Dancing Past the Dark ~ distressing near-death experiences

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ICU, Memory, NDE

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It has been almost eighteen months since a hemorrhagic stroke in my right temporal lobe knocked me almost completely out of commission. From the very beginning, even the days of confusional mental states in ICU, a single ambition about recovery has been clear to me:  I will put up a blog post. An interesting blog post.

The prospects ranged from dire to unlikely. Tremors snarled my typing and my handwriting is illegible. Sitting up to work required a hoist; I could not stand or reach or lift even a small book. It was a struggle to read a simple mystery novel, much less think enough to write paragraphs. I could not think of a thing to say.

But “inch by inch, row by row,” and as I write this, 517 days of healing have happened and are continuing. I still cannot think of a thing to say on my own; but this past week an email brought a perspective so fascinating that it popped everything open. This morning I made it through a full session of physical therapy walking shakily but without a walker, and this afternoon, here we are, drafting that blog post. Obviously, beyond my own determination, it is the care of a raft of health professionals, therapists, helpers, and people who love me that has brought us all to this point. I am so grateful to them, and to the writer of the email that ignited today’s topic, and to you readers for coming back.

The email from “Ann”:

 My mother (over 80 years old retired teacher) told me that she remembered some things from her recent surgery. I started to look for references about near death experiences and found your article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6173534/.

In January this year, my mother underwent an 8-hour-long abdominal surgery under general inhalational anesthesia [anesthetic gas] with endotracheal intubation [insertion of breathing tube] . She was septic, and she had a subileus [partial bowel obstruction] from extensive peritoneal adhesions [abdominal scar tissue] from prior surgeries.

She did not regain consciousness after her surgery and she stayed in the ICU for 45 days. During this time she was extubated, then she experienced hypoxia [low blood oxygen], reintubation, unstable SVT [very fast heart beat with low blood pressure] corrected by synchronized cardioversion, [electrical jolt to restore normal  heart rate] pneumonia, and tracheostomy [opening on of the neck to place a breathing tube].  She did have 2-5 day periods between these crises when she was under light sedation by propofol infusion or no sedation.

My mother is now recovering at a lower acuity unit and she told us that she remembered “things” from her OR and ICU stays:

  1. First she saw amorphous, dark entities approaching her. She was afraid of them.
  2. Then her field of vision brightened up and there was a pleasant light.
  3. In the end she saw a friend, and she knew that she would be all right. The friend is a physician at the hospital where Mother is staying and the friend visits her daily.

My mother thinks it is a memory and it made her more reflective. She is asking questions she would have never asked before (Am I a good person?). Before her illness she never talked about death, the word was banned and her goal was to live to be 100. She was raised Catholic, but for her religion is more of remembering childhood and Latin rituals. She believes in God, though, without defined beliefs about what happens after death.

Do you think this might have been an NDE?  

Thank you so much for your time and consideration.

~ ~ ~

Other than that the writer is clearly medically sophisticated, did anything in the content strike your attention? What do you think it was that caught mine?

Here is an expanded version of my response:

Intensive care units are (understandably) notorious for their association with hard-to-explain states of consciousness. Given the seriousness of your [letter-writer] mother’s condition, her intermittent sedations, and the length of her stay in such high-stress surroundings, it is not surprising she has a blur to deal with.

Patients coming out of deep unconsciousness are like travelers returning home from abroad, though the ‘foreign country’ they describe is the unfamiliar territory of the deep unconscious. It is not unusual to hear of indistinct, shadowy figures such as those you mentioned. While many patients, like your mother, experience them as frightening, others find them non-threatening, even comforting presences. There is no “one explanation fits all” to identify them or their function.

Images have always been the language of disordered thinking—but they are also the vocabulary of art and spirituality, subject to much interpretation. The pleasant light your mom mentions is probably as close to having a universal meaning as any symbol, usually interpreted as having something to do with the sacred. The one anomalous element in her description is the presence of the physician friend, as it is not at all common for people who are still living to appear in these experiences.

The experiences are so different from everyday awareness! What are they, and how to interpret them? Given your mother’s situation, three explanations come immediately to mind: hallucination, ICU delirium/delusion, and anomalous experience (near-death experiences, for one).

  • Hallucinations are sensory perceptions, often chaotic, illogical, and emotionally charged, which are not shared in consensual reality. They may be vivid but do not ordinarily carry much in the way of deeper meaning (simply forms). Although a patient’s interpretation of a hallucination may endure and be troublesome, they are not known for creating life-changing aftereffects such as overturned values or sudden psychic abilities.
  • ICU delirium/delusion is a complex quick-onset confusional state, described by DSM-5 as involving attention deficits, disorientation and perceptual disturbances. Delirium, according to PubMed (https://pubmed.ncbi.nlm.nih.gov/32644706/) is “the most common clinical manifestation of acute brain dysfunction in ICU,” especially for patients on mechanical ventilation. It may have long-lasting effects such as PTSD.
  • NDEs also present as emotionally charged images, often about movement through space and entering what feels like a profoundly meaningful environment. They tend to be more highly structured than hallucinations and can fall easily into a logical narrative form. They are known for their durability in memory and the pervasiveness of their effects on people’s lives.

So—NDE or not? Many people are powerfully affected by having to think of themselves as dead. If the “near-death” aspect is alarming, there may be comfort in knowing that in any sizable collection of these accounts, the majority are from people who were not medically declared dead (clinically dead), though as many as seventy-five per cent “had a sense of being close to death, were in a life-threatening situation, or believed they were clinically dead” [emphasis added]. (www.iands.org/ndes/about-ndes/key-nde-facts21.html) In other words, although the experiencers felt death, their physicians would not have confirmed it.

That is perhaps the greatest mystery of these experiences: if most do not originate in actual death, what is their source? The fault of the common confusion lies in the “near-death” name, which was accurate for the original study sample, all of whom had been in cardiac arrest; but that uniformity does not hold up in the general population of experiencers. In fact, many accounts featuring elements such as presences and a memorably pleasant light, like your mother’s report, have not explicitly mentioned death at all. The “non-death accounts” are called by many names–mystical experiences, exceptional human experiences, spiritually transformative experiences–there are dozens of terms and acronyms for them—but all may include the familiar NDE reports of out-of-body events, movement through space, encounter with presences, a sense of place and of being at home, emotions, profound life changes. Like death-related NDEs, they rarely speak to the beliefs and dogmas of any specific religion, though there is affirmation for love, compassion, fair play, and a sense of what I will call reverence.

Your mother’s circumstances certainly put her experience within the NDE type of non-pathological event. Coming from the confusing swirl of post-ICU images, as you and your mother are now discovering, the label of the incident is likely less important than the living of the experience’s beneficial psychological and spiritual effects. They are all full of mystery, whatever biological specifics may contribute to understanding them and by whatever name we call them.

The most striking observation to me is this:

“She thinks it is a memory and it made her more reflective. She is asking questions she would have never asked before.”

I have been fascinated by that: “She thinks it is a memory.” I wonder, a memory as opposed to…what? Perhaps a memory, in her terms, is more closely aligned with a physical experience than merely a glimpse of something? I am hearing it as perhaps an instance of our Enlightenment thinking: in Newtonian terms, does a memory originate somewhere tangible, as in a place? (Is this a restatement of the “hallucination vs NDE” question again?

Most NDE accounts are structured like stories, tangibly, with a sequence of incidents, one or more settings, characters—overall, becoming like a location for the memory. Otherwise, the happening might seem like something of no substance, something nonexistent. It’s a fascinating question! Is it perhaps the narrative sense which gives an NDE its feel of stability and being “realer than real”? Is memory simply a perspective?

I am aware that this exploration of things non-physical is likely to be unsatisfying for those grounded in the hard sciences. In terms of consciousness, though, there is no material substance, no physicality. What the writer’s mother remembers is a genuine memory of an experience of consciousness. This seemingly flimsy, invisible reality is actually so powerful that it is launching her, over 80, into asking the kinds of self-reflective questions maturity demands. She has been able to refuse them house-room before this hospitalization, but is now asking developmentally and morally imperative questions about herself and her life.

It is not easy, encountering whatever it is that lives, at least in part, in images across time and cultures and, at least in another part, in our individual heads. Socrates would be pleased that her life is being so carefully examined.

Please share your thoughts!  And “Ann”,  thank you for sharing your question!

On the reality of near-death experiences

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Here’s the latest thing to think about:

Are near-death experiences real? A  recent study at the University of Liège (Belgium) compared the characteristics of memories of near-death experience with those of memories after coma without NDE, and after both actual and imagined events. Although the samples were small, the findings are surprisingly strong. The memories of NDEs included significantly more detail, a greater sense of personal involvement, and far higher emotional content than any of the other memories, including those of actual events.

The researchers observe that NDEs have too many vivid characteristics to be considered imagined events; they acknowledge the NDEs as real perceptions. However, the research conclusion is that as the NDEs did not occur in reality,  they probably result from a physiological dysfunction and are actually hallucinatory.

An article at the website (IANDS.org) of the International Association for Near-Death Studies is entitled, “Study finds NDE memories are not of imagined events.” The author, who is not credited, describes the Liege study briefly and clearly, and responds:

The researchers’ conclusions are based on two assumptions that are inconsistent with other evidence from NDEs: (1) that the perceived events do not occur in reality and (2) that NDE phenomena are determined neurophysiologically. Therefore, other interpretations are possible.

The first assumption, that perceived events in an NDE do not occur in reality, is not consistent with the veridical [truthful] perceptions that are reported by NDErs. In fact, nearly all “apparently nonphysical veridical perceptions” (AVPs) are verified when checked. Janice Holden (2009) reported that of 93 veridical perception cases in the NDE literature, 92% were completely accurate, 6% were accurate with some errors and only one case was completely erroneous.

Furthermore, previously unknown veridical information received during the “transcendent” part of the NDE (e.g. meeting deceased relatives) is frequently later verified. For example, a man saw and interacted with an apparently deceased person and later found out the man was his biological father who had died in the holocaust (van Lommel, 2010, pp. 32-33).

You can read the entire IANDS article (it’s not long) here.

Regular readers of this blog will probably have guessed the direction my comments will take: We need some new vocabulary.

To believe that “NDE phenomena are determined neurophysiologically” is a logical assumption from within the prevailing materialistic view of most academic researchers and their audience. For anyone who has grown up surrounded only by the materialist worldview, that is a foregone conclusion. The only “real” there is, is physical.

Say that an NDE is occurring for an individual who is lying unconscious directly in front of us. The person is obviously, physically present, in the real world; we can see her. But whatever is going on with her is invisible; we cannot see what she is seeing, or measure or authenticate its events as observers. We are not part of what will later be reported; any landscapes or deceased family members are with her, not with us. Remember, “It’s all in your mind” means, “It isn’t real.” From the logical, materialist perspective, that NDE is by its nature unreal.

Ironically, something of the same thought process creeps into the arguments put forward by NDE experiencers and apologists who continue to report elements of near-death experience as if they were physically real. And so we get statements like, “a man saw and interacted with an apparently deceased person and later found out the man was his biological father.” This is how NDEs are reported, and how sympathetic researchers talk about them, as if they were physical events. 

Leaving aside the curious question of how one identifies a person as being “apparently deceased,” other than his looking like a zombie, the problem is simple: In common speech, a person/“a man” is a creature, a personality encased in a physical body. We can know an individual’s personality, but we cannot see it, for without a body it is invisible. We may intuit the existence of an individual’s spirit, untied to a body; but that is generally also invisible. A body, being physical, must inhabit some location in the time/space universe, where the only place currently known to be inhabited by bodies is either Earth or in a space capsule. And obviously, despite the movies, there is no known place on Earth populated by resurrected bodies.

It is my belief that the experiencer did not see a person; he did not interact with a man. What he saw was a meaningful image, a perception of a person. What he saw was not the physicality of his biological father but an image, a perception, a message–like a dream image but moreso, from a related neighborhood where symbol carries the weight of being.

That much is simple. What is not simple is the cry of the experiencer, “It was so real! It was realer than real!” And that is the way the experience registers. The far deeper problem is that we have no specialized vocabulary in which to express the reality of the non-physical “something” which he saw and with which he interacted in such a vividly memorable way that even materialist researchers recognize that it was clearly not imagined. Make no mistake: the “something” is phenomenologically real, though it has no corporal existence.

So researchers must logically reject the physicality of NDEs; yet we continue to contribute to the confusion by speaking of NDEs as if they were occurring on some physical plane, as if they relied on a kind of planetary travel. Until we can find a way to make the distinction, researchers will continue to believe, in all good faith, that NDEs must be hallucinatory, and family members and health care professionals will continue to believe that experiencers have suffered some physiological dysfunction. The least we can do, it seems to me, is to be meticulous about referring to the visual objects in NDEs as perceptions rather than as physical entities.

I am convinced that we do experiencers, the research, and the entire field of near-death studies a great disservice by speaking the language of materialism to discuss non-physical reality. Until we can do otherwise, we will continue to mislead ourselves and our hearers about how veridicality works, and where it is these experiences take place, and what they actually mean.

Where is the medical evidence that NDEs happen?

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The blog Skeptico recently featured an interview with PMH Atwater, after which a couple of commenters kept asking about the medical evidence that her three NDEs happened. In fact, they wondered whether any NDE can be said to happen in the absence of corroboration. Where are the records? Or, to quote one comment, “An NDE-like experience without any witnesses or medical documentation to support it can be anything, including hallucinations.”

Those questioners are far from alone. The fact that this question keeps being asked is an indication that a great many people don’t get the idea of “experience.” Any experience is a private, personal happening in consciousness. It is not a public activity. By definition, a near-death or similar experience cannot be witnessed, although in rare instances it may be shared.

The best a medical record can do is track physiological events and record circumstances. Although a monitoring device may register a blip in some function being recorded, it cannot indicate the presence of an NDE during that blip. No one watching the monitor will see, or feel, or think what the patient is seeing and feeling and thinking. In short, the biological event may be witnessed, but the NDE itself is not open to observers.

It seems ironic that under the most tightly monitored circumstances, in cardiac arrest with stringent clinical recording, studies find the fewest reports of NDEs. Does this mean that near-death experiences in other circumstances are fraudulent? No, it means simply that the conditions surrounding cardiac arrest and resuscitation either do not promote having an NDE or affect a patient’s being physically and cognitively able to report it afterward. As for mistaking one type of experience for another, the differences between the sensations and effects of NDEs and hallucinations have been well documented for two decades; that is no longer an issue except for people who are unaware of the research.

I wonder, after so many thousands of NDE reports with no corroborating medical records but with objective evidence of life changes to indicate that something happened, what is it that people are looking for in demanding medical evidence?