Tuesday, November 3, 2009

Medical Evidence for Near Death Experiences: A Reply to Shermer - by Pim van Lommel

Dr. Pim van Lommel, one of the presenters at the Conference on Neuroscience, Consciousness, and Spirituality that was the subject of our last post, is a clinician who studies near death experiences. He and his colleagues published a landmark study in The Lancet in 2001 entitled “Near-death experiences in survivors of cardiac arrest; a prospective study in the Netherlands.” Michael Shermer, in his article "The Demon-Haunted Brain" in Scientific American, wrote that the Lancet study ‘delivered a blow’ to the view that consciousness and the brain are separable. The following post is an abridged version of Dr. van Lommel’s response to Shermer. Dr. van Lommel’s book, ENDLESS CONSCIOUSNESS will be published in English in 2010. (The references refer to the original article. Reprinted with permission of the author.)

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We performed our prospective study in 344 survivors of cardiac arrest to study the frequency, the cause and the content of near-death experience (NDE). A near-death experience is the reported memory of all impressions during a special state of consciousness, including specific elements such as out-of-body experience, pleasant feelings, and seeing a tunnel, a light, deceased relatives, or a life review. In our study 282 patients (82%) did not have any memory of the period of unconsciousness, 62 patients (18%) however reported a NDE with all the “classical” elements. Between the two groups there was no difference in the duration of cardiac arrest or unconsciousness, intubation, medication, fear of death before cardiac arrest, gender, religion, education or foreknowledge about NDE. More frequent NDE was reported at age younger than 60 years, more than one cardiopulmonary resuscitation (CPR) during hospital stay, and previous NDE. Patients with memory defects after lengthy and complicated CPR reported less frequent NDE.

There are several theories that should explain the cause and content of NDE. The physiologic explanation: the NDE is experienced as a result of anoxia in the brain, possibly also caused by release of endomorphines, or NMDA receptor blockade.

In our study all patients had a cardiac arrest, they were clinically dead, unconscious, caused by insufficient blood supply to the brain because of inadequate blood circulation, breathing, or both. If in this situation CPR is not started within 5-10 minutes, irreparable damage is done to the brain and the patient will die. According to this theory, all patients in our study should have had an NDE, they all were clinical dead due to anoxia of the brain caused by inadequate blood circulation to the brain, but only 18% reported NDE.

The psychological explanation: NDE is caused by fear of death. But in our study only a very small percentage of patients said they had been afraid the seconds preceding the cardiac arrest, it happened too suddenly to realize what occurred to them. However, 18 % of the patients reported NDE. And also the given medication made no difference.

We know that patients with cardiac arrest are unconscious within seconds, but how do we know that the electro-encephalogram (EEG) is flat-lined in those patients, and how can we study this?

Complete cessation of cerebral circulation is found in cardiac arrest due to ventricular fibrillation (VF) during threshold testing at implantation of internal defibrillators. This complete cerebral ischaemic model can be used to study the result of anoxia of the brain.

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In cardiac arrest global anoxia of the brain occurs within seconds. Timely and adequate CPR reverses this functional loss of the brain because definitive damage of the brain cells, resulting in cell death, has been prevented. Long lasting anoxia, caused by cessation of blood flow to the brain for more than 5-10 minutes, results in irreversable damage and extensive cell death in the brain. This is called brain death, and most patients will ultimately die.

In acute myocardial infarction the duration of cardiac arrest (VF) on the CCU is usually 60-120 seconds, on the cardiac ward 2-5 minutes, and in out-of-hospital arrest it usually exceeds 5-10 minutes. Only during threshold testing of internal defibrillators or during electro physiologic stimulation studies will the duration of cardiac arrest hardly exceed 30-60 seconds.

From these studies we know that in our prospective study of patients that have been clinically dead (VF on the ECG) no electric activity of the cortex of the brain (flat EEG) must have been possible, but also the abolition of brain stem activity like the loss of the corneareflex, fixed dilated pupils and the loss of the gag reflex is a clinical finding in those patients. However, patients with an NDE can report a clear consciousness, in which cognitive functioning, emotion, sense of identity, and memory from early childhood was possible, as well as perception from a position out and above their “dead” body. Because of the sometimes reported and verifiable out-of -body experiences, like the case of the dentures reported in our study, we know that the NDE must happen during the period of unconsciousness, and not in the first or last second of this period.

So we have to conclude that NDE in our study was experienced during a transient functional loss of all functions of the cortex and of the brainstem. It is important to mention that there is a well documented report of a patient with constant registration of the EEG during cerebral surgery for an gigantic cerebral aneurysm at the base of the brain, operated with a body temperature between 10 and 15 degrees, she was put on the heart-lung machine, with VF, with all blood drained from her head, with a flat line EEG, with clicking devices in both ears, with eyes taped shut, and this patient experienced an NDE with an out-of-body experience, and all details she perceived and heard could later be verified. (8)



Credit: NASA, ESA, T. Megeath (University of Toledo) and M. Robberto (STScI)
http://hubblesite.org/gallery/album/nebula/pr2006001q/

There is also a theory that consciousness can be experienced independently from the normal body-linked waking consciousness. The current concept in medical science states that consciousness is the product of the brain. This concept, however, has never been scientifically proven. Research on NDE pushes us at the limits of our medical concepts of the range of human consciousness and the relationship between consciousness and memories with the brain.



Interrupting the electrical fields of local neuronal networks in parts of the cortex also disturbs the normal function of the brain, because by localized electrical stimulation of the temporal and parietal lobe during surgery for epilepsy the neurosurgeon and Nobel prize winner W. Penfield could sometimes induce flashes of recollection of the past (never a complete life review), experiences of light, sound or music, and rarely a kind of out-of-body experience. These experiences did not produce any transformation.(15-16) After many years of research he finally reached the conclusion that it is not possible to localize memories inside the brain. Olaf Blanke also recently described in Nature a patient with induced OBE by inhibition of cortical activity caused by more intense external electrical stimulation of the gyrus angularis in a patient with epilepsy (17).

The effect of the external magnetic or electrical stimulation is dependent of the amount of energy given. There may be no clinical effect or sometimes stimulation is seen when only a small amount of energy is given, for instance during stimulation of the motoric cortex. But during “stimulation” with higher energy inhibition of local cortical functions occurs by extinction of the electrical and magnetic fields resulting in inhibition of local neuronal networks (personal communication Blanke). Also in the patient described by Blanke in Nature stimulation with higher electric energy was given, resulting in inhibition of the function of the local neuronal networks in the gyrus angularis.

And when for instance the occipital visual cortex is stimulated by TMS, this results not in a better sight, but instead it causes temporary blindness by inhibition of this part of the cortex. We have to conclude that localized artificial stimulation with real photons (electrical or magnetic energy) disturb and also inhibit the constant changing electrical and magnetic fields of our neuronal networks, and so influence and inhibit the normal function of our brain.

In trying to understand this concept of mutual interaction between the “invisible and not measurable” consciousness, with its enormous amount of information, and our visible, material body it seems wise to compare it with modern worldwide communication.

There is a continuous exchange of objective information by means of electromagnetic fields (real photons) for radio, TV, mobile telephone, or laptop computer. We are unaware of the innumerable amounts of electromagnetic fields that constantly, day and night, exist around us and through us as well as through structures like walls and buildings. We only become aware of these electromagnetic informational fields the moment we use our mobile telephone or by switching on our radio, TV or laptop. What we receive is not inside the instrument, nor in the components, but thanks to the receiver the information from the electromagnetic fields becomes observable to our senses and hence perception occurs in our consciousness. The voice we hear in our telephone is not inside the telephone. The concert we hear in our radio is transmitted to our radio. The images and music we hear and see on TV is transmitted to our TV set. The internet is not located inside our laptop. We can receive at about the same time what is transmitted with the speed of light from a distance of some hundreds or thousands of miles. And if we switch off the TV set, the reception disappears, but the transmission continues. The information transmitted remains present within the electromagnetic fields. The connection has been interrupted, but it has not vanished and can still be received elsewhere by using another TV set. Again, we do not realize us the thousands of telephone calls, the hundreds of radio and TV transmissions, as well as the internet, coded as electromagnetic fields, that exist around us and through us.

Could our brain be compared with the TV set that electromagnetic waves (photons) receives and transforms into image and sound, as well as with the TV camera that image and sound transforms into electromagnetic waves (photons)? This electromagnetic radiation holds the essence of all information, but is only conceivable to our senses by suited instruments like camera and TV set.

The informational fields of our consciousness and of our memories, both evaluating by our experiences and by the informational imput from our sense organs during our lifetime, are present around us as electrical and/or magnetic fields [possible virtual photons? (18)], and these fields only become available to our waking consciousness through our functioning brain and other cells of our body.

So we need a functioning brain to receive our consciousness into our waking consciousness. And as soon as the function of brain has been lost, like in clinical death or in brain death, with iso-electricity on the EEG, memories and consciousness do still exist, but the reception ability is lost. People can experience their consciousness outside their body, with the possibility of perception out and above their body, with identity, and with heightened awareness, attention, well-structured thought processes, memories and emotions. And they also can experience their consciousness in a dimension where past, present and future exist at the same moment, without time and space, and can be experienced as soon as attention has been directed to it (life review and preview), and even sometimes they come in contact with the “fields of consciousness” of deceased relatives. And later they can experience their conscious return into their body.

Michael Shermer states that, in reality, all experience is mediated and produced by the brain, and that so-called paranormal phenomena like out-of body experiences are nothing more than neuronal events. The study of patients with NDE, however, clearly shows us that consciousness with memories, cognition, with emotion, self-identity, and perception out and above a life-less body is experienced during a period of a non-functioning brain (transient pancerebral anoxia).

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6 comments:

Unknown said...

Excellent article. Just in case you haven't heard her talk, Jill Bolte Taylor, a Brain scientist got to observe herself during her own stroke:

http://www.ted.com/talks/jill_bolte_taylor_s_powerful_stroke_of_insight.html

Very much in line with your discussion.

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Paul Becke said...

nonconOur secular West places so much emphasis on the merit of worldly intelligence, it seems bizarre to us, doesn't it, that often some of the most distinguished professionals could implicitly disbelieve the adage that you can have your own opinions, but not your own facts. Integrity is not necessarily proper to our worldly intelligence, is it? Apparently, when apprised of Einstein's relativist theories, one very distinguished scientist of his day announced that he was a half-wit.