The first detailed write-up of the AWARE study is out, and it makes for interesting reading. It appears in the journal Resuscitation, and is signed by Sam Parnia and many co-authors, including longtime NDE researchers Peter Fenwick and Bruce Greyson.
The basic facts are these. Fifteen hospitals in the US, the UK, and Australia participated in the first large-scale prospective study of near-death experiences. The study took place between July 2008 and December 2012, during which time 2,060 cardiac arrests were recorded. Only 16% of the patients (330) survived. 140 of these consented to be interviewed. Of those interviewed, 61% (95) had no memory of any awareness during their cardiac episode. The other 39% (55) did report memories of some form of awareness. Of these, 46 patients described memories said to be "incompatible with a NDE," while the remaining nine had NDEs. Only two of the nine reported "visual awareness" of events in the hospital room during their cardiac arrest. One of them was interviewed on a preliminary basis, but could not give a more detailed interview because of poor health. The other went into some detail, and his observations seem to have been verified by hospital personnel.
The most publicized aspect of the study, at least prior to the release of the results, was that special visual targets had been concealed in many hospital rooms near the ceiling. The hope was that NDErs, who often report that they hovered near the ceiling and observed events transpiring below, would see these targets. But the two patients who reported visual observations were in rooms without targets.
The article quotes one NDEr who had a fairly typical otherworldly experience, involving travel through a tunnel toward a bright light, a "beautiful crystal city" and beautiful people "without faces" bathing in a "crystal clear" river, "beautiful singing," and strong emotion ("I was moved to tears").
The detailed veridical observation includes the patient's memory of an automated voice saying, "Shock the patient," and a "chunky fella" with a bald head who was part of the resuscitation team (and whom the patient recognized the next day). These details were later verified.
The less detailed veridical observation, which could not be followed up, involved seeing a nurse the patient did not know, but whom he recognized later, and seeing his blood pressure being taken, the intubation procedure, "a nurse pumping on my chest ... blood gases and blood sugar levels being taken."
I find some of the "non-NDE cognitive themes" interesting. From the brief quotes provided, it's hard to be sure, but many of them sound as if they could be compatible with NDEs, albeit perhaps of a negative or "hellish" variety. Examples:
"Being dragged through deep water with a big ring and I hate swimming - it was horrid."
"I felt scared."
"The whole event seemed full of violence ..."
"I had to go through a ceremony and ... the ceremony was to get burned. There were four men with me, whichever lied would die ... I saw men in coffins being buried upright."
And there are these:
"The sun was shining."
"Recalled seeing a golden flash of light."
"All plants, no flowers."
"Saw lions and tigers."
The first set of "non-NDE" reports are not necessarily dissimilar from hellish or nightmarish NDEs. The second set, though vague, suggest elements often found in NDEs - bright golden light, plants, animals.
But in general these excerpts are too brief to allow any real assessment.
The article stresses the likelihood that the detailed veridical NDE took place while the patient was in full cardiac arrest (not before or after), and that it appeared to occur beyond the point at which even residual brain activity should have ceased. Though the article doesn't go into detail, Sam Parnia's comments in an interview with the Telegraph provide more information:
“We know the brain can’t function when the heart has stopped beating,” said Dr Sam Parnia, a former research fellow at Southampton University, now at the State University of New York, who led the study.
“But in this case, conscious awareness appears to have continued for up to three minutes into the period when the heart wasn’t beating, even though the brain typically shuts down within 20-30 seconds after the heart has stopped.
“The man described everything that had happened in the room, but importantly, he heard two bleeps from a machine that makes a noise at three minute intervals. So we could time how long the experienced lasted for.
“He seemed very credible and everything that he said had happened to him had actually happened.”
The timing of the beeps seems to be the basis for the study's conclusion that awareness was present after three minutes or more.
The paper speculates that relatively few NDEs are recalled because post-resuscitation inflammation of the brain and/or post-resuscitation sedatives erase these memories. The "surge" theory is briefly addressed, with the article asserting that "in contrast to anesthesia typically there is no measurable brain function within seconds after cardiac arrest." Moreover, the flatlined EEG continues throughout conventional CPR since there is greatly reduced blood flow to the brain. It is also noted that reductions in cerebral blood flow would be expected to lead to delirium and coma, not "an accurate and lucid mental state."
So what can we make of all this? As I said, the study is interesting, and it has added one or two cases to the list of "veridical" NDEs. But since only two veridical accounts were obtained, and since neither patient was in a room with a visual target, the results are, to me, somewhat less than jaw-dropping. Even the more detailed veridical NDE is open to skeptical dismissal. The patient's reported sighting of the bald hospital worker could possibly be explained as his having seen the man previously, or as a false memory created when he saw the man the next day. Inasmuch as the sense of hearing is the last to go when entering unconsciousness, it is arguable that the patient heard the automated voice by normal means. Hearing a second beep seems, in itself, to be a slender reed on which to hang any conclusion.
Of course the whole study is already being trashed by skeptics - as in this online organ of "critical thinking," which declares that the study found "no evidence of NDE." It would be more correct to say that the study found some evidence, but not conclusive evidence. But drawing that distinction would require, well, critical thinking.
What the study mainly shows is just how difficult it is to study NDEs prospectively. Over a four-year period at 15 hospitals, only 2 veridical cases were obtained. I'm sure the study's organizers hoped for a larger number. As it is, we'll have to hope for future studies, perhaps on an even larger scale - and for a dash of luck.
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A couple of commenters feel I'm downplaying the study too much. They make good points, so I'm reproducing edited versions of their comments below.
GregL wrote,
The study, to me anyway, does indeed have significance. They have good evidence of a functioning consciousness three minutes after heart stoppage. I don’t think that I have seen this documented before, and I see no reason to begin to doubt the veracity of the patient’s remarks. The main skeptical argument against the NDE has been that the events are occurring either during the early recovery period or during the very early stage of heart stoppage. This study, as Parnia’s own comments suggest, refutes this. The material brain should just not be producing lucid consciousness this long after heart stoppage.
Duck soup wrote,
The [veridical] case is remarkable, though the sceptics of course are creatively posing mundane explanations as is their business. I'm not a doctor but I've read up on the physiological state of the brain in cardiac arrest and what the sceptics are saying about the brain still having some activity enabling the ears to work is nonsense. And I do mean nonsense.
When the heart stops as in VF the brain stem goes down very quickly and with that all the global reflexes of the brain follow rapidly so that the whole caboodle is off line. You can't hear, see, feel or experience anything after 10-20 seconds, that is why you can stick a tube down the patients throat and they don't gag etc etc.
This man was definitely in cardiac arrest VF, the machine (which cannot make a mistake) tells us that ... so when the patient heard the first shock he would already have been "out" for two minutes before it had completed its analysis and advised a shock. There followed a prescriptive round of CPR for two minutes until the machine was used to analyse his heart rhythm again ... no pump action, brain still down (because CPR cannot force sufficient blood into the brain to enable consciousness) and the patient was shocked again.
Now he heard these two automated instructions to shock the patient, not only that, he remembered them which he should not have been able to do. That is impossible according to medical science and don't let the sceptics tell you otherwise because if they do they are being dishonest. So he had cognition and memory working actively when his brain could not have been. Also worth bearing in mind is that if the the patient had been conscious in a normal way during the shock treatment, he would have felt the pain of the shocks which is variously described as like being kicked by a mule or having your insides torn out, furthermore, CPR is very painful and bruises the patients chest sometimes breaking ribs. He reported no pain or discomfort and that is very significant.
As I say, good points. Though we might have hoped for more, the study is still an important contribution to the growing evidence for the NDE as a non-hallucinatory state.
Besides, I don't want to be too much of a Debbie Downer ...
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