Antoine Wiertz’s painting, ‘The Premature Burial’

The nature and success of horror fiction lies in its ability to take our most innate fears and turn them into reality. It provides a controlled, safe environment in which we can explore our darkest curiosities and vulnerabilities without ever being hurt. But what about the real fears that lie behind the fiction?

The idea of awakening underground in complete consciousness, with the knowledge that everyone thinks we are dead, is utterly terrifying. Unfortunately, this is a very real fear that dates back to the middle ages. Back when little was known about the definitive signs of death, it was all too easy to commit people to the ground before their time. Horrifying stories were told of muffled cries heard from the graveyard, corpses with their hair torn out, and telling scratch marks discovered on the inside doors of tombs.

It’s easy to pass these off as legends or folklore, but there are various accounts of people being buried alive by accident in medical journals and textbooks throughout the centuries. In 1749 alone, the French physician Jean-Jacques Bruhier reviewed 56 cases of premature burial or dissection, and 125 narrow escapes.

However, the fact that it was a recognised problem was seemingly not enough to prevent it from happening. Few measures were taken to reduce the occurence of premature burial, or even just to make people more aware.

There are many possible reasons for this. Once a person was thought close to death, a physician was seen to have done his job and deemed no longer necessary. This would leave inexperienced laymen to determine the moment of death, often on the basis of cessation of breathing or just a general lack of response. In the early 17th century there wasn’t much consideration of the stages of dying; a person was either alive or dead.

Secondly, some groups of people – even educated medical professionals – viewed an unexpectedly revived person to be not a case of premature burial, but a resurrection; perplexingly, many chose to believe people were ‘awakening’ from death as opposed to the more realistic notion that they were simply not dead to begin with. Gnawed body parts were sensationalised as evidence of devilry and possession, instead of the signs of torment and distress that they likely were. This fuelled fear and mistrust of the victim as some kind of evil, demonic being, turning people away from sensible precautions and solutions.

The third reason may be that despite the notoriety of these cases, they are but few and far between. Many experts believe the prevalence of premature burial is exaggerated. This is supported by the fact that, while various escape devices and ‘safety coffins’ were installed to reassure the dying and avoid accidental burials, they were rarely used.

Exaggerated or not, tales of live burial are abundant in literature and film throughout the ages, the most famous earliest example being Poe. Featured in a number of his short stories but most notably in The Premature Burial (1844), he draws on the fears of Victorian society (and perhaps himself), claiming ‘we have the direct testimony of medical and ordinary experience to prove that a vast number of such interments have actually taken place.’

Poe’s protagonist suffers from catalepsy, a condition that causes him to appear lifeless. As such he has an intense phobia of being buried alive, instructing his closest friends to check he is definitely dead before burying him, and even installing an elaborate device in the tomb for a quick escape. The story reaches its peak when the narrator awakes in what he thinks is a tomb, only to recall he is actually in a berth on a boat.

The first half of Poe’s story details the history of premature burial, setting the scene and providing the reader with the necessary background to make the second, fictional part of the story more believable: ‘it is the reality – it is the history which excites’.

He even goes on to frame the fictional part as true:

‘[premature burial is] an interest… which, through the sacred awe of the topic itself, very properly and very peculiarly depends upon our conviction of the truth of the matter narrated. What I have now to tell is of my own actual knowledge – of my own positive and personal experience.’

As with much of Poe’s literature, this shows how the reality and fiction of horror has always been intrinsically linked; one cannot exist without the other. Moreover, this ‘positive’ experience of thinking he has been buried alive is what ultimately cures the narrator of his fear (and, apparently, his epilepsy); he has lived out his fear in the safety of his imagination and is absolved of anxiety. Poe is well aware of the cathartic role of horror in diminishing our overwhelming fears: ‘They must sleep, or they will devour us.’

Premature burial continues to be used as a horror trope today. The first example that comes to mind is in Kill Bill 2, when Uma Thurman’s character finds herself buried underground inside a makeshift coffin, with nothing but a torch and a switchblade. The dim close-up shots of her limited movements as she begins the painstaking process of escape can’t fail to resonate with the most hardcore horror fans – even with that valiant music played over the top. In reality, her chances of escape would be quite unlikely.

Another is Rodrigo Cortés’ Buried, in which Paul Conway finds himself interred underground following a terrorist ambush in Iraq. His subsequent unravelling state of mind and worsening fate is the focus of the entire film as he communicates with rescuers and family on a mobile phone. The camera never leaves the coffin; just like in Poe’s first-person narrative we are right there with him.

These modern examples are somewhat removed from the notion of actual, unintentional premature burial that troubled our ancestors, but they demonstrate how the idea has persisted as a theme.

That’s not to say that modern history is completely free of this tragedy. In much the same vein as medieval pandemics and plagues, a number of soldiers in World War I are thought to have been buried alive due to sheer haste, and the fact that so many were dying in rapid succession. Speed was of the essence to avoid the smell and putrefaction becoming unmanageable. Unfortunately, this likely meant that many who were injured but not quite dead were thrown into mass graves among the corpses.

Even more recently, there have been some instances of people waking up in morgues, often as a result of medical conditions not dissimilar to Poe’s ‘catalepsy’. On rare occasions these conditions render a person ‘dead’ when they are in fact experiencing a prolonged seizure as a result of epilepsy or the effects of Parkinson’s Disease. Other cases have been observed following the administration of drugs for treating conditions such as schizophrenia, which slow breathing and give the impression of death.

Thankfully, medical knowledge has vastly improved through the ages, and premature burial is unlikely to be something we have to worry about. But the fact that it continues to crop up as a theme in various literature, TV shows and films, is proof that the fear still exists. After all, most fears stem from things we are uncertain about, and no one really knows what happens when we die. Poe’s musings still ring true today: ‘The boundaries which divide Life from Death are at best shadowy and vague. Who shall say where the one ends, and where the other begins?’


The Complete Tales and Poems of Edgar Allan Poe, Penguin Books, London, 1982

Bondeson, Ian, Buried Alive: The Terrifying History of Our Most Primal Fear, Norton, New York, 2001