Consciousness Beyond Life: The Science of the Near-Death Experience

Introduction

1
A Near-Death Experience and Its Impact on Life

2
What Is a Near-Death Experience?

3
Changed by a Near-Death Experience

4
Near-Death Experiences in Childhood

5
There Is Nothing New Under the Sun

6
Research into Near-Death Experiences

7
The Dutch Study of Near-Death Experience

8
What Happens in the Brain When the Heart Suddenly Stops?

9
What Do We Know About Brain Function?

10
A Comprehensive NDE: Monique Hennequin

11
Quantum Physics and Consciousness

12
The Brain and Consciousness

13
The Continuity of the Changing Body

14
Endless Consciousness

15
Some Implications of NDE Studies

16
Epilogue

Appendix:
The Practical Significance of NDE in Health Care

Notes

Glossary

Bibliography

Searchable Terms

Acknowledgments

About the Author

Credits

Copyright

About the Publisher

It is 1969. At the coronary care unit the alarm suddenly goes off. The monitor shows that the electrocardiogram of a patient with a myocardial infarction (heart attack) has flatlined. The man has suffered a cardiac arrest. Two nurses hurry over to the patient, who is no longer responsive, and quickly draw the curtains around his bed. One of the nurses starts CPR while the other places a mask over his mouth and administers oxygen. A third nurse rushes over with the resuscitation trolley that contains the defibrillator. The defibrillator is charged, the paddles are covered in gel, the patient’s chest is bared, the medical staff let go of the patient and the bed, and the patient is defibrillated. He receives an electric shock to the chest. It has no effect. Heart massage and artificial respiration are resumed, and, in consultation with the doctor, extra medication is injected into the IV drip. Then the patient is defibrillated for the second time. This time his cardiac rhythm is reestablished, and more than a minute later, after a spell of unconsciousness that lasted about four minutes, the patient regains consciousness, to the great relief of the nursing staff and attendant doctor.

That attendant doctor was me. I had started my cardiology training that year.

Following the successful resuscitation, everybody was pleased—everybody except the patient. He had been successfully revived, yet to everybody’s surprise he was extremely disappointed. He spoke of a tunnel, colors, a light, a beautiful landscape, and music. He was extremely emotional. The term
near-death experience
(NDE) did not yet exist, and I had never heard of people remembering the period of their cardiac arrest. While studying for my degree, I had learned that such a thing is in fact impossible: being unconscious means being unaware—and the same applies to people suffering a cardiac arrest or patients in a coma. At such a moment it is simply impossible to be conscious or to have memories because all brain function has ceased. In the event of a cardiac arrest, a patient is unconscious, is no longer breathing, and has no palpable pulse or blood pressure.

Near Death in the Hospital

The first coronary care units in Dutch hospitals opened in 1966, when massaging the heart, administering oxygen, and defibrillation were found to be effective in treating cardiac arrest patients. Cardiac arrest was and remains the most common cause of death for people with an acute myocardial infarction—in the United States, about one death each minute, and in the UK about one death every two minutes. Since the introduction of modern techniques of resuscitation and the establishment of coronary care units, mortality rates as a result of cardiac arrest have fallen sharply, and these days it is not uncommon for patients to survive cardiac arrest.

When I was working as a cardiologist, I was confronted with death on an almost daily basis. As a doctor, you are all but forced to reflect on the emotional, philosophical, and physiological aspects of life and death. But often such reflection does not actually take on any urgency until you are personally affected by the death of a family member. In my case, this happened when my mother died at the age of sixty-two and my brother at the age of forty-one.

Although I had never forgotten the successfully resuscitated patient in 1969, with his memories of the period of his cardiac arrest, I had not done anything with the experience. This changed in 1986 when I read a book about near-death experiences by George Ritchie with the title
Return from Tomorrow.
¹
When he had double pneumonia as a medical student in 1943, Ritchie experienced a period of clinical death. At the time antibiotics such as penicillin were not yet widely used. Following an episode of very high fever and extreme tightness of the chest, he passed away: he ceased breathing and his pulse also stopped. He was pronounced dead by a doctor and covered with a sheet. But a male nurse was so upset by the death of this medical student that he managed to persuade the attendant doctor to administer an adrenalin injection in the chest near the heart—a most unusual procedure in those days. Having been “dead” for more than nine minutes, George Ritchie regained consciousness, to the immense surprise of the doctor and nurse. It emerged that during his spell of unconsciousness, the period in which he had been pronounced dead, he had had an extremely powerful experience of which he could recollect a great many details. At first he was unable and afraid to talk about it. Later he wrote a book about what happened to him in those nine minutes. And after graduating as a psychiatrist, he began to share his experiences in lectures to medical students. One of the students attending these lectures was Raymond Moody, who was so intrigued by this story that he began to look into experiences that may occur during life-threatening situations. In 1975 he wrote the book
Life After Life,
which became a global best-seller. In this book Moody first coined the term
near-death experience
(NDE).
²

After reading Ritchie’s book, I kept wondering how somebody can possibly experience consciousness during cardiac arrest and whether this is a common occurrence. So in 1986 I began to systematically ask all the patients at my outpatient clinic who had undergone resuscitation whether they had any recollection of the period of their cardiac arrest. I was more than a little surprised to hear, within the space of two years, twelve reports of such a near-death experience among just over fifty cardiac arrest survivors. Since that first time in 1969, I had not heard any other such reports. I had not inquired after these experiences either because I had not been open to them. But all the reports I was hearing now roused my curiosity. After all, according to current medical knowledge it is impossible to experience consciousness when the heart has stopped beating.

During cardiac arrest patients are clinically dead. Clinical death is defined as a period of unconsciousness caused by a lack of oxygen to the brain because either circulation or breathing or both have stopped. If no resuscitation takes place, the brain cells will suffer irreparable damage within five to ten minutes and the patient will nearly always die, even if the cardiac rhythm is reestablished later.

Questions About Brain Function and Consciousness

For me it all started with curiosity—with asking questions, with seeking to explain certain objective findings and subjective experiences. Learning about near-death experience raised a number of fundamental questions for me. An NDE is a special state of consciousness that occurs during an imminent or actual period of physical, psychological, or emotional death. How and why does an NDE occur? How does the content of an NDE come about? Why does an NDE bring about such profound changes in someone’s life? I was unable to accept some of the answers to these questions because they seemed incomplete, incorrect, or unsubstantiated. I grew up in an academic environment where I was taught that there is a reductionist and materialist explanation for everything. And up until that point, I had always accepted this as indisputably true.

After immersing myself in the personal, psychological, social, and scientific aspects of near-death experience, I found other frequently asked questions becoming important to me too: Who am I? Why am I here? What is the origin of my life? When and how will my life end? And what does death mean to me? Will my life go on after death? In all times and all cultures and during every phase of life—among them the birth of a child or grandchild and confrontations with death and other serious crises—these essential questions are asked again and again. You may have asked them yourself. Yet we seldom receive satisfactory answers. Whatever happens in our lives—whether we meet with success or disappointment, no matter how much fame, power, or wealth we acquire—death is inescapable. Everything we gather around us will perish within the not-too-distant future. Birth and death are realities during every single second of our lives because our bodies undergo a constant process of death and renewal.

Some scientists do not believe in questions that cannot be answered, but they do believe in wrongly formulated questions. In 2005 the journal
Science
published a special anniversary issue featuring 125 questions that scientists have so far failed to answer.
³
The most important unanswered question, What is the universe made of? was followed by, What is the biological basis of consciousness? I would like to reformulate this second question as follows: Does consciousness have a biological basis at all? We can also distinguish between temporary and timeless aspects of our consciousness. This prompts the following question: Is it possible to speak of a beginning of our consciousness, and will our consciousness ever end?

In order to answer these questions, we need a better understanding of the relationship between brain function and consciousness. We will have to find out if there is any indication that consciousness can be experienced during sleep, general anesthesia, coma, brain death, clinical death, the process of dying and, finally, after confirmed death. If the answer to any of these questions is yes, we must try to find scientific explanations and analyze the relationship between brain function and consciousness in these situations. This raises a series of other questions that will be addressed in this book:

Where am I when I
sleep?
Can I be aware of anything during sleep?


Sometimes there are indications of consciousness under
general anesthesia.
How is it possible that some patients under general anesthesia can later describe exactly what was being said or even done, usually at the moment when they suffered complications during surgery.


Can we speak of consciousness when a person is in a
coma?
A recent article in
Science
looked at the scientific evidence of awareness in a patient in a
vegetative state.
⁴
This is a form of coma with spontaneous breathing and brain-stem reflexes. Brain tests showed that when this patient was instructed to imagine certain activities like playing tennis or moving around her home, the monitors recorded changes identical to those in healthy volunteers who carried out the same instructions. This means that the identified changes can be explained only by assuming that this patient, despite her vegetative state, not only understood the verbal instructions but also carried them out. The research demonstrated that this coma patient was aware of both herself and her surroundings but that her brain damage prevented her from communicating her thoughts and emotions directly to the outside world. In her book
Uit coma
(Out of Coma), Alison Korthals Altes also describes seeing staff and family in and around the intensive care unit during her three-week coma following a serious traffic accident.
⁵


Can we still speak of consciousness when a person has been pronounced
brain-dead?
In his book
Droomvlucht in coma
(Dream Flight in Coma), Jan Kerkhoffs tells us about his conscious experiences after neurologists declared him brain-dead following complications during brain surgery. Only because his family refused organ donation was he able to write about his experiences because, much to everybody’s surprise, he regained consciousness after three weeks in a coma.
⁶


Does brain death really equal death, or does it mark the start of a
process of dying
that can last anywhere between hours and days? What happens to our consciousness during this process of dying?


Does
clinical death
equal loss of consciousness? Many of the reports of near-death experience covered in this book suggest that during a cardiac arrest, that is, during a period of clinical death, people may experience an exceptionally lucid consciousness.


Can we still speak of consciousness when a person is
confirmed dead
and the body is cold? I will look more closely at this question below.

Is There Consciousness After Death?

Can research into near-death experiences give us any indication of what happens to consciousness when a person is confirmed dead? We must start by exploring answers to the question whether and how consciousness may be experienced after death. How can we surmise what happens to our consciousness when we are dead? And where do our ideas about death come from? Why would we want to learn more about death, about the meaning of being dead?

The confrontation with death raises urgent questions because death remains a taboo in our society. Yet it is normal for people to die every day. Today, as you are reading this, approximately 6,925 people die in the United States (375 in the Netherlands and 1,400 in the United Kingdom). This means that more than 2,530,000 people die in the United States each year (155,000 people in the Netherlands and 509,000 people in the United Kingdom). Worldwide, more than 70 million people die every year. However, because global birth rates exceed mortality rates, the global population continues to grow. On average, every day in the United States about 11,000 babies are born (515 babies in the Netherlands and 1,600 in the United Kingdom). Dying is just as normal as being born. And yet death has been banished from our society. People increasingly die in hospitals and care homes although there is a growing preference for dying at home or in a hospice.

What is death, what is life, and what happens when I am dead? Why are most people so afraid of death? Surely death can be a release after a difficult illness? Why do doctors often perceive the death of a patient as a failure on their part? Because the patient lost his or her life? Why are people no longer allowed to “just” die of a serious, terminal illness but instead are put on a ventilator and given artificial feeding through tubes and drips? Why do some people in the final stages of a malignant disease opt for chemotherapy, which may prolong life for a short while but certainly does not always improve the quality of their remaining life? Why is our first impulse to prolong life and delay death at all costs? Is fear of death the reason why? And does this fear stem from ignorance of what death might be? Are our ideas about death accurate at all? Is death really the end of everything?