“As the temperature gets colder and colder,” Dr. Spetzler told me in an interview, “we get to a point—usually around 60 degrees—where we can turn off the machine, and actually drain blood out of the body.”
They drained all the blood from Pam’s head into “reservoir cylinders,” similar to draining oil from a car. The aneurysm sac collapsed for lack of blood. “We can then expose the aneurysm and clip it.”
“At this point,” I asked, “could Pam see or could she hear? Could you describe her state?”
“She is as deeply comatose as you can possibly be and still be alive,” Spetzler replied. “Now, how do we define that? First is the anesthesia that puts her to sleep. Then we give her medication—barbiturates—which knocks out her deepest brain functions. And how do we know that? Because we monitor an EEG and we monitor evoked potentials,” which measure brain-stem activity.
The device used to measure brain-stem activity was a set of molded ear speakers, affixed with mounds of tape over her ears. These emit loud clicks of 90 to 100 decibels, equal to the sound of a jet plane taking off.
“As the brain goes deeper and deeper into sleep, it becomes less and less of a signal, and in her case, they [the vital signs on the monitors] go completely flat,” the neurosurgeon explained.“So not only is she given medication to put her into the deepest coma, but then you add on this hypothermia, which puts her into an even deeper coma. Her brain is as asleep, as comatose, as unresponsive, as it can possibly be.”
“She wasn’t technically dead, though, was she?” I asked, anticipating the criticism of skeptics.
“It’s an artificial definition,” Dr. Spetzler explained. “If she were awake, and she had no pulse, no blood pressure, no respiration, we would call her dead. But if you are in this suspended state, because we know you can come back, I would not define it as dead.”
“During this time, could she see anything or hear anything?”
“Absolutely not.”
After Pam’s aneurysm was clipped and removed, the doctors reversed the process, warmed the blood, introduced it into her body, and at around 78 degrees, Pam’s heart began beating on its own.
When she awakened, Pam had a story to tell.
The View from Above
After the doctors administered the anesthesia, Pam told me, “I barely remember going to sleep. And I was lying there on the gurney, minding my own business, seriously unconscious. Dr. Spetzler said I was in a deep coma—when the top of my head began to tingle. And I started to hear a noise. It was guttural. It was very deep. It was a
natural D
,” she recalled, with the ear of a musician with perfect pitch. She listened to the harmonics for a few moments.
“As the sound continued, I don’t know how to explain this other than to go ahead and say it: I popped up out the top of my head,” Pam said, looking for my reaction.“It felt like a suction cup at the top of my head, popping. And then I was looking down at the body, and I knew it was my body, and the odd thing was, I didn’t care. It was wonderful.”
From her vantage point just above and behind Dr. Spetzler’s shoulder, Pam said she could see the entire surgical team. She wondered why they needed twenty people in surgical gowns to operate on her. At first she thought she was hallucinating but realized she felt too clearheaded to be on a drug-induced trip.
“My hearing was better than it is now, my vision better than it ever was, colors were brighter, the sounds were more intense. It was as if every sense that I had ever known—and add on a few—was perfect.”
Pam’s attention was drawn to the source of the natural D: an instrument in Dr. Spetzler’s hand that looked like a dentist’s drill.
“It was an odd-looking thing,” she said. “It looked like the handle on my electric toothbrush. And there was a case—it all kind of freaked me out because it looked like my father’s toolbox, like his socket-wrench case. And there were these little bits in there so it looked like he was doing home improvement and not brain surgery.”
This was a Midas Rex bone saw—and Pam’s was a near-perfect description of the saw and its blade container. At that point she noticed the other doctors midway down the table.
“It looked like they were doing surgery on the groin area. I heard a female voice say, ‘Her arteries are too small.’ And Dr. Spetzler—I think it was him, it was a male voice—said,‘Use the other side.’ I’m thinking,
Wait a minute, this is brain surgery!
I did not know what they were doing. I was quite distressed, but about this time I began to notice the light.”
At that moment, Pam’s out-of-body experience ended and her journey “into the light” began. Michael Sabom, the doctor who analyzed the surgery from the medical documents, believes this may have marked the moment when her heart stopped and the brain-stem monitor flatlined. Pam’s near-death experience contained common hall-marks : she saw a pinpoint of light that grew bigger and bigger, felt a pull toward the light, and then she heard a familiar voice.
“It was Grandmama,” she recalled.“And I went to her. And with her was my musical uncle David Saxton,” Pam’s mentor, who had died of a massive heart attack years earlier. They looked young, she said. They shimmered as if they were wearing coats of light, and soon she spotted “a sea of people and they were all wearing the light.”
“I remember asking,‘Is God the light?’And the communication was, ‘No, He’s not the light. The light is what happens when God breathes.’
“And I thought, I am standing in the breath of God.”
My mind caught on the word “breath.” The connection between breath and spirit dates back at least two thousand years. The Hebrews called it
ruach
, the Greeks called it
pneuma
, and what they meant was the spirit of God.When Jesus appeared to his friends after the Crucifixion, He
breathed
on them and said, “Receive the Holy Spirit.”
5
It occurs to me that perhaps this metaphor, like DNA, has been passed down through the generations, not because it is poetic, but because it is true: whether that breath arrives in death or in life, in practiced meditation or unbidden surprise, in first-century Jerusalem or twentieth-century Atlanta, that is what standing in the presence of God feels and sounds like—a wind that penetrates the heart, a breath that transforms a person and her world at a cellular level, a spirit that robs her of words but leaves peace in their stead.
Pam stood for a few moments in the breath of God. She yearned to go deeper into that light, but was stopped and told she needed to return. Her uncle, David, escorted a reluctant Pam back to the operating room.
“There I was again, with David, looking down at the body. Only at this point, that thing looked like a train wreck. It looked like what it was—dead. I did not want to get in it, I didn’t even want to look at it, and now my uncle is reasoning with me. He says, ‘Sweetheart, it’s like diving into the swimming pool. Just dive in.’ ”
She protested, and then her uncle began reminding her of all her favorite things—her favorite food, her favorite smell, her favorite bird-songs—Pam’s connection to the world.
“And I’m looking down and the body jumped. There were people around the gurney and the body jumped”—as they restarted her heart with a defibrillator. “And I thought, Okay, you know what, they’re electrocuting that thing, I’m not getting in it.’ Then my uncle
pushed
me! And I hit the body, and I heard the title track to the Eagles album
Hotel California
. When I hit the body the line was, ‘You can check out anytime you like, but you can never leave.’ And the body jumped again. That time I was
in
it and I
felt
it. And I opened my eyes and I saw Dr. Karl Greene, and I said, ‘You know, that is really insensitive!’ ”
Pam laughed. “He told me I needed to get some more sleep.”
At first she thought she had been hallucinating. But the next day, Pam met the cardiac surgeon who had commented on Pam’s small femoral vein near the groin. From her angle, Pam had not seen the doctor’s face during the out-of-body experience.
“I recognized her voice and I mentioned it. She looked at me kind of funny.”
When Pam returned to Phoenix for her one-year checkup, she told Dr. Spetzler what she had “seen,” including “doing the electric paddle thing” at the end of the surgery. And he said, ‘Oh no. That didn’t happen. ’ And he looked a little relieved, and frankly I was as well.”
“Why relieved?” I asked.
“Well, if that part is wrong, maybe the rest of it is as well. Maybe it was just a hallucination,” she said
“So I came back and told my doctor here. And he said, ‘No, I’ll check my records but I believe that they defibrillated twice’—which would make sense because I saw it once and felt it once. And sure enough, he confirmed it. And he called and talked to Dr. Spetzler, and Dr. Spetzler said, ‘You know what, I wasn’t in the operating room at that point.’ ”
Eventually Dr. Sabom conducted an exhaustive investigation of Pam’s story. He obtained her records, including a timeline of the surgery and transcripts. He confirmed the conversation about her small veins, the description of the Midas Rex bone saw and its case. He confirmed the defibrillation, the number of doctors and nurses, even their position around the operating table.
I asked Pam’s neurosurgeon, Robert Spetzler, how he explains Pam’s perceptions.
“From a scientific perspective, I have absolutely no explanation about how it could have happened,” he replied.
What about the drugs, or neurotransmitters, creating hallucinations?
“Those are suspect, but not in this setting,” Spetzler said. “You can have patients who become hypoxic”—who have too little oxygen in the blood; in that situation, patients may experience hallucinations—“where you see yourself transported up into maybe a corner of the ceiling and you’re looking down on things. But in virtually every one of those settings, you have a warm body which is missing something— either not enough oxygen, or it’s metabolically missing something—or it is feverish. So that you can imagine all sorts of neurons firing in an unorganized fashion and it would give you an explanation.
“Here you have the opposite,” Spetzler continued. “Here you have the neurons in a depth of a sleepy state, of a suspended animation, that makes it very hard to think that it’s from active neural transmission.”
“So in your opinion,” I said, “what does Pam’s case say about consciousness, and whether it can be separate from the brain?”
“It comes down to the metaphysical,” the neurosurgeon reflected. “It comes down to the soul. It comes down to whether you’re religious and believe in these things. I think it is the ultimate arrogance for anyone, whether they’re a scientist, or anyone else, to say that something can’t be. I accept Pamela’s account, although I have no explanation of how it could have happened.”
Hallucinations and the Last Gasp of a Dying Brain
Gerald Woerlee believes he can explain it.
“It’s a total load of rubbish,” he said with a laugh.
The Australian anesthesiologist and author of
Mortal Minds
6
is one of the feistier debunkers of near-death experiences. When I reached him by phone,Woerlee told me the mind simply cannot perform when the brain is disabled. Pam Reynolds’s case, he said, crumbles under scrutiny.
First, he said, Pam awakened from the anesthesia when the surgeon began drilling her skull. Hence the “natural D.” In other words, she was
conscious
right up to the moment that her heart fully stopped, and during this semiconscious period, she underwent her out-of-body experience. She “floated” out of her body, he explained, when the bone saw vibrated her muscle spindles. These are the movement sensors associated with your muscles. You may have learned about these sensors when you were a child if you ever pressed your arms against a doorframe, stepped away, and felt your arms floating upward. Woerlee theorized that when the bone saw vibrated, the muscle spindles contracted and suddenly Pam felt herself moving upward until she was perched above the operating table.
Alternatively,Woerlee offered, oxygen deprivation could be the culprit : When Pam’s brain was gasping for oxygen, it began suffering from “hypoxic convulsions,” or epileptic activity, an electrical storm in the brain. Woerlee contended this stimulated the part of the brain that located Pam in space, and suddenly, her brain told her she was not on the operating table but up near the ceiling, looking down.
Many neurologists embraced the epileptic-seizure explanation, and indeed there appears to be a link between temporal lobe epilepsy and out-of-body experiences.
7
Neurologists in Switzerland have even located a spot in the brain that sparks out-of-body experiences—and it is, of course, in the temporal lobe.
8
British skeptic Susan Blackmore argues that the brain creates models of reality based on sensory impressions, and when the normal perception is jarred—when the heart stops beating, for example—the brain draws on what it can: on memories and imagination.
9
In this case, Woerlee said, Pam’s addled brain created a “veridical perception” of her resuscitation. Perhaps her memory drew from what she had noticed as she was rolled into the operating room, or it could have drawn from previous memories, such as watching television shows like
ER
.
“But her eyes were taped shut,” I protested, “and what she saw was
accurate
.”
“Easily explained,” Woerlee chuckled. Take the Midas Rex bone saw. “What she heard was a sound very similar to a dental drill, and a dental drill is something that everyone born in the 1950s understands and knows all too well. Most of them have four rows of lead in their teeth to prove it.”
He argued that Pam’s mind naturally created an image of the Midas Rex that looked like a dental drill. And she could imagine what an operating theater looks like from television and movies and perhaps from personal experience.