Contemporary Americans might look back to the eighteenth and nineteenth centuries and see an enormous gap in knowledge, but serious questions concerning the determination of death continue unresolved into the present. For instance, is the “soul” or “vital principle” of life located in a single organ or is it spread throughout a person’s organs, tissues and cells? Some in the medical community now are asking, “Does death occur and unique ‘personhood’ end when a small number of organs, or perhaps only one, permanently cease(s) to function, or must the entire organism go through such a process before death is defined?” A by-product of the medical profession’s failure to successfully treat tuberculosis prior to the twentieth century was the preservation of the ambiguous vampire figure, the living dead. Modern medicine’s current inability to reach consensus regarding the definition and diagnosis of death has reintroduced the ambiguity of the living dead. The artificial ventilator and the concept of brain death have conjured ancient apprehensions, as one medical ethicist wrote: “Concern about ‘bad’ deaths—those that are unnatural, accidental, or untimely, or repugnant—is a universal, age-old preoccupation. Technologically orchestrated deaths appear intuitively to many people to be unnatural. We worry that individuals who die bad deaths suffer unduly, and, even though most of us consider such thoughts irrational, even some health-care practitioners may be harrowed by the idea that this suffering will come back to haunt the living.”

Blaming the dead for death seems a logical step from the fundamental vampire concept that the dead have a life after death. A cause-and-effect relationship between the dead and death lurks beneath the surface of everyday folklore. Fear that the angry, jealous or vengeful dead will prey upon the living unless certain steps are taken to appease or disable them, probably explains why a reanimated corpse is the primary type of vampire. A common folk belief in both the United States and Great Britain, for example, is that a corpse not stiffening “is a sure sign that death will be knocking pretty soon again at the door of this house for some other member of the family.” This belief suggests an uncanny connection between living and dead family members, evoking the scene at the graves of the American vampires, where corpses that appeared to be in an unnatural state were interpreted to be at least signs, if not the actual causes, of the looming death of kin. The inclination of these vampires to infect their near relations with a lethal disease links pre-twentieth century America to a very large community. This core belief is found in Europe, India, Asia, and Africa and is as persistent as it is widespread.

In the vast stretch of history before the twentieth century, death and disease were ever-present and endured. Yet, almost everyone alive in America today was brought up believing in the inevitable conquest of disease and, by extension, death. Vaccines, antibiotics, modern hygiene and aggressive public health campaigns had all but eradicated such feared scourges as tuberculosis, pneumonia, small pox, polio and measles. We seemed to be on the way to a disease-free world. Today, however, some terrible things have shaken our complacency. Antibiotic-resistant bacteria and new infectious enemies, such as AIDS, Avian Flu and Swine Flu, have appeared and some old ones, particularly tuberculosis and pneumonia, have reemerged. Our microbial adversaries have shown us the vulnerability even of modern medicine. Humbled by our failure to conquer disease and decipher death, we should acknowledge our kinship with those who endured the fear and uncertainty that tuberculosis embodied in pre-twentieth century America.