“I started to see people die in front of me,” Parnia said. “Hospitals were very used to the idea, but I was very much affected
by the fact that we would make decisions about how to proceed, how aggressive to be [with dying patients]—without any real
science about what death meant or any input from these people.”
I think most doctors don’t take enough time to reflect on death. No doubt, as members of a profession dedicated to preserving
life, death can be viewed simply as a failure, not doing the job we hoped we could. It is more than that, though. Anytime
I see a patient die, I’m reminded again of just how large the stakes are when you’re a neurosurgeon. I’m reminded, too, of
what the future holds for all of us. On the rare occasion that I have more than a few minutes to think about the patient who
has just passed on, I also think about how that person reminds me of a family member or close friend.
In his final year of training, now abroad for a stint at New York-Presbyterian Hospital/Weill Cornell Medical Center, Parnia
met a man whose death left an especially deep impression on him. Desmond Smith was a cheerful, gregarious West Indian immigrant,
celebrating his sixty-second birthday at home just outside New York City. Despite a lifelong smoking habit, Smith was in good
health and full of energy, until he began coughing up blood while preparing a big birthday breakfast. In the emergency room,
he was still in good spirits, telling the twenty-two-year-old British medical student to cheer up, that everything would be
fine. Smith did not seem gravely ill, so while they waited for a few test results, Parnia moved on to other patients.
Thirty minutes later, his pager was blaring the code for a cardiac arrest. Rushing back to the ER, he saw the tall figure
of Desmond Smith sprawled on the floor, surrounded by a bustle of white coats. Smith never took another breath. Parnia was
devastated and couldn’t shake the questions that filled his head: How could a man so full of life be suddenly gone? What did
gone
really mean? Where was he now? Was this truly the end?
“I was left with the question of what did this person experience? Was he still with us in some way, or was he completely annihilated?
I was fascinated, but I knew there was a science,” said Parnia. “These questions in my mind made me want to investigate it
myself.”
5
That hunger to understand never left, but Parnia’s next three years were consumed with the grueling training of a medical
residency. There was no time to pursue his curiosity about the possibility of life after death. So it was that three years
went by until, the week after emerging as a newly minted, fully credentialed physician, Parnia sought out a doctor named Peter
Fenwick, who was at the time perhaps the world’s leading authority on near-death experience.
Fenwick is a neuropsychiatrist and neurophysiologist at King’s College Hospital in London. In 1995, he had just published
The Truth in the Light,
an evaluation of more than three hundred near-death experiences. To some it might have seemed an odd obsession, but Parnia
was fascinated. With Fenwick’s encouragement, the young doctor started reading the scientific literature on near death. By
1997, he had landed a job at Southampton General Hospital in southern England, and he was ready to launch his own experiment.
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).
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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).
O
UT-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.
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