About the Continuity of Our Consciousness
Pim van Lommel,
Cardiologist, Division of Cardiology, Hospital Rijnstate, PO Box 9555, 6800 TA Arnhem, The Netherlands.
Dr. van Lommel is author of the book --
Consciousness Beyond Life, The Science of the Near-Death Experience
and his website is
www.consciousnessbeyondlife.com
1. INTRODUCTION
Some people who have survived a life-threatening crisis report an
extraordinary experience. Near-death experiences (NDE) occur with
increasing frequency because of improved survival rates resulting from
modern techniques of resuscitation. The content of NDE and the effects
on patients seem similar worldwide, across all cultures and times. The
subjective nature and absence of a frame of reference for this
experience lead to individual, cultural, and religious factors
determining the vocabulary used to describe and interpret the
experience. NDE can be defined as the reported memory of the whole of
impressions during a special state of consciousness, including a number
of special elements such as out-of-body experience, pleasant feelings,
seeing a tunnel, a light, deceased relatives, or a life review. Many
circumstances are described during which NDE are reported, such as
cardiac arrest (clinical death), shock after loss of blood, traumatic
brain injury or intra-cerebral haemorrhage, near-drowning or asphyxia,
but also in serious diseases not immediately life-threatening. Similar
experiences to near-death ones can occur during the terminal phase of
illness, and are called deathbed visions. Furthermore, identical
experiences, so-called fear-death experiences, are mainly reported
after situations in which death seemed unavoidable like serious traffic
or mountaineering accidents. The NDE is transformational, causing
profound changes of life-insight and loss of the fear of death. An NDE
seems to be a relatively regularly occurring, and to many physicians an
inexplicable phenomenon and hence an ignored result of survival in a
critical medical situation.
And should we also consider the possibility of conscious experience
when someone in coma has been declared brain dead by physicians, and
organ transplantation is about to be started? Recently several books
were published in the Netherlands about what patients had experienced
in their consciousness during coma following a severe traffic accident,
following acute disseminated encephalomyelitis (ADEM), or following
complications with cerebral hypertension after surgery for a brain
tumour, this last patient being declared brain dead by his neurologist
and neurosurgeon, but the family refused to give permission for organ
donation. All these patients reported, after regaining consciousness,
that they had experienced clear consciousness with memories,
emotions, and perception out of and above their body during the period
of their coma, also seeing nurses, physicians and family in and around
the ICU. Does brain death really means death, or is it just the
beginning of the process of dying that can last for hours to days, and
what happens to consciousness during this period? Should we also
consider the possibility that someone who is clinically dead during
cardiac arrest can experience consciousness, and even whether there
could still be consciousness after someone really has died, when his
body is cold? How is consciousness related to the integrity of brain
function? Is it possible to gain insight in thisrelationship? In my
view the only possible empirical approach to evaluate theories about
consciousness is research on NDE, because in studying the several
universal elements that are reported during NDE, we get the opportunity
to verify all the existing theories about consciousness that have been
discussed until now. Consciousness presents temporal as well as
everlasting experiences. Is there a start or an end to consciousness?
In this paper I first will discuss some more general aspects of death,
and after that I will describe more details from our prospective study
on near-death experience in survivors of cardiac arrest in the
Netherlands, which was published in the Lancet.1 I also want to comment
on similar findings from two prospective studies in survivors of
cardiac arrest from the USA2 and from the United Kingdom.3 Finally, I
will discuss implications for consciousness studies, and how it could
be possible to explain the continuity of our consciousness.
Originally published in: Brain Death and Disorders of Consciousness.
Machado, C. and Shewmon, D.A., Eds. New York, Boston,
Dordrecht, London, Moscow: Kluwer Academic/ Plenum Publishers, Advances
in Experimental Medicine and Biology Adv Exp Med Biol. 2004; 550:
115-132.
2. ABOUT DEATH
First I want to discuss death. The confrontation with death raises many
basic questions, also for physicians. Why are we afraid of death? Are
our concepts about death correct? Most of us believethat death is the
end of our existence; we believe that it is the end of everything we
are. We believe that the death of our body is the end of our identity,
the end of our thoughts and memories, that it is the end of our
consciousness. Do we have to change our concepts about death, not only
based on what has been thought and written about death in human history
around the world in many cultures, in many religions, and in all times,
but also based on insights from recent scientific research on NDE?
What happens when I am dead? What is death? During our life 500000
cells die each second, each day about 50 billion cells in our body are
replaced, resulting in a new body each year. So cell death is totally
different from body death when you eventually die. During our life our
body changes continuously, each day, each minute, each second. Each
year about 98% of our molecules and atoms in our body have been
replaced. Each living being is in an unstable balance of two opposing
processes of continual disintegration and integration. But no one
realizes this constant change. And from where comes the continuity of
our continually changing body? Cells are just the building blocks of
our body, like the bricks of a house, but who is the architect, who
coordinates the building of this house. When someone has died, only
mortal remains are left: only matter. But where is the director of the
body?What about our consciousness when we die? Is someone his body, or
do we have a body?
3. SCIENTIFIC RESEARCH ON NEAR-DEATH EXPERIENCE
In 1969 during my rotating internship a patient was successfully
resuscitated in the cardiac ward by electrical defibrillation. The
patient regained consciousness, and was very, very disappointed. He
told me about a tunnel, beautiful colours, a light and beautiful music.
I have never forgotten this event, but I did not do anything with it.
Years later, in 1976 Raymond Moody first described the so-called
near-death experiences, and only in 1986 I read about these experiences
in the book by George Ritchieentitled Return from Tomorrow, which
relates what he experienced during a period of clinical death of
6-minutes duration in 1943 during his medical study.4 After reading his
book I started to interview my patients who had survived a cardiac
arrest. To my great surprise, within two years about fifty patients
told me about their NDE.
My scientific curiosity started to grow, because according to our
current medical concepts, it is not possible to experience
consciousness during a cardiac arrest, when circulation and breathing
have ceased.
Several theories on the origin of an NDE have been proposed. Some think
the experience is caused by physiological changes in the brain such as
brain cells dying as a result of cerebral anoxia, and possibly also
caused by release of endorphins, or NMDA receptor blockade.5 Other
theories encompass a psychological reaction to approaching death6 or a
combination of such reaction and anoxia.7 But until now there was no
prospective, meticulous and scientifically designed study to explain
the cause and content of an NDE. All studies had been retrospective and
very selective with respect to patients. In retrospective studies 5-30
years can elapse between occurrence of the experience and its
investigation, which often prevents accurate assessment of medical and
pharmacological factors. We wanted to know if there could be a
physiological, pharmacological, psychological or demographic
explanation why people experience consciousness during a period
of clinical death. The definition of clinical death was used for the
period of unconsciousness caused by anoxia of the brain due to the
arrest of circulation and breathing that happens during ventricular
fibrillation in patients with acute myocardial infarction.
We studied patients who survived cardiac arrest, because this is a
well-described life threatening medical situation, where patients will
ultimately die from irreversible damage to the brain if
cardio-pulmonary resuscitation (CPR) is not initiated within 5 to 10
minutes. It is the closest model of the process of dying.
So, in 1988 we started a prospective study of 344 consecutive survivors
of cardiac arrest in ten Dutch hospitals with the aim of investigating
the frequency, the cause and the content of an NDE.1 We did a short
standardised interview with sufficiently recovered patients within a
few days of resuscitation, and asked whether they could remember the
period of unconsciousness, and what they recalled. In cases where
memories were reported, we coded the experiences according to a
weighted core experience index. In this system the depth of the NDE was
measured according to the reported elements of the content of the NDE.
The more elements were reported, the deeper the experience was and the
higher the resulting score was.
Results: 62 patients (18%) reported some recollection of the time of
clinical death. Of these patients 41 (12%) had a core experience with a
score of 6 or higher, and 21 (6%) had a superficial NDE. In the core
group 23 patients (7%) reported a deep or very deep experience with a
score of 10 or higher. And 282 patients (82%) had no recollection of
the period of cardiac arrest.
In the American prospective study of 116 survivors of cardiac arrest 11
patients (10%) reported an NDE with a score of 6 or higher; the
investigators did not specify the number of patients with a superficial
NDE with a low score.2 In the British prospective study of 63 survivors
of cardiac arrest only 4 patients (6.3%) reported an NDE with a score
of 6 or higher, and 3 patients (4.8%) had a superficial NDE, a total of
7 patients (11%) with memories from the period of cardiac arrest.3
In our study about 50% of the patients with an NDE reported awareness
of being dead, or had positive emotions, 30% reported moving
through a tunnel, had an observation of a celestial landscape, or had a
meeting with deceased relatives. About 25% of the patients with an NDE
had an out-of-body experience, had communication with the light, or
observed colours, 13% experienced a life review, and 8% experienced a
border.
What might distinguish the small percentage of patients who report an
NDE from those who do not? We found that neither the duration of
cardiac arrest nor the duration of unconsciousness, nor the need for
intubation in complicated CPR, nor induced cardiac arrest in
electrophysiological stimulation (EPS) had any influence on the
frequency of NDE. Neither could we find any relationship between the
frequency of NDE and administered drugs, fear of death before the
arrest, foreknowledge of NDE, religion or education. An NDE was more
frequently reported at ages lower than 60 years, and also by patients
who had had more than one CPR during their hospital stay, and by
patients who had experienced an NDE previously. Patients with memory
defects induced by lengthy CPR reported an NDE less frequently. Good
short-term memory seems to be essential for remembering an NDE.
Unexpectedly, we found that significantly more patients who had an NDE,
especially a deep experience, died within 30 days of CPR (p<0.0001).
We performed a longitudinal study with taped interviews of all late
survivors with NDE 2 and 8 years following the cardiac arrest, along
with a matched control group of survivors of cardiac arrest who did not
report an NDE.1 This study was designed to assess whether the
transformation in attitude toward life and death following an NDE is
the result of having an NDE or the result of the cardiac arrest itself.
In this follow-up research into transformational processes after NDE,
we found a significant difference between patients with and without an
NDE. The process of transformation took several years to consolidate.
Patients with an NDE did not show any fear of death, they strongly
believed in an afterlife, and their insight in what is important in
life had changed: love and compassion for oneself, for others, and for
nature. They now understood the cosmic law that everything one does to
others will ultimately be returned to oneself: hatred and violence as
well as love and compassion. Remarkably, there was often evidence of
increased intuitive feelings. Furthermore, the long lasting
transformational effects of an experience that lasts only a few minutes
was a surprising and unexpected finding.
Several theories have been proposed to explain NDE. However, in our
prospective study we did not show that psychological, physiological or
pharmacological factors caused these experiences after cardiac arrest.
With a purely physiological explanation such as cerebral anoxia, most
patients who had been clinically dead should report an NDE. All 344
patients had been unconscious because of anoxia of the brain resulting
from their cardiac arrest. Why should only 18% of the survivors of
cardiac arrest report an NDE?
And yet, neurophysiological processes must play some part in NDE,
because NDE-like experiences can be induced through electrical
stimulation of some parts of the cortex in patients with epilepsy,8
with high carbon dioxide levels (hypercarbia)9 and in decreased
cerebral perfusion resulting in local cerebral hypoxia, as in rapid
acceleration during training of fighter pilots,10 or as in
hyperventilation followed by Valsalva maneuver.11 Also NDE-like
experiences have been reported after the use of drugs like ketamine,12
LSD,13 or mushrooms.14 These induced experiences can sometimes result
in a period of unconsciousness, but can at the same time also consist
of out-of-body experiences, perception of sound, light or flashes of
recollections from the past. These recollections, however, consist of
fragmented and random memories unlike the panoramic life-review that
can occur in NDE. Further, transformational processes are rarely
reported after induced experiences. Thus, induced experiences are not
identical to NDE.
Another theory holds that NDE might be a changing state of
consciousness (transcendence, or the theory of continuity), in which
memories, identity, and cognition, with emotion, function independently
from the unconscious body, and retain the possibility of non-sensory
perception. Obviously, consciousness during NDE was experienced
independently from the normal body-linked waking consciousness.
With lack of evidence for any other theories for NDE, the concept thus
far assumed but never scientifically proven, that consciousness and
memories are localized in the brain should be discussed. Traditionally,
it has been argued that thoughts or consciousness are produced by large
groups of neurons or neuronal networks. How could a clear consciousness
outside ones body be experienced at the moment that the brain no longer
functions during a period of clinical death, with flat EEG?15
Furthermore, blind people have also described veridical perceptions
during out-of-body experiences at the time of their NDE.16 Scientific
study of NDE pushes us to the limits of our medical and
neurophysiological ideas about the range of human consciousness and
relationship of consciousness and memories to the brain.
Also Greyson2 writes in his discussion: No one physiological or
psychological model by itself explains all the common features of NDE.
The paradoxical occurrence of heightened, lucid awareness and logical
thought processes during a period of impaired cerebral perfusion raises
particular perplexing questions for our current understanding of
consciousness and its relation to brain function. A clear sensorium and
complex perceptual processes during a period of apparent clinical death
challenge the concept that consciousness is localized exclusively in
the brain. And Parnia and Fenwick3 write in their discussion: The data
suggest that the NDE arises during unconsciousness. This is a
surprising conclusion, because when the brain is so dysfunctional that
the patient is deeply comatose, the cerebral structures, which underpin
subjective experience and memory, must be severely impaired. Complex
experiences such as are reported in the NDE should not arise or be
retained in memory. Such patients would be expected to have no
subjective experience [as was the case in the vast majority of patients
who survive cardiac arrest in the three published prospective
studies1-3 or at best a confusional state if some brain function is
retained. Even if the unconscious brain is flooded by neurotransmitters
this should not produce clear, lucid remembered experiences, as those
cerebral modules, which generate conscious experience, are impaired by
cerebral anoxia. The fact that in a cardiac arrest loss of cortical
function precedes the rapid loss of brainstem activity lends further
support to this view. An alternative explanation would be that the
observed experiences arise during the loss of, or on regaining
consciousness. The transition from consciousness to unconsciousness is
rapid, with the EEG showing changes within a few seconds, and appearing
immediate to the subject. Experiences which occur during the recovery
of consciousness are confusional, which these were not. In fact, memory
is a very sensitive indicator of brain injury and the length of amnesia
before and after unconsciousness is an indicator of the severity of the
injury. Therefore, events that occur just prior to or just after loss
of consciousness would not be expected to be recalled. And as stated
before, in our study1 patients with loss of memory induced by lengthy
CPR reported significantly fewer NDE. Good short-term memory seems to
be essential for remembering NDE.
4. SOME TYPICAL ELEMENTS OF NDE
Before I discuss in greater detail some neurophysiological aspects of
brain functioning during cardiac arrest, I would like to reconsider
certain elements of the NDE, like the out-of-body experience, the
holographic life review and preview, the encounter with deceased
relatives, the return into the body and the disappearance of the fear
of death.
4.1. The Out-of-Body Experience
In this experience people have veridical perceptions from a position
outside and above their lifeless body. NDEers have the feeling that
they have apparently taken off their body like an old coat and to their
surprise they appear to have retained their own identity with the
possibility of perception, emotions, and a very clear consciousness.
This out-of-body experience is scientifically important because
doctors, nurses, and relatives can verify the reported perceptions.
This is the report of a nurse of a Coronary Care Unit:
During night shift an ambulance brings in a 44-year old cyanotic,
comatose man into the coronary care unit. He was found in coma about 30
minutes before in a meadow. When we go to intubate the patient, he
turns out to have dentures in his mouth. I remove these upper dentures
and put them onto the crash cart. After about an hour and a half the
patient has sufficient heart rhythm and blood pressure, but he is still
ventilated and intubated, and he is still comatose. He is transferred
to the intensive care unit to continue the necessary artificial
respiration. Only after more than a week do I meet again with the
patient, who is by now back on the cardiac ward. The moment he sees me
he says: O, that nurse knows where my dentures are. I am very
surprised. Then he elucidates: You were there when I was brought into
hospital and you took my dentures out of my mouth and put them onto
that cart, it had all these bottles on it and there was this sliding
drawer underneath, and there you put my teeth. I was especially amazed
because I remembered this happening while the man was in deep coma and
in the process of CPR. It appeared that the man had seen himself lying
in bed, that he had perceived from above how nurses and doctors had
been busy with the CPR. He was also able to describe correctly and in
detail the small room in which he had been resuscitated as well as the
appearance of those present like myself. He is deeply impressed by his
experience and says he is no longer afraid of death.
4.2. The Holographic Life Review
During this life review the subject feels the presence and renewed
experience of not only every act but also every thought from ones
past life, and one realizes that all of it is an energy field which
influences oneself as well as others. All that has been done and
thought seems to be significant and stored. Insight is obtained about
whether love was given or on the contrary withheld. Because one is
connected with the memories, emotions and consciousness of another
person, you experience the consequences of your own thoughts, words and
actions to that other person at the very moment in the past that they
occurred. Hence there is during a life review a connection withthe
fields of consciousness of other persons as well as with your own
fields of consciousness (interconnectedness). Patients survey their
whole life in one glance; time and space do not seem to exist during
such an experience. Instantaneously they are where they concentrate
upon (non-locality), and they can talk for hours about the content of
the life review even though the resuscitation only took minutes.
Quotation:
All of my life up till the present seemed to be placed before me in a
kind of panoramic, three-dimensional review, and each event seemed to
be accompanied by a consciousness of good or evil or with an insight
into cause or effect. Not only did I perceive everything from my own
viewpoint, but I also knew the thoughts of everyone involved in the
event, as if I had their thoughts within me. This meant that I
perceived not only what I had done or thought, but even in what way it
had influenced others, as if I saw things with all-seeing eyes. And so
even your thoughts are apparently not wiped out. And all the time
during the review the importance of love was emphasised. Looking back,
I cannot say how long this life review and life insight lasted, it may
have been long, for every subject came up, but at the same time it
seemed just a fraction of a second, because I perceived it all at the
same moment. Time and distance seemed not to exist. I was in all places
at the same time, and sometimes my attention was drawn to something,
and then I would be present there.
Also a preview can be experienced, in which both future images from
personal life events (sometimes remembered only later in the shape of
d骡 vu) as well as more general images from the future occur, even
though it must be stressed that these surveyed images should be
considered purely as possibilities. And again it seems as if time and
space do not exist during this review. Quotation:
I had a nice eye contact, they looked at me full of love, and then I
surveyed a great part of my life to come; the care for my children, the
terminal illness of my wife, the circumstances I would be mixed up
with, in my job and besides. I surveyed it completely; and then I got
the feeling that I had to decide now: I may stay here, or I have to go
back, but I had to decide now.
4.3. The Encounter with Deceased Relatives
If deceased acquaintances or relatives are encountered in an
otherworldly dimension, they are usually recognized by their
appearance, while communication is possible through thought transfer.
Thus, during an NDE it is also possible to come into contact with
fields of consciousness of deceased persons (interconnectedness).
Sometimes persons are met whose death was impossible to have known;
sometimes persons unknown to them are encountered during an NDE.
Quotation:
During my cardiac arrest I had a extensive experience () and later I
saw, apart from my deceased grandmother, a man who had looked at me
lovingly, but whom I did not know. More than 10 years later, at my
mothers deathbed, she confessed to me that I had been born out of an
extramarital relationship, my father being a Jewish man who had been
deported and killed during the second World War, and my mother showed
me his picture. The unknown man that I had seen more than 10 years
before during my NDE turned out to be my biological father.
4.4. The Return into the Body
Some patients can describe how they returned into their body, mostly
through the top of the head, after they had come to understand through
wordless communication with a Being of Light or a deceased relative
that it wasnt their time yet or that they still had a task to fulfil.
The conscious return into the body is experienced as something very
oppressive. They regain consciousness in their body and realize that
they are locked up in their body, meaning again all the pain and
restriction of their disease. They also realize that a part of their
consciousness with deep knowledge and understanding as well as the
feeling of unconditional love and acceptance have been taken away from
them again. Quotation:
And when I regained consciousness in my body, it was so terrible, so
terrible that experience was so beautiful, I never would have liked to
come back, I wanted to stay there and still I came back. And from that
moment on it was a very difficult experience to live my life again in
my body, with all the limitations I felt in that period.
4.5. The Disappearance of Fear of Death
Nearly all people who have experienced an NDE lose their fear of death.
This is due to the realization that there is a continuation of
consciousness, even when you have been declared dead by bystanders or
even by doctors. You are separated from the lifeless body, retaining
the ability of perception. Quotation:
It is outside my domain to discuss something that can only be proven by
death. For me, however, the experience was decisive in convincing me
that consciousness lives on beyond the grave. Death was not death, but
another form of life.
Another quotation:
This experience is a blessing for me, for now I know for sure that body
and mind are separated, and that there is life after death.
Following an NDE people know of the continuity of their consciousness,
retaining all thoughts and past events. And this insight causes
exactly their process of transformation and the loss of fear of death.
Man appears to be more than just a body.
5. NEUROPHYSIOLOGY IN CARDIAC ARREST
All these elements of an NDE were experienced during the period of
cardiac arrest, during the period of apparent unconsciousness,
during the period of clinical death! But how is it possible to explain
these experiences during the period of temporary loss of all functions
of the brain due to acute pancerebral ischemia?
We know that patients with cardiac arrest are unconscious within
seconds. But how do we know that the electroencephalogram (EEG) is flat
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 ischemic model can be used to
study the result of anoxia of the brain.
In VF complete cardiac arrest occurs, with complete cessation of
cerebral flow, resulting in acute pancerebral anoxia. The middle
cerebral artery blood flow, Vmca, which is a reliable trend monitor of
the cerebral blood flow, decreases to 0 cm/sec immediately after the
induction of VF.17 Through many studies in both human and animal
models, cerebral function has been shown to be severely compromised
during cardiac arrest, and electrical activity in both cerebral cortex
and the deeper structures of the brain has been shown to be absent
after a very short period of time. Monitoring of the electrical
activity of the cortex (EEG) has shown that ischemia produces a
decrease of power in fast activity and in delta activity and an
increase of slow delta I activity, sometimes also an increase in
amplitude of theta activity, progressively and ultimately declining to
isoelectricity. More often initial slowing and attenuation of the EEG
waves is the first sign of cerebral ischemia. The first ischemic
changes in the EEG are detected an average of 6.5 seconds after
circulatory arrest. With prolongation of the cerebral ischemia,
progression to isoelectricity occurs within 10 to 20 (mean 15) seconds
from the onset of cardiac arrest.18-21
After defibrillation the Vmca, measured by transcranial Doppler
technique, returns rapidly within 1-5 seconds after a cardiac arrest of
short duration. However, in the case of a prolonged cardiac arrest of
more than 37 seconds, the Vmca shows an initial overshoot upon
reperfusion, a transient global hyperaemia, followed by a significant
decrease in cerebral blood flow up to 50% or less of normal.22 This
results also in an initial overshoot of cerebral oxygen uptake
(hyperoxia) with a fast decrease in cerebral oxygen uptake to
borderline values for a considerable time due to delayed
hypoperfusion.18,22 In the case of a prolonged cardiac arrest the EEG
recovery also takes more time, and normal EEG activity may not return
for many minutes to hours after cardiac function has been restored,
depending on the duration of the cardiac arrest, despite maintenance of
adequate blood pressure during the recovery phase. Additionally, EEG
recovery underestimates the metabolic recovery of the brain, and
cerebral oxygen uptake may be depressed for a considerable time after
restoration of circulation.18 In acute myocardial infarction the
duration of cardiac arrest (VF) in the Coronary Care Unit (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
electrophysiological stimulation studies will the duration of cardiac
arrest rarely exceed 30-60 seconds.
Anoxia causes loss of function of our cell systems. However, in anoxia
of only some minutes duration this loss may be transient; in prolonged
anoxia cell death occurs, with permanent functional loss. During an
embolic event a small clot obstructs the blood flow in a small vessel
of the cortex, resulting in anoxia of that part of the brain, with loss
of electrical activity. This results in a functional loss of the cortex
like hemiplegia or aphasia. When the clot is dissolved or broken down
within several minutes the lost cortical function is restored. This is
called a transient ischemic attack (TIA). However, when the clot
obstructs the cerebral vessel for minutes to hours, it will result in
neuronal cell death, with a permanent loss of function of this part of
the brain, with persistent hemiplegia or aphasia, and the diagnosis of
cerebrovascular accident (CVA) is made. So transient anoxia results in
transient loss of function.
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 irreversible
damage and extensive cell death in the brain. This is called brain
death, and most patients will ultimately die.
From these studies we know that in our prospective study1 as well as in
the other studies2,3 of patients who have been clinically dead (VF on
the ECG), total lack of electric activity of the cortex of the brain
(flat EEG) must have been the only possibility, but also the abolition
of brain-stem activity, such as the loss of the corneal reflex,
fixed and 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 occasional and verifiable out-of-body experiences, like the one
involving the dentures in our study,1 we know that the NDE must happen
during the period of unconsciousness, and not in the first or last
seconds of this period. There is also a well documented report of a
patient with constant registration of the EEG during surgery for an
gigantic aneurysm at the base of the brain, operated with a body
temperature between 10 and 15 degrees Celsius. She was connected to a
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.15
So we have to conclude that NDE in our study,1 as well as in the
American2 and the British study,3 was experienced during a transient
functional loss of all functions of the cortex and of the brainstem.
How could a clear consciousness outside ones body be experienced at the
moment that the brain no longer functions during a period of clinical
death, with a flat EEG? Such a brain would be roughly analogous to a
computer with its power source unplugged and its circuits detached. It
couldnt hallucinate; it couldnt do anything at all. As stated before,
up to the present it has generally been assumed that consciousness and
memories are localized inside the brain, that the brain produces them.
According to this unproven concept, consciousness and memories ought to
vanish with physical death, and necessary also during clinical
death or brain death. However, during an NDE patients experience the
continuity of their consciousness with the possibility of perception
outside and above ones lifeless body. Consciousness can be experienced
in another dimension without our conventional body-linked concept of
time and space, where all past, present and future events exist and can
be observed simultaneously and instantaneously (non-locality). In the
other dimension, one can be connected with the personal memories and
fields of consciousness of oneself as well as others, including
deceased relatives (universal interconnectedness). And the conscious
return into ones body can be experienced, together with the feeling of
bodily limitation, and also sometimes the awareness of the loss of
universal wisdom and love they had experienced during their NDE.
6. NEUROPHYSIOLOGY IN A NORMAL FUNCTIONING BRAIN
For decades, extensive research has been done to localize consciousness
and memories inside the brain, so far without success. In connection
with the unproven assumption that consciousness and memories are
produced and stored inside the brain, we should ask ourselves how a
non-material activity such as concentrated attention or thinking can
correspond to an observable (material) reaction in the form of
measurable electrical, magnetic, and chemical activity at a certain
place in the brain,23-25 even an increase in cerebral blood flow is
observed during such a non-material activity as thinking.26
Neurophysiological studies have shown these aforesaid activities
through EEG, magnetoencephalography (MEG), magnetic resonance imaging
(MRI) and positron emission tomography (PET) scanning. Specific areas
of the brain have been shown to become metabolically active in response
to a thought or feeling. However, those studies, although providing
evidence for the role of neuronal networks as an intermediary for the
manifestation of thoughts, do not necessary imply that those cells also
produce the thoughts. Direct evidence of how neurons or neuronal
networks could possibly produce the subjective essence of the mind and
thoughts is currently lacking. It is also not well understood how to
explain that in a sensory experiment, the subject stated that he was
aware (conscious) of the sensation a few thousands of a second
following the stimulation, whereas neuronal adequacy in the subjects
brain wasnt achieved until a full 500 msec following the sensation.
This experiment has led to the so-called delay-and-antedating
hypothesis,27 and it is a challenge to our current neurophysiological
theories, as well as phenomena like anticipatory activation, or
presentiment,28 with changes on MRI up to 3 seconds preceding emotional
stimuli. 29
The brain contains about 100 billion neurons, 20 billion of which are
situated in the cerebral cortex. Several thousand neurons die each day,
and there is a continuous renewal of the proteins and lipids
constituting cellular membranes on a time-span basis ranging from
several days to a few weeks.30 During life the cerebral cortex
continuously adaptively modifies its neuronal network, including
changing the number and location of synapses. All neurons show an
electrical potential across their cell membranes, and each neuron has
tens to hundreds of synapses that influence other neurons.
Transportation of information along neurons occurs predominantly by
means of action potentials, differences in membrane potential caused by
synaptic depolarization and hyperpolarization. The sum total of changes
along neurons causes transient electric fields and therefore also
transient magnetic fields along the synchronously activated dendrites.
During cerebral activity, these electrical and magnetic patterns of the
100 billion neurons change each nanosecond. Neither the number of
neurons, nor the precise shape of the dendrites, nor the position of
synapses, nor the firing of individual neurons seem to be crucial for
information processing properties, but the derivative, the fleeting,
highly ordered 4-dimensional (space and time) patterns of the
electromagnetic fields generated along the dendritic trees of
specialized neuronal networks. These patterns should be thought of as
the final product of chaotic, dynamically governed self-organization.31
The influence of external localized magnetic and electric fields on
these constant changing electromagnetic fields during normal
functioning of the brain should now be mentioned. Neurophysiological
research is being performed using transcranial magnetic stimulation
(TMS),32 in the course of which localized magnetic fields are produced.
TMS can excite or inhibit different parts of the brain, depending of
the amount of energy given, allowing functional mapping of cortical
regions and creation of transient functional lesions. It allows
assessing the function in focal brain regions on a millisecond scale,
and it can study the contribution of cortical networks to specific
cognitive functions. TMS can interfere with visual and motion
perception, by interrupting cortical processing for 80-100
milliseconds. Intracortical inhibition and facilitation obtained during
paired-pulse studies with TMS reflect the activity of interneurons in
the cortex. Also TMS can alter the functioning of the brain beyond the
time of stimulation, but it does not appear to leave any lasting
effect.32
Interrupting the electrical fields of local neuronal networks in parts
of the cortex also disturbs the normal functioning of the brain. By
localized electrical stimulation of the temporal and parietal lobe
during surgery for epilepsy the neurosurgeon and Nobel prize winner
Wilder 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 (OBE).33,34 These
experiences did not produce any life-attitude transformation.
The effect of the external magnetic or electrical stimulation depends
on the intensity and duration of energy given. There may be no clinical
effect; sometimes an effect occurs when only a small amount of energy
is given. But during stimulation with higher energy, inhibition of
local cortical functions occurs by extinction of their electrical and
magnetic fields (personal communication Dr. Olaf Blanke, neurologist,
Laboratory for Presurgical Epilepsy Evaluation and Functional Brain
Mapping Laboratory, Department of Neurology, University Hospital of
Geneva, Switzerland). Blanke recently described a patient with induced
OBE by inhibition of cortical activity caused by more intense external
electrical stimulation of neuronal networks in the gyrus angularis in a
patient with epilepsy.35
We have to conclude that localized artificial stimulation with real
photons (electrical or magnetic energy) disturbs and inhibits the
constantly changing electromagnetic fields of our neuronal networks,
thereby influencing and inhibiting the normal functions of our brain.
Could consciousness and memories be the product or the result of these
constantly changing fields of photons? Could these photons be the
elementary carriers of consciousness?31
Some researchers try to create artificial intelligence by computer
technology, hoping to simulate programs evoking consciousness. But
Roger Penrose, a quantum physicist, argues that Algorithmic
computations cannot simulate mathematical reasoning. The brain, as a
closed system capable of internal and consistent computations, is
insufficient to elicit human consciousness.36 Penrose offers a quantum
mechanical hypothesis to explain the relation between consciousness and
the brain. And Simon Berkovitch, a professor in Computer Science of the
George Washington University, has calculated that the brain has an
absolutely inadequate capacity to produce and store all the
informational processes of all our memories with associative thoughts.
We would need 1024 operations per second, which is absolutely
impossible for our neurons.37 Herms Romijn, a Dutch neurobiologist,
comes to the same conclusion.30 One should conclude that the brain has
not enough computing capacity to store all the memories with
associative thoughts from ones life, has not enough retrieval
abilities, and seems not to be able to elicit consciousness.
7. QUANTUM MECHANICS AND THE BRAIN
With our current medical and scientific concepts it seems impossible to
explain all aspects of the subjective experiences as reported by
patients with an NDE during their period of cardiac arrest, during a
transient loss of all functions of the brain. But science, I believe,
is the search for explaining new mysteries rather than the cataloguing
of old facts and concepts. So it is a scientific challenge to discuss
new hypotheses that could explain the reported interconnectedness with
the consciousness of other persons and of deceased relatives, to
explain the possibility to experience instantaneously and
simultaneously (non-locality) a review and a preview of someones life
in a dimensionwithout our conventional body-linked concept of time and
space, where all past, present and future events exist, and the
possibility to have clear consciousness with memories from early
childhood, with self-identity, with cognition, and with emotion, and
the possibility of perception out and above ones lifeless body.
We should conclude, like many others, that quantum mechanical processes
could have something critical to do with how consciousness and memories
relate with the brain and the body during normal daily activities as
well as during brain death or clinical death.
I would like now to discuss some aspects of quantum physics, because
this seems necessary to understand my concept of the continuity of
consciousness. Quantum physics has completely overturned the existing
view of our material, manifest world, the so-called real-space. It
tells us that particles can propagate like waves, and so can be
described by a quantum mechanical wave function. It can be proven that
light in some experiments behaves like particles (photons), and in
other experiments it behaves like waves, and both experiments are true.
So waves and particles are complementary aspects of light (Bohr).38 The
experiment of Aspect, based on Bells theorem, has established
non-locality in quantum mechanics (non-local interconnectedness).39
Non-locality happens because all events are interrelated and influence
each other.
Phase-space is an invisible, non-local, higher-dimensional space
consisting of fields ofprobability, where every past and future event
is available as a possibility.Within this phase-space no matter is
present, everything belongs to uncertainty, and neither measurements
nor observations are possible by physicists.40 The act of observation
instantly changes a probability into an actuality by collapse of the
wave function. Roger Penrose calls this resolution of multiple
possibilities into one definitive state objective reduction.35 So it
seems that no observation is possible without fundamentally changing
the observed subject; only subjectivity remains.
The phase-speed in this invisible and non-measurable phase-space varies
from the speed of light to infinity, while the speed of particles in
our manifest physical real-space varies from zero to the speed of
light. At the speed of light, the speed of a particle and the speed of
the wave are identical. But the slower the particle, the faster the
wave-speed, and when the particle stops, the wave-speed is infinite.
The phase-space generates events that can be located in our space-time
continuum, the manifest world, or real-space. Everything visible
emanates form the invisible.
According to Stuart Hameroff and Roger Penrose, microtubules in neurons
may process information generated by self-organizing patterns, giving
rise to coherent states, and these states could be the explanation of
the possibility of experiencing consciousness.42 Herms Romijn argues
that the continuously changing electromagnetic fields of the neuronal
networks, which can be considered as a biological quantum coherence
phenomenon, possibly could be the elementary carriers of
consciousness.31
Quantum physics cannot explain the essence of consciousness or the
secret of life, but in my concept it is helpful for understanding the
transition between the fields of consciousness in the phase-space (to
be compared with the probability fields as we know from quantum
mechanics) and the body-linked waking consciousness in the real-space,
because these are the two complementary aspects of consciousness.41 Our
whole and undivided consciousness with declarative memories finds its
origin in, and is stored in this phase-space, and the cortex only
serves as a relay station for parts of our consciousness and parts of
our memories to be received into our waking consciousness. In this
concept consciousness is not physically rooted. This could be compared
with the internet, which does not originate from the computer itself,
but is only received by it.
Life createsthe transition from phase-space into our manifest
real-space; according to our hypothesis life creates the possibility to
receive the fields of consciousness (waves) into the waking
consciousness which belongs to our physical body (particles). During
life, our consciousness has an aspect of waves as well asofparticles,
and there is a permanent interaction between these two aspects of
consciousness. This concept is a complementary theory, like both the
wave and particle aspects of light, and not a dualistic theory.
Subjective (conscious) experiences and the corresponding objective
physical properties are two fundamentally different manifestations of
one and the same underlying deeper reality; they cannot be reduced to
each other.30 The particle aspect, the physical aspect of consciousness
in the material world, originates from the wave aspect of our
consciousness from the phase-space by collapse of the wave function
into particles (objective reduction), and can be measured by means of
EEG, MEG, MRI, and PET scan. And different neuronal networks function
as interface for different aspects of our consciousness, as can be
demonstrated by changing images during these registrations of EEG, MRI
or PET scan. The wave aspect of our indestructible consciousness in
phase-space, with non-local interconnectedness, is inherently not
measurable by physical means. When we die, our consciousness will no
longer have an aspect of particles, but only an eternal aspect of waves.
With this new concept about consciousness and the mind-brain relation
all reported elements of an NDE during cardiac arrest could be
explained. This concept is also compatible with the non-local
interconnectedness with fields of consciousness of other persons in
phase-space. Following an NDE most people, often to their own amazement
and confusion, experience an enhanced intuitive sensibility, like
clairvoyance and clairaudience, or prognostic dreams, in which they
dream about future events. In people with an NDE the functional
receiving capacity seems to be permanently enhanced. When you compare
this with a TV set, you receive not only Channel 1, the transmission of
your personal consciousness, but simultaneously Channels 2, 3 and 4
with aspects of consciousness of others. This remote, non-local
communication seems to have been demonstrated scientifically by
positioning subject pairs in two separate Faraday chambers, which
effectively rules out any electromagnetic transfer mechanism. A visual
pattern-reversal stimulus is used to elicit visual evoked responses in
the EEG registration of the stimulated subject, and this was
instantaneously received by the non-stimulated subject resulting in an
analogous neural event with a similar brain wave morphology, or
transferred potentials, as revealed on the EEG.43,44
8. THE ROLE OF DNA
How should we understand the interaction between our consciousness and
ourfunctioning brain in our continuously changing body? As stated
before, during our life the composition of our body changes
continuously, as during each second 500000 cells are being replaced in
our body. What could be the basis of the continuity of our changing
body? Cells and molecules are just the building blocks. In assessing
all the theories mentioned above, it seems reasonable to consider the
person-specific DNA in our cells as the place of resonance, or the
interface across which a constant informational exchange takes place
between our personal material body and the phase-space, where all
fields of our personal consciousness are available as fields of
possibility.
DNA is a molecule, composed of nucleotides, with a double helix
structure. In humans it is organized into 23 pairs of chromosomes,
defines 30,000 genes, and contains about 3 billion base pairs.45 About
95% of human DNA has a still unknown function, for which reason it is
called junk DNA, non-protein-coding DNA, or introns,46 and the 5%
protein-coding called exons. The more complex a species is, the more
introns it has. Simon Berkovich assumes that this junk DNA could have
an identifying purpose, comparable to a kind of barcode functionality.
According to his hypothesis DNA itself does not contain the hereditary
material, but is capable of receiving hereditary information and
memories from the past, as well as the morphogenetic information, which
contains the way the body will be built with all its different cell
systems with specialized functions.47 Person-specific DNA is in this
model the receiver as well as the transmitter of our permanently
evolving personal consciousness.
According to Erwin Schr��ger, a quantum physicist, DNA is an
a-statistic molecule, and a-statistic processes are quantum mechanical
processes which originate from phase-space.48 In his theory DNA
should function as a quantum antenna with non-local communication, and
also Stuart Hameroff considers DNA as a chain of quantum bits (qubits)
with helical twist, and according to him DNA could function in a way
analogous to superconductive quantum interference devices. In his
quantum computer model the 3 billion base pairs should function
as qubits with quantum superposition of simultaneously zero and one.49
Following a heart transplant, the donor heart contains DNA material
foreign to the recipient. In a few recent books it has been
reported that sometimes the recipient experiences thoughts and feelings
that are totally strange and new, and later it becomes obvious that
they fit with the character and consciousness of the deceased
donor.50,51 The DNA in the donor heart seems to give rise to fields of
consciousness that are received by the organ recipient. Unfortunately,
until now scientific research on this has not been possible due to the
reluctance of the transplant centers.
9. ANALOGY WITH WORLDWIDE COMMUNICATION
In trying to understand this concept of quantum mechanical mutual
interaction between the invisible phase-space and our visible, material
body, it seems appropriate to compare it with modern worldwide
communication. There is a continuous exchange of objective information
by means of electromagnetic fields for radio, TV, mobile telephone, or
laptop computer. We are unaware of the vast 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 at 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 over our telephone is not inside
the telephone. The concert we hear over our radio is transmitted to our
radio. The images and music we hear and see on TV are transmitted to
our TV set. The internet is not located inside our laptop. We can
receive 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
(non-locality).
Could our brain be compared to the TV set, which receives
electromagnetic waves and transforms them into image and sound, as well
as to the TV camera, which transforms image and sound into
electromagnetic waves? This electromagnetic radiation holds the essence
of all information, but is only perceivable by our senses through
suitable instruments like camera and TV set.
The informational fields of our consciousness and of our memories, both
evolving during our lifetime by our experiences and by the
informational input from our sense organs, are present around us,and
become available to our waking consciousness only through our
functioning brain (and other cells of our body) in the shape of
electromagnetic fields. As soon as the function of the brain has been
lost, as in clinical death or brain death, memories and consciousness
do still exist, but the receptivity is lost, the connection is
interrupted.
10. CONCLUSION
According to our concept, grounded on the reported aspects of
consciousness experienced during cardiac arrest, we can conclude that
our consciousness could be based on fields of information, consisting
of waves, and that it originates in the phase-space. During cardiac
arrest, the functioning of the brain and of other cells in our body
stops because of anoxia. The electromagnetic fields of our neurons and
other cells disappear, and the possibility of resonance, the interface
between consciousness and physical body, is interrupted.
Such understanding fundamentally changes ones opinion about death,
because of the almost unavoidable conclusion that at the time of
physical death consciousness will continue to be experienced in another
dimension, in an invisible and immaterial world, the phase-space, in
which all past, present and future is enclosed. Research on NDE cannot
give us the irrefutable scientific proof of this conclusion, because
people with an NDE did not quite die, but they all were very, very
close to death, without a functioning brain.
The conclusion that consciousness can be experienced independently of
brain function might well induce a huge change in the scientific
paradigm in western medicine, and could have practical implications in
actual medical and ethical problems such as the care for comatose or
dying patients, euthanasia, abortion, and the removal of organs for
transplantation from somebody in the dying process with a beating heart
in a warm body but a diagnosis of brain death.
There are still more questions than answers, but, based on the
aforementioned theoretical aspects of the obviously experienced
continuity of our consciousness, we finally should consider the
possibility that death, like birth, may well be a mere passing from one
state of consciousness to another.
