by Sanjay Gupta
At Southampton, Parnia won permission from the director to do a bit of interior decorating in the emergency rooms. When he described what he did, it struck me as one of the most fascinating experiments I’ve ever heard. He purchased 150 ceiling tiles, and at a local printer had one side of each tile coated with a unique image, like a photo or newspaper headline. With a bit of wire, he and some colleagues managed to hang all 150 tiles, image-side up, about two feet from the ceiling, in various spots around the emergency room and other areas that were used during emergency resuscitation. From the ground, the hanging panels just looked white, like regular ceiling tiles. But if anyone was really leaving their body to float around the room, they would be able to see the images. 6
The study would include anyone who survived a cardiac arrest in the hospital. Sometime after being revived, they would be interviewed by Parnia or a fellow investigator and asked a simple question: “Do you remember anything from the period in which you were unconscious?” I think of it as trying to catch the white light in a bottle.
Over the next year, of sixty-three cardiac arrest survivors at Southampton Hospital, four answered yes to the question. The stories they told were interesting but didn’t provide much insight into what might be the cause of NDEs. The first question Parnia wanted to answer was whether these people were really dying when they had their experience. Was there a difference physically in what happened to them as opposed to the other cardiac arrest patients? It turned out there was no significant difference in blood levels of oxygen, carbon dioxide, sodium, or potassium between the people who had NDEs and those who didn’t. There was no particular difference in their religious beliefs, either, and nothing overtly religious about the experiences themselves. None of the four claimed to have left their body. And while it would have made for a much better story, none of them described seeing anything on the specially hung ceiling tiles.
The results were a bit of a letdown, but Parnia stood undaunted. He’d succeeded in bringing near-death research into the realm of science. Earlier investigators, like Moody and Kenneth Ring (who wrote Lessons from the Light and other NDE books), had been less rigorous, using loose definitions of death that lump Duane Dupre together with a cancer patient who has a vision while he lingers in the hospital, or a driver who sees her life flash before her eyes as she swerves to narrowly avoid an accident. 7
By contrast, Parnia was studying people whose hearts had actually stopped, shutting off blood flow to the brain. A similar study, by Dr. Bruce Greyson, who founded the Division of Perceptual Studies at the University of Virginia, looked at people whose hearts were intentionally stopped for the purpose of implanting a defibrillator (to his dismay, none of them reported a near-death experience). 8 Now, you might say that having your heart stop is not quite the same thing as death. After all, anyone being interviewed afterward, for a study, has obviously managed to live through the experience. But Parnia was very comfortable playing with that line between life and death. In fact, he thought of death as a continuum and suspected that whether you were revived by CPR or died and stayed dead—well, those first few minutes were pretty much the same.
“Our roots began in the near-death experience, but what I talk about now is the ‘actual death experience,’ ” Parnia told me. “We are actually objectively studying people during clinical death. As far as we can measure, there is no brain activity going on with these people. If that can be verified, it opens up a whole new field.”
The pursuit of these questions is not always popular in the world of serious medicine. New York-Presbyterian Hospital/Weill Cornell Medical Center is the sister hospital of New York-Presbyterian Hospital/Columbia where Zeyad Barazanji was taken after his cardiac arrest. When my team first tried calling Parnia and said we wanted to ask about his near-death research, the public relations staff wouldn’t put the call through.
He laughed when I finally reached him on the phone. “They’ve picked up on the negative connotations, and I’ve picked up on them, too. If you do a Google search, 99 percent of the available material is sort of out there. They don’t want to be associated with that.” Parnia knows the feeling—he was chagrined when his book on the subject, What Happens When We Die, ended up in the new age section of bookshops. “I thought to myself, ‘Why is this sitting next to all these books about angels?’ ”
Indeed, most books and websites about near-death experience share an affinity for rainbow-hued skyscapes full of wispy clouds and sunbeams. Most people who have had a near-death experience, or who have thought about the topic at all, conclude that it’s a sign of another spiritual world. Take, for instance, the experience of a woman I interviewed, a near-drowning victim.“I knew I was going to God. I knew I was going home. And I had no fear,” said Jean Potter. 9
Of course, the talk about meeting God unsettles people who think our lives are firmly grounded here in the physical universe. Nowhere in our lives is there as transparent an interface between spirituality and science as there is with near-death experience. But now a growing number of researchers, Parnia among them, are looking for a more standard medical explanation.
Some of these scientists suggest that a near-death experience is purely psychological, caused by intense fear or spiritual beliefs about death. Others say that it’s essentially a hallucination caused by a critical lack of oxygen in the brain. For example, the tunnel that is such an integral part of many NDEs may simply be a narrowing of the visual field, just like the one someone experiences before they faint. In a fainting spell, it generally takes less than ten seconds for vision to disappear. This is caused by a lack of blood flow to delicate structures behind the eye that are needed for us to see.
What these theories have in common is the possibility that a mystical near-death experience has its basis in the nuts-and-bolts connections of the brain. I have been personally fascinated by the possibility that out-of-body experience may be grounded in brain circuitry. As I investigated this further, I realized the scientific precedent goes back at least to the 1930s. That’s when the neuroscientist Wilder Penfield, who pioneered surgery to treat epilepsy, discovered that he could induce out-of-body experiences by stimulating certain parts of the brain with a metal probe.
A modern version of the experiment was written up in 2007. Belgian neurologists reported in the New England Journal of Medicine that they had repeatedly induced out-of-body experiences by mechanically stimulating a part of the brain known as the superior temporal gyrus. The Belgians were trying to treat a debilitating case of tinnitus, or ringing in the ears. The treatment failed, but as they probed the brain to find the source of the problem, the doctors repeatedly caused their sixty-three-year-old patient to experience a sense of being outside his body. One episode lasted a full seventeen seconds. 10
Confident they were on to something, the Belgians decided to take it a step further by performing specialized brain imaging tests. Remarkably, the scans taken during the procedure show two distinct areas of the brain suddenly lighting up: an area of the brain known as the temporoparietal junction, and more specifically the angular-supramarginal gyrus (associated with speech and self-perception, or sense of self); and the right precuneus and posterior thalamus (a brain region associated with the integration of the senses).
OUT-OF-BODY EXPERIENCES ARE actually pretty common. Even without direct brain stimulation, out-of-body experiences are reported by some epileptics, as well as by people under the influence of psychedelic drugs like PCP or ketamine—both of which are used legitimately as tranquilizers and illicitly as recreational drugs. A psychiatrist at the University of New Mexico, Rick Strassman, has actually theorized a direct role in NDE for another psychedelic drug, dimethyltryptamine (DMT). The brain naturally produces small amounts of DMT; Strassman suggests that in moments of intense bodily stress the pineal gland would release a larger amount of DMT, inducing the mystical near-death experience. 11
Beyond drugs, some people are able to induce an out-of-body feeling through intense meditation or prayer. In
case you are curious, the common link to all these things may be found in the brain’s superior parietal lobe—found toward the rear on the top side of the head. I get asked all the time about which parts of the brain are responsible for different things. First off, it’s easy to oversimplify, and keep in mind, the brain can change due to injury. And some people are just born with brains that don’t obey the laws of anatomy texts.
But the superior parietal lobe does seem to be the home for out-of-body experiences. Two University of Pennsylvania neurologists have used brain scans to show how this might work. Dr. Andrew Newberg and Dr. Eugene D’Aquili say the superior parietal lobe is where we generate our sense of space and time; in subjects who were praying or meditating, the scans detected less blood flow to the area. In other words, that part of the brain was less active. Those test subjects felt less of a sharp distinction between themselves and the world around them. They were at one with their surroundings. It is easy to understand why these same two scientists started referring to the superior parietal lobe as the OAA, the orientation association area. It seems logical that a similar brain process in this area is responsible for out-of-body feelings experienced during an NDE. 12
But then in 2006, Dr. Kevin Nelson, a neurologist at the University of Kentucky, proposed a different and novel explanation. Nelson is a tall and wiry man who still looks like a college student—except that the shock of bristling hair on his head is largely silver. He first became interested in near-death experience when he was doing his internship training in Albuquerque, New Mexico. One day, a man walked into the hospital and handed Nelson a small, beautiful painting. Nelson recognized a patient he had treated in the ICU, who had suffered a near-fatal cardiac arrest and only been released from the hospital a few days earlier. The man said the painting was a gift. He had made it himself and said it represented an experience he had had while lying in the ICU. 13
“He came in with a really incredible story,” says Nelson. “As he was lying there, the devil came to take his soul, but a guardian angel came to him, on his shoulder, and then along came Jesus Christ, his savior, who dispelled the devil—and at that point he knew he was no longer meant to leave this earth, and he almost immediately made a good recovery.”
Nelson was glad to see the man doing well—he had grown to like him in the ICU—but he didn’t put much stock in the story. “I was dismissive,” says Nelson. “But I was struck by the intensity of his experience and how powerful it was. I kept the painting for years.”
At the University of Kentucky in Lexington, Nelson is what’s known as a neurophysiologist, specializing in treating muscle diseases like multiple sclerosis or myasthenia gravis. But even as he settled into his specialty, the same curiosity that nagged at Parnia started tugging on Nelson’s sleeve. He found himself thinking more and more about the man who claimed that a guardian angel and Jesus had saved him from a heart attack. “In the back of my mind, I was thinking that not a single neurologist had ever paid attention to the phenomenon of near death,” said Nelson. The brain must be central to the experience, he reasoned, just as it’s central to any experience. And yet the only doctors who had taken the time to study NDEs were cardiologists or psychologists or even oncologists like Jeffrey Long, who runs the Near Death Experience Research Foundation (NDERF). Says Nelson, “These are not the neuroscientists who really know how the brain works.”
Nelson closely read the first-person accounts in Moody’s Life After Life, searching for clues the way a physician looks for clues in a patient’s medical history. There was one account that particularly struck him. A woman was lying in a hospital’s radiology suite, waiting for a scan of her liver, when she suffered a severe allergic reaction to a medication. She told Moody that she heard the radiologist walk over to a telephone on the wall, dial, and say, “Dr. James, I’ve killed your patient, Mrs. Martin.” She struggled to let them know she was still alive but couldn’t move a muscle. In this frozen manner, she watched and listened as an emergency team worked to revive her. She could see the needles going into her skin but couldn’t feel them. 14
Says Nelson, “She felt wide awake, and yet she was unable to move. I thought, what causes transient paralysis? Because that’s what it sounds like, to a neurologist. I started thinking in terms of normal physical processes that cause paralysis, and what came to mind immediately was something we experience several times a night, and that’s the REM stage of sleep. And then, many things started falling into place.”
For Nelson, everything about an NDE—from the glowing light to the out-of-body experience to the mystical feeling—can be explained by a glitch in the body’s sleep-wake machinery. More specifically, Nelson believes the near-death experience can be explained as a manifestation of a REM state—the same REM that we experience in deep sleep, when we dream.
Most people don’t realize just how complex our sleep is, but anyone who’s ever had trouble falling asleep, or struggled to drag themselves out of bed, can understand that sleep is more than a simple on-off switch. Healthy sleep involves multiple phases and multiple shifts in brain activity. Most of us have heard of REM sleep, named for the rapid eye movements—underneath the eyelids—that occur in this stage. In a healthy person, the REM stage makes up about 20 or 25 percent of total sleep time. The body and brain exhibit several distinctive changes. Aside from the eye movements, during REM sleep the body is paralyzed—a condition known as atonia. This is controlled by the brain, which during REM sleep stops releasing certain chemical transmitters, including serotonin and dopamine, which typically permit the muscles to be active. 15
It’s not uncommon for the gears of this machinery to get out of sync, so we’re not completely awake or asleep at some given time. This can lead to some pretty weird behavior. Perhaps the most debilitating yet fascinating condition occurs when the REM stages break down and muscle paralysis doesn’t occur. Sufferers may act out dreams or do bizarre things in their sleep, like trying to have sex or even lashing out with their fists. The condition is called REM behavior disorder. In severe cases, spouses have seriously injured each other or been forced to sleep in different beds for years. There was even an infamous case in Canada where a man named Kenneth Parks drove across town, broke into a house, and stabbed his wife’s parents to death—all supposedly while asleep. Bizarre as it sounds, a jury acquitted Parks of murder, after hearing testimony that several members of his family suffered from extreme versions of REM behavior disorder. 16
Aside from oddities like this, the REM stage is when we dream. Dreams, as we all know, can be unsettling, joyful, or terrifying—sometimes all in the same dream. But when thinking about that stunning bright light, it is important to know that the sights and sounds of our dreams are processed in parts of the brain that are different from the brain regions processing the sights and sounds we experience in our actual lives. For example, blind people are known to sometimes “see” things when they dream—especially if they’ve experienced sight at some point in their lives. 17
What struck Nelson is that hearing about a near-death experience sounds a lot like someone telling you what they dreamed the night before. “If you listen to these near-death experiences, they’re narratives—stories—and there’s a plot. It’s very action oriented. There’s a lot of emotion, but very little language,” says Nelson. That’s the ineffability described by Moody. While some people can recount dreams in great detail, most of us have a lot of trouble describing just what happened in a dream. Time is slowed or distorted, and it’s hard to remember the sequence of events. Once we awake, what’s left is mostly a feeling—and maybe a few intense images. “If you’re awake and kick in the dream machinery, the key brain parts are, number one, the limbic system, and two, the activation of the visual system. That’s what really gets turned on when you’re dreaming.”
The limbic system is the network of brain structures that is involved in our emotions. It includes the hippocampus, which is vital to making new memories, and the amygdala, which not only plays a key ro
le in memory, but is central to our stress response and its interplay with our emotions. According to Nelson, “Dreams are a play out of emotion more than anything else.” It was sounding more and more as if sleep, dreams, and near-death experience were linked. According to the hypothesis, a near-death experience could be thought of as a sudden and powerful sleep episode interwoven with elaborate dreams.
If you want to try and find a scientific basis for an NDE, you also have to explain one of its cardinal features: the bright light—usually perceived in a sacred, awestruck manner. The “dead” person finds himself moving through a gloomy darkness, drawn inexorably to the brightness. Raymond Moody called this “the Being of Light” and wrote, “What is perhaps the most incredible common element in the accounts I have studied, and is certainly the element which has the most profound effect upon the individual, is the encounter with a very bright light” of “indescribable brilliance.” According to Nelson, this can also be explained by a connection to REM sleep, because several studies have found increased activity in the brain’s visual centers during the REM stage.
Nelson tested his hypothesis by interviewing fifty-five people who had reported a near-death experience. What he found is that people who have had an NDE are far more prone to REM intrusion than non-NDEers. Of the fifty-five “experiencers,” thirty-three—60 percent—reported experiencing REM intrusion compared to just 24 percent of a control group. A participant was recorded as experiencing REM intrusion if they reported ever experiencing sleep paralysis, visual or auditory hallucinations around sleep, or cataplexy—sudden incidence of muscle weakness, which in extreme cases has been mistaken for death. One such sufferer—a woman named Allison Burchell—was famously taken to the morgue, while still alive, three times. NDEers are also eight times more likely to answer yes to the question “Just before falling asleep or awakening, have you had the sense that you are outside your body and watching yourself?” 18
