A 65-year-old Thai woman’s faint knocking from inside her coffin has prevented what would have been an unimaginable tragedy, raising questions about death verification procedures and highlighting the safeguards in place within Australian medical systems.
Chonthirat Sakulkoo was moments away from cremation at Wat Rat Prakhong Tham, a Buddhist temple on the outskirts of Bangkok, when staff heard soft knocking from within the white coffin.
“I was a bit surprised, so I asked them to open the coffin, and everyone was startled,” temple manager Pairat Soodthoop told reporters. “I saw her opening her eyes slightly and knocking on the side of the coffin. She must have been knocking for quite some time.”
The discovery came after Ms Sakulkoo’s brother, Mongkol, had driven her body 500 kilometres from their home in Phitsanulok province to Bangkok. She had been bedridden for approximately two years, and her brother believed she had stopped breathing two days earlier.
Mr Sakulkoo had initially planned to honour what he understood to be his sister’s wishes to donate her organs to a Bangkok hospital. However, hospital staff turned him away and he lacked an official death certificate. He then proceeded to the temple, which offers free cremation services, but was again refused for the same reason. It was during this second rejection, as temple staff explained the process for obtaining proper death certification, that the knocking began.
Ms Sakulkoo was rushed to Bang Yai Hospital, where she was treated for hypoglycaemia (dangerously low blood sugar) and later released. In a detail that has raised eyebrows, the Bangkok Post reported that when asked how he felt learning his sister was alive, Mr Sakulkoo said he was “indifferent.”
When bureaucracy saves lives
Ironically, it was the insistence on proper documentation that ultimately saved Ms Sakulkoo’s life. The refusals created delays that allowed her to regain enough consciousness to signal she was alive a stark reminder that administrative requirements in medicine exist as critical safeguards.
The case has drawn attention to hypoglycaemia, a condition where blood glucose levels drop dangerously low. In severe cases, it can lead to unconsciousness, dramatically slowed breathing and heart rate, and a lack of obvious vital signs that might convince an untrained observer that death has occurred. The condition can genuinely cause death through cardiac arrhythmias or brain death, making professional medical assessment essential.
Dr Sarah Chen, an emergency medicine specialist at Royal Brisbane Hospital, explained that proper death verification involves multiple checks. “We assess for breathing, pulse, pupillary response, and in hospital settings, we often use ECG monitoring,” she said. “It’s not something that should ever be determined by a family member alone, no matter how certain the circumstances appear.”
Australian safeguards vs global gaps
The incident stands in stark contrast to Australian protocols, where multiple layers of protection prevent premature declarations of death. In Australia, death must be verified by a qualified medical practitioner or, in some jurisdictions, a registered nurse or paramedic with appropriate training. The Medical Certificate of Cause of Death must be completed within 48 hours, and certain deaths must be reported to a coroner.
Funeral directors cannot take a deceased person into their care without proper medical certification, and no cremation or burial can proceed without documentation from a qualified medical practitioner.
“The system is built with checks and balances precisely to prevent scenarios like what happened in Thailand,” said Peter Davis, CEO of the Australian Funeral Directors Association. “Every step requires verification, documentation, and professional oversight.”
Yet Ms Sakulkoo’s case is far from unique. In January 2023, 76-year-old Bella Montoya in Ecuador was declared dead after a stroke, only to wake during her wake. The same year, a 66-year-old woman in Iowa was found “gasping for air” at a funeral home, and an 82-year-old woman in New York was discovered alive at a funeral home. In 2021, a man in India woke minutes before being placed on a funeral pyre. In 2014, a Mississippi woman woke in a body bag.
These cases, while rare, reveal a troubling pattern involving elderly patients, care facilities, and situations where medical oversight may be limited. The 19th century saw “safety coffins” with bells and breathing tubes designed for exactly this fear. While modern medicine has largely eliminated the risk in countries with strong healthcare systems, the Thai case reveals how quickly protections dissolve when systems aren’t followed.
Unanswered questions
The incident has prompted Thai health authorities to review the case, but troubling questions remain. How did a woman who had been bedridden for two years end up in a coffin without documented medical assessment? Why was she transported 500 kilometres without proper certification? And what explains her brother’s reported indifference?
“This raises questions that go beyond just death verification,” said Professor James Morrison, a geriatrician at the University of Melbourne. “How was this woman being cared for during those two years she was bedridden? What medical supervision was in place? These are the kinds of situations where vulnerable people can fall through the cracks.”
The Thai Medical Council has indicated it will review current guidelines, particularly around rural and home deaths. For Australian health professionals, the case serves as a reminder of why existing protocols must never be treated as mere formalities.
The temple has offered to cover Ms Sakulkoo’s ongoing medical expenses, a gesture that acknowledges the extraordinary circumstances. Her survival stands as both a miracle and a warning: in matters of death, there can be no shortcuts, no assumptions, and no room for error. As temple staff discovered, the difference between appearing dead and being dead may be nothing more than a faint knock from within a coffin if anyone is listening closely enough to hear it.
