CEDARS/ASPENS Debates

Ophthalmologists explore scientific and personal aspects of near-death experience

John C. Hagan III, MD, FACS, FAAO, and Jean R. Hausheer, MD, FACS, address this common but not well-understood topic.

Welcome to another edition of CEDARS/ASPENS Debates. CEDARS/ASPENS is a joint society of cornea, cataract and refractive surgery specialists, here to discuss some of the latest hot topics in ophthalmology.

This month we will discuss an unusual topic, the near-death experience. While many physicians have been approached by patients with these reports, few really understand what this means, as this is a topic not typically addressed in medical school. In this issue, John C. Hagan III, MD, FACS, FAAO, describes his research on the topic, and Jean R. Hausheer, MD, FACS, discusses her personal experience. We hope you enjoy the discussion.

Kenneth A. Beckman, MD, FACS
OSN CEDARS/ASPENS Debates Editor

The syndrome of near-death experiences

John C. Hagan III

Prospective studies of cardiac arrest survivors have shown that if thoughtfully asked, “When you were unconscious and being resuscitated, did anything unusual happen that you would like to talk about?” 20% will report a near-death experience (NDE). When not asked, less than 1% will voluntarily report a NDE. Those who self-report are often met with indifference, even hostility, from their physicians and nurses. They are told it never happened; it was all imagined; that these ultra-vivid, hyper-real and often life-changing events are just the product of an oxygen-starved brain. They are told if they tell people about these events, they will be thought mentally ill and impaired. This often creates enormous mental and physical distress that can last a lifetime. This is especially true in children. Physicians are rarely taught how to recognize and treat the very common clinical syndrome of NDE even though it is extraordinarily simple. This must stop.

This was a primary reason that I gathered the world’s leading experts on NDEs and published in Missouri Medicine the first comprehensive set of papers in the world’s peer-review literature. University of Missouri Press has published these manuscripts in the newly released book The Science of Near-Death Experiences. The book has generated considerable attention in medical school departments, especially ICUs, CCUs and ERs where patients frequently “almost die.” I have been invited to lecture medical students at two Missouri medical schools.

NDEs date to antiquity and are pictured in medieval art. In 1975, Raymond Moody, MD, PhD, described the classical features of a typical NDE and reported 150 cases. Estimates of the number of people having NDEs in the U.S. range up to 20 million. The classic “redemptive/positive” NDE (90%) can have as many as 12 different stages. Most do not have every element. Kenneth Ring, PhD, has simplified NDEs to peace, body separation, entering the darkness, seeing the light, entering the light and returning from the light. A typical redemptive NDE is described in the accompanying article by nationally known ophthalmologist Jean R. Hausheer, MD, FACS. Approximately 10% of NDEs are called “distressing or ‘dark’ NDEs.” These have an essentially malevolent universe and a descent into hellish images and perdition. These distressing NDEs require considerably more treatment and frequently psychiatric referral.

Why should we as ophthalmologists know or care about NDEs? Most of us are rarely present when a patient clinically dies and is then retrieved from the locus of the newly dead. First of all, we are physicians and should care about our patients receiving appropriate care. Secondly, the study of verified (veridical) NDEs can make us question whether the brain is the source of consciousness and the end organ of vision. How can a person with no pulse, no blood pressure, and no brain or vascular activity covered in surgical drapes with their eyes taped shut return and recount accurately not only the events of the resuscitation but also what went on elsewhere in the hospital such as the waiting room? This defies a materialist brain-based source of consciousness. Harvard neurosurgeon Eben Alexander, MD, who wrote two New York Times best-selling books on his NDE, calls this “non-materialistic” consciousness. He and other experts believe consciousness can navigate not only space but time. Dutch cardiologist Pim van Lommel, MD, calls this “non-local consciousness.” Ken Ring in his book Mindsight: Near-Death and Out-of-Body Experiences in the Blind reports verified cases of people with total congenital and acquired blindness who are able to describe details of resuscitation that would be only available to sighted individuals. We present in chapter 12 a brain-based explanation of NDE by University of Kentucky neurologist Kevin Nelson, MD. This is the minority opinion in our collection of manuscripts.

All individuals resuscitated from clinical death should be interviewed by a physician who thoughtfully inquires about a NDE using the words in the first paragraph. If the patient does report a NDE, the event should be validated and sympathetic thoughtful listening used. The patient should be reassured that many other people have these and usually they have a positive effect on their lives. Referral to appropriate reading material or the International Association for Near-Death Studies should be made.

The content of NDEs, such as visiting with deceased family, life reviews and conversations with a supreme being, are interesting to consider but fall in the field of religion and are not the focus of our book. The Division of Perceptual Studies at the University of Virginia School of Medicine is a full-time science-based academic program that conducts research in NDEs, the only department of its kind at a major U.S. university.

Disclosure: Hagan reports no relevant financial disclosures. He reports any profits from the sale of the NDE book will be used by the Missouri State Medical Association for student loans.

Jean R. Hausheer

A personal near-death experience

In the summer of 1977, at the age of 20, an extraordinary event involving a respiratory arrest occurred that forever changed my personal and professional life. I want to share the joyous content of that near-death experience (NDE) with you to enhance your clinical knowledge of NDE syndrome. Insights gained about the meaning and purpose of life forever extinguished any previous fear of death and confirmed the knowledge of where we originate and the joy and loving peace of an afterlife.

At the time of my NDE, I was a medical student at the University of Missouri-Kansas City School of Medicine. Recently I had recovered from a bad cold. Suddenly I developed diplopia that progressed. I could not hold my eyelids open either.

I called my dad, also a physician, who sent me to the emergency room. Hospitalized, my situation evolved into a descending paralysis. Chewing, facial expressions, swallowing, moving my extremities and even breathing were demanding and worsening. Zika virus-associated Guillain-Barre syndrome, Jacksonian variant, was considered likely. Before being sent to the pulmonary lab, a physician performed a physostigmine challenge, with the amount being an overdose. Rather quickly, iatrogenic acute respiratory failure ensued, and I lost consciousness.

Next, I simply floated upward and away, as if in a dream or movie. I was looking down approximately 30 feet above this young brunette on the floor. I could see with incredible detail anything I desired and see through anything I chose. Vision was beyond 3-D and was spherical 360°. I saw everywhere and comprehended instantly. My soul — the essence of who I am — was suspended midair high above the action below.

Above me was a brilliant sphere of peaceful, loving, living whitest of lights. It had a familiar and comfortable living presence and existence. Ineluctably I was drawn toward this distant loving light source. It emitted and transferred the most pure love and acceptance, which remain ineffable to describe. Just by desiring to be with this loving lighted presence, I rapidly traveled to it. I left the darkness here on earth. Midway to the living loving light source it occurred to me that I was dying and completely separate from my body.

I could not wait to join this amazing loving light. Upon arrival, my soul merged within the loving living light source. We became one. This was truly an extraordinary place full of countless souls who each fully and completely loved me, always had, and knew all about me. I knew this was home, from whence I originated. The knowledge of these souls, as well as mine, was greatly and extraordinarily enhanced (upon return to earth, my limited human knowledge resumed). We conversed in unison, simply by thinking. I was given to know that earth is a place of tremendous learning. It is not about all the difficulties we each encounter here. Instead it is about how to honor God and help others in our response.

I could choose to stay or return. The countless souls would lovingly cheer me on no matter my choice. I was allowed to feel the deep profound pain and anguish of my parents if I chose to stay. The body I left behind was paralyzed. What would my earthly purpose be if I could not finish medical school? In my mind I had not lived my full life. I was given to know upon return my body would be restored fully and quickly enough to finish medical school on time. The moment this decision became clear to me, a voice surrounded me, as if coming from everywhere and all consuming. “It’s not your time yet. Return!”

Faster than I had arrived at this Godly place, I rapidly returned to my now resuscitated body, which had since been moved to a new location. Immediately I could feel my familiar human characteristics return, including the Guillain-Barre. The assembled emergency response team was shouting with joy that I was awaking.

I could not wait to find my parents and talk to them.

I was in the ICU for a week and the hospital for a month. My physicians upon discharge discouraged me from resuming medical school. They felt I would not completely recover for a long time and would lack the stamina needed to graduate. In my NDE, I had been given to know otherwise. I was fully recovered in a year and graduated on time with my classmates.

Those of us who have had a NDE are reluctant to share the experience with our colleagues and others because of the lack of human words to accurately describe it. I was not deserving of this life-changing event. My academic roots have remained diligent in science, yet I see and know the wondrous love of God here among us. Occasionally we encounter patients with NDEs, and we should inquire and listen. The hallmarks of this place of heaven and God remain His tremendous love for each of us.

Disclosure: No products or companies that would require financial disclosure are mentioned in this article.

Welcome to another edition of CEDARS/ASPENS Debates. CEDARS/ASPENS is a joint society of cornea, cataract and refractive surgery specialists, here to discuss some of the latest hot topics in ophthalmology.

This month we will discuss an unusual topic, the near-death experience. While many physicians have been approached by patients with these reports, few really understand what this means, as this is a topic not typically addressed in medical school. In this issue, John C. Hagan III, MD, FACS, FAAO, describes his research on the topic, and Jean R. Hausheer, MD, FACS, discusses her personal experience. We hope you enjoy the discussion.

Kenneth A. Beckman, MD, FACS
OSN CEDARS/ASPENS Debates Editor

The syndrome of near-death experiences

John C. Hagan III

Prospective studies of cardiac arrest survivors have shown that if thoughtfully asked, “When you were unconscious and being resuscitated, did anything unusual happen that you would like to talk about?” 20% will report a near-death experience (NDE). When not asked, less than 1% will voluntarily report a NDE. Those who self-report are often met with indifference, even hostility, from their physicians and nurses. They are told it never happened; it was all imagined; that these ultra-vivid, hyper-real and often life-changing events are just the product of an oxygen-starved brain. They are told if they tell people about these events, they will be thought mentally ill and impaired. This often creates enormous mental and physical distress that can last a lifetime. This is especially true in children. Physicians are rarely taught how to recognize and treat the very common clinical syndrome of NDE even though it is extraordinarily simple. This must stop.

This was a primary reason that I gathered the world’s leading experts on NDEs and published in Missouri Medicine the first comprehensive set of papers in the world’s peer-review literature. University of Missouri Press has published these manuscripts in the newly released book The Science of Near-Death Experiences. The book has generated considerable attention in medical school departments, especially ICUs, CCUs and ERs where patients frequently “almost die.” I have been invited to lecture medical students at two Missouri medical schools.

NDEs date to antiquity and are pictured in medieval art. In 1975, Raymond Moody, MD, PhD, described the classical features of a typical NDE and reported 150 cases. Estimates of the number of people having NDEs in the U.S. range up to 20 million. The classic “redemptive/positive” NDE (90%) can have as many as 12 different stages. Most do not have every element. Kenneth Ring, PhD, has simplified NDEs to peace, body separation, entering the darkness, seeing the light, entering the light and returning from the light. A typical redemptive NDE is described in the accompanying article by nationally known ophthalmologist Jean R. Hausheer, MD, FACS. Approximately 10% of NDEs are called “distressing or ‘dark’ NDEs.” These have an essentially malevolent universe and a descent into hellish images and perdition. These distressing NDEs require considerably more treatment and frequently psychiatric referral.

PAGE BREAK

Why should we as ophthalmologists know or care about NDEs? Most of us are rarely present when a patient clinically dies and is then retrieved from the locus of the newly dead. First of all, we are physicians and should care about our patients receiving appropriate care. Secondly, the study of verified (veridical) NDEs can make us question whether the brain is the source of consciousness and the end organ of vision. How can a person with no pulse, no blood pressure, and no brain or vascular activity covered in surgical drapes with their eyes taped shut return and recount accurately not only the events of the resuscitation but also what went on elsewhere in the hospital such as the waiting room? This defies a materialist brain-based source of consciousness. Harvard neurosurgeon Eben Alexander, MD, who wrote two New York Times best-selling books on his NDE, calls this “non-materialistic” consciousness. He and other experts believe consciousness can navigate not only space but time. Dutch cardiologist Pim van Lommel, MD, calls this “non-local consciousness.” Ken Ring in his book Mindsight: Near-Death and Out-of-Body Experiences in the Blind reports verified cases of people with total congenital and acquired blindness who are able to describe details of resuscitation that would be only available to sighted individuals. We present in chapter 12 a brain-based explanation of NDE by University of Kentucky neurologist Kevin Nelson, MD. This is the minority opinion in our collection of manuscripts.

All individuals resuscitated from clinical death should be interviewed by a physician who thoughtfully inquires about a NDE using the words in the first paragraph. If the patient does report a NDE, the event should be validated and sympathetic thoughtful listening used. The patient should be reassured that many other people have these and usually they have a positive effect on their lives. Referral to appropriate reading material or the International Association for Near-Death Studies should be made.

The content of NDEs, such as visiting with deceased family, life reviews and conversations with a supreme being, are interesting to consider but fall in the field of religion and are not the focus of our book. The Division of Perceptual Studies at the University of Virginia School of Medicine is a full-time science-based academic program that conducts research in NDEs, the only department of its kind at a major U.S. university.

Disclosure: Hagan reports no relevant financial disclosures. He reports any profits from the sale of the NDE book will be used by the Missouri State Medical Association for student loans.

PAGE BREAK
Jean R. Hausheer

A personal near-death experience

In the summer of 1977, at the age of 20, an extraordinary event involving a respiratory arrest occurred that forever changed my personal and professional life. I want to share the joyous content of that near-death experience (NDE) with you to enhance your clinical knowledge of NDE syndrome. Insights gained about the meaning and purpose of life forever extinguished any previous fear of death and confirmed the knowledge of where we originate and the joy and loving peace of an afterlife.

At the time of my NDE, I was a medical student at the University of Missouri-Kansas City School of Medicine. Recently I had recovered from a bad cold. Suddenly I developed diplopia that progressed. I could not hold my eyelids open either.

I called my dad, also a physician, who sent me to the emergency room. Hospitalized, my situation evolved into a descending paralysis. Chewing, facial expressions, swallowing, moving my extremities and even breathing were demanding and worsening. Zika virus-associated Guillain-Barre syndrome, Jacksonian variant, was considered likely. Before being sent to the pulmonary lab, a physician performed a physostigmine challenge, with the amount being an overdose. Rather quickly, iatrogenic acute respiratory failure ensued, and I lost consciousness.

Next, I simply floated upward and away, as if in a dream or movie. I was looking down approximately 30 feet above this young brunette on the floor. I could see with incredible detail anything I desired and see through anything I chose. Vision was beyond 3-D and was spherical 360°. I saw everywhere and comprehended instantly. My soul — the essence of who I am — was suspended midair high above the action below.

Above me was a brilliant sphere of peaceful, loving, living whitest of lights. It had a familiar and comfortable living presence and existence. Ineluctably I was drawn toward this distant loving light source. It emitted and transferred the most pure love and acceptance, which remain ineffable to describe. Just by desiring to be with this loving lighted presence, I rapidly traveled to it. I left the darkness here on earth. Midway to the living loving light source it occurred to me that I was dying and completely separate from my body.

I could not wait to join this amazing loving light. Upon arrival, my soul merged within the loving living light source. We became one. This was truly an extraordinary place full of countless souls who each fully and completely loved me, always had, and knew all about me. I knew this was home, from whence I originated. The knowledge of these souls, as well as mine, was greatly and extraordinarily enhanced (upon return to earth, my limited human knowledge resumed). We conversed in unison, simply by thinking. I was given to know that earth is a place of tremendous learning. It is not about all the difficulties we each encounter here. Instead it is about how to honor God and help others in our response.

PAGE BREAK

I could choose to stay or return. The countless souls would lovingly cheer me on no matter my choice. I was allowed to feel the deep profound pain and anguish of my parents if I chose to stay. The body I left behind was paralyzed. What would my earthly purpose be if I could not finish medical school? In my mind I had not lived my full life. I was given to know upon return my body would be restored fully and quickly enough to finish medical school on time. The moment this decision became clear to me, a voice surrounded me, as if coming from everywhere and all consuming. “It’s not your time yet. Return!”

Faster than I had arrived at this Godly place, I rapidly returned to my now resuscitated body, which had since been moved to a new location. Immediately I could feel my familiar human characteristics return, including the Guillain-Barre. The assembled emergency response team was shouting with joy that I was awaking.

I could not wait to find my parents and talk to them.

I was in the ICU for a week and the hospital for a month. My physicians upon discharge discouraged me from resuming medical school. They felt I would not completely recover for a long time and would lack the stamina needed to graduate. In my NDE, I had been given to know otherwise. I was fully recovered in a year and graduated on time with my classmates.

Those of us who have had a NDE are reluctant to share the experience with our colleagues and others because of the lack of human words to accurately describe it. I was not deserving of this life-changing event. My academic roots have remained diligent in science, yet I see and know the wondrous love of God here among us. Occasionally we encounter patients with NDEs, and we should inquire and listen. The hallmarks of this place of heaven and God remain His tremendous love for each of us.

Disclosure: No products or companies that would require financial disclosure are mentioned in this article.