Dr Peter Fenwick & Dr Pier-Francesco Moretti, Dr
Vasileios Basios, and Martin Redfern write: "There can be no evidence clearer than
the personal testament of someone who has died. Thanks to the success of
medical interventions following cardiac arrest, many people do return from
something that would have been classified as dead 50 years ago – a state in
which the brain has ceased to function, the heart has stopped and the person is
to all intents and purposes actually dead. And some report experiences
which suggest the existence of another state of consciousness, unavailable in
our normal everyday world.
"The international definition of death
is: no respiration, no cardiac output and absent brain stem reflexes. This is
the exact clinical state after a cardiac arrest. Simultaneous recording of
heart rate and brain electrical activity show that within 11 seconds of the heart
stopping, the brainwaves go flat. You are clinically dead.
"Consciousness is lost in a matter of
seconds when the heart stops and may not be regained until hours to days after
it restarts.
"Even if cardiopulmonary resuscitation
(CPR) begins straight away, blood pressure will not rise high enough to
establish an adequate blood flow through the brain. Doine Stub and Graham
Nichol found that only 7% of cardiac arrest patients survived and most had some
evidence of brain damage; and the mental state during recovery is confusional.
"The flat EEG indicating no brain
activity during cardiac arrest and the high incidence of brain damage
afterwards both indicate that unconsciousness is total. The brain can’t create
images, so it should be impossible to have clearly structured and lucid
narrative experiences and because memory is not functioning, if experiences did
occur they should not be remembered. The brain does not begin to function again
until the heart restarts. So in theory it is impossible for anyone in this
state to a) experience or b) remember anything that occurred during it. And if
an experience occurred during the gradual return to consciousness it would be
confusional, and not the clear, lucid story which is characteristic of actual
death experiences.
"However, to muddy the waters some
studies have found that in patients who are being monitored and have begun the
actual death process, there is a sudden recurrence of brain activity,
containing faster frequencies which may last up to five minutes. Materialists have jumped on this as the explanation for
the ADE. But this is random cortical activity which does not integrate
different areas of the brain, and certainly could not restore consciousness.
"Conventional science cannot
explain how an ADE could occur at any point during the death process, and there
are special difficulties in accepting that it happens when the ADErs say it
happens — during unconsciousness. However, about 10% of those who survive a
cardiac arrest report an ADE .
"It is very difficult to judge
the exact timing of an ADE during a cardiac arrest. But two prospective studies
were of people who had had cardiac arrests and were resuscitated in coronary
care units, where their medical records show exactly what had happened; the
patients had the same medication and resuscitation procedures and could be
questioned as soon as they were well enough.
"Of the 63 cardiac arrest
survivors interviewed, 89% had no memories and about 10% reported ADEs, which
they said had occurred while they were unconscious. These ADEs were, as was
expected, very similar to those NDEs already reported in the literature. The
authors also found that the ADEs were not due to medication, electrolytes,
blood gases, religious belief or any other cultural factors.
"Other research groups have
found similar results. In a Dutch study of 344 cardiac arrest survivors, 41
(about 12%) reported ADEs (van Lommel, 2011). Their occurrence was not influenced
by the duration of unconsciousness or cardiac arrest, or by medication but more
ADEs were reported in the group of survivors who died shortly after their
experience. In another study a higher rate of 23% was reported (Schwaninger et
al., 2002) about 10% were found by Greyson, (2003) , while others (Sartori et
al., 2006) report about 25%. What is clear is that actual death
experiences do occur in association with cardiac arrest, and their contents are
similar to those reported in the NDE literature.
"No studies have so far been able to
provide definitive scientific proof of when an ADE occurs. Parnia, with Fenwick
and others (Parnia et al., 2001) found that the patients themselves felt that
the experiences occurred during unconsciousness - important because, as
discussed above, we have no idea how clear consciousness can be experienced
during a period of clinical death with a flat EEG. This question is absolutely
crucial to one of the biggest problems facing neuroscience: is consciousness
entirely a product of brain function and is it confined to the brain? ADE
research is perhaps the most promising way of filling the ‘consciousness gap’
in neuroscience. From the point of view of science, the ADE cannot occur during
unconsciousness, and yet there is tantalizing evidence that that is just when
they do occur.
"About a third of ADEs are preceded by
an out of body experience in which the experiencer says they leave the body and
rise to the ceiling and can see the resuscitation taking place. Anecdotal
evidence points to the OBE and therefore the ADE occurring during
unconsciousness. Certain subjects even described their own resuscitation
procedures accurately, suggesting that their ADE had occurred when the brain
was ‘down’ (Sabom, 1982).
"Dr. Penny Sartori studied a
group of cardiac arrest survivors in a coronary care unit, several of whom said
they had left their bodies and witnessed the resuscitation process. She
compared their accounts of their resuscitation with those of another group of
patients who had had no ADE during their resuscitation but were asked to
describe what they thought had happened. It is usually argued that everyone
sees so much resuscitation on TV that they know the procedure. Dr. Sartori was
able to show convincingly that the patients who claimed to have seen their
resuscitation, described it much more accurately than those who could only
guess what had happened and who made significant errors (Sartori et al., 2006).
"The case of Pamela Reynolds, described
in the BBC’s documentary film The Day I Died, (Broome, 2002) is worth quoting at
length because it seems so clear that even the most ardent debunkers have been
unable to produce a satisfactory explanation for it.
"Pamela had to
undergo surgery to remove a cerebral aneurysm situated deep in the central
structures of her brain. The operation was carried out in a specialized
neurosurgery center under close medical monitoring during the entire operation.
Her brain was cooled and EEG electrodes measured her brain activity. When the
anesthesia had reached sufficient depth, the brain was known to be
non-functioning. Pamela was clinically dead. Her circulation was taken over by
a heart lung machine, the blood was emptied from her brain and the
neurosurgeons removed the aneurysm. Then the heart was restarted, and the wound
was closed.
"After the
operation Pamela made several observations about what she had ‘seen’ during it
which were acknowledged by the medical team to be correct. The best skeptics
have been able to come up with to rebut this was that it was a case of
‘anesthesia awareness’, which does indeed occur under some circumstances, but
is impossible in cases such as this when the brain is emptied of blood and
clinically dead. Far more significant is the following comment on the case,
from the British Medical Journal.
“There is still
much scientific work to be done before we can confidently suggest mind-body
separation during the NDE. Dr Spritzer, the neurosurgeon who operated on Pam
Reynolds, stated that he could not explain her NDE in the physiological state
she was in, commenting 'I don’t want to be so arrogant to be able to say that
there is no way it can happen'. Let us hope that all those engaged in
NDE research can adopt a similar attitude.” (BMJ-editorial, 2003).
“To Be And Not To Be. This
is The Answer: Consciousness Survives,” essay for the 2021 Bigelow essay
contest submitted by Dr Peter Fenwick & Dr Pier-Francesco Moretti, Dr
Vasileios Basios, and Martin Redfern.