Can A Case Of The Hiccups Kill You?

There are cases of individuals having the hiccups for more than 50 years, and the hiccups themselves don’t seem to have killed them. However, they are a sign that something else (that could potentially be fatal) may be the cause of the hiccups.

If you’re a Grey’s Anatomy fan (like me) you probably have extreme feelings about one particular episode. In this episode, Susan Grey, the protagonist Meredith’s stepmother, seemingly dies from a case of the hiccups.

Like many people who watched the show, this episode struck me as having a weird premise. After all, if we were to list all the things in the world that could probably kill us, hiccups would probably not even make the list.

Hiccups are common. If you’ve ever gulped down beer too quickly or binged on way too much food in a single sitting, chances are that you’ve had the hiccups. In fact, people even end up hiccuping when they’re stressed!

Given how common and harmless hiccups generally are, it’s pretty jarring to think that hiccups might actually be more dangerous than we think.

So, can hiccups actually kill you?

Before we get into the intricacies, let’s first find out what hiccups actually are.

What Are Hiccups?

Did you know that the hiccup is actually a two-step process? When we have a hiccup, the diaphragm first contracts and pulls itself downward. These contractions (or spasms) are involuntary and occur in the time that passes between two consecutive breaths.

Each spasm is followed by a constriction of the vocal cords. This two-step process essentially “creates” a hiccup. In fact, the second step is what causes the characteristic and high-pitched “hic” sound.

All of this happens in the blink of an eye. For most people, hiccups don’t last more than a few seconds, or worse, a few minutes. However, some people do suffer from prolonged or chronic hiccups.

What Qualifies As Chronic Hiccups?

While most of us can’t imagine hiccuping for more than a few minutes, chronic hiccups are real. A hiccuping bout that lasts more than 2 days qualifies as “chronic hiccups”. There’s even a classification for hiccups that last for over a month. If an episode of the hiccups stretches well beyond a month, at that point they’re called “intractable hiccups”.

Believe it or not, the longest case of hiccups ever recorded went on for 68 years. Charles Osborne, a man born in 1893, suffered through hiccups for almost seven whole decades.

According to WebMD, chronic (specifically intractable) hiccups afflict every 1 in 100,000 individuals.

Chronic hiccups take a large toll on the body. It’s extremely exhausting and disruptive to everyday life events. Camielle Rizzo, a doctor who works at Middlesex Hospital, had the following to say to Smithsonian magazine regarding the side effects of intractable or chronic hiccups, “Insomnia from having hiccups all night can be incredibly distressing, and then, not surprisingly, if you haven’t slept for two to three weeks, you can become depressed and anxious. ”  

Can Hiccups Kill You?

It doesn’t seem so. There is no direct evidence that too many hiccups have ever killed someone.

While hiccups alone don’t cause death, chronic hiccups can still significantly drag down an individual’s quality of life. Intractable hiccups often trigger dangerous side effects, such as an irregular heartbeat.

Additionally, hiccups can manifest as signs of a much larger or unresolved underlying condition, such as gastroesophageal reflux disease (GERD).

This is the same thing that happened to Susan, Meredith’s stepmother on Grey’s. In her case, her GERD had silently advanced to the point where she began hiccuping constantly as a side effect.

Similarly, hiccups have also been considered indicators of a stroke. This is basically what happened to Charles Osborne in 1922, in Union, Nebraska. While hanging a 350-pound hog for butchering, Osborne fell down. After that incident he hiccupped roughly 20 to 40 times a minute, non-stop, until February 1990, an estimated 430 million hiccups in total. Guinness World Records listed him as the man with the longest attack of hiccups, and he died in May 1991 at age 97.

A doctor, Ali Seifi, told the Smithsonian magazine that Osborne may have suffered a mild stroke at the moment of the fall, or alternatively that the fall damaged the nerves controlling his diaphragm; either could explain the sudden, decades-long bout of hiccups.

How Did Susan Grey Die On Grey’s Anatomy?

For everyone arriving here straight after that episode: Susan Grey is Meredith’s stepmother, the second wife of her father, Thatcher Grey. Her storyline plays out across the Season 3 two-parter The Other Side of This Life (Parts 1 and 2), which aired in the spring of 2007. She walks into Seattle Grace having hiccupped almost non-stop for weeks, paired with a stubborn case of acid reflux.

The team traces the hiccups to severe gastroesophageal reflux disease (GERD) and performs an endoscopic gastroplication, one of a family of anti-reflux operations that reinforce the valve where the stomach meets the esophagus. The best known is the Nissen fundoplication, which wraps the top of the stomach around the lower esophagus to keep stomach acid from creeping back up. Susan is sent home to recover. She soon returns with a fever and severe abdominal pain, and the doctors discover she has developed a toxic megacolon. She goes septic and dies before they can save her.

So how much of this is real medicine? The first half holds up surprisingly well. Relentless, weeks-long hiccups genuinely can flag severe GERD, and fundoplication is a standard surgery for reflux that has stopped responding to medication. The death is where the writers reach for dramatic license. A toxic megacolon is a dangerous, balloon-like swelling of the colon, and it is almost always driven by severe inflammation of the bowel, such as ulcerative colitis or a Clostridioides difficile infection, rather than by an operation on the stomach and esophagus higher up the digestive tract. The complication that actually kills Susan has little to do with either the hiccups or the reflux surgery that came before it.

The takeaway echoes the rest of this article: the hiccups were the symptom that got Susan through the hospital doors, not the thing that killed her. As a plot device they were a clever red flag for a deeper problem, which is exactly how doctors treat a case of stubborn, unexplained hiccups in real life.

Conclusion

Medical drama plots aren’t as serious and genuine as chronic hiccups, but they are fun to break down and dissect.

In Grey’s Anatomy, when Meredith’s stepmother presents with a bad case of hiccups, the doctors in the hospital narrow it down to a horrendous instance of acid reflux or gastro-oesophageal reflux disease (GERD). In this case, the GERD was so advanced that it could only be resolved or treated by surgery, a procedure known as endoscopic gastroplication. From that point onwards, an entire hour of television magic concludes with Meredith’s stepmother being wheeled away to surgery. Long story short… she doesn’t make it.

The show was on the right path in terms of hiccups manifesting as a symptom of an extreme case of GERD, which can persist into chronic hiccups if the underlying disease is not addressed.

Similarly, there are many other health conditions that hiccups act as precursors to. For example, hiccups can also arise in conjunction with sharp chest pains, numbness all over your body, and blurry vision; these hiccups are likely manifestations of a stroke.

So, here’s the gist. While hiccups themselves did not kill Susan Grey, we shouldn’t ever dismiss them completely!