Near the end of his surgical career, neurosurgeon Allan J. Hamilton had an experience that convinced him near-death experiences were real and the patient’s conscious mind can exist when the patient is ‘brain dead.’
A thirty-four-year-old woman had suffered an aneurysm in her brain stem. “The swollen, ballooned portion of the aneurysm had actually engulfed and surrounded two important arteries that could simply not be injured or sacrificed. The aneurysm had swelled, like a rising loaf of bread, and would have to be teased off both blood vessels before it could be definitively repaired. But how to do this? Almost for certain, dissecting the aneurysm in this fashion would cause it to rupture — in which case she was dead for sure. But what if there was no blood to spill out when it did rupture? What if there was no flow at all?
“The surgical team decided to address the repair by cooling the patient’s body temperature down low enough to put her into a state of suspended animation. To make her core temperature cold enough to stop her heart so all blood flow would cease — maybe for as long as twenty minutes. To accomplish this goal, the young woman’s body would have to be slowly cooled on a heart-lung bypass machine, a device that oxygenates and then pumps the blood back into the patient’s body. Eventually, as the body’s temperature dropped below 90 degrees Fahrenheit, her heart would stop beating altogether. Once it stopped, the bypass machine would also be shut down. All blood flow to her body and brain would then cease entirely.
“At that point, all her brain wave activity on an EEG monitor would fall to zero. Then the aneurysm could be approached without being obscured by bleeding. It would be clipped under deep hypothermia. No more than twenty minutes could be allowed to complete this task. By then, if all went well, Dr. Tom Reed would have the aneurysm successfully clipped so it would be completely excluded from the circulating blood flow. When the deadline was reached, the bypass machine would be turned back on. Her blood could then be slowly and progressively rewarmed. We hoped that as her body temperature returned closer to normal, the young woman’s heart would resume beating.
“From a technical point of view, everything required for this daring surgical undertaking went well. There’s a video and audio track documenting the operation through the microscope. The audio portion is simply a recording of whatever ambient noise is picked up on a small boom microphone. As the operation began to wind down, several trivial conversations were picked up. One involved a conversation between Tom Reed and the perfusionist, the technician who overseas the heart-lung bypass pump.
We’re going to need to start the pump back up in a minute or two. Everything ready to go? Tom asked.
We’ve got to blow first, the perfusionist answered.
“To ‘blow’ is vernacular for firing up the pump and letting it circulate for a few seconds to ensure any bubbles in the system are cleared before reestablishing blood flow in the patient. While the pump was readied, there was a second important conversation picked up by the microphone. One of the nurses in the operating room, a certain Rita Hightower, announced she had just gotten engaged. A couple of the other nurses shrieked in excitement. Because Rita was scrubbed in, wearing surgical gloves, she wore no engagement ring.
“But she said, Oh, wait till you see it. It’s a one-and-a-half-carat square-cut yellow diamond. And he proposed to me right there at Morton’s. John got down on his knees and proposed. In fact, one of the waiters didn’t see him and tripped and fell into the wine case. Nothing broken, but it was funny.
“Someone in the background asked where the ring was from. Johnston Fellows. This was one of the most exclusive shops in the Phoenix area. John had it custom-made for me.
“The pump was cleared. Thar she blows, captain, came the answer.
Okay, then. Let’s pump this baby up, shall we?
“The bypass machine churned and red blood began to flow again through the patient’s tissue. The patient’s body was gently rewarmed. Her heart started beating again. A few minutes later a normal, healthy brain wave pattern reappeared on the EEG. The operation by Dr. Reed went flawlessly. But there was one matter than troubled everyone. That was why I felt compelled to go see things for myself.
“As the patient awoke in the intensive care unit, she emerged gradually from the grogginess left by all the anesthetic agents. After several hours, her head cleared. She sat up to greet Dr. Reed and his team of residents when they stopped in to see her in the evening.
How did everything go today? The patient asked.
Textbook-perfect, Tom said with a smile. He quickly examined her. All of it was recorded on the video camera in her room.
Well, I thought I remembered hearing something ‘blow’ during the case,” she said. “Did the aneurysm blow?
No. Tom must have gone sheet-white. I could not see, as his back was toward the stationary camera in the corner.
I thought someone said, ‘Thar she blows.’ Like in Moby-Dick.
Yes, well that . . . what you might have heard . . . was the tech telling me all the air bubbles were blown clear out of the lines. That’s all.
Oh. I’m glad. I was just remembering what a disaster you said it would be the aneurysm leaked or ruptured.
No. Everything went fine with the aneurysm. Tom leaned in closer to the young patient. Is there anything else you recall?
Yes, a ring. A one-and-a-half-carat yellow diamond from Johnston Fellows . . . and Morton’s restaurant where someone fell into a wine case.
“Tom just kept staring at her. You remember all that?
Yes. Why? What does it mean?
Well, those were just conversations we had in the operating room. Nothing special.
“Tom left the room and immediately paged the anesthesiologist. She remembers what happened in the OR!
No. No way! the anesthesiologist responded. No, it’s impossible.
Well, you come here and ask her what she remembers!
"The anesthesiologist came up a minute later and charged into the room and made her repeat word for word everything she could remember. He scratched his head and muttered, How the hell could this happen?
“What shook everyone up who watched the video between Tom and his young patient was we all knew that this woman’s brain had been dead — without discernible electrical activity whatsoever. This meant that no brain cells were active, working, or emitting electrical signals. Yet somehow the patient managed to recall the conversation in the operating room while her EEG was flat. In other words, while she was, for all intents and purposes, clinically dead — with no ability for her brain to function — she somehow managed to make or ‘encode’ specific memories of that conversation in the OR. And this was no hazy recollection. The patient was reproducing practically word for word what had been said. Right down to the jewelry store and the waiter stumbling. No, she clearly recalled what had been said. There was no doubt about that.
“From everything we currently know about how the brain works, it would be utterly impossible, from a biochemical, metabolic, and physiologic point of view, for this woman’s brain to create a memory. To do so would require neurons to be activated and then capable of encoding incoming electrical signals. This electrical activity would cause them to convert the voltage signals across the cell’s surface membrane into specific changes in the transcription of messenger RNA — or mRNA — in each neuron. These changes in mRNA produce precise molecular changes, altering amino acid and peptide production within thousands of cells to make a lasting memory the brain can recall. In order to create a ‘Kodak moment of recollection,’ the brain must be very much alive and bristling with electrical activation, and intracellular metabolism must be ‘revved up’ to the maximum of each cell’s capacity.
“Yet we also had here unequivocal, scientific evidence that not only was her brain not working, it specifically demonstrated the absence of all cortical electrical activity when these conversations actually took place. So where could these brand-new memories have been created? Where had these memories gone? And where could such a place exist? Certainly, wherever it was, it would have been beyond the confines of her brain and mind, as we currently understand them. But wherever these memories existed while her brain ceased to function, how could they be accessed later from such a location? And how could such memories survive intact ‘out in the ether,’ a place accessible to her brain for later storage only after it revived and awoke? One thing was clear: Explanation or not, she had stored and recalled accurate memories of what had happened.”
Allan J. Hamilton, The Scalpel and the Soul: Encounters with Surgery, the Supernatural, and the Healing Power of Hope (Penguin, 2009).
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