For a layperson — and in some historical circumstances, even for a physician without extensive experience with epilepsy — a patient in a deep post-ictal state can present with an alarming resemblance to death.

This resemblance was recognized in historical medical literature, and there are documented cases, primarily from the eighteenth and early nineteenth centuries, of epileptic patients being incorrectly reported as dead following seizures.

By 1915, medical education about epilepsy had advanced considerably from the state of knowledge in the eighteenth century.

The condition was reasonably well-understood by trained physicians, and the post-ictal state was a recognized phenomenon.

However, the depth of clinical knowledge available to a rural general practitioner in South Carolina in 1915 varied considerably, and the specific presentation of a deeply unconscious post-ictal patient in the heat of a summer afternoon might have been, in extreme circumstances, misread.