The reason the Essie Dunbar story resonated so powerfully when it finally appeared in print in 1955, and the reason it has continued to be retold ever since, is that it connects to one of the most enduring and deeply felt fears in Western culture: the fear of being buried alive.

This fear is not irrational.

Throughout the eighteenth and nineteenth centuries, premature burial was a recognized, documented, and medically discussed risk.

The development of standardized medical definitions of death, and the clinical tools needed to establish death with confidence, was a gradual process.

In the centuries before those definitions and tools were established, there was a genuine — if often overstated — risk that a person in a deep coma or profound unconscious state might be mistaken for dead.

The nineteenth century in particular produced an extensive literature on premature burial, ranging from serious medical treatises to Gothic horror fiction.