February 25, 2010 — What happens when a person dies?
It is a question that has been pondered since the beginning of the human race, and scientists, theologians, and everyone in between have offered their own beliefs and theories on the subject. But for Jeffrey Long, MD, a radiation oncologist in Houma, Louisiana, the answer to that question has become increasingly clear.
On the basis of his own research and that of many other investigators, he has become convinced that the phenomenon known as near-death experience (NDE) establishes the reality of an afterlife.
For more than 10 years, Dr. Long studied thousands of accounts of NDEs and created the Near Death Experience Research Foundation (NDERF), which has become the largest NDE research database in the world. Dr. Long's new book, Evidence of the Afterlife, which is based on more than 1300 accounts of NDEs that were shared with the NDERF, became a New York Times bestseller almost immediately after its release.
People from all walks of life have had near-death experiences, and that even includes some physicians.
"People from all walks of life have had near-death experiences, and that even includes some physicians," Dr. Long told Medscape Oncology in an interview. "It shakes them up, and it makes it difficult because they are inclined not to let it be known publicly that they've had this experience."
Although there is some variation, NDEs can loosely be defined as mystical or transcendent experiences reported by individuals who are either dying or clinically dead. Common experiences reported to Dr. Long and other investigators are feelings of peacefulness, the sense of leaving one's body, the sense of moving through a dark tunnel toward a bright light, a review of one's life, and meeting up with other "spiritual" beings. Some people have even clearly described their own resuscitations with remarkable accuracy, down to conversations that occurred outside the room and beyond normal hearing range.
Dr. Long first became interested in NDEs in 1984, when he read an article on the subject that was published in a medical journal. Several years later, the wife of a college friend relayed her own experience with it, when she nearly died of an allergic reaction while under general anesthesia. A decade later, he started the NDERF to better study it.
In general, the subject is highly controversial, especially the conclusion that NDEs offer proof of an afterlife. However, Dr. Long pointed out that feedback from his medical colleagues has been positive for the most part. "Everyone respects the success of the book and many of them have thought and wondered about this on their own," he said. "All of my colleagues who read my book were impressed, as it was intended to be scholarly."
He acknowledged that not everyone agrees with his conclusions, but although "they may not agree, they feel that this is a significant point of view," he explained. "If they disagree, it may be due to factors such as their personal religious point of view or the scientific evidence. I can't blame them, because if someone had approached me 20 years ago, I would feel the same way."
Dr. Long believes that NDEs provide powerful scientific evidence that "makes it reasonable to accept the existence of an afterlife." Specifically, he cites "9 lines of evidence" that he has derived from his research.
"I find any 1 of them to be very strong evidence that there's an existence of life after death," Dr. Long explained. "But if you put all of them together, I think that the combination — in my opinion — becomes compelling."
The 9 Lines of Evidence From Evidence of the Afterlife
Crystal-clear consciousness. The level of consciousness and alertness during NDEs is usually greater than that experienced in everyday life, even though NDEs generally occur when a person is unconscious or clinically dead. In addition, the elements in NDEs generally follow the same consistent and logical order in all age groups and cultures.
Realistic out-of-body experiences. Out-of-body experiences are among the most common elements of NDEs, and what is seen or heard is almost always realistic. Even if out-of-body-experience observations include events that occur far from the physical body, and far from any possible sensory awareness of the patient, they are almost always confirmed to be completely accurate.
Heightened senses. Heightened senses are reported by most people who have experienced NDEs, and normal or supernormal vision has occurred in those with significantly impaired vision, and even legal blindness. Several people who have been totally blind since birth have reported highly visual NDEs.
Consciousness during anesthesia. Many NDEs occur while a person is under general anesthesia, at a time when any conscious experience should be impossible. Although there is speculation that these NDEs are the result of too little anesthesia, some result from anesthesia overdose.
Perfect playback. Life reviews in NDEs include real events that took place in the lives of those having the experience, even if the events were forgotten or happened before the person was old enough to remember.
Family reunions. During a NDE, the people encountered are virtually always deceased, and are usually relatives of the person having the NDE; sometimes they are even relatives who died before the patient was born.
Children's experiences. The NDEs of children, including children who are too young to have developed concepts of death, religion, or NDEs, are essentially identical to those of older children and adults.
Worldwide consistency. NDEs appear remarkably consistent around the world, and across many different religions and cultures. NDEs in non-Western countries are incredibly similar to those that occur in Western countries.
Aftereffects. It is common for people to experience major life changes after having NDEs. These aftereffects are often powerful, lasting, and life-enhancing, and the changes generally follow a consistent pattern.
Research and Different Viewpoints
The term "near-death experience" was coined by Ralph Moody, MD, PhD, in 1975 in his classic book Life After Life. Researchers have been studying NDEs for decades, and although most research has concluded that NDEs are real and unexplainable, the idea of consciousness beyond death has not been widely accepted.
"There have been over 20 different explanations of NDEs, and they cover any feasible physiological, biological, cultural, and psychological explanations you can think of," said Dr. Long. "But the truth is that not 1 of them makes any sense, even to skeptics, and that's why there are so many of them. None have been accepted as plausible, even by skeptics."
One proposed theory of the origin of NDEs is physiological changes in the brain, such as hallucinations caused by oxygen deprivation. Other theories are psychological, such as a reaction to approaching death, or are linked to a changing state of consciousness and cognitive functioning.
Kevin Nelson, MD, professor of neurology at the University of Kentucky in Lexington, has hypothesized that rapid eye movement (REM) intrusion contributes to NDEs. "The REM state of consciousness is, by its very nature and definition, activation of the visual system," he told Medscape Oncology. "The very first physiological sign of REM is pontogeniculoocciptal waves electrifying all levels of the visual system."
Because sleep-related hallucinations are most often visual, the REM system can account for the "heavenly" light so often reported in the NDE, he explained.
Dr. Nelson and colleagues investigated the lifetime prevalence of REM intrusion in 55 people who had experienced a NDE, and compared them with age- and sex-matched control subjects. They found that sleep paralysis and sleep-related visual and auditory hallucinations are substantially more common in people with a NDE. Although the results are preliminary, they suggest that REM intrusion could promote subjective aspects of NDEs and the often associated syncope (Neurology. 2006;66;1003-1009).
"The feeling of being in a tunnel and heading to the light can be explained by retinal ischemia, which causes blindness first in the periphery and preserves our central vision," said Dr. Nelson; "hence, the tunnel."
It's just that the brain is science, and anything beyond the brain is faith.
Dr. Nelson explained that the similarities between many NDE accounts exist because all people have similar brain biology. As for the feeling of leaving one's body, he pointed out that "out-of-body experiences are illusions that occur when our brain cannot integrate all of our sensations. They can be created by a trickle of electricity in the temporal-parietal region."
According to Dr. Nelson, brain physiology explains all the features of NDEs. "That is not to say that there isn't a reality beyond the brain," he said. "It's just that the brain is science, and anything beyond the brain is faith."
No Medically Explicable Explanation
In 2001, the Lancet published the results of a 13-year study of NDEs that was conducted in 10 different centers in the Netherlands (Lancet.2001;358:2039-2045). The study, one of the few to be conducted prospectively, tracked 344 cardiac patients who were successfully resuscitated after a cardiac arrest.
The researchers, led by Dutch cardiologist Pim van Lommel, MD, who was affiliated with Hospital Rijnstate in Arnhem at the time of the study, found that 62 patients (18%) reported NDEs. Of that group, 41 (12%) had what is referred to as core (or deep) NDEs.
At 2- and 8-year follow-ups, all surviving patients recalled their NDE experience almost exactly as they originally described it. The researchers found little difference between patients who had experienced a NDE and those who hadn't. They also noted that their findings failed to show any psychological, neurophysiological, or physiological factors that would have caused these experiences after cardiac arrest.
Even though the researchers were unable to uncover a medically explicable explanation for NDEs, they did acknowledge that neurophysiological processes must play some sort of role. But if NDEs are purely physiological — for example, caused by cerebral anoxia — then most patients who have been clinically dead should report one, they write.
Dr. van Lommel and colleagues note that there are similarities between NDEs and various other phenomena, such as electrical stimulation of the temporal lobe of the brain, but that those experiences usually consist of fragmented and random memories. In contrast, the recall after a NDE is clear and sequential.
NDE pushes at the limits of medical ideas about the range of human consciousness and the mind–brain relation.
"How could a clear consciousness outside one's body be experienced at the moment that the brain no longer functions during a period of clinical death with flat EEG?" the authors ask, adding that "NDE pushes at the limits of medical ideas about the range of human consciousness and the mind–brain relation."
For the past several years, Dr. van Lommel has been lecturing all over the world on NDEs and the relation between consciousness and the brain. "It is a challenge to explain to physicians and medical students, in the many lectures I give, why I came to the conclusion that consciousness can be experienced during a period of a nonfunctioning brain," Dr. van Lommel told Medscape Oncology.
"The hypothesis that consciousness is a product of brain function has never been proven whatsoever," he said. "Most physicians are not aware of the medical literature about what happens in the brain during cardiac arrest, and what exactly is really known about how the brain functions."
He explained that, in the Netherlands, more and more physicians seem to be "open to the possibility of a facilitating function of our brain to experience consciousness, and our consciousness being nonlocal — not cemented in place or time."
"But, of course, many neuroscientists have great difficulty in changing their basic concepts," Dr. van Lommel added.
On a personal level, Dr. van Lommel acknowledged that there is no hard scientific proof of an afterlife, and there will never be. "But for me, it seems very likely because it has been scientifically proven that patients experience, paradoxically, an enhanced consciousness during a cardiac arrest and during a period of a temporarily nonfunctioning brain."
Physicians need to be aware of NDEs, contends Dr. Long, especially oncologists and others who care for patients with life-threatening illnesses. "I would advocate that if patients bring it up, physicians be ready to talk about it," he said. "But patients are often hesitant, so it's best to wait until they are ready to share [their experiences]."
Patients might just hint around about their experience; under those circumstances, doctors need to be ready to ask and need to know the right response. "These experiences are medically inexplicable, and they can be powerfully life-changing," said Dr. Long. "If physicians don't have the experience or feel uncomfortable discussing them, they need to refer patients to sources and organizations that can help them."
Dr. Long feels that increasing his understanding of NDEs has helped him to be a better physician for his cancer patients. Individuals who experience NDEs often become kinder, more loving, and more accepting of others, and he has begun to reflect those same effects in his own life. He explained that he now "faces life with more courage and confidence."
Dr. Long emphasizes that his years of research have culminated in his own personal conclusion that there is an afterlife, but not everyone is going to be convinced of that. Instead, he urges people to consider the evidence and "come to your own conclusions."
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Cite this: Near-Death Experiences: Evidence of Afterlife, Says Radiation Oncologist - Medscape - Feb 25, 2010.