, facing anxious fellow patients, nurses,