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'Natural causes' can mean a number of things

EDITOR'S NOTE: This weekly column by reporter Bill Kettler answers readers' questions about topics of general medical interest with information provided by doctors from PrimeCare, Jackson County's independent physicians association.

What does it mean when someone dies of "natural causes?"

I know many people, young and old, die from cancer, heart attack, and various other illnesses, but what does it mean when I read "natural causes" as the cause of death?

It can't mean that someone is just old and worn out, because I read "natural causes" in the obituaries of young people, too.

Can you explain this?

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- Michale G., Medford

Part of your confusion may lie in the difference between semantics and science.

"Natural causes" as used in an obituary has no specific meaning. The term is sometimes chosen when people are reluctant to describe a loved one's actual cause of death.

In the medical sense, most people die from natural causes, says Dr. James Olson, deputy state medical examiner for Jackson County and seven other Oregon counties.

From a physician's perspective, homicides, suicides and accidental deaths are really the only "un-natural" deaths.

Olson says diseases of the cardiovascular system account for about 40 to 45 percent of all deaths in our region, and coronary artery disease "leads the pack."

Respiratory diseases in various forms account for about 25 percent of all natural deaths. Old diseases such as pneumonia still happen.

"People come down with a flu-like illness and don't realize how ill they are," Olson says.

Death comes when critical body parts wear out. Some may function at a reduced level for decades before they fail; others may give up suddenly in dramatic fashion.

A blood vessel with a weak spot along the wall (an aneurysm) may function for years before it bursts. If the aneurysm is in a critical artery such as the aorta (the main artery from the heart) death can occur in minutes.

Occasionally things just go wrong. A bowel twists. A spleen ruptures. An infant dies in its crib.

Deaths from infectious diseases are relatively rare in areas such as Southern Oregon, where sophisticated medical care is available. They do occur, however. Olson notes that a 38-year-old Medford resident recently died from meningitis.

Accidental deaths include those in which people are involved in car crashes or industrial accidents, or suffer unintentional injuries.

Death certificates are filed for each person who dies, and the cause of death is included on the document. Physicians usually know the cause of death for the people they have been treating because they are familiar with their patients' health problems.

Olson and other state medical examiners perform autopsies when the cause of death isn't readily known, or a person hasn't been under a physician's care or isn't known to have had potentially life-threatening illness.

Olson does about 300 autopsies a year. Every once in a while, he can't determine the cause of death. He says the most difficult cases are young people who die suddenly and unexpectedly. Their deaths are due to cardiac rhythm disturbances that are usually not evident anatomically, which can only be identified at the molecular level.

Send questions to reporter Bill Kettler by e-mail at: bkettler@mailtribune.com.or mail them to: "Ask your Doctors," Mail Tribune, P.O. Box 1108, Medford OR 97501