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'She was given thiopental barbiturate aswell as general anesthesia. The barbiturate was given second place. Spetzler says so here...that drug has the power to get rid of all your brainwaves. at 2.30 minutes.'

I looked at the clip. I'm not trying to be a jerk about this, but... you're getting it wrong. The barbituate was administered around the time that the cooling process began. This was *after* the veridical part of the NDE had concluded. What Pam witnessed was the early part of the procedure, when her skull was opened to examine the aneurysm. Only after this examination was completed did the cooling process and administration of barbituates commence. By the time the shutdown procedure began, she was no longer perceiving her surroundings. If the TV documentary implies otherwise, it is misleading.

Anyway this is intriguing:

Parnia’s research shows that death is, in almost all cases, reversible and that some afterlife is uniquely ours, as evidenced, among other things, by the ability of the “dead” to formulate memories and maintain some awareness.

(from http://www.harpercollinscatalogs.com/Harper/Winter2013-Trade.pdf)

I cannot understand why it sounded "like that means it is only occurring in our head" for BailSnail, the topic starter at abovetopsecret. Maybe it's because my english is not good enough...

The timeline linked below provides useful details on Pam Reynolds' surgery. Note that she does not flatline until 11:05, while the last veridical part of her NDE (other than hearing the song "Hotel California" after the operation is over) is sometime prior to 10:50.

http://en.wikipedia.org/wiki/Pam_Reynolds_case#Timeline


"So this is what I'm on about: after cardiac arrest there is an interim of up to ten minutes before the brain is damaged."


But that does *not* mean that it is functioning during that period. There is zero measurable brain function 10-20 seconds after onset of cardiac arrest and before initation of CPR, but NDErs sometimes accurately describe details that took place during that time period. Where's the confusion?? The fact that functional damage can be avoided for several minutes isn't relevant to the point here.

Pat: 'But that does *not* mean that it is functioning during that period.'

And therein is the rub, because it also does not mean that the brain is not functioning during that period. So the brain-consciousness connection is therefore not ruled out. This is an argument on which materialists rely heavily.

And this is why I am suggesting that cardiac-arrest NDEers are not supremely important for the survival thesis. The techincal brain death to which Dr Alexander attests has the supreme virtue of being unassailable by the 'possible residual brain activity' argument. So there is no need to panic about how the Parnia team concludes.

Indeed, I cannot resist the view that Dr Alexander is William James's 'one white crow': his NDE is alone sufficient to disable the hypothesis that consciousness is a function of the brain.

I'm not trying to be a jerk about this, but... you're getting it wrong.

Hi, Michael,
I may be wrong but I don't think I am actually. The wiki link says that the barbiturate is given at the beginning...but leaving that aside have a look at this paper by Spetzler and co. Go to the bottom of page 870. It says barbiturate induced burst suppression is maintained intraoperatively. Then it says after the aneurysm has been exposed etc...This implies that the barbiturates are in place when the skull is opened which is what she witnessed.

http://ether.stanford.edu/library/neuroanesthesia/SNACC%20Reading%20List%20articles/Spetzler_Aneurysms%20of%20the%20basilar%20artery%20treated.pdf

Also, Spetzler states here
..at 8 minutes (http://ndeinfo.wmthost.com/
scroll down to MS NBC SPECIAL 2001 APRIL
that you can't make a case for her hearing anything at that stage.


And therein is the rub, because it also does not mean that the brain is not functioning during that period. So the brain-consciousness connection is therefore not ruled out.

Hi, Sophie,
Sorry, I'm still baffled. After 10 seconds into cardiac arrest, brain function ceases. That is a medical fact. There 'should' be no experience and little pockets of activity don't remain.

Only after this examination was completed did the cooling process and administration of barbituates commence.

Actually the cooling process begins well before that. It starts with the lowering of the ambient temperature of the room and the placing of the patient on a cooling blanket.

Also I was surprised to discover volotile anesthetics such as isoflurane which was used on Pam initially also have EEG supressing properties.

Let me ask this. Didn't Horizon Research put the money up for this project. They seem awfully slanted toward the survival of consciousnesses idea. I wonder if they would have backed it and so heavily promoted it if they thought that it wasn't going to support their agenda. Am I looking at this incorrectly?

I have the same question about others who have attached their name to the project like Dr. Penny Sartori, who we know want to see positive results, Peter Fenwick, Bruce Greyson. I would assume they are all going to be very disappointed if Parnia comes up with a dull, clinical book with little new information.

Thoughts?

And PS, I realize that you can't fudge the data to fit what you would like to see happen, but it seems that enough "famous" pro-survival people have been listed as being affiliated with the project, I would assume they expected to see results that leaned more to their direction if they were willing to put their name on it.

Hi,J9
Penny hasn't attached her name to the project at all, she isn't involved. Horizon research didn't put the money up, I believe the NOUR foundation did that. As for being slanted towards the survival of consciousness, I'm afraid that is not correct either. Dr Parnia is not biased one way or the other rather they conducting the experiment to find out which view is correct
but they are also studying other interesting sidelines that will help with the preservation of life.

And they haven't backed it or been backed heavily, they have recieved the bare minimum of funding from what I have been able to gather. What will happen is that this study will lead to an even bigger one which will be able to catch many more cardiac arrest patients and give them the answers they are seeking.

Personally I think Parnia is doing a great job (free) which is an absolutely enormous amount of work so we should all wish him well and wait and see.

I don't know where all the speculation is coming from about there being no hits. The information will not be released like that, it would be ridiculous.

Hi Duck Soup.

I got Penny's name off of the Horizon website. Here is the link it came from and the list of doctors they gave affiliated either directly or as consultants. Penny is listed the fourth or fifth one down with the Morriston Hospital.

I also got the notion that Horizon was involved in the funding from their quote on the same website

"The [Aware] study is being funded by the UK Resuscitation Council, the Horizon Research Foundation, and the Nour Foundation in the United States."

Here is the link where Penny's name is listed, with the list below.

http://www.horizonresearch.org/main_page.php?cat_id=213&pid=38


East Sussex Hospitals: Dr Harry Walmsley (Anaesthetics & Resuscitation)
Hammersmith Hospital, London: Mr Ken Spearpoint, (Resuscitation)
James Paget Hospital: Ms Pam Cushing (Resuscitation)
Mayday Hospital, London: Mr Russell Metcalfe Smith (Resuscitation)
Morriston Hospital: Dr Penny Sartori (Critical Care Nursing)
Stevenage Hospital: Ms Salli Lovett (Critical Care)
Northampton Hospital: Ms Celia Warlow (Resuscitation)
Royal Bournemouth Hospital: Ms Hayley Killingback (Resuscitation)
Royal London Hospital, Bath: Dr Jerry Nolan (Critical Care & Resuscitation)
Salisbury Hospital: Mr Iain Macleod (Resuscitation)
St Georges Hospital: London: Ms Leanne Smythe (Resuscitation)
St Peters Hospital: Mr Paul Wills (Resuscitation)
Swindon Hospital: Mr Jon Taylor (Resuscitation)
University of Birmingham: Dr Peter Doyle (Emergency Medicine), Ms Tina Millward (Resuscitation)
University of Cambridge: Ms Susan Jones (Resuscitation), Dr David Menon2 (neurocritical care)
University of Cardiff: Professor Douglas Chamberlain (Cardiology & Resuscitation)
University of Oxford: Ms Sue Hampshire (Resuscitation)
University of Southampton: Chairman - Dr Sam Parnia1 (Respiratory), Professor Stephen Holgate (Respiratory Medicine), Dr Peter Fenwick (Psychiatry), Professor Robert Peveler (Psychiatry), Ms Niki Fallowfield (Resuscitation)

(UNITED STATES)
Albert Einstein Medical College: Dr Gabriele Devos (Immunology & Biostatistics)
Indiana State University: Dr Mark Faber (Pulmonary & Critical Care)
Johns Hopkins University: Dr Romer Geocadin2 (neurocritical care)
New York University: Dr Nonkulie Dladla (Biostatistics & Internal Medicine)
University of North Chicago: Dr Eric Gluck (Pulmonary & Critical Care)
University of Virginia: Professor Bruce Greyson (Psychiatry), Dr Robert O’Connor (Emergency medicine)

Hi again, j9
I'm fairly certain that Penny is not involved. I remember her saying so recently on her blog so I'm not sure why she is listed there but I will see if can find out tomorrow.
I think Peter Fenwick might have had some excess funds from other projects which he might have diverted.. but the study has been conducted on a tight budget as far as I know.

Last week, when I had a private discussion with Dr Pim van Lommel, he told me that Parnia had to do the work almost all on his own, that is, with the help of a part time secretary, that's all. No matter where the funding is coming from, it certainly is not much.

Hello Rudolf,

No matter where the funding is coming from, it certainly is not much.

Maybe it's also much about some conspiration...the fewer people involved the less possibility for info leaks? Or at least a bit less whining from so called "skeptics".

By the way, Rudolf, do you remember that story about veridical OBE, somewhere in Spain or so, mentioned at Skeptiko? You've said then Titus Rivas could get some additional info for he's half Spanish. Did you find anything more on that case?
2All: Sorry for the offtop!

That's interesting, Smithy. I am a great admirer of Pim Van Lommel.

He is one of the pioneers of this research and deserves much praise for his efforts in the face of severe resistance from sceptics in his own country.

Sophie,

"it also does not mean that the brain is not functioning during that period"

*If* there is any functioning at all then it would be a *fraction* of brain activity - it certainly is not even measurable. Cardiac arrest *destroys*/completely wipes out EEG activity, the gag reflex, pupil responses, etc. within 10-20 seconds after onset.

So in *that* condition, there is no model to explain how cognition could not only continue, but could be amplified (as often reported in NDEs). In that condition, before the initiation of CPR, the eyes and ears *cannot* receive information. This actually isn't debated within the medical community. It's widely accepted.

That's why it's so hard to casually dismiss cardiac arrest NDEs where the subjects accurately describe events that took place 20+ seconds after onset but before CPR.

- Pat

Duck Soup, I know that barbiturates were administered early and intraoperatively, but AFAIK this is just another way of saying that Pam was under anesthesia. Anesthesia doesn't cause the brain to flatline. It is true that barbiturates are used for EEG burst suppression, as the Spetzler article says, but burst suppression does not equal flatlining. Here is an excerpt from a technical article:

"Burst-suppression (BS) is an electroencephalography (EEG) pattern consisting of alternative periods of slow waves of high amplitude (the burst) and periods of so- called flat EEG (the suppression) (Swank & Watson, 1949)."

http://criticalcaremedicine.pbworks.com/f/Basic+Physiology+of+Burst-Suppression.pdf

The accompanying diagrams make it clear that there can be significant brain activity during burst suppression. The "so-called flat EEG" referenced in the excerpt is not true flatlining; see the diagrams.

It could be argued that higher brain functions are impossible in this state, but then again, some anesthetize patients do experience anesthesia awareness, so higher brain activity is apparently possible in some cases.

I do think Pam's detailed perceptions of verifiable details strain the anesthesia awareness hypothesis to the breaking point, but we're still not talking about a flatlined patient at that stage of the procedure. We're talking about an anesthetized patient who was sensorily isolated.

Hi Mitil,

By the way, Rudolf, do you remember that story about veridical OBE, somewhere in Spain or so, mentioned at Skeptiko? You've said then Titus Rivas could get some additional info for he's half Spanish. Did you find anything more on that case?

I have asked Rivas a minute or so ago. Hopefully he will provide an answer.

Pam, I do not see the point of conjectures of this kind: '*If* there is any functioning at all then it would be a *fraction* of brain activity - it certainly is not even measurable.'

Please note that I am not dismissing cardiac-arrest NDEs. I am saying only that they remain vulnerable to the denial that they are not brain products while there is any residual brain activity of the experiencer. And I am positing Dr Alexander's technically dead brain alongside his NDE as the superior quality of evidence of the survival of consciousness independently of the brain.

There is no point in this kind of rumination either: 'So in *that* condition, there is no model to explain how cognition could not only continue, but could be amplified (as often reported in NDEs.' The absence of 'model' here is hardly remarkable, given that we are without a model even of the causal relationship between the brain and consciousness, which is axiomatic in the materialist thesis.

I see no need to discuss this further.

Michael, thanks for the reply but that's not correct. When burst suppression is achieved there is no brainwave activity of the kind associated with consciousness. Burst suppression takes the brainwaves into Delta pattern where there can be no possibilty of processing anything. This is what they mean by getting rid of the brainwaves. A flatline is the absence of any electrical activity whatsoever which also occured later in the operation when her blood was drained and heart stopped etc.

The sceptical Doctor doesn't accept that burst suppression was achieved when her head was being sawn open but that's understandable.
Spetzler has stated that she was in the deepest anesthetic state possible when she heard the conversations.

This video here http://www.youtube.com/watch?v=B4lniKDF8EE&noredirect=1
explains burst suppression nicely.

@Mitil,

Just got a note from Titus Rivas. He says that he did contact those people in Spain but that after one or two exchanges there was no response anymore. So it is not certain that those veridical OBE's were so veridical after all.

BTW - To all: I had promised that I would get back on the Flint case. I have just prepared a long private message to Paul. After he has given his consent, I will post most of that message here on this blog.

Let me wrap this up because I don't want to spam up your blog (which I always enjoy reading).
I believe it is reasonable to take direction on this case from the conductor of the operation, Spetzler and not from the sceptical doctor who was not there.

Unless we can obtain the charts/read outs of the case, we cannot prove 100% that she did not wake up. However, based on everything that has been said about the operation including some correspondence with another neurosurgeon who was not there (but who travelled there to examine the charts because of the extraordinary facts of the case) we are entitled to disregard anesthesia awareness as being a reasonable hypothesis.

Of course, Stuart Hameroff/Chris Carter JNDS has/have been very gracious and conceeded to the sceptical doctor that awareness, although *extremely* unlikely, can't be ruled out so of course I wouldn't expect you to listen to a layperson such as myself, Michael.

However, although I greatly respect Hameroff and Carter I prefer to go with what Spetzler says.."In that state no one can observe or hear anything and I find it inconceivable let alone the fact that she had clicking nodules in her ears that there was any way for her to hear a conversation through normal pathways.

I'd say it would be impossible.

@ Duck soup! Hear, hear!

Sophie, please consider what Facco and Agrillo note in their recent paper (http://www.frontiersin.org/Human_Neuroscience/10.3389/fnhum.2012.00209/full):

"There is increasing evidence that consciousness is mediated by a large-scale coherence in the gamma band, binding different cortical areas, and recurrent activity between the cortex and thalamocortical loops, with perceptual periods in the order of 80–100 msec (Singer, 1998, 2001; Zeman, 2001; John, 2002; Melloni et al., 2007). Anesthesia can suppress consciousness by simply interrupting binding and integration between local brain areas without the need for suppressing EEG activity (Alkire and Miller, 2005; Alkire et al., 2008). This is the reason why, in clinical practice, general anesthesia can be associated with almost normal EEG with peak activity in the alpha band (Facco et al., 1992), while in deep, irreversible coma, consciousness can be lost even with a preserved alpha pattern activity (Facco, 1999; Kaplan et al., 1999). In short, loss of consciousness can occur with preserved EEG activity, while, in the case of a flat EEG, neither cortical activity nor binding can occur; furthermore, short latency somatosensory-evoked potentials, which explore the conduction through brain stem up to the sensory cortex and are more resistant to ischemia than EEG, have been reported to disappear during cardiac arrest (Yang et al., 1997). The whole of these data clearly disproves any speculation about residual undetected brain activity as a cause for some conscious experience during cardiac arrest." [END OF QUOTATION]

Sophie, you said that you "do not see the point of conjectures of this kind". But it's more than a mere conjecture. As I noted before, the state that the brain is in 10-20 seconds after cardiac arrest is *much* more severe than what happens to the brain during a 10-second properply-applied "blood choke" (see relevant MMA fights), which never produces anything more than incoherent fragments of information with massive gaps in memory and awareness and a massive DEcrease in cognition.

I likewise do not feel the need to address this further. But btw I'm nowhere near 100% convinced of the survivalist interpretation of NDEs; it's just that I find current speculations about "undetected brain activity during cardiac arrest" to be medically naive at best (no offense intended).

- Pat

"Let me wrap this up because I don't want to spam up your blog"

We can wrap it up, but I don't regard your comments as spam. I thought they were interesting and provocative.

I don't know enough about anesthesia to judge whether Pam was capable of higher brain function in the early stages of the procedure. I do think, however, that it's most unlikely that she could have used her normal senses to acquire certain details, such as the appearance of the bone saw, when her eyes were taped shut. Overall, I think the case is strong, and when combined with many other cases of a similar nature, it points to a genuine OBE (as the first part of an NDE).

Thanks for your kind comment, Michael.:-)

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