BOOK REVIEW/SURVEY ARTICLE : Bruce Greyson – After: A Doctor Explores What Near-Death Experiences Reveal About Life and Beyond.

NOTE: This publication has relevance for two Paper 1 Philosophy of Religion topics, namely, the discussion of near death experiences and the role of evidence in connection with Life and Death/the Soul, and the nature and veridicality of mystical experiences in relation to Religious Experience.

SPOILER ALERT: Greyson’s book is an enjoyable and compelling ‘page-turner’. So teachers or students with a wider interest in NDE’s might be better off acquiring and reading it first before returning here, in order to avoid finding out too much in advance. Bear in mind, though, that the discussion below will also explore Susan Blackmore’s sceptical view of this phenomenon, as well as theologian Mark Fox’s critique of Blackmore that can be found in his older but still highly relevant publication, Religion, Spirituality and the Near-Death Experience. Reference will also be made to philosopher Evan Thompson’s extended analysis of the well-known case of Pam Reynolds, as well as other pertinent writing in the territory.

To begin with, an attempt should be made to describe the common features of an NDE.

According to Raymond Moody, one of the pioneers of NDE research, these include a sense of having left one’s body, together with a viewing of resuscitation attempts from a ‘bird’s eye’ perspective above it. The survivor then finds themselves moving through a dark tunnel towards a bright light, followed by an encounter with a “being of light” who helps them to make sense of their own life by reviewing events from it. Finally, there is a return to the body. Accompanying feelings of bliss and peace are so profound as to make those who experience NDE’s reluctant to abandon their state of disembodiment.

Reports of this type of experience are universal, and have been found to occur among members of all faiths or none. Even the noted atheist philosopher AJ Ayer, for example, had a powerful and vivid NDE that – according to some sources – caused him to re-assess his views on the possibility of surviving death.

NDE’s are typically experienced by patients in cardiac arrest, who subsequently allege that they were capable of recalling procedures carried out on them by doctors and nurses from the ‘bird’s eye’ vantage point at a time when they were clinically dead and all brain activity must have ceased. For example, one famous and much discussed case is that of a singer called Pam Reynolds who was in this state for approximately forty minutes. During this time she was able – so she claimed – to accurately describe the shape of a electric toothbrush-shaped drill that was used to get at a blood clot at the base of her brain.

At the outset of his book Greyson too recalls how he was taken aback by a patient’s ability to repeat the details of a conversation he had conducted with her roommate in a family lounge that was located at the end of a hallway and therefore quite removed from where the patient was lying. In particular, this survivor drew attention to a striped tie with a red food stain that Greyson happened to be wearing. What was especially confounding for Greyson was that no-one outside of the lounge could have been aware of the stain, as he had taken steps to conceal it behind a white lab coat whilst on duty. He states that ‘the hair rose on the back of my neck and I felt goose bumps’, and this incident proved to be the catalyst for the decades of research into NDEs that followed.

If this encounter caused Greyson to chart a trajectory that has eventually led him to abandon his initially sceptical stance, Susan Blackmore is well-known for having travelled in the opposite direction, as attested in this online article:

My adventures began in 1970 when, as a student in Oxford, I had a most extraordinary out-of-body experience. For more than two hours, wide awake and reporting what was happening, I seemed not to be inside my own body looking out but free to roam the world. Beginning with vividly realistic flights over Oxford and the countryside, the experience morphed into extraordinary visions, and culminated in what I can only describe as a classic mystical experience of light and oneness. I was no longer a separate self, and the universe was one.’

… From this one dramatic experience I concluded the following: 1) that this experience could not be explained by the science I was studying; 2) that my soul or spirit or astral body had left my physical body and could function without it; 3) that life after death was therefore possible.

However, after many failures to experimentally confirm the reality of a range of parapsychological phenomena that she subsequently investigated (telepathy, clairvoyance, astral projection, an alleged ability to perceive auras), Blackmore eventually became sceptical about even her own OBE. Here she is again:

Since then, research has revealed things I could never have known at the time, such as how OBEs can be induced in the lab, and which part of the brain is responsible. I no longer need to believe that my soul left my body because I have a better explanation. Nor do I need to deny the validity of that deep and vivid personal experience. It really did happen. It really did change my life – and no, it wasn’t paranormal.

Similarly, when I meet people who have had near-death experiences I don’t need to choose between denying their experiences or agreeing with their religious or psychic interpretations. I can explain how the tunnel is created in the visual cortex, how the emotions depend on endorphin release, and how the life review originates in the temporal lobe. I can sympathise with how real it seemed and understand how it could change their life, even though it was not a glimpse of heaven.

An account of Blackmore’s career as a parapsychologist can be found in the publication below, which reflects her trademark flamboyancy and scientific rigour. It is a classic of sceptical writing that deserves to be better known:

Blackmore’s explanation for various aspects of an NDE has, nevertheless, attracted criticism. For example, her neuroscientific account of the ‘tunnel’ feature suggests that it is the result of disinhibition in the visual cortex, which causes the cells within it to fire randomly. As more of these cells are devoted to the centre of a person’s visual field rather than the periphery, such random firing in a dying subject may cause them to experience an effect that in their mind’s eye resembles a dark tunnel with a glowing and expanding light at the end. However, as Mark Fox has pointed out, Blackmore’s analysis is too much in thrall to Moody’s early but still highly influential typology. Later studies of a wider range of Western and Non-Western NDE testimonies has revealed that the tunnel effect is not as frequently mentioned as Blackmore assumed. Indeed, in a later publication than the one depicted immediately below, Fox writes of “‘Journeys’ towards lights via a passage through darkness” rather than of a tunnel. Nevertheless, in adopting her materialistic stance, Blackmore should be given credit for attempting to account for the consistencies that are found within reports of NDEs, as if she is correct, it must be the case that the brain is configured to hallucinate in some kind of set manner during cardiac arrest.

Religion, Spirituality and the Near-Death Experience by  Mark Fox - Paperback - from Phatpocket Limited (SKU: Z1-R-013-01096)

Another suggestion she makes is that NDEs may occur either at the point when a patient initially goes into cardiac arrest or emerges from this state. The aforementioned testimony of Pam Reynolds is significant in this respect as it provides a challenge to the timing of the onset of an NDE at either of these points, especially with respect to her description of the medical instrument that was not unpacked until her brain had been rendered clinically inactive. It is this kind of detail that presumably inspired Dr Sam Parnia’s co-ordinated studies of NDE’s in various hospitals around the world. These studies involved signs being placed in operating theatres in a position where they would be visible from the ceiling but not from ground level, with none of the medical staff being aware of what was depicted in them.

Meanwhile, Evan Thompson has recently bolstered the sceptical position on NDE’s in a chapter in the above work. His analysis is based on aspects of the paradigmatic Reynolds case, which therefore needs to be outlined in a little more detail.

Reynolds was a musician who had been diagnosed with a large aneurysm located at the base of her brain. A tricky procedure was required to remove it that necessitated a substantial lowering of her body temperature and the stopping of her heart, in order to produce a cessation of brain activity. As previously noted, during surgery Reynolds claimed to have had an OBE or Out-of-Body-Experience during which she attested to having seen the electric toothbrush-shaped saw that was used to gain access to the aneurysm. Additionally, she accurately reported the details of a conversation that took place between the surgeons in theatre about attaching the tubing for a cardiac bypass machine to blood vessels into her left rather than right groin when those in the right groin were found to be too small. As Reynolds’ eyes were taped shut and she had been fitted with earplugs that issued white noises and clicking sounds in order to monitor her auditory brainstem response, her specificity of recall at this point in the surgery seems to be remarkable.

However, Thompson remains unconvinced. Drawing on an evaluation produced by the anesthesiologist Gerald Woerlee, he thinks that what transpired is an example of a rare case in which a patient retains awareness even under anesthesia. This might have enabled Reynolds to hear the sound of the saw through a process of bone conduction, which in turn caused her to visualise what it looked like in her mind’s eye. Her recollection of the conversation between the surgeons could also, Thompson speculates, have still been possible in spite of the masking sounds produced by the earplugs.

Crucially, he also points out that Reynolds’ observations dovetail with events that took place during the first two hours of the surgery before her body was subjected to the cooling procedure and not ‘in the approximately 35 to 40 minute period of time when no blood flowed through her brain, her EEG was flat, and her brain stem response was absent.’

According to Reynolds herself, she went on to travel down a dark shaft towards an expanding bright light which resulted in encounters with deceased relatives when she entered it. But she was not permitted to merge completely with this light and was eventually guided back down the tunnel by her uncle and then pulled back into her body. Again, this seems impressive and startling, but Thompson points out that there is nothing in Reynolds’ account that can tie this part of her journey to the time at which her brain was inactive.

So has Woerlee and Thompson’s evaluation gained sufficient traction for them to claim a final victory for the sceptical camp when it comes to assessing the veridicality of NDE’s?

In actual fact it hasn’t and the debate is still ongoing. For example, the author of a letter to the Journal of Near-Death Studies has expressed surprise and dismay that remarks made by Robert Spetzler (the neurosurgeon who operated on Reynolds) in a BBC Horizon documentary that is still available on Daily Motion called The Day I Died have not received sufficient attention from those who remain unimpressed by this case*. These comments are helpfully transcribed in that letter:

I don’t think the observations she made were based on what she experienced when she went into the operating theatre. They were just not available to her. For example, the drill and so on were covered up and invisible. They were inside their packages.

At that stage of the operation nobody can observe or hear in that state. I find it inconceivable that your normal senses such as hearing, let alone the fact that she had clicking modules in each ear, that there was any way for her to hear those through the normal auditory pathways.

I don’t have an explanation for it. I don’t know how it is possible for it to happen considering the physiological state she [was] in. At the same time I have seen so many things that I cannot explain that I won’t be so arrogant to say that there is no way that it can happen.

The author of the letter concludes:

Spetzler, who performed the operation, showed his greatness of mind by admitting that he did not know. Woerlee and Augustine, however, who were not there when the surgery was performed, were indeed so arrogant as to forward a mere speculation as truth. When I told this to Woerlee he retorted that Spetzler, as a surgeon, would not have known about the phenomenon of “awareness during anesthesia.” Now it is my turn to find that inconceivable, that a pioneering neurosurgeon such as Robert Spetzler would not have known of this phenomenon that is taught to all surgeons and surgery assistants.

Additionally, here is a quotation from the abstract of an article submitted to the same journal:

Gerald Woerlee has attempted to explain Reynold’s experience as a result of auditory impressions combined with an anesthesia-induced fantasy. I argue here that Woerlee’s attempted explanation is simply unsupported by the documented facts of the case. I also invite Woerlee to accompany me to the Barrow Neurological Institute to participate in an empirical test under the exact auditory conditions Reynolds experienced [NOTE: this reviewer has not been able to determine whether Woerlee did so].

Greyson’s publication therefore needs to be set against this somewhat bewildering and occasionally fractious backdrop, one inhabited by ambassadors for often entrenched and stubbornly defended positions that are argued for from the perspective of a range of academic and scientific disciplines. These include psychiatry (in his case), medicine (Parnia**, Woerlee), neuroscience and the study of consciousness (Blackmore), theology (Fox), and philosophy (Thompson).

Of course, the appeal of this strange phenomenon for theologians and philosophers is that, if proved genuine, it has the potential to confirm the dualistic view of the self historically maintained by philosophers like Plato and Descartes, one that also plays a major if not defining role in some world faiths. Hindu ontology, for example, has to include belief in a period of temporary disembodiment, as our atman or soul must be in this state before we reincarnate (as does the ontology of Plato – according to whom we keep on reincarnating until we recover our latent knowledge of the ‘World of the Forms’ to remain in contemplation of them). And for those Muslims who die before Judgement Day, it is usually proclaimed that their soul hovers above the body in the grave before being reunited with it in order to be judged. So although mainstream Muslims tend to believe that we are physically resurrected in the afterlife there is also a period of disembodiment before that. Lastly, Descartes was a devout Christian, and so faith provides some of the context for his defence of substance dualism.

Moreover, if NDE’s may be regarded as mystical in the sense that they appear to hold out the future possibility of a final merging or union with ‘the light’, then evidence for their veridicality is important when it comes to the study of this form of religious experience. Significantly, the essentially ineffable nature of an NDE is something highlighted by Greyson:

Now I was faced with how to evaluate these accounts of NDEs. Of course, I couldn’t observe their experiences directly. All I knew was what the experiencers told me and how they were affected by their NDEs. But one of the first things many experiencers say is that is that there are no words to describe what they experienced.

Ineffability is, of course, one of the four ‘marks’ identified by William James as characteristic of mystical experiences, which are also noetic, transient and passive, and it quickly becomes apparent that NDE’s also exhibit these other qualities. For example, they are obviously temporary, and the experiencer tends to be swept along by events as they unfold. Their noetic aspect (for James this term refers to the acquisition of previously unknown knowledge about the nature of reality) is suggested by the fact that, according to Greyson, ‘NDEs often contradict experiencers’ beliefs about an afterlife’. Similarly, in his study, Mark Fox observes that those who have had an NDE are often surprised by what happens to them (which implies that prior expectations do not somehow determine or create the experience), and notes that some subjects ‘described their experiences as in some sense ineffable: surpassing their abilities to put them into words.’

So one of the merits of Greyson’s book for A Level students is that it suggests that personal NDE narratives perhaps deserve to be afforded a similar status to descriptions of mystical union found in the writings of exemplars like, say, Meister Eckhart, Teresa of Avila or Ramana Maharshi.

Furthermore, he draws attention to some other striking research discoveries.

Quite separate investigations, for example, have all demonstrated that NDE experiencers’ descriptions of what was going on around them while they were unconscious and attempts were being made to resuscitate them are, in fact, usually highly accurate.

Additionally, having completed an unsuccessful ‘target’ experiment of his own similar to that undertaken by Parnia in order to delve into this issue a little more specifically, on sharing the details with a large number of those who had had NDE’s, Greyson is somewhat disconcerted by their response: ‘They were astounded at what they considered my naivete in carrying out this study. Why, they argued, would patients whose hearts had stopped and who were being resuscitated – patients who were stunned by their unexpected separation from their bodies – go looking looking around the hospital room for a hidden image that has no relevance to them, but that some researcher has designated as the “target”? This may, in turn, help to explain why Parnia’s research has, thus far, been able to only modestly suggest that awareness may be retained after clinical death, (his subjects did not notice any of the strategically placed signs), though this discovery is itself not without significance.

Given that there are now ways to distinguish memories of real events from those that are mere fantasies, Greyson has also found that, for people who had NDEs, their recollections were like memories of a genuine episode rather than something merely imagined. He also refers to a study carried out by a research team in Italy which concluded that the brain waves of NDE experiencers were similar to those associated with the recall of real rather than purely fantasised events.

Perhaps more significantly, memories of NDEs have been found to be stable and consistent over time. They remain fresh and unembellished. One reason for this might be because they are perceived as being more real than recollections of other genuine happenings, with Greyson observing that , ‘Among all the experiencers I’ve studied, 71 percent said their memories of their NDEs are clearer and more vivid than their memories of other events, while only 3 percent said they were less clear or less vivid.’

One common feature of an NDE involves encounters with relatives or significant ‘others’ that are no longer living, and these might ordinarily be dismissed as expressions of wish-fulfilment, of the desire and hope to be re-united with loved ones in the afterlife. However, Greyson cites several intriguing examples of encounters with deceased people who were not known to have died at the time of the NDE, and in at least one instance the experiencer told others about their meeting with the dead person before finding out that they had passed. Contrastingly, Greyson notes that there are no instances in his collection of more than a thousand NDE reports of someone erroneously meeting a person who subsequently turned out to be alive rather than dead.

What is not in doubt in this controversial field is that NDE’s are profoundly transformative. For example, in his role as a psychiatrist, Greyson has repeatedly observed that experiencers commonly lose their fear of death and become far less materialistic, with some even changing their occupation to pursue a career in one of the ‘helping professions’, such as counselling or social work. According to Greyson, these radical changes of lifestyle are often the product of ‘a heightened sense of purpose, increased empathy, awareness of the interconnectedness of all people, and a belief that all religions share certain core values‘, with even those who had previously been atheists embracing a more broadly spiritual outlook on life.

After ends with one last revelation: simply studying NDEs secondhand apparently confers psychological benefits on those who do so. Several studies of high school, college and nursing students have shown that just learning about this unusual phenomenon can arouse a greater sense of self-worth, diminished fear of death, and a more spiritual orientation in many who delve into it. Indeed, one of the most persuasive and compelling features of this contribution to the field of near-death research is Greyson’s inclusion of lengthy extracts from memoirs authored by those who have had NDEs, though it must also be said that these tend to have the cumulative effect of disturbing the detachment with which one should, perhaps, more ideally approach the academic study of this subject.

Frustratingly, though, one of the problems with this whole field of enquiry is that its multidisciplinary nature tends to bolster its elusiveness, in the sense that some of the contributors to it do not themselves seem to directly engage with each other or to be sufficiently aware of theories and research that may run counter to their own suppositions. This, in turn, tends to impede the drawing of any firm conclusions about NDEs as a whole.

One example should serve to illustrate this problem.

The co-authors of the above publication are professors of philosophy who are both sceptically inclined when it comes to NDEs. Accordingly, when they examine one especially striking sub-category of experiencer, namely, those who are blind but report an ability to see during their NDEs, they remain unimpressed. Instead, they suggest that such instances could be explained in terms of what they refer to as ‘no-input blindness’, a form of sightlessness that might still permit visual experiences to be generated by the brain and experienced in the mind’s eye. This is because the neural mechanisms involved in processing inputs to generate visual impressions may be intact and functional, even when the complementary apparatus that provides material for such processing is not. Contrastingly, there is ‘processing blindness’, in which this situation is reversed. In other words, the mechanisms that would ordinarily be capable of processing visual information are incapable of doing so even though those that provide the raw input for that processing are.

However, in venturing this theory, the authors do not sufficiently address the issue of whether ‘no input’ experiences are in any way feasible for the congenitally blind, something that seems unlikely. If, since birth, there has never been any kind of visual input to be subjected to neural processing, then surely the appropriate mechanisms would have nothing to work with, no prior visual experiences on which to base any internal projection of imagery for the mind’s eye to perceive, as is the case when it comes to dreaming. So, at best, Fischer and Mitchell-Yellin’s hypothesis can only account for NDEs in those who are adventitiously blind or perhaps otherwise visually impaired.

And unfortunately, they appear to be unaware of either the very well-known example of Vicki Noratuk (a.k.a. Vicki Umipeg)***, or that of Brad Barrows, both of whom are congenitally blind and whose narratives are included and discussed in Kenneth Ring and Sharon Cooper’s book Mindsight: Near Death and Out-of-Body Experiences in the Blind, an entire volume devoted to this special and extremely rare type of case. In fact, Mark Fox’s study includes a detailed analysis and evaluation of Ring and Cooper’s research, and he draws attention to some quite different reasons for being cautious about drawing any definite conclusions from it****. Given also that neither publication is listed in Fischer and Mitchell-Yellin’s bibliography, this further suggests that they needed to have cast their net wider before formulating their own theory and perhaps run their ‘no input blindness’ proposal past a neuroscientist familiar with cognitive development in the blind before suggesting it.

Similarly, although Greyson does not avoid a discussion of some of the concerns raised by sceptics (e.g. that NDEs are hallucinatory or associated with mental health issues), including ones that have been briefly looked at here, a more direct level of engagement with prominent dissidents like Blackmore would have been helpful, though perhaps this was sacrificed in order to make his writing more accessible for the general reader.

In summary, Greyson’s book is a valuable addition to the literature on NDEs, and one that can be recommended to students and teachers of Religious Studies, along with Mark Fox’s older, more demanding but academically rigorous and thorough survey of the territory. And one of Greyson’s conclusions is certainly worth keeping in mind by A Level students:

The idea that our minds – our thoughts, feelings, hopes, fears – are produced solely by our physical brains is not a scientific fact. It is a philosophical theory proposed to explain scientific facts.

Having noted this, if we set the alternative theory – that NDEs incorporate visions of what is a genuine spiritual reality – in a wider context, we are then entitled to ask (as Mark Fox does in another of his books shown directly above) why so few (less than 20%) of those who have been clinically dead have this type of experience? What is it about the other 80 per cent that prevents them from being vouchsafed something this extraordinary? Here, the issue is one familiar to those who have studied the topic of miracles: if divine intervention does occur, why does it often fail to happen when it is most needed, for example, at Auschwitz or Hiroshima? Furthermore, if NDEs are veridical then this would imply that benevolence is an attribute of ultimate reality. So what are we to make of the presence of seemingly gratuitous forms of natural evil in a physical world that appears to be a product of a blind evolutionary process? How is this to be accounted for in a grander scheme of things of which NDEs afford us a partial glimpse?

Given that in the aftermath of an NDE, subjects tend to become more spiritually inclined, and given also the noetic element of the experience itself, it might therefore be interesting to read a future study that focuses specifically on what the experiencers themselves now make of such issues and other ultimate questions that have been pondered by philosophers and theologians.

*Though not specifically referred to by the letter writer, Thompson, for example, appears to have seen the documentary but does not refer to Spetzler’s comments.

** Although it pre-dates his AWARE 1 and AWARE II studies of the recalled experiences of cardiac arrest survivors, this earlier publication of Parnia’s serves as a lively, well-written and engaging introduction to the subject of NDEs.

What Happens When We Die: A Ground-breaking Study into the Nature of Life  and Death: A Ground-Breaking Study Into the Nature of Life and Death. Sam  Parnia: Parnia, Sam: 9781401915391: Books

*** Noratuk appears in the BBC Horizon documentary for which a link is provided above. A viewing of it is highly recommended as Susan Blackmore also features, along with Bruce Greyson, Sam Parnia, and other prominent researchers. Several YouTube videos also look at the Noratuk case.

**** For example, Noratuk was unable to see colour, which does not align well with Ring and Cooper’s contention that ‘mindsight’ involves ‘omnidirectional awareness’ with the doors of perception opening to an ‘infinite’ Blakean level, while Barrows’ experience happened when he was eight years old and was recalled twenty five years later (though one should bear in mind Greyson’s observation that such experiences are vividly recalled even with the passage of time).