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Incurable Cough of Death

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"A cough is the first sign of a terminal disease."
"Hollywood Rule Book," Vanity Fair

If you have a cough, you're going to be dead before the end of the show.

This is usually accompanied by nasty amounts of Blood from the Mouth which is always a bad sign, even when there's no plausible reason for it. May also involve collapsing. The character will probably try to hide it and will usually succeed until they actually pass out. This trope is almost always carried out by the Littlest Cancer Patient or one who is Delicate and Sickly. A more proactive sufferer may be a Death Seeker looking for A Good Way to Die or an Old Master desperate to train The Chosen One before the illness takes them.

In Western literature the trope was heavily influenced by the prevalence of tuberculosis, an infectious disease considered by many historians to be the greatest killer in human history - yes, even greater than malaria or plague. The symptoms of tuberculosis (also known as consumption, phthisis, TB, or the White Death) are identical to those of the Incurable Cough Of Death, but death would usually come far more slowly for the TB patient, at least in Real Life.

Thematically, the unnamed disease tends to act like pneumonia or tuberculosis, even in futuristic settings where those real diseases might be cured. Other times it's a hyped up version of unfortunately very real symptoms of chronically overworked people. In general, wider knowledge of medical conditions doesn't let writers be specific without slipping up. In modern or advanced settings, the presence of a fictional tuberculosis expy is done because the real tuberculosis, while still a nasty disease, is relatively easy to detect and treat using modern medicine.

Of course, in real life, people cough all the time from non-life-threatening causes, but those generally don't make for interesting stories. Think of this trope as the medical variant of Chekhov's Gun: if someone coughs in the first act, they better be dead by the third. note  The Law of Conservation of Detail also applies.

Sister trope of Deadly Nosebleed. Compare Soap Opera Disease and Victorian Novel Disease. If the character insists that it's nothing, then it's Definitely Just a Cold. The trope may also lead to a Healthcare Motivation. Compare Wring Every Last Drop out of Him. Generally speaking, a single cough is safe as it normally is used to gain attention or signal embarrassment.

This trope is also used for people dying of a chest wound (where it can indeed occur, either because the person's lungs are trying to cough up whatever foreign body has been pushed into them, or because blood is leaking into the respiratory tract.)

As this is a Death Trope, unmarked spoilers follow, though, really, the entire point of the trope is that the death isn't a spoiler to the viewer, so as far as spoiler by definition tropes go, this is one of the safer ones. In any case, you have been warned.


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    Anime & Manga 
  • Souji Okita makes quite a few appearances in fiction, complete with his famous sickness. In Bakumatsu Kikansetsu Irohanihoheto he is a frail looking spectre of a man, who sees a ghostly cat and wastes away while reminiscing with the hero and lamenting his sad fate. Then he dies.
  • ×××HOLiC main character Watanuki — who is also the Butt-Monkey / The Woobie of the show — suffers from the dreaded blood-coughing after befriending a lonely ghost whose presence sadly sucks out his life energy even if she doesn't want him harm in a episode arc. He does survive because another character kills the ghost with a spiritual arrow in order to save him, but it is made clear that it would have killed him if the situation would have continued any longer.
  • Hatsune Otonashi in Angel Beats! suffers from this.
  • In B't X, Hokuto suffers from radiation poisoning, and is stated to have few months of life left He isn't planning to last that long.
  • In Berserk, one character seen during the "Conviction" arc is a prostitute who appears to be dying of a severe venereal disease. She claims the inside of her mouth is swelling up and her legs are covered in sores. Berserk being Berserk, we see plenty of her body, and none of the symptoms she describes are visible. The only symptom we do see? A nasty cough. Though she does suffer from severe vaginal bleeding, too.
  • In the Black Butler manga during the circus arc Ciel is dragged off to the makeshift outdoor baths by his roommate. During this time it's winter and the water the circus performers are washing up with isn't heated (it's Victorian London, after all). After being soaked with the freezing water we later see Ciel coughing, eventually falling into an aggressive coughing fit that causes him to vomit. We find out that he suffers from asthma, a disease he inherited from his mother. The cold had aggravated it. He gets better, though.
  • Bleach:
    • Hisana Kuchiki died years before the manga begins from an unspecified sickness. In the anime, she is given an incurable cough to show that she's beginning to succumb to the illness that eventually kills her.
    • Captain Ukitake contracted an illness as a child that turned his hair white, wracks his body with terrible, bloody coughs and leaves him bedridden for days. It's implied his reiatsu is as powerful as Aizen's, but has to be used to keep him alive. Fans theorise he has tuberculosis, but the manga never specifies. When he was three years old, his parents begged a divine entity for help. The entity possessed him to keep alive but the price was that Ukitake would have to give up the entity and his life on the day of Soul Society's greatest need. When that day comes, Ukitake keeps his promise without hesitation.
  • Buso Renkin: The reason that Papillon wanted to become a humanoid homunculus was due to his terminal illness, shown by him having coughing fits that would bring up quite a bit of blood. Due to the interference of his brother, however, his transformation was incomplete so that although he gained an immortal, super-human body, his illness wasn't cured like it should have been and his bloody coughing fits continued.
  • Ayumi starts to do this in Episode 5 of Charlotte, first over the phone while talking to Yu during their stakeout camping trip. Later when he's back home a few days later, she starts coughing again, and also mentions that she ran out of her pizza sauce. Double subverted, however, as while it turns out that her cough was merely a one-day cold, it does, in a very roundabout way, lead to her death. Yuu thinks she's still safe at home, but Ayumi, feeling all better, has decided to sneak out to school, where her yandere classmate's threatening her with a knife causes her to panic and accidentally trigger her special ability, Collapse. This kills her.
  • In Chrono Crusade, Joshua Christopher suffers from this trope, until he accepts Chrono's horn from Aion and becomes part of the antagonist organization, the Sinners..
  • In CLANNAD, Nagisa has an evidently non-lethal version of this. Until she gives birth, which complicates things a bit.
    • In After Story, One of the first signs that her and Tomoya's daughter Ushio inherited the already deceased Nagisa's illness is that she beings coughing profusely. It gets nastier for both father and daughter. And then better.
  • In Code Geass R2, The Ace Li Xingke has a chronic Incurable Cough Of Death that also causes Blood from the Mouth every so often when he pushes himself or his Knightmare Frame too far. Despite having the disease, he survives to see the end of the series. He is missing from the big wedding portrait in the end, but his mech is present in the background, leaving some potential for debate.
  • In the Cowboy Bebop episode "Jupiter Jazz (Part 2)", Gren starts coughing and bleeding from the mouth as a result of internal injuries sustained in a fight with Vicious. Spike tries to summon medical aid, but Gren tells him not to bother, since he's dying anyway, and asks Spike to instead tow his ship into orbit. He dies in the cockpit and the ship crashes back to the planet's surface.
  • Nemu in Da Capo coughs up Cherry Blossoms and quickly deteriorates in health. Subverted in that she survives.
  • Subverted in Dr. STONE, where village high priestess Ruri has had a debilitating illness all her life (usually marked by severe coughing fits) and isn't expected to make it to age 20. In the end it turns out to be ordinary pneumonia, which would have been this trope in the science-less "Stone World", but Teen Genius Senku manages to create sulfonamide and Ruri makes a full recovery.
  • Dragon Quest: The Adventure of Dai:
  • In the manga Emerging, a heavy cough that sometimes produces blood is one of the first signs that a character may have contracted the extremely deadly mystery illness that is spreading across Tokyo.
  • Hyatt in Excel♡Saga is constantly coughing up blood, collapsing, vomiting and dying (several times a chapter).
  • In the Fruits Basket manga, it is revealed that Tohru's father Kazuya died of badly treated pneumonia.
  • Fullmetal Alchemist:
    • Izumi Curtis does this, although she isn't the usual character type. And there's a darker reason for the cough than just illness. A failed attempt to transmute her stillborn infant son back to life caused the destruction of her internal reproductive organs. The hemorrhaging gets much worse during periods of extreme stress or guilt, causing her to cough up a truly frightening amount of blood. In spite of this, she still outlives nearly every major character while enduring heavy combat. In the manga, Hohenheim later cures her Incurable Cough Of Death. He cannot bring her organs back, but via an alchemical punch to the gut he can permanently stop the bleeding and the cough. Ironic, no? In Fullmetal Alchemist (2003), she survives the series but dies of her injuries off-screen by The Movie. That said, Hiromu Arakawa's signature sense of humor manages to make even this trope funny. Such as when Izumi was caught a thug while looking for the Elrics.
      "If you don't tell me where they are..."
      "So? What happens if I don't tell you?!"
      "I'll give you this!" (pukes blood in his face)
      "NO YEEAKH UGH AAAH!!!!"
      • Note: This gag never made it into the anime(s).
    • Ed and Al's mom Trisha also succumbs to this; not to mention the deaths of homunculi, and whenever anyone sustains a serious torso wound… Aw heck, FMA is in love with this trope.
    • Alfons Heiderich of Fullmetal Alchemist: The Conqueror of Shamballa also has a Cough of Death, and for a more traditional reason: fumes from the rocket fuels he was creating have destroyed his lungs. As it turns out, that isn't what eventually kills him. It's Rudolf Hess shooting him that does.
  • Takiko Ohkuda from Fushigi Yuugi: Genbu Kaiden continuously coughs during her journey. When she's back in the Real World, it's revealed that she caught the consumption of her late mother, Yoshie. Then again, it's already revealed by Miaka that she originally was mercy killed at the hands of her father.
  • Gintama has few of these too. Most of them happen during serious fights (and usually only bad guy dies afterwards), but there's actual example too. Since killing off Okita Sougo (a character loosely based on Okita Souji) would've completely messed up the comedic nature of the series, mangaka twisted things a bit - instead of Sougo having tuberculosis, it was his sister Mitsuba who suffered from illness... and she lasts for about two episodes.
    • Also Kouka (Umibozu's wife/Kagura and Kamui's mother), during her lingering illness due to being separated from the altana of the devastated Yato home world. The symptoms first appear when she coughs up blood on newborn Kagura.
  • In Giovanni's Island, Kanta's illness, likely tuberculosis, starts out with him coughing constantly.
  • Somewhat subverted in Glass Mask, since Maya's mother, Haru does suffer from tuberculosis, but actually dies after being hit by a car.
  • Averted in Gravitation where Yuki not only collapses as he also coughs blood in the process but manages to survive. The illness is blamed on stress (it might be ulcers) and just as mysteriously as it appeared it disappears. Ironically or not Shuichi assumes that his lover is about to die.
  • Hellsing: Integra's father dies of (as one review put it) "a terminal case of coughing up blood".
  • In Hetalia: Axis Powers, Word of God says that a pre-teen Holy Roman Empire suffered from this and Blood from the Mouth. Team Mom Hungary is seen picking him up and carrying him around in her arms at least once. He died later, but is strongly implied to have sort-of being brought Back from the Dead... as Germany.
  • In His and Her Circumstances's play "Steel Snow", the Inventor's Forrest-Gump-esque first love Rose reappears to give him a baby to take care of, coughs three times, and promptly dies.
  • Karakuri Circus: The manga begins with Narumi's doctor explaining the Zonapha syndrome, which makes it painful to breathe until the sufferer makes someone laugh.
  • Aslan Battour from Kaze to Ki no Uta suffers from tuberculosis in the backstory. He's already dead in the main storyline.
  • In Kodomo No Jikan, Rin Kokonoe's mother Aki coughs after being in perfect health for the rest of the manga. She's dead within a dozen pages. Fixed in the anime - she actually finds out that she has lung cancer, but decides the money for expensive treatment to prolongue her life for a short while would be better used to raise Rin as well as possible. She hides it as long as possible; by the time it becomes inescapably noticeable, it's too far gone, and Aki dies a relatively quick wasting death.
  • Yuna Miyama from Maburaho starts coughing, but this is later subverted when Kazuki dies from healing her.
  • Macross:
    • In Macross Frontier, the Incurable Cough Of Death is simply one of the V-Type Infection's syndromes (among dizzy spells, fever, keeling over at the drop of a hat...) that Sheryl Nome has to endure, even though Grace has claimed the V-Infection to be incurable and fatal. Her struggling to overcome these in order to reassert herself and her ideals seems to be one of the major plot arcs as the series nears its end.
      • However, Sheryl doesn't die, but is saved when Ranka uses her own Vajra skills to move the virus from her brain to her stomach region, turning it into more of a benign symbiosis than infection.
    • Parodied in Macross 7 Encore, where Millia comes down with a cough and assumes that she is dying. She begins doing a whole bunch of really silly things that she wants to do before she finally gives out. At the end of the episode, Dr. Chiba finally states his diagnosis: a cold. The cough was never anything more than a cough, but Millia overreacted due to apparently never having gotten sick before.
  • Zest of Magical Girl Lyrical Nanoha StrikerS has this, due to being one of Jail's botched attempts at an Artificial Mage. While Agito hates her for doing it, she thanks Signum for killing Zest in battle, letting him die as a knight instead of a sick man.
    • Precia Testarossa as well. Why is she coughing up blood? Who knows! Probably stress and overworking herself, even though we never actually see her doing much apart from whipping Fate.
      • It's possible that it's a sickness brought on by that magical reactor explosion that claimed her daughter's life, akin to radiation poisoning.
      • The movie manga reveals that she actually suffered from cancer.
  • In the anime Magic Knight Rayearth (second season), Anti-Villain Eagle Vision is in an advanced stage of this, complete with Blood from the Mouth. He forces his friend and minion Geo to not reveal it so he can die a "warrior's death".
  • A character appearing on two episodes of the mecha anime Metal Armor Dragonar is shown to have this disease. However, he ends up surviving just long enough to see his two longtime compatriots killed, one by "friendly" fire, and then gets shot down himself after proving to be a significant enough opponent to elicit an upgrade of all three main Humongous Mecha.
  • In Mobile Fighter G Gundam, the "elderly" (actually only 50) Master Asia is the greatest fighter in the world. His Kung Fu is stronger than everybody else's. He can effortlessly destroy Humongous Mecha using just his bare hands, or by swinging a piece of cloth at them. Basically the only one who's even worthy of thinking about fighting him is the main character... who happens to be his student. Yet when he turns against his boss, a weakling of a normal human, poor Master Asia is conveniently incapacitated by his Incurable Cough Of Death.
  • Also, in the manga Mobile Suit Gundam SEED Astray, a master swordsmith and swordsman named Un'no is also able to fight against Humongous Mecha on foot...though he uses a katana to do it, and "only" slices the barrels off their guns. His Incurable Cough Of Death actually is TB, which he dies from shortly after passing on his knowledge to Lowe Gear.
  • Justified in Nabari no Ou, as Yoite's entire body is failing as a result of his use of the forbidden Kira technique. It's explicitly mentioned later on that he won't survive the month.
  • Nagasarete Airantou: Ikuto is trying to make a wooden object that involves water and then he starts sneezing. Few pages later Suzu runs into Michiru saying that she's in a hurry for some ice for Ikuto. Eager to help with his cold she quickly finds a way to fly with her ice powers, but keeps falling and hitting stuff all over the island looking for him. When she finds him he's still sneezing but he was just allergic to the sawdust while trying to build a refrigerator.
  • Naruto:
    • Itachi Uchiha dies from one of these. Apparently, he had been keeping himself alive with all sorts of medicine so he could be killed by Sasuke. Then we find out why.
    • There's also Kimimaro, who plays this completely straight, and Hayate who has a cough, but averts the death aspect by being sliced in half.
      • So far, Hayate's cough is the only actual sign of a disease we've seen in-universe. And we don't even actually know what it is.
    • Hinata Hyuga nearly avoids this. She acquires exponential damage to her body's chakra system and heart from facing her cousin, Neji Hyuga, in the preliminaries. She is still feeling the affects of such a strain on her body that she breaks out in a violent coughing fit during the fight between Neji and Naruto a month later and subsequently passes out. Kiba Inuzuka finds an ANBU overlooking the final Chunin matches It's really Kabuto Yakushi in disguise and has him heal her with his medical ninjutsu.
    • Sai's "older brother" Shin also died from one of these before Danzo could force them to fight to the death.
  • Hiruluk of One Piece has a disease similar to this, in which he periodically coughs up blood. But this isn't what kills him; even when fatally poisoned by Chopper's misguided attempt to cure him, and facing death at the hands of Wapol's firing squad, he drinks a potion and explodes.
    • Doc Q and Stronger of the Blackbeard Pirates are also frequently shown coughing up blood; they have yet to die.
    • Whitebeard had it, too. Considering everything else he went through, though, it's easy to forget. Though it's indicated that if not weakened by disease, all the punishment he took in his final battle still wouldn't have been enough to kill him.
  • Xerxes Break from PandoraHearts suffers from this at times.
  • The Rose of Versailles:
    • We know that since this is a tragic shojo anime, that there's little chance that Lady Oscar will make it to the end of the series alive, but when she starts coughing up blood, that pretty much cinches it. Although, unusually, she doesn't actually die from the cough (though she is informed that it's terminal) but in a far more suitably dramatic manner while storming the Bastille and being shot to death.
    • Also, both the Dauphin Louis Joseph and Marie Antoinette had tuberculosis (a particularly painful osseous tuberculosis for Louis Joseph), although only the Dauphin died of it.
  • In one episode of Rune Soldier Louie, Louie helps a little girl to find a rare flower for her grandmother, who has an unspecified sickness, that mostly consists of a bad cough.
  • Sayo Muto aka Magdaria from Rurouni Kenshin's filler arcs is dying of tuberculosis. Specifically, she got it from her mother when she was a little girl, and her older brother Shougo tried to search for a cure to no avail. Neither mother nor daughter die of illness; both of them were shot to death, with several years of difference.
    • One could argue that it's played straight, in that the cough signals the audience that the character is doomed. Of course, the way the writers were practically splashing "Wouldn't it be so tragic if this character died?" all over the screen every time poor Magdaria appeared, most of us already knew that.
    • Other two with that cough: the famous and aforementioned Souji Okita from both the manga and the TV series, and Shinsaku Takasugi from the Tsukiokuhen OAV. Very much a Justified Trope: as seen below, both were based on real life people who DID die of tuberculosis.
    • Kenshin, and then Kaoru contract some kind of unspecified disease in the Seisouhen OVA whose symptoms include this.
  • In the "Dream" arc of the Sailor Moon manga, Mamoru hides his Incurable Cough Of Death from Usagi at first, but he is soon discovered. He also coughs up some black blood and, more significantly, has a black rose in his lungs showing this to be some sort of magic disease (apparently without followup testing for known diseases that can produce anomalous chest x-rays). It turns out it is a result of his kingdom, Elysion/The Golden Kingdom, that he ruled being attacked which affects him physically... once the enemy is defeated he is cured.
  • Subverted in Superior when Angelica mistakes Umberto's cough as a sign of a deadly illness (not helped by him asking for a specific medicine during a coughing fit). It was actually a pollen allergy.
  • Uchuu Senkan Yamato had The Captain Juzo Okita (a nod to Okita of The Shinsengumi mentioned above; a.k.a. Captain Avatar for Star Blazers fans) suffering from a worsening case of radiation poisoning as the series progressed. The practical effect in the series was demoting him to the Mentor in favor of Hot-Blooded Hero Susumu Kodai (Derek Wildstar), the "Acting Captain" to be.
  • Wild ARMs:
    • Raquel Applegate of Wild ARMs 4, due to suffering from an unknown, incurable disease that's implied to be radiation poisoning. This doesn't stop her from being the most powerful character in the game, though it does explain why her HP and speed are so low. She eventually dies in the Distant Finale epilogue, having never found a cure for her sickness.
    • Subverted in Wild ARMs 5, by the same character, but in a cameo appearance. Although she still has the cough, the player can go on an obnoxiously long Irrelevant Sidequest to cure her and give her a happier ending. Ironically, the thing you use is the same cure-all that had no effect on her in Wild ARMs 4.

    Asian Animation 
  • In Season 2 episode 20 of Happy Heroes, Doctor H. wishes on a genie to be married to Miss Peach, with the side-effect of the Supermen being misbehaved since he is now too occupied with Miss Peach to do anything about them. To bypass this, Doctor H. uses the second of his Three Wishes to make the Supermen well-behaved again... only this time, he also has an incurable disease and is seen coughing up blood onto a tissue.

    Comic Books 
  • Marvel 1602: Queen Elizabeth I is shown coughing blood into a handkerchief due to Count Otto von Doom's poison device.
  • Green Lantern: In Sinestro Corps War, Guy Gardner coughs in mid-battle, indicating that he's infected by the sentient bio-virus Despotellis. He soldiers on and fights, until eventually collapsing, before the Corps medic injects him with Leezle Pon, a sentient smallpox virus... who's also a Green Lantern. Two viruses enter, one leaves victorious.
  • 52: Averted when it is revealed that Vic Sage knew he was dying of lung cancer since before the start of the series, but the only hint of that is him disapproving of his protégées smoking, and that is treated like a Running Gag more than anything. Of course, once the cat is out of the bag, his symptoms starts to show. Fast.
  • Supergirl: During the Sterling Gates/Jamal Igle's run Lana Lang was often shown coughing or vomiting blood. She managed to keep it from Kara for a while until the Girl of Steel finally found out in The Hunt for Reactron. A quick X-Ray Vision scan indicated a strange organism was mixing with the cells around it. In Death & the Family it was revealed that villain Insect Queen was taking over Lana.
  • In an issue of Teenage Mutant Ninja Turtles Adventures, the turtles find themselves in the Caribbean in 1492 in time for Christopher Columbus' "discovery" (It Makes Sense in Context), and one of the natives develops a cough, foreshadowing the epidemic from diseases the Europeans brought over that they themselves had immunities against.
  • This was how Illyana Rasputin showed that she had been infected with the Legacy Virus. "There was a time when characters would just have a cough, but this being the early nineties, it's obviously a plot point."
  • In Hellblazer, this was how John's terminal lung cancer manifested itself, although intermittently enough at first that he spent a long time in denial.
  • In The Metabarons, Othon von Salza takes terminal damage to his lungs when he destroys the Shabda-Oud cetacyborg. He coughs up blood for the rest of the issue until he dies.
  • Played with in Marvel Zombies 4. Jack Russell/Werewolf by Night wanders off coughing. It's an indicator that Morbius' vaccine has backfired: when Jack is reunited with his team mates a little later he's turned into a zombie.
  • Fatale: Booker coughing is a sign that he's deathly ill. Of course, eventually he starts coughing up blood, so he better be.
  • Early in Swordquest Realworld, Peter is seen hacking up blood into the sink at work. After he suffers another coughing fit after rescuing a dog from a burning building, he is taken to the doctor, who informs him that he's got degenerative lung disease and that he'll be dead within a year.
  • In volume 9 of Okko, during the Flash Back to the title character's youth, his father Takeda Kiritsu is seen suffering from this, complete with Blood from the Mouth. He try to hide it from his subjects as much as he could.

    Fan Works 
  • An Impractical Guide to Godhood: A Roman who volunteers for the Suicide Squad in year two has a bad cough and says that a magical curse is slowly killing him and he needs the money the quest offers to afford decent healers.
  • The main character in the Mass Effect 2 fanfic Pariah suffers from this.
  • Joey in the Yu-Gi-Oh! The Abridged Series fanfic Decks Fall Everyone Dies has this.
  • Marty has one of these in No Antidote.
  • In the little known WHOO! Kingdom Hearts RPG! The character Reeves seems to have contracted one.
  • Lady Silvermane in Whispers is stated to be old and sickly, and has a nasty cough that worsens with stress. She also keeps a handkerchief on her reading desk, which is mentioned to be drenched in blood, suggesting tuberculosis or some other lung disease.
  • Fluttershy in The Cough admits to a cough, which is the only warning sign of a dangerous and notably incurable but also unnamed contagion, and is murdered [quite brutally] to protect the remaining refugees. A literary interpretation of The Incurable Cough of Death. It is implied that Rainbow Dash was actually the one who coughed and that they killed the wrong pony.
  • Meadowgrass from the tenth chapter of The Mare Who Once Lived On The Moon has one of these due to pneumonia in a Steampunk setting. she doesn't make it to the end of the chapter, and the whole experience ends up affecting Twilight a lot.
  • Melania Black in Harry Potter fanfic If Them's the Rules starts coughing up blood when the poison runs it course and she starts to die.
  • In Number XII: The Savage Nymph, Larxene's mother has this as the only symptom of her unspecified disease.
  • In the Harry Potter and Doctor Who crossover fic Harry Who, this with some nasty results is one of the signs that the final battle didn't end quite the same way. he got better.
  • In The Vow, Lianne's mother is gravely ill when she's introduced. She coughs so violently at one point that her handkerchief is bloodied. She deliberately hides it, but Shen spots it. She dies in the next chapter.
  • A semi-common trope in fanfiction in general is 'Hanahaki Disease', which has at its focus people coughing up flower petals as a result of unrequited love, with the most common result being that the victim chokes to death on flowers, though occasionally a non-fatal version crops up where it's more a chronic condition. The only cures are for the victim's love to be requited (or merely confessed, to avoid Unfortunate Implications) or to have surgery, which removes the flowers but also the feelings that caused it, and possibly also the victim's ability to love again. Often enough, the victim will refuse the surgery option even if they don't believe their feelings are requited/are too chicken to confess, though often enough their love interest finding out about the hanahaki is enough to prompt a confession that the feelings were requited all along.
  • Little Fires: Duckkit is a sickly kitten with a permanent cough and a constantly runny nose. He dies in the same chapter he's introduced in.
  • Escape from the Moon: In the later sequel Scavenge for the Future, Aerostorm’s coughing turns out to be this - it’s a sign of her lung cancer, which is slowly killing her. Ultimately subverted when Spliced fixes it, saving her life.
  • Breath of Fresh Air is an Ed, Edd, 'n' Eddy fic where Edd has a persistent cough. When he coughs up blood, he goes to the hospital and it turns out he has a lung cancer.
  • In Destiny (Afterandalasia), Angel realizes that she's dying when she coughs up blood.
  • In Which Guzma Is Frustrated: Acerola's father breaks out into a cough before telling Nanu that he doesn't have much time left.
  • Fuges is a fanfic of The Simpsons that tries to explain Edna's death. She had a persistent cough but thought nothing of it. It turned out to be terminal lung cancer.
  • In UA:LA, Hero's mom died in a Flash Back from this.

    Films — Animation 
  • Subverted in Balto. The entire point of the story is that the titular dog-wolf hybrid had to help a dogsled team get medicine so that the diphtheria epidemic didn't kill most of the town's children. They are shown occasionally, growing weaker and often coughing weakly per the disease's actual symptoms, but Balto and the team make it in time to save them.
  • Averted in The Secret of NIMH. Timmy is bedridden and coughing because he has pneumonia, but we're led to believe by the end of the movie that he's getting better thanks to the medicine his mother gave him.
  • Corpse Bride: The Van Dorts' servant, Mayhew, has a nasty cough at the beginning of the film that Nell Van Dort frequently complains about. He later succumbs to whatever was causing itnote  and keels over while driving them home. The Van Dorts don't even notice aside from the sudden lurching of the carriage. He then shows up in the Land of the Dead as a "new arrival".
  • This trope is spoofed in the Animaniacs movie Wakko's Wish, in which Dot constantly coughs and claims she "needs an operation" but never mentions quite what the problem is. At the end of the movie, she does a Disney Death that lasts for less than five minutes (Those acting lessons paid off!), and is later shown emerging from the operating room with a new beauty mark to make her "even cuter".
  • Clara in David Copperfield (1993).
  • In Scrooge: A Christmas Carol, Tiny Tim has a bad cough, as did Scrooge's little sister Jen in the past. The "death" part of the trope is semi-averted in Jen's case, though – she recovered from her illness, but was permanently weakened by it, leading to her Death by Childbirth as a young woman – and completely averted in Tim's case, as Scrooge's Heel–Face Turn brings him the medical care he needs.
  • Hayao Miyazaki's mother had TB (specifically Pott Disease) while he and his brothers were kids. She spent eight years of his childhood in and out of sanatoriums until she was cured of the infection in 1955. Since it was such a big part of his formative years, it left an impact on him and it's shown up in a couple of his works:
    • Averted in My Neighbor Totoro. It's never outright stated, but Yasuko Kusakabe clearly is in a clinic for tuberculosis. Fortunately, she recovers and comes home (after a few scares) in the end. It’s based on his own childhood, after all.
    • Played straight in The Wind Rises. Jiro’s wife, Naoko, is already in advanced stages of the disease when they meet again as adults. He marries her despite knowing how sick she is and she dies from it at the end.

    Films — Live-Action 
  • In AVP: Alien vs. Predator, Charles Bishop Weyland not only has a cough, but actually listens to a story about someone who died because they were in no physical shape to take on the challenges that they faced. It doesn't take a rocket scientist to figure out that he won't be walking off into the sunset at the end of this movie.
  • Bohemian Rhapsody: Freddie Mercury develops a cough as a result of his AIDS and at one point coughs up blood during a recording session. Truth in Television, as the AIDS complication that killed him was bronchial pneumonia.
  • In Boy & the World, a harvester has a terrible cough. It's implied that his cough isn't what kills him, it's the government that doesn't find him useful anymore.
  • Justified in Brassed Off. Coal lung (caused by inhaling small particles of coal dust, which proceed to abrade membranes in the lungs) has all the symptoms, and is incurable and invariably fatal. Danny is a retired miner who has probably worked for over thirty years, most of that before protective gear.
  • Longshanks from Braveheart. Introduced subtly as a very mild sneeze; by the end he's dead from consumption. Given his age and the time period, however, he was going to go pretty soon anyway.
  • In Brian's Song, the first big sign that something more than a little weight loss is happening is Brian Piccolo hacking and wheezing on the sideline complaining of hay fever and allergies. A fairly realistic example of this trope since he's actually got a tumor in his lung.
  • Bright Star has John Keats succumb to an Incurable Cough of Death, which is a Truth in Television because the actual John Keats died of TB.
  • Byzantium: Clara gains this in her adult life before she turned vampire. She's also shown coughing up blood.
  • Captain America: The Winter Soldier: Agent Peggy Carter starts coughing during her discussion with Steve in hospital. This is heavily implied to be related to her illness, except that further context indicates her illness is Alzheimer's disease — not exactly a respiratory ailment.
  • In Captain Blood, Hanging Judge Lord Jeffreys coughs into a cambric handkerchief and is diagnosed by the eponymous hero as dying from "a bleeding death in the lungs." (In the novel and in Real Life, Jeffreys' fatal illness was actually kidney disease. (Admittedly, kidney disease is rather more of a challenge to show tastefully on screen...)
  • In Clear and Present Danger, Admiral Greer's mild coughing fit during a Joint Chiefs of Staff meeting heralds a diagnosis of pancreatic cancer, and he's dead two scenes later. To be fair though, pancreatic cancer does have an incredibly low survival rate.
  • In Constantine (2005), the eponymous Anti-Hero is dying of lung cancer, complete with bloody cough, and he knows it. In the end, of course, the Devil cures him so that he won't go to Heaven.
  • The disease in Contagion (2011) takes this form, killing you mere days after you start coughing. Subverted on the "incurable" part, though, as a vaccine ends up being created at the end of the film.
  • Edith in Crimson Peak picks up a bloody cough a few nights after arriving at the titular household. With her mother dying of disease during her childhood and then haunting her, you'd expect Edith to be concerned, but she seemingly forgets about it. Probably best she didn't bring it up, since Lucille is poisoning her tea. Subverted in that Edith survives the film, although her recovery is an open question.
  • In Danger Diva, Stanley's terminal illness makes itself known with rough, persistent coughing.
  • Dark Waters: Tennant, once he gets cancer from the water.
  • This is the first sign of infection in Dead Air (2009).
  • In The End of the Affair (1999), Sarah coughs lightly in a restaurant and Maurice asks if she's alright. Needless to say, she's on her death bed within 20 minutes of screen time. In an essay about seeing this movie with his boyfriend, David Sedaris pokes fun at how this trope was used; "It might have been different had Julianne Moore suddenly started bleeding from the eyes, but coughing, in and of itself, is fairly pedestrian".
  • Subverted in Escape from L.A.: Up until the end of the film, everyone was convinced that Snake's cough was due to him being infected with a deadly toxin. Then, it was revealed that he and the audience had been duped; the "Plutoxin 7" virus he was given was actually a common influenza virus.
  • In Finding Neverland, Sylvia Llewelyn Davies is a widow with five young sons, so you think she'd want to look after her health for their sakes. There were consumption treatments and sanitariums (though no cure, some people DID recover) in Edwardian England, especially for a woman with money. Instead, she says "I need to go on pretending... until the end...". That's about as useful as "think happy thoughts and you can FLY!" Though it should be noted that in Real Life, her cough (and death) was caused by cancer of the chest and trachea, which, unlike consumption, wasn't treatable at the time.
  • Johnny Blaze's dad in Ghost Rider (2007) gets the Cough of Death as a symptom of his blatant lung cancer from smoking too many cigarettes.
  • Gran Torino: Walt exhibits the cough complete with bright red blood and the coughing fits being violently enough to bring him to his knees. He passes it off as nothing, but a later scene with the doctor implies that it's a great deal more serious. He doesn't die of it, instead dying in a hail of bullets to make sure a violent street gang stays put away. Given the frequent smoking in the film and his advanced age, it's probably lung cancer.
  • In Gremlins 2: The New Batch, Mr. Wing is coughing from his lifetime of smoking. When he refuses to sell his shop to corporate minion Forster, the latter notices how much he's coughing and correctly decides all he has to do is wait him out.
  • Subverted by Juliet Hulme in Heavenly Creatures. Juliet suffered from TB as a child, and her relapse as a teenager is signaled by one scene of her in school coughing slightly and then spurting a tasteful amount of blood on her textbook. She spends months in hospital, and helps her best friend Pauline murder Pauline's mother, after Juliet recovers.
  • In The Host (2006), coming into contact with the tadpole monster reportedly infects the touched with a lethal virus. When main character Gang-Du is infected, the media makes a big case about how he is exhibiting "cold-like symptoms", including coughing (which leads to some mild hysteria on the streets of Seoul when a man coughs in a crowd while the media piece is playing). Subverted in that the virus doesn't actually exist (the US Army stuck with the story because it was too late to say they were wrong), and Gang-Du probably just has a cold.
  • Tom from How It Ends starts coughing at frequent intervals, eventually culminating in coughing up blood over the passenger-side window of his car, sometime after taking a hit to the chest during a scuffle with a convict pretending to be a police officer. A justified example, as it turned out that hit fractured several ribs, one of which punctured his lung; it ends up collapsing less than ten minutes after the actual bloody-cough and Will is forced to perform an impromptu thoracostomy to re-inflate it. It's also not the only sign of the injury either, since at one point Tom tries to draw his gun on another set of bad guys, but collapses in pain before he can get it out of the holster.
  • The Hunger Games: It is implied that President Snow suffers from some kind of terminal illness. He coughs up blood in Catching Fire, and is visibly sick in both Mockingjay films. Finnick's speech in Mockingjay: Part 1 reveals that Snow used poison to eliminate rivals during his rise to power. In order to prevent suspicion, he drank the poison himself, but quickly used antidote before he succumbed. Poison is still poison, though, and the antidote didn't fully cure Snow, so he is likely living on borrowed time.
  • In Inception, Saito (who had been shot in the chest in the first dream level) appears to be fine... until he starts coughing. By the time they've finished the third dream level, he's died and gotten stuck in limbo.
  • In Iron Jawed Angels, Inez starts with a cough... then coughs blood... then dies. Same as her real-life counterpart, she has pernicious anemia.
  • George "The Gipper" Gipp in Knute Rockne, All American dies this way after his freshman season playing for Notre Dame (which was covered in about ten minutes in the film).
  • In the film adaptation of The Last Song, the main character's father has an ominous coughing fit shortly before his daughter (and the audience) find out that he has terminal cancer.
  • At about the halfway point of Man on the Moon, Andy Kaufman coughs while explaining his latest stunt to his agent; later, during a comedy club appearance where he invites audience members to touch a cyst on his neck, he has a brief fit of coughing. These are both given no heed and the latter could be seen as All Part of the Show... but in the next scene Andy breaks the news to his confidantes that he has a rare form of lung cancer, which he eventually dies from. Notable because this is actually Truth in Television: Andy developed a cough in the mid-1970s, and he sometimes can be seen coughing in interviews. In 1983, when it became too frequent and pronounced to ignore, he took his loved ones' advice, went to a doctor, and learned that he was dying; the cough was a side effect of his illness.
  • Ratso Rizzo's persistent pneumonia gives him a cough of death in Midnight Cowboy.
  • In Mildred Pierce, the younger daughter gets the fatal cough after the first 15 minutes.
  • Miss Potter: Ewan McGregor's character, Norman Warne. Mr. Warne's sister has to tell his fiancée Beatrix that Norman died suddenly, possibly caused by getting rained on at the train station to say goodbye to Beatrix. "It was just a cough!", Millie Warne says. Actually, Norman Warne died of Leukemia, which apparently doesn't cause coughing, but maybe that's not nearly as "romantic"?
  • Satine from Moulin Rouge! is dying from tuberculosis. In a slight subversion, she doesn't know she's dying (even though it should be pretty frickin' obvious), because Harold (her boss and father figure) tells the doctor not to tell her so she can continue to perform. Even though someone in the late stages of tuberculosis would not have been able to hit the notes she was singing, or sing at all for that matter.
  • Ray in Off the Black suffers from multiple coughing fits. It's implied that he's living on borrowed time, likely due to his job dropping Agent Orange during Vietnam.
  • In Pan's Labyrinth, Ofelia's mother is very ill, this is apparent because she has both a cough and a handkerchief. She's also pregnant, so you just know how this is going to end.
  • Invoked in Parasite (2019). The Kim family spends most of the first act scheming their way into getting jobs for the rich Park family. Along the way they have to get rid of the rest of the household staff. By the end of the first act, the only one who’s left standing is the housekeeper. Mr. Kim tells Mrs. Park that he ran into her when he went to get his annual check-up and she was telling someone on the phone that she had active TB. Mrs. Park says she didn’t know people still got that in rich countries like South Korea but he retorts that Korea is the OECD country with the highest infection rate. He also says that he personally wouldn’t want someone with such a horrible, contagious disease around his own kids. When they get home, he has his daughter float some peach fuzz in the air as the housekeeper is deathly allergic. He then follows behind her coughing fit and squirts hot sauce onto the tissue to make it look like she’d coughed up blood and it gets her fired.
  • Repo! The Genetic Opera has Rotti Largo, whose very first scene has him being brought the news that he's dying and has very little time left. His only symptom is a rather bad cough, and of course, he's dead by the movie's end. In fairness, they do hint that it's some kind of cancer — he's bald and has lesions on his face, which can both be caused by chemotherapy and similar treatments. It's the stress of the Genetic Opera that kills him by the end.
  • In Return of the Jedi, Yoda's imminent death is heralded by his rather nasty cough in his last scene while alive, although he apparently dies of simple old age — perhaps his weakened immune system couldn't stand the swampy air of Dagobah?
  • The mysterious virus in Right at Your Door seems to give people coughs and prompt tearful evaluations of life and the government.
  • The Road has the father coughing through most of the movie. His sickness is never identified, but he does die from it.
  • In Saving Mr. Banks, Travers is frequently shown coughing blood into a white handkerchief.
  • Used in Shadrach with Paul's mother, who has a persistent cough (probably from tuberculosis) and dies a few years after the events in the movie.
  • In Sherlock Holmes: A Game of Shadows, Irene Adler is murdered with some kind of poison that causes this and Blood from the Mouth followed by death in minutes.
  • Early in Shortcut to Happiness, Mike tends to cough every time he lights up a cigarette. This leads to a Running Gag between him and Stone, as every time he does this Stone sarcastically tells him to "have another cigarette". Eventually, after a particular bad coughing fit, Stone takes the cigarette out of his mouth and throws it away. The viewer later learns that this was the moment when Mike quit. However, the coughing is an early symptom of the lung cancer that eventually kills him.
  • Eazy-E in Straight Outta Compton begins coughing when he fires Jerry Heller for embezzling money from his group. It turns out his coughing is foreshadowing his HIV/AIDS diagnosis.
  • Sarcastically parodied in Superhero Movie. The soon-to-be-villain has a brief coughing fit; the handkerchief he uses comes away with a blood splotch on it. When the protagonist asks if he's okay, the villain replies, "Oh, yes, I'm fine. This is healthy cough blood."
  • In Thérèse, Thérèse (soon to be St. Thérèse of Lisieux) develops a violent cough, complete with Blood from the Mouth, which proves to be tuberculosis.note 
  • The James Eckhart indie film To Be Friends has one scene like this on a beach to establish that the lead female character is terminally ill, explaining why she and her best friend are in the countryside so that she can commit suicide.
  • In Tombstone, Doc Holliday's cough marks his eventual death by tuberculosis, much like the real Doc Holliday.
  • Strangely enough, Ram in TRON starts coughing after being mortally wounded.
  • Luigi in The Wages of Fear has a cement lung and coughs throughout the movie, most dramatically when he handles the nitroglycerine in the Thermos jug.

  • Dragon Queen: Trava's father coughs a lot before he dies.
  • In Cormac McCarthy's The Road, the father has a cough due to the bad quality of the air.
  • In The Stand, coughing = having Captain Trips (the "superflu" which all but wipes out humanity).
  • Lord Gyles Rosby, a minor character from A Song of Ice and Fire, was known for his constant coughing. Queen Cersei appointed him to her Council (because the alternative was Garth The Gross, a man troubled by constant flatulence who was also a bannerman of Lord Tyrell, who Cersei despises), after which he promptly died.
    Cersei: Lord Gyles has had that cough for years, and it never killed him before. He coughed through half of Robert's reign and all of Joffrey's. ... You will return to Lord Gyles and inform him that he does not have my leave to die.
    • This may have been partially due to the stress a Braavosi put him under, as they kept asking for the repayment of loans from the Iron Bank of Braavos.
  • In Charlotte Brontë's Jane Eyre, the minor character Helen Burns expires from consumption during a typhus epidemic. Helen's illness is portrayed quire realistically, though. Her general weakness is emphasised far more than the coughing, and she is well enough to more or less function for a long time. Helen, in both character and condition, was based on one of the older Bronte siblings (who died before her younger sisters became famous), so Charlotte knew what she was talking about.
  • In "The Golden Road" by L. M. Montgomery, Cecily (after having always been more delicate than her friends, and spending a night with them in a bitter snowstorm) develops a persistent mild cough around the middle of the novel. She was otherwise perfectly happy and healthy for the rest of the novel, but after that point, the author begins to sprinkle in very subtle hints that she died soon after the book ended.
  • Parodied in the Fourth Wall-abusing novel The Cat Who Killed Lilian Jackson Braun'. In one scene near the beginning Philip Roth—yes, that Philip Roth—coughs, and remarks that means he'll be dead by the end of the novel. The protagonist tells him that it's a parody and he shouldn't worry. As you've probably guessed, it's played straight in the end. Roth knew he was dying all along, and furthermore, had killed Lilian Jackson Braun himself, out of a deep-seated hatred of her books.
  • Stephen Leacock names this as one of the ways out to end a detective novel without having to hang or imprison the culprit in ''The Great Detective'' , itself a collection of tropes for detective stories.
  • In The House of Night series, once a fledgling vampyre starts coughing, this means they are rejecting the change and will die. Blood from the Mouth often occurs as well.
  • In Dream of the Red Chamber, Lin Tai-yu has one from her introduction. It escalates considerably after she makes a certain discovery.
  • Fantine in Les Misérables, of an unnamed illness, probably tuberculosis. Apparently she coughs after every word - which doesn't stop her from delivering lengthy speeches on how happy she will be to see her daughter again. In the book, it both plays straight and inverts The Power of Love - she might be cured if her daughter is brought to her, but she dies of shock when these hopes are dashed by Javert. (Also, see Theater.)
  • In The Kite Runner, the first sign of the illness that will kill Amir's father is a cough. Doesn't quite fit this trope because the novel goes into a lot of detail about his diagnosis of lung cancer. But later, in a textbook example, Amir (and the reader) are alerted to Amir's old friend Rahim Khan's fatal illness by his coughing up blood.
  • The Plague And I is set in a TB Sanatarium, so there is a lot of this. Subverted in that the author, Betty Mac Donald, never has this symptom, though, which is why she went undiagnosed for so long.
  • During the third book of The Wheel of Time, Thom Merrilin starts coming down with a dreadful cold from hard traveling and being caught in awful weather during his rescue mission with Mat. He insists that it's nothing, but his one-time apprentice is wary enough to bring him to a local healer because Thom is rather old and he had recently expressed a worrying death wish after his lover was assassinated in the previous novel. Thanks to this, Thom winds up surviving, but he is incapacitated for the rest of The Dragon Reborn, leaving Mat to save his friends alone without his skills or expertise.
  • Invoked and Discussed Trope: in Henri Guigonnat's Daemon in Lithuania, here's Max-Ulrich describing his sister Kinga:
    She sighed a great deal, she used to sink down on to the divans, and sometimes even faint. She would interrupt her wearisome embroidery, raising her eyes to the heavens (she was subject to strange mystical states), or let the heavy anglo-saxon novels, which she never finished, drop on to her knees. She often held a delicate batiste handkerchief to her lips, and coughed faintly. In those moments she paraded an ostentatious discretion, and a truly unbearable resignation. I kept a pitiless watch on her, and I can positively state that she never coughed the slightest drop of blood. But she had cultivated the art of languishing gracefully, and no doubt her head had been turned by romantic examples of phthisis, of homecomings from balls where you catch cold in the snow.
  • Subverted with Mr. Poe in A Series of Unfortunate Events. He has always had that cough, but doesn't die. Lemony Snicket is just weird like that.
  • In the story Laura and the Silver Wolf, the heroine who has leukemia begins to cough... and from then on, she wakes up exactly once and then dies. But if we believe her, then she is forever in the Ice-Land and quite happy there.
  • In The Tartar Steppe by Dino Buzzati, in the first scene where Lieutenant Pietro Angustina appears, this is how readers are clued in that he's elegant, self-possessed, and ill: "Angustina had a slight fit of coughing. It seemed strange that a sound so disagreeable should proceed from such a refined young man. But he coughed with due restraint, lowering his head each time as if to indicate that he could not help it — that it was really something he had nothing to do with but which he must endure. So he transformed the cough into a kind of willful habit for others to imitate." Seventy pages later, Angustina dies an elegant and self-possessed death.
  • Played literally and horrifically straight in Plague by Michael Grant. In the book several characters contract a cough that causes them to cough out their lungs out.
  • Jem's illness that causes him to cough up blood in The Infernal Devices. No cure has been found. That is until the epilogue of The Clockwork Princess, where a cure was finally found.
  • Lampshaded and subverted in The True Meaning of Smekday.
    I know when somebody usually coughs in a story it means they're gonna die, but the Chief had had that cough ever since I met him.
  • In Chime, catching the swamp cough means almost certain death, and several children die of it before the end of the book. Rose (the protagonist's twin sister) starts coughing midway through the book, leading Briony to fear for her life enough that she asks the Old One in the swamp if Rose is really sick. Turns out Rose didn't have swamp cough, just a normal cough...until the Old One gives it to her to force Briony to stop the draining of the swamp. She succeeds, and Rose (barely) survives. The swamp-draining plan was also the reason behind the unusually large number of swamp cough cases that year.
  • In the Hetty Feather trilogy by Jacqueline Wilson, Ida Battersea starts to suffer from this in the second book. She doesn't make it.
  • The Red Death in The Reynard Cycle causes this, as well as Blood from the Mouth. The disease is so feared that sufferers of it in The Baron of Maleperduys are locked aboard prison barges and left to starve.
  • In Warrior Cats, many cats die of greencough, or, less frequently, whitecough throughout the series. Notable examples include Leopardstar's siblings and mother, and Tigerstar's siblings. Firestar and Bluestar even lose one of their nine leader's lives this way.
  • Jonathan Strange & Mr. Norrell: Lady Pole, nee Emma Wintertowne. Though it's made very clear that it might well not have been incurable if her mother had acknowledged that her perfect daughter was sick and allowed her to see a doctor.
  • Pure-blooded infant dragons in Elcenia have an unusually high mortality rate in their first month of life. The first symptom is coughing; once that shows up, they're dead within an angle.
  • Averted by Kitty Bennet in Pride and Prejudice coughs so much that she "tears [her mother's nerves] to pieces" after a short conversation about "coughing when one must" her father gives her leave to cough as much as she likes. She never falls ill and ends the book in perfect health.
  • The Locked Tomb: Gideon the Ninth: Dulcinea is dying from advanced stage blood cancer, and is prone to coughing blood. Made more complicated by the fact that she's actually The Ageless and has essentially been trapped in a state of dying for ten thousand years. The person she was impersonating (her distant descendant) had the same disease, but was less prone to coughing up blood due to actually taking care of herself more, since she lacked a Healing Factor.
  • Deeplight: Lung damage is a potential consequence of Riser's Bane, the setting's name for the Bends. Quest suffers from it; returning to the Undersea worsens his condition, and he passes away in the epilogue.
  • Wuthering Heights: Hindley's wife Frances and Heathcliff's son Linton both die of tuberculosis (not mentioned by name in Linton's case, but the symptoms are clear), and accordingly both cough throughout their illness. Edgar also dies of a lung infection, though he's never specifically described as coughing.
  • Into The Broken Lands: Keetin develops a hacking cough after he's dragged into Chest Burster-infested water and nearly drowned, leaving his best friend terrified that the creatures have gotten into his lungs. Eventually, they reach a safe city and he's healed in the Dénouement.
  • Ben Snow: When Ben eventually meets the Dangerous Deserter he has been hunting in "Snow in Yucatan", he notes that he does not look well and is discreetly coughing up blood. This is actually a symptom of radiation poisoning he contracted from the 'medal' Professor Irreel gave him, which contains a sliver of radium. This kills him not long after Ben arrives.
  • Gone: The titular disease from Plague starts as a cough, followed by some flu-like symptoms. As the disease progresses, the fever becomes higher and higher, and the cough continues to get worse and worse, until in their final moments, patients start coughing up chunks of their own lungs.

    Live-Action TV 
  • On The 4400, people whose bodies don't accept promicin get one of these before death.
  • Angel: Fred is killed when her body is taken over by an ancient god. The first symptom? Coughing up blood.
  • Babylon 5: I, Claudius is Referenced in an episode when Emperor Cartagia introduces Londo to his... "Shadow cabinet"; he mentions one of the cabinet members was "always coughing... Most distressing, but we finally managed to cure it."
    • This was also used with Londo as Foreshadowing. Londo, being a Centauri, has seen a vision of his own eventual death, but no context for the scene (seeing their own deaths in a vision is one of several hats the Centauri wear). One of the details of the scene is him having a sickly cough (though he knows from the beginning it's unrelated to his actual cause of death: being strangled to death by G'Kar). Starting from late in the second season, we see Londo cough occasionally, Word of God being that it is foreshadowing his eventual fate.
    • Played With in the Made-for-TV Movie The River of Souls, when a Soul Hunter arrives on the station. It is mentioned that Soul Hunters always appear shortly before someone important dies... and Zack Allen coughs. Played for Laughs when he immediately begins protesting that he's not sick, is not dying, and only coughed because his throat itched.
  • The Barrier: The noravirus, the story's iteration of The Plague, affects the respiratory system, resulting in coughing being a common symptom. Coughing at one of the checkpoints that are on the lookout for infected people among other things can ruin one's day.
  • In Better Call Saul, Jimmy's old scamming buddy Marco has one in S1 episode Marco. Marco is, true to trope, dead by the end of the episode. In S4, lead construction engineer Werner Ziegler has what seems to be one as well, but it's never disclosed whether he's ill.
  • The 2005 BBC adaptation of Bleak House by Charles Dickens; Richard Carstone works himself to death over the Jarndyce vs. Jarndyce case in hopes of getting his inheritance for himself and his pregnant wife, Ada... rather than staying alive by going to the doctor's and getting a regular night's sleep so he can provide for them. Plenty of "it's nothing!"s and "it's just a cold!" abound, and NO ONE forces him to get help until it's too late.
    • Actually, they DO try. Esther asks Woodcourt to keep an eye on him, and Ada is clearly worried - she tries to persuade Richard several times to give up the case. Apart from that, there's not much they can do, which is one reason why his decline is so painful to watch - everyone knows Richard is sick, but he is a) deeply in denial, and b) obsessed with the court case to the point that nothing else matters to him.
    • Jo also contracts some sort of illness (in the book it's smallpox) that causes him to cough blood. Unlike Richard, he does try to seek medical help, however a crooked lawyer tells a constable to force the boy to stay away from people. Ultimately he is found by most of the main cast and brought in for rest. Though he still dies, he at least is safe and relieved of feelings of guilt (worried that he caused Esther to die of the disease as well).
  • Played straight then subverted the played straight again in Breaking Bad. The protagonist develops lung cancer at the start of the show and his first symptom is a cough. He becomes a drug dealer to make money fast for his family before he dies In the episode where he starts coughing badly and even spitting up blood, he assumes he has little time left, kicking off a rather dark take on Like You Were Dying. It turns out it's just a reaction he's having to the medication, and the blood is from a slight tear due to all the coughing—he's actually in remission. In the final season, his cancer comes back and he starts coughing again.
  • The Buffy the Vampire Slayer episode "Lies My Parents Told Me" indicates (in flashback) that Spike's mother won't have long to live when she coughs a bit of blood into her handkerchief.
  • Cases of the 1st Department: Mjr. Plisek is a heavy smoker and he coughs from episode one. In "48 Hours", he has a coughing fit and spits blood. All points to lung cancer, but it's something less serious and he's cured after an operation. Subverted.
  • Episode "Awakened" of Charmed opens with Piper coughing up a storm and Phoebe trying to convince her to go home and rest. Piper insists she's fine. She collapses two minutes later. She's in a coma within a day. Her life is only saved via magic, conventional medicine is shown to be unable to save her.
  • In the Miniseries Chernobyl, Party Bureaucrat Boris Shcherbina develops a bloody cough during the trial, indicating that he has a terminal illness from radiation exposure in the exclusion zone.
  • In an early episode of Scottish Sketch Show Chewin' the Fat, Ford Kiernan and Greg Hemphill are discussing movie tropes, one of which being that the minute you see a young child (no matter how healthy she may seem) cough, she's probably going to die.
  • A non-lethal example from an episode of The Cosby Show. Cliff is rushing about preparing an anniversary dinner for Claire. About a third of the way into the episode, he begins to cough, and by the episode's end, is laid up in bed with the flu.
  • Subverted in Criminal Minds episode "North Mammon". Three teenaged girls were kidnapped by a man and held in a cold, damp cellar. Just before this happened, one of the girls had coughed, indicating that she was getting a cold. That same girl grew worse and worse in health due to her surroundings as she and her friends were locked up. In order to be let go, the kidnapper made the friends choose among themselves which one of them would die in order for the other two to be let go. One of the healthier girls made up her mind to kill the sick girl and was trying to convince the other healthier girl to help, but in the end the sick girl bashed the former's head in with a hammer in order to survive. She and her remaining friend made it out of the cellar alive, but horribly shaken up from the experience.
  • In the very first scene of The Crown (2016), King George VI violently coughs up blood into the toilet, before assuming a Stiff Upper Lip and going into preside over Prince Philip's investiture ceremony. Given that the focus of the series is about George's daughter Elizabeth II's early years on the throne, it's not hard to guess what's coming.
  • In Deadwood, Doc Cochrane begins hacking up blood in the third season, and Silas and others describe him as "a lunger", implied to be tuberculosis. Cochrane starts getting depressed, but Swearengen gives him a tough-love pep-talk, telling him that he isn't dead yet and to get back to work. Of course, the fact that Cochrane is the only doctor in town means Swearengen and the rest of the town residents rely on him. Subverted, since the Doc lives to the end of the series.
  • Don Fernando in the ridiculously Narmy educational Spanish-learning program Destinos has one of these. He has it throughout the entire 52-episode series and doesn't die. Supposedly, he dies of it after the end.
  • Doctor Who:
    • In early serial "The Sensorites", Ian develops a case of this. He goes from coughing to unconcious and dying in about two minutes. Fortunately, he has a natural immunity — he's a program regular. (That didn't stop some viewers from mistaking William Russell's acting-cough for an on-camera bout of real real-life choking — a different kind of ICOD.)
    • "The Empty Child": The elderly Dr. Constantine is seen coughing.
      The Doctor: You're very sick.
      Dr. Constantine: Dying, I should think. I just haven't been able to find the time.
  • In an episode of Friends, Phoebe poses as Chandler's dying wife to help him get an engagement ring for Monica. She coughs rather casually to emphasize the point that the other man is going to "break a dying woman's heart", prompting Chandler to explain that she's dying "of a cough, apparently".
  • Game of Thrones:
    • When King Joffrey drinks a goblet of poisoned wine and begins to cough, it's immediately obvious that he's going to be dead in the next couple of minutes.
    • Played With when Jon Snow suffers a serious coughing fit after downing a Gargle Blaster offered by Mance Rayder.
  • Goodbye My Princess: Ming Yuan has tuberculosis, and her frequent coughing fits show how close she is to death.
  • Horatio Hornblower:
    • Captain Keene is a very old and frail man who coughs and wheezes all the time. It's clear that he's dying. He dies after the obligatory two thirds of the episode, but interestingly enough, he died when his ship Justinian was attacked and sunk by the French.
    • Finch, a lower-deck character, feels dizzy and feverish, and falls down from a mast. He coughs while his fellow sailors try to nurse him back to health, and even Mr. Hornblower is invested in his recovery. It doesn't help that they are on half-rations and his fever doesn't disappear. He dies very soon.
  • House gives two giant middle fingers to this trope, because Dr. House's patients just about never die. Except that one time. "But... it's just a cough." One time they had TB patient, and he didn't cough at all. Cue the good doctor declaring, on live television, "THAT is not TB!"
  • House of the Dragon: Used in a slightly more realistic manner in the fifth episode of Season One; King Viserys is shown coughing and visibly weakened after a strenuous sea voyage exacerbates the wasting disease he has already contracted from a wound inflicted by the Iron Throne, but it takes several more episodes before he finally succumbs.
  • In an episode of How I Met Your Mother Marshall imagines Lily dying from an Incurable Hiccup Of Death.
  • Played with in I, Claudius, where Gemellus's chronic cough is fatal because it really annoys Caligula.
  • JAG: This is a symptom shown by the submarine crew exposed to an unshielded nuclear weapon in "Enemy Below".
  • Played frighteningly straight with Kamen Rider Dragon Knight as Chris Ramirez, aka Kamen Rider Sting, had asthma severe enough to get him discharged from the Marines. It probably wasn't lethal on its own, but when given the offer to be a Kamen Rider he Jumped at the Call. After that he really aggravated his condition with all the superheroics, ignoring every warning sign along the way. At least when he went out, it was by Heroic Sacrifice instead of illness (and due to being a Fate Worse than Death that turned out to be not really, he was able to come back in the epilogue and the heroes now could use Phlebotinum to cure him).
  • While not Chris' counterpart, the series from which Dragon Knight adopted its footage, Kamen Rider Ryuki also contains one such character in Shuichi Kitaokao/Kamen Rider Zolda. In fact, its more or the less the main reason why he becomes involved in the Rider War as he wants to use the promised wish to grant himself immortality, thereby curing himself. By the end of the series, Shuichi decides to quit the Rider War deciding to enjoy what little time he has left. However, he also begins to feel the need to take some personal responsibility over his role in allowing his Arch-Enemy to become a Rider, and decides to fight him one last time. Before he gets the chance, however, he succumbs to his illness and dies. Even taking the Reset Button ending into account, there's no indication that things will turn out any better for Kitaoka, and worse, he'll probably never go through the Character Development he did in the series and grow out of his Jerkass tendencies.
  • The second season of The Last Man on Earth has Phil's brother Mike track him down after finally leaving the International Space Station. But while staying with the group, he starts to show signs of illness. It's hinted that he's not immune to the virus that killed off most of the population as previously thought. When he coughs up blood, he takes it as a sign that his days are numbered and goes back to Tucson to live out the rest of his days. Subverted as he makes a full recovery offscreen and later tracks the group to Mexico.
  • On Lost, Richard's wife dies shortly after coughing up blood. The soundtrack identifies her illness as pneumonia. This occurs in 1867 in an isolated town on the Canary Islands, so her prognosis is reasonable.
  • Monty Python's Flying Circus: a couple discusses what's for dinner.
    He: Well, what kind of fish you got that isn't jugged?
    She: Rabbit!
    He: What, rabbit-fish??
    She: Err, yes. It's got fins...
    He: Is it dead?
    She: Well, it was coughing up blood last night.
  • In NCIS, Mike Franks shows signs of some kind of illness, but what it was was never revealed. However, Gibbs was making a coffin for him before he was killed, so it wasn't an illness he would've survived. Given his smoking habit, it's highly likely it was lung cancer.
  • In the NUMB3RS episode, "Janus List", the a bomber, Taylor Ashby coughed a few times in the beginning before being blown up by one of his bombs. Later, it was revealed that he was poisoned and that he only have a short time to live even if he wasn't burned.
  • Orphan Black: Some of the clones get an autoimmune disease that attacks endometrium and lungs. When Cosima coughs blood, curing it becomes a major plot thread; until then, the main concern was who has been murdering us and why. In the end, she finds a cure and Delphine goes globe-trotting to give it to the surviving clones.
  • Referenced in the QI episode "Illness", where the panelists' buzzers are a man coughing, a man coughing more severely, an ambulance siren, and the funeral march.
  • The Queen's Gambit: Beth's mother's health is implied to not be very strong early on, but when she starts coughing occasionally, it's a reliable indicator that her illnesses are serious. Soon enough, she dies with little warning.
  • Saturday Night Live: Analyzed in a sketch with Alec Baldwin, where he hawks DVD #72 in his instructional acting series: "First Coughs: Foreshadowing Your Character's Death." Actually provides a pretty good breakdown of the various ways it's commonly handled, including "Ignoring It," "It's Just a Cold," and "I Don't Need Any Damn Doctors." The Advanced lesson is "Coughing Into a Handkerchief, Seeing Blood in It, Looking Nervously Around, and Hiding it in Your Pocket".
  • Practically invoked and inverted in Scrubs episode "My White Whale". Dr. Cox's son Jack develops a cough, which turns out to merely be the sniffles, but that doesn't prevent his dad from charging down the hospital hall like a mad bull, violently shoving over other doctors and patients. Dr. Norris, Jack's pediatrician, explains to Cox that as a doctor, he has to deal with the burden of knowledge, knowing what can really go wrong, and that he has to take control of it or it will ruin him. In the episode's closing scene, Cox is lying in bed, panicking about Jack's coughing.
  • In episode 2 of Shinya Shokudo, a singer coughs blood after a concert (complete with collapsing). In the next scene she is seen in a hospital bed, while the voice-over explains that she died about one month later.
  • In one Sliders episode, they end up in a world where a disease ("The Q") is spreading throughout the world, and wiping out humanity because, as a paranoidly clean society, they never discovered penicillin. Anyone who coughs has the disease (and often try to cover it up).
  • In one arc of Spooks the team is dealing with a biological weapon that's been smuggled out of Iran. Carriers are asymptomatic for the first 20 hours or so, but when they start coughing up blood they become contagious and die soon afterwards, though the team is able to secure an antidote from Russian intelligence.
  • In the series finale of Stargate SG-1, the title team is trapped in a bubble of time. As twenty years pass during a montage, an aged General Landry coughs. By the end of the montage, he is lying on his deathbed.
  • Subverted in the That Mitchell and Webb Look sketch "The Man Who Has A Cough And It's Just A Cough And He's Fine" - an Edwardian man reguarly meets his lover at the railway station, his cough getting worse each day, despite his insistence that "it's just a cough." Then one day, the woman gets off the train, and finds him gone… only for him to enter in perfect health. Confused, she says she thought he had TB. Surprised, he says he certainly would have mentioned something like that. No, it was actually just a cough.
    Woman: Right. Wish I hadn't let you do me, now.
    • Parodied in another sketch, in which a terminally ill man gets his best friend to fulfill his increasingly extravagant dying wishes by putting on a sickly-sounding cough.
  • Played with in Treme: Albert Lambreaux is diagnosed with lymphoma. This itself doesn't cause coughing, because it has nothing to do with the lungs, but coincided with him developing chronic coughing fits for unrelated reasons.
  • The Tudors features this at one point, where King Henry's sister starts coughing up blood and dies within an episode. Henry mildly lampshades the suddenness by telling her husband (who is his best friend) in an accusatory tone that "You didn't even tell me she was sick." Unfortunately, somewhat Truth in Television... the real life woman died of tuberculosis, which was quite common at the time and manifested primarily as coughing and later hemorrhaging from the lungs.
  • The Twilight Zone (1985): In "There Was an Old Woman", Brian Harris, who has an unnamed serious illness, coughs during Hallie Parker's visit and his parents tell him that it is time to rest. He dies a week later.
  • Victoria: In the episode covering the Irish Famine, Dr. Robert Trail coughs while dishing out stew to his parishioners. In his very next scene, he is being buried, having died of typhus.
  • Walker, Texas Ranger. Towards the end of the two-part episode "Lucas", the AIDS-stricken child develops a persistent cough. Walker takes him to the hospital, and the next scene is of the boy's funeral.
  • The Walking Dead:
    • A boy named Patrick develops this in the season 4 premiere, and by the end of the episode he's dead and re-animated. This results in a walker outbreak inside the prison, necessitating a massive quarantine.
    • In general, this happens all the time on the show. In order, symptoms are: cough, fever, death, walker. Most characters who get a cough try to hide it, as they'll likely get put in quarantine (or killed) when anyone finds out.
  • The White Queen:
    • Isabel Neville is seen coughing before she becomes bedridden and then dies of childbed fever.
    • Queen Anne's violent bouts of coughing are symptoms of tuberculosis, and it gradually kills her.
  • Parodied on The Carol Burnett Show when they did a sketch called "Lovely Story" (a parody of Love Story). Jenny (played by Carol Burnett) coughs twice, and five minutes later, she's dead.
    • At the very end of the sketch, the doctor tells Oliver (played by Harvey Korman) that the only thing they know about the disease that killed Jenny was very contagious. Oliver coughs twice, and drops dead.

  • In Wolf 359, Eiffel develops a cough at the start of season 2, which gets progressively worse over time. At the end of "Lame-O Superhero Origin Story", he's audibly out of breath even though he hasn't done any physical labour. He then starts coughing and gagging, hacks up blood and collapses. The next episode, "Do No Harm", consists entirely of Hilbert and Minkowski performing emergency surgery on him, desperately tring to keep him alive as he suffers a collapsed lung and severe internal bleeding. He does survive, but only after hours of emergency surgery and a blood transfusion from Lovelace.
  • Edwin Stanton struggled with asthma for most of his life, and coughs constantly throughout 1865. His asthma ultimately claims his life by 1868.


  • Older Than Radio: The "coughing tragic consumptive heroine" trope dates back to the 1852 novel and play La Dame aux Camélias by Alexandre Dumas, fils, as well as the opera La Traviata and Greta Garbo film Camille based on it.
  • Mimì from Puccini's La Bohčme is another operatic character who coughs and faints her way to a tear-jerking death scene. Mimi from RENT fares much better.
  • Both of the above were based on real people (though Mimi very loosely so). What makes La Boheme even more depressing is that the real 'Rodolfo' also died of TB shortly after writing Episodes from the Artistic Life, as did most of the main cast. (Except Musetta... who saved up money to quit prostitution for good after 'Marcello' died, and sailed away to start a new life in French Tunisia... only to be killed when her ship sank.)
  • Not an exclusively Western trope - in Tsukiuta's second play, Yumemigusa, Arata (in the Sakura version) and You (in the Moon version) are dying of this. Their stories are based on Okita Souji of The Shinsengumi, a real-life 19th-century figure who died of tuberculosis, and is, of course, romanticized in fiction similarly to figures like Violetta.
  • In Long Day's Journey Into Night, Edmund coughs frequently; he subsequently learns he has tuberculosis. He tries to hide the truth from Mary, his morphine-addicted mother, by passing it off as a "summer cold." In the heart-rending final scene, as the relapsing Mary thinks she's back in her adolescence, Edmund tries to break through to her by shouting, "Mother! It's not a summer cold! I've got consumption!", but she's too far gone for this to register.
  • Double Subversion in Martin McDonagh's play The Cripple of Inishmaan: Cripple Billy, having a pronounced cough from the start of the play, produces a doctor's letter diagnosing him with TB, and is seen to die of it in a Hollywood motel room. It turns out that he forged the letter so that Babbybobby, the boatman whose wife died of TB, would take him to Inishmore so that he could be in the film Man of Aran. His "death scene" is actually him rehearsing his lines in his motel room. And then after Billy returns to Inishmaan when, irony of ironies, it turns out that he has contracted TB after all, complete with Blood from the Mouth. On a related note, the play is also a Deconstruction of Bury Your Disabled.
  • Fantine in the musical Les Misérables, of tuberculosis. However, it's difficult to convincingly fake tuberculosis and sing heartbreaking arias at the same time, so it depends on the actress sneaking in a few coughs when she has the time. (The French concept album was more explicit, where Fantine actually sings, "Inspector, I'm sick, sometimes I cough up blood.")

    Video Games 
  • Reflecting the broken keel that saw the historical IJN Amagi scrapped, Amagi from the Azur Lane event Crimson Echoes has a damaged Wisdom Cube that gives her this trope. Predictably, she dies at the end of the event.
  • Battle for Wesnoth: In Secrets of the Ancients, Ras-Tabahn starts coughing not long after he becomes playable and, sure enough, his coughing fits gets worse until he dies, but Ardryn-Na uses the opportunity to test her theory that one must die before becoming immortal by turning into a lich. It works.
  • The Blackpine Outbreak: The Voice with an Internet Connection can be heard coughing over the radio, showing that he is infected. By the time you reach him, he's dead.
  • In Cyberpunk 2077, when the Relic begins to cause fatal brain damage to V, one of the symptoms they develop is coughing (if not outright vomiting) blood.
  • In Daughter for Dessert, an interesting variation is shown with Lainie. The protagonist noticed that Lainie had a cough, but didn’t think anything of it, and it is clearly implied to have caused Lainie’s death in childbirth. However, Lainie might have been able to get cured if she so chose; however, she concealed the full extent of her illness from the protagonist so that her treatment money could instead go to the business that he wanted to start.
  • Dr. Light has this both during the flashback at X's ending sequence in the Continuity Reboot called Mega Man: Maverick Hunter X and in the Day of Sigma OVA included in said game during the flashback showing Dr. Light creating X on his final days.
  • Solid Snake in Metal Gear Solid 4 coughs horribly whenever he's out of his suit, even though the disease giving him trouble is Plot-Relevant Age-Up.
    • Though, considering the amount he smokes...and he's had his cigs from the first game, and possibly even through training...
    • He doesn't really cough until he's horribly burned in a fire at the end of Act 3. Prior to that, he's actually mostly okay. Likely he inhaled the superheated air and burned his throat.
    • In the novelisation, it's specified that he has developed pulmonary fibrosis from a combination of his genetic issues and his smoking habit.
  • At the beginning of Hector's path in Fire Emblem: The Blazing Blade, Uther of Ostia coughs during a conversation with Oswin. This pretty much seals his fate.
    • In Uther's case, it doesn't really help that he's apparently putting an insane amount of stress on himself and barely sleeps; he may have lasted a little longer if not for that. Also of note is the fact that his and Hector's parents apparently died of the exact same illness.
  • Fjorm from Fire Emblem Heroes gains a nasty cough after performing the Rite of Frost; it turns out the Rite of Frost grants the user massive power, but will eventually kill them.
  • In Fire Emblem: Three Houses, Ionius IX, the Adrestian Emperor and Edelgard's father, coughs sporadically when he talks from his sickbed. He dies during the Time Skip when the poisoning from those who slither in the dark finally claims his life.
  • Ukyo from Samurai Shodown has long had such a cough, but is a subversion, as his popularity makes him essentially immune to the death he was set up for.
    • In at least one of the games' endings, they hang a lampshade on this quite nicely.
    • Ukyo's Seppuku takes advantage of his tuberculosis - instead of killing himself somehow like the other characters, his disease finally kills him.
  • Dah from Far Cry Primal suffers from this, due to having a sickness called "skull fire", like most of the Udam tribe to which he belongs. Ultimately, he asks Takkar for a Mercy Kill instead of letting himself die a slow, Undignified Death.
  • At the end of the introduction of Dragon Quest V, the lead character's mother manifests one of these as an explanation of why she isn't present when the game proper kicks off. It's actually a trick, though — she's still alive, and gone for entirely different reasons.
    • In Dragon Quest IX, many people in the town of Coffinwell are coughing due to a contagion. Naturally, the only character who dies from it is the one character who downplays their coughing: Catarrhina.
  • In Silent Hill 2, at the end of the Maria ending, Maria coughs, and it is implied that what happened with Mary will happen again with Maria. Mary's illness also started with one, but some other, nastier degenerative symptoms began to set in as her condition got worse.
  • Star Ocean: Till the End of Time: Nothing about Ameena augers well for her life expectancy, but it's the cough that makes it possible.
  • Subverted in Prince of Persia: The Sands of Time. In the first few cutscenes, the Vizier is shown coughing violently, getting blood in his handkerchief. Since he wasn't in a fight beforehand and this has nothing to do with his later death - either of them - it may actually fall under Vader Breath.
    • The relevance is more character-driven than plot. The cough and blood show that the Vizier is dying of Tuberculosis. It is this impending mortality which drives him to seek the Sands of Time (and the immortality they can provide).
  • Persona 3: There's two examples of this:
    • Shinjiro in coughs on occasion, the only real sign the meds he takes to keep his Persona under control have wrecked his health. Interestingly, this is worked into gameplay: during combat, when someone misses with a melee attack, there's a chance they'll trip and be left prone for a round. Shinjiro doesn't trip - he bursts into such a severe fit of coughing that he drops to his knees.
    • And then we have the Delicate and Sickly Akinari Kamiki, the Sun Social Link, a frail, thin young man who has this nasty tendency to go into such fits of coughing that he ends up briefly unable to speak. The name the game gives his Social Link says it all: "Dying Young Man". Notable for actually giving an identity to his ailment (a terminal genetic disorder). He actually does fall victim to his illness, and it's hinted that, in a case of Not Too Dead to Save the Day, it's his ghost who gives you his book as a Tragic Keepsake if you max said Link. Also, his soul will cheer you on before you go fight the Big Bad.
  • Syphon Filter 2: Lian Xing's main symptom after being infected with The Virus.
  • Mass Effect 2:
    • When "Archangel" was active on Omega "cleaning house", there was a serial killer who also was a biologist specialized in virology. His cause of death was found to be "a cough". Since the killer was a quarian, a species known for having incredibly weak immune systems, "Archangel" simply coughed on him to kill him.
    • The quarantine in Omega is in place because of a disease that starts off as a simple cough...
      "It starts out as a cough, then you start coughing blood. And then... well. Then I shoot you."
  • Mass Effect 3:
    • If he survived 2, Thane Krios is coughing when met in 3. In this case, it's justified as his illness is stated to be Kepral's Syndrome, a drell-specific condition where their lungs slowly fill with fluid. By the time of 3, he says he was given 3 months to live... 9 months ago. He'll later be seriously wounded and die due to complications resulting from his illness, keeping with the trope.
    • Eve is a female krogan shaman who became immune to the genophage inflicted upon her species after some well-intentioned but barbaric experimentation. She coughs during conversations with the player if they previously chose to destroy said experimentation data in 2, and sure enough dies later on if this is the case.
  • In Metro Exodus, tuberculosis is one the main killers in post-apocalyptic Russia.
    • Anna develops a cough after falling into a chemical dump and lying unconscious without a gas mask before Artyom finds her. It doesn't get better in the dusty desert air of the Caspian and she eventually reveals that the doctor in Yamantau told her the lung damage will kill her in a few months. Finding a treatment becomes the next main objective.
  • In inFAMOUS 2: The hero's buddy, Zeke develops a cough soon after the plague becomes a part of the plot.
  • In Unreal, you'll sometimes hear Nali cough for no plot-relevant reason.
  • According to Doctor Who: The Adventure Games - City of the Daleks, getting caught in a paradox will not only cause you to fade into non-existence, Back to the Future style, but will also give you a really bad cough. Yeah.
  • The Joker in Batman: Arkham City has a cough that gets more pronounced as the game goes on, thanks to his TITAN poisoning from the last game. This is also one of the few cases where Joker Immunity gets thrown out the window.
  • Zhuge Liang in Dynasty Warriors 6. Oddly, he actually survives, unlike the real person.
    • Guo Huai in Dynasty Warriors 7 has this as his primary character trait. He still manages to kick all kinds of ass with his ancient Chinese machine gun, despite keeling over after performing most of his special attacks.
  • Subverted in Trauma Team when Naomi Kimishima coughs up blood near the end of the game, a symptom of the fatal Rosalia virus. It turns out to be the virus, but she's saved from it by CR-S01.
  • Ace Attorney:
    • In Trials And Tribulations, Terry Fawles falls victim to this in case 4 from ingesting poison.
    • Subverted in Spirit Of Justice, as it is suggested that Dhurke Sahdmadhi died this way, but it is actually found out that it was blood from gunshot wounds. This reveal, however, helps dissipate most of (if not all) the suspicion surrounding that case's defendant.
      Phoenix: Maybe he coughed it up?
    • Also subverted in The Great Ace Attorney with Inspector Hosonaga. From the moment he is introduced, he is seen to have violent coughing fits that include Blood from the Mouth, all in a case where the cause of death of the victim is poison. However, in his case it turns out to be a Red Herring; his condition has nothing to do with the case at hand (and is never actually gone into at all, even in the subsequent cases he appears in).
  • Portal 2: Cave Johnson acquires a fatal illness from handling moon rocks, and his intercom messages are frequently interrupted by violent coughing fits. Somewhat justified since it's speculated that lunar dust could cause respiratory disease.
  • A character in Illusion of Gaia coughs when you first meet him. He turns out to be your opponent in a Russian Roulette-type game, which he was playing to earn money for his family, since he knew he was dying anyway.
  • During the opening sequence of The 7th Guest, we see a girl dying of a "mysterious virus" and hear her coughing rather persistently.
  • In The Sims Livin' Large, there's the so-called Guinea Pig Disease that your sim can catch if (s)he doesn't keep his/her guinea pig cage clean. Once the guinea pig has bitten the sim, (s)he will start coughing and sneezing and will most likely die in the next few days if (s)he's not treated. The "incurable" part of the trope is subverted, though, because it can be cured in two ways: either buy the Forgotten Guinea Pig painting and wait for several in-game hours or let one of your sims use the Concoction Station several times until (s)he gets a white potion, then let the ill sim drink it.
  • In Disgaea 3: Absence of Justice, Almaz starts getting sick when he's pricked by a needle thus suffering from an incurable curse. He insists that he's fine throughout the majority of chapter 6 and 7 until he finally drops dead due to progressively getting weaker. Only in the bad ending does he stay dead. Other than that, he'll get better.
  • Pokémon Conquest surprisingly has this with Hanbei. Once you beat his episode, he starts coughing up a storm. When Hideyoshi asks if anything is wrong, Hanbei just responds that he got too excited. Kanbei doesn't believe a single thing he said though which causes Hanbei to glare at him saying not to say anything before switching the subject on something funnier. Naturally Hanbei didn't die on screen, but given his real life counter part died of tuberculosis, it's easy to assume that he died shortly after.
  • Brothers: A Tale of Two Sons begins with the father having contracted what Ben Croshaw described as "the old classic unspecific-persistent-cough disease", and the two protagonists are tasked with finding a cure before he dies of it.
  • Hakuouki: It follows The Shinsengumi from before the Ikedaya Incident up to the end of the group, and thus unsurprisingly shows the onset of Okita Souji's tuberculosis and his struggle to cope with his illness. In most routes, it takes him out of the story entirely right around the onset of the Boshin War just like his real-life counterpart; in his own route (and in the anime adaptation) he manages to stick around a little longer thanks to becoming a fury, but his cough doesn't entirely go away and even his ending implies that he's living on borrowed time.
  • The main quest of the titular Drifter from Heart Machine's Hyper Light Drifter is to Find the Cure to his own Cough of Death: the Immortal Cell... In the end it turns out that the Cell is not a cure, but an Artifact of Doom, a false hope that the Drifter has to destroy.
  • Tear in Tales of the Abyss. The cough, like several examples on this page, comes from poison, which in every other case (meaning the NPCs) plays this trope straight when they come on contact with the miasma. She only avoids death because a dying Ion takes Tear's poisoned fonons out of her body when his fonons dissipate. It does play the trope straight when it comes to fainting, trying to cover it up, and pretending to be getting better. Overlaps with Definitely Just a Cold sometimes.
  • Radiant Historia: Field Marshal Viola. The fact that she thinks she doesn't have long to live goes a long way to explaining some of her behavior late in the game, though she doesn't die of it no matter what. Either you kill her, or, if you completed her sidequest, she survives and gets treatment for her disease, which turns out to be less incurable than previously anticipated.
  • The Silent Age: During one of the final gaming sequences, Joe stumbles a couple of times and gives out a cough. By that time the player can already guess it means he got infected by the virus from the future and is going to inevitably die. He doesn't only because he is kept in a cryogenic capsule for the next 40 years untill the virus can be cured.
  • In Zombies, Run!, coughing is known as the first sign that someone is "going gray".
  • Minecraft: Story Mode: Inflicted upon whoever Jesse saved from the Wither Storm when they rejoin the group.
  • An NPC in Final Fantasy Tactics A2 has a cough that grows worse as he sends you on quest after quest. At the end of the quest chain, the NPC dies off-screen from an unspecified illness and his apprentice delivers the news of his death to you.
  • In NieR, your daughter Yonah has one. Although if you're playing the Japanese PS3 version Yonah is your sister instead.
  • Inverted in Deep Fear, where the player character's coughing is merely due to a cold, which happens to make him immune to The Virus.
  • Spoofed in Sengoku Rance: Okita Nozomi does the classic coughing routine, and is identified as having the "Cough Cough Disease", a disease whose only symptom is prolonged coughing fits. The game notes that it's easily treatable, but if it goes on for too long, it can eventually be lethal.
  • Red Dead Redemption II: The trope is justified as the disease in question is tuberculosis, and the game is set at a time when TB was completely untreatable.
    • Thomas Downes, the person who intervenes in the fight between Arthur and Valentine's local brute Tommy, has a pretty nasty cough when you meet him for the first time, and dies of it about 1/3 of the way into the game. But not before infecting Arthur with his TB while Arthur tries to collect a debt from him, resulting in Arthur's death by the end of the story.
    • Towards the end of the story, Arthur is diagnosed with tuberculosis, and his coughing gets progressively worse. Unlike many video game examples of this trope, Arthur starts taking stat penalties as his condition worsens. By the end, he ultimately succumbs to it. The unusually quick progression of the disease is most likely because Arthur suffers from a variety of harsh conditions (such as being taken captive and tortured in chapter 2) which would make him extra-vulnerable.
    • Abigail Marston has an unexplained cough in the epilogue of Red Dead Redemption II and the main story of Red Dead Redemption. The cause is never clarified, but is generally seen as setup for her offscreen death in the Time Skip before the first game's epilogue (as Abigail would have only been 37 at most when she died, an illness or disease related death seems likely). A common fan theory is that Arthur accidentally infected her with tuberculosis while rescuing her from Agent Milton, which remained latent for years but worsened significantly due to the trauma caused by John's death.
  • Hades has an extremely subtle example. The first time Zagreus successfully escapes from the Underworld, he lets out a single cough while en route to Persephone's farm. After reaching Persephone and spending some time with her, his condition suddenly and rapidly worsens, and Persephone realises that, just like his father, Zagreus is bound to the Underworld and cannot survive outside it for long. He soon collapses and dies, ending up back at the House of Hades.
  • Averted by Quistis Trepe in Final Fantasy VIII. She appears to cough several times needing hold up her hand in a wait a moment gesture to get her breath back. She's in peak physical condition and remains that way through out the game.
  • Fate/Grand Order: A Gender Flipped Okita Souji is a summonable Servant and much to her annoyance, her tuberculosis still remained within her. She tends to feel like her body's being fine and she could fight, only to be Instantly Proven Wrong with the trope.
    "Okita-san's great victory/daishouri! Yep, my body's all fine! I Can Still Fight! — *cough!?*"
  • In Azur Lane, upon finishing construction of Battlecruiser Amagi, she would cough during her introduction. The reason would be revealed during the final stage of the Crimson Echoes event, where she reveals that due to being born 'weak' and having a defective core that she was not long for the world.
  • In Danganronpa V3: Killing Harmony, Kaito Momota first starts coughing up blood in chapter 3, and his condition worsens quickly, ultimately killing him mid-execution in chapter 5. Not wanting to die before accomplishing his life goal of going to space, his illness serves as motivation for many of his more reckless actions in the second half of the game.

    Web Animation 
  • TP: The old roll of toilet paper has a cough from his first line, and is pretty much on his last few strips by the time we see him. Soon enough, Earl comes along and finishes him off.

  • Keychain of Creation: Secret, shortly pre-Abyssalization exhibited this in a flashback, complete with blood, after catching a plague of some sort.

    Web Originals 
  • The Fire Never Dies: US Secretary of State Robert Lansing starts coughing in the middle of a speech at the Basel Conference. Sure enough, he soon dies of the American Flu.

    Web Videos 
  • Elizabeth Avery's cancer manifests itself this way in lonelygirl15.
  • In Marble Hornets:
    • The more wrapped up in whatever happened to Alex Jay gets, the sicker he seems to grow. Entries set in the past show Tim having a similar coughing fit. The following seasons show this is the least of his health problems - without meds, he turns back into the Masked Man, which involves something approaching a seizure.
    • The idea got picked up by a few other stories in The Slender Man Mythos, with one suggesting that it's due to Slender Man dragging the victim back and forth through time, which the human body is not designed to handle.
    • One Hundred Yard Stare has the symptom appear in episode four.
  • In the episode written by a computer of Hardly Working, we are told that Grant "will pass away underneath the couch exactly one year from today". Grant chooses to represent this by coughing unhealthily.
  • Poor Beth has one in Shipwrecked Comedy's Little Women parody "Little V Vomen." Somewhat subverted in that she doesn't exactly die by the end of the trailer, but she's not in the greatest condition either.

    Western Animation 
  • Arcane: Always sickly and weak even as child, Viktor coughing heralds his declining health. He eventually learns that he doesn't have much longer to live after collapsing during an experiment.
  • Parodied in the South Park episode "Kenny Dies". Kenny randomly starts coughing during one scene, and if you can't guess where it leads to, take another look at the episode title. (Probably Muscular Dystrophy, judging from the vague descriptions we get.)
    • Played straight in the South ParQ Vaccination Special, though: Ms. Nelson starts coughing with no build-up just as the boys bring the vaccines against COVID-19 at the school and the scene suddenly cuts to her funeral. However, it's heavily implied that Mr. Garrison made a pact with "The Elite" to get rid of Ms. Nelson and regain his place as teacher at South Park Elementary.
  • Also spoofed in American Dad! "Tears of a Clooney". Hayley randomly coughs during one scene, which sure enough leads to her developing cancer (though she ultimately does not die.)
  • In an animated short called The Kinematograph. It's a truly heartbreaking story about a man attempting to create moving pictures (aka movies) in color. His wife is the one who tells him her theory on how to make color film, which ends up working. However, as soon as he leaves the room, she starts coughing. When he finally makes it work, he asks her to sit down in front of the camera and talk so he can film her. After he's developed the film and is excited to show her, he finds her collapsed on the floor near a bloody handkerchief. She dies, and all the man is left with is the film of her he was so eager to make.
  • Subverted in the Drawn Together episode "Clum Babies". Clara develops tuberculosis. Foxxy and Spanky convince Wooldoor to produce another Clum Baby (which he no longer produced due to the Veggie Fables convincing him that masturbation is a sin) to save Clara's life. As Clara is dying and about to use a Clum Baby, the Veggie Fables tell her not to use the Clum Baby. Foxxy tries to convince the Veggie Fables otherwise, but Bob the Cucumber refuses to listen. Bob kills Clara and proceeds to kill everyone else in the house except for Wooldoor.
  • Superjail! - poor little "Sanser"...
  • In The Simpsons, Poor Violet is one half of a pair of orphans who always show up in Springfield whenever a heartstring needs tugging. She suffers from this. Most likely due to living in an orphanage that can't afford the proper number of walls.
    Poor Violet: Three is not enough ... (COUGH HACK COUGH)
  • Lampshaded in Spider-Man: Into the Spider-Verse with the first Peter Parker. He is severely injured and buried under a pile of rubble. Despite first insisting that he's fine, he coughs, indicating to the viewer that he will probably not be getting up from this. Also somewhat subverted because rather than dying of his injuries, he is killed by Kingpin.
    Peter Parker: The coughing's probably not a good sign.
  • Over the Garden Wall features Lorna, who spends the majority of her appearance coughing due to a "mysterious illness" (actually an evil spirit that has possessed her).

    Real Life 
  • A bad nosebleed can cause blood to drip into the throat. Naturally, this causes coughing, and while obviously not fatal, it's unsettling and by no means fun. It can be even worse in the winter, when it's easier to be dehydrated and when it's easier to catch an illness, thanks to everyone staying indoors in close environments.
  • Legendary gunfighter Doc Holliday eventually died of tuberculosis. It's said that knowing he was terminal was what made him such a Death Seeker in the first place. (Reportedly his last words were "This is funny." He'd always thought he'd die with his boots on but found himself dying in bed looking at his socks.) Accounts of his Incurable Cough Of Death can be found in the historically inaccurate (but still pretty cool) movie Tombstone or here.
  • Averted, Post-nasal drip can cause continuous coughing but by itself wouldn't likely cause death. Have fun scaring people though.
    • A rather common symptom of bronchitis, which is not normally fatal, is rusty colored or blood streaked sputum. Which unfortunately is a common sign of pretty much every ER worthy lung disease.
    • It's also not entirely difficult to tear a blood vessel in your throat by coughing or vomiting and seeing blood, which doesn't have any serious consequences.
    • Prolonged periods of heartburn or other ailments that cause stomach acids to go into the throat (GERD), which can result in the vocal cords making large amounts of mucus to defend itself. This results in a nasty cough that most likely will not harm you.
    • A common allergy can be met with advice to "go home before you infect anyone".
  • A non-human example: If your computer's hard drive does strange clicking sounds, you can almost certainly tell that it's doomed.
  • Pertussis aka Whooping Cough. It's usually only fatal to infants (which just makes it worse), but even in older kids it can cause fainting, hernias, and rib fracture. It's also very unpleasant to endure, being that the endless deep coughs can make a person feel like they're dying, even in mild to moderate cases.
  • French playwright and actor Molière, who suffered from tuberculosis, is famous for having collapsed into a coughing fit while performing in the last play he wrote, ironically titled The Hypochondriac (Le Malade imaginaire). Despite coughing up blood, he insisted on finishing the performance. Afterward he had another fit of coughing and hemorrhaging before being taken home, where he died a few hours later.
  • As mentioned above, Shinsaku Takasugi and Souji Okita.
  • Composer and Pianist Fryderyk Chopin was almost as famous for his consumption as he was for his music (he finally died of it at age 39).
  • As mentioned in the The Rose of Versailles entry above, both queen Marie Antoinette and her second son Louis Joseph had tubercolosis, with Louis Joseph dying of it (and his illness having a deep impact in the relationship between the royals and the Estates-General due the latter refusal to allow the king and queen to visit their dying son), while Marie Antoinette was executed before it reached that point.
  • Cases of cystic fibrosis can cause this, due to the mucus the body produces becoming thicker and clogging the lungs and other parts of the respiratory system. Subverted by the fact that treatment for the disease is improving and life expectancy for the affected is much higher than a few decades ago.
  • General Lazare Hoche died of tuberculosis at 28 just a few days after he started coughing violently (and bloodily, according to some accounts). Since his death was very sudden and he was one of the most prominent French generals at that time, there was rumors that he had been, in fact, poisoned, but his autopsy did not support this.
  • The Other Wiki says the following about the voice actor Jim Varney: During the filming of Treehouse Hostage in August 1998, Varney started developing a bad cough. As the cough became worse, Varney began noticing blood on his handkerchief and, after filming was complete, he went to the doctor. A chain smoker, Varney had developed lung cancer.
  • Henrik Wergeland famously died from two-sided pneunomia that chained him to bed for 14 months. It began with a day in April 1844 when he decided to take his jacket off because the weather was bright, but his office accordingly cold (located in the old castle in Oslo). He had a fit of pneunomia, but after two weeks, he decided he was well enough to celebrate the National holiday of May 17, but his sister noticed he was "pale as death" when she saw him strolling downhill to town. After that, the illness returned, and this time, no power in the world could save him. His lungs deteriorated to a point where he passed out and died the following summer. Of course there was a lot of coughing and blood involved. Also possibly lung cancer, not very well known at the time.
  • Norwegian painter Nicolai Astrup died of a similar illness in the autumn of 1928, having caught pneunomia after - believe it or not - taking off his jacket in April that year (April in Norway can be treacherous). Astrup got his because of a car ride, combining hot sunshine with cold airs.
  • Unfortunately, it seems to be happening to 9/11 first responders: Their symptoms include all sorts of lung diseases, many types of cancer, and a persistent cough called the "World Trade Center Cough".
  • A shorthand that some medical professionals use when assessing patients over 40 is "A persistent cough is cancer until proven otherwise." An unexplained cough that lasts longer than ~2 months can be cancer that has spread to the lungs, so the patient is usually sent for a chest X-ray to rule out that possibility.
  • After the development of the antibiotic streptomycin, it was believed for a while that TB would be completely eradicated, and that this would become a Discredited Trope. However, the bacterium which causes tuberculosis quickly developed resistance to this and other antibiotics developed to treat it, mainly due to people not completing their antibiotic courses. This isn't helped by how even unresistant strains of the bacterium have some adaptations which limit the antibiotics which are effective against them, such as having a complex cell wall which many antibiotics can't penetrate. Mishandling of cases has lead to even more resistant strains developing and even some strains which seem to be completely incurable, which play this frighteningly straight.
  • COVID-19. Starts with coughing (which can last for weeks) and fever, in serious cases can lead to difficulty breathing and even death (especially if comorbidities are involved). While multiple vaccines exist, there is currently no cure.
  • According to a Facebook post by Michael Schlesinger, voice actor Will Ryan had a persistent cough that sounded very bad a week before he passed away from terminal cancer.

Alternative Title(s): Chekhovs Cough, Tuberculosis


Eric's Cough

Chris recalls how his buddy Eric / Wise Sage had a cough for weeks.

How well does it match the trope?

5 (4 votes)

Example of:

Main / IncurableCoughOfDeath

Media sources: