Important Research Articles

Dr. Peter Fenwick, M.D.: Science and Spirituality

 

Prospective Studies of NDEs

Now, none of you will know this study because it is not published yet. It is a new prospective study from the U.K., conducted by Dan Shears at Guy’s Hospital. He was the doctor on the meningitis ward and questioned the 90 percent of children who had recovered from meningitis. What he found was very similar to Melvin Morse’s retrospective findings (Morse and Perry, 1990), but, again, Shears’ study was prospective, so he knew the medical condition of the children involved. Of the children he questioned, one, a 3½-year-old boy, three months after the meningococcal disease, said that when he had been ill, ‘‘Two angels took me: a big angel and a boy angel.’’ He met with his grandfather and played with toys and other children, and ‘‘then the angels brought me back.’’ It was a lovely, simple, experience – and his grandfather had died nine days after the child had been admitted to the hospital, which is interesting.

Another 4-year-old boy, two weeks after his discharge from hospital, reported, ‘‘A man with wings came to see me while I was in hospital. I could see him out of the corner of my eye.’’ He went on to describe an out-of-body experience. He recalled his still-living grandmother talking to him at his bedside, and he could not tell her to shut up, as he was ‘‘asleep.’’ So he was outside himself and watching. He was also adamant that his grandmother knew who this winged man was, but I do not think she did; I do not think she could see him.

A 7-year-old girl described having an experience in the pediatric intensive care unit of St. Mary’s Hospital. She described feeling very calm and peaceful, clearly the beginnings of a near-death experience. She was observing herself from the end of the bed, and, again, she was standing next to a boy whom she did not know.

I have a videotaped account for you, which I will play now. The child is 3 years old and has reflex anoxic seizures in which her heart stops. During the time that she is unconscious she has out-of-body experiences. Here she is describing how, in one of these episodes, she goes up to the ceiling and then watches her mother do the resuscitation process ‘‘all wrong’’:

Narrator:
Most of us have preconceived ideas about such experiences, but this little girl was barely 3 years old when she described an out-of-body experience to her mother.
Mother:
She was telling me that she goes, and she goes up, and she’s watching herself. Now, I did find it amazing. I was speechless.
Narrator:
She suffers from a rare illness called reflex anoxic seizures, which temporarily stop her heart beating. In her short life, she has clinically died over 20 times.
Mother:
She has no vital signs; she has no respiration, no pulse, no heartbeat, no anything. She turns from a blue to an ashen, and black, I would say, lips.
Narrator:
Fortunately, she normally recovers from a seizure within a minute, but as she grew older, she began to talk to her mother about them.
Mother:
She watches herself, and then, she tells me, again, her words, she ‘‘clicks’’ back in.
Narrator:
On one occasion, she collapsed in her mother’s bedroom. Her mother placed her in the recovery position and soothed her. When the child ‘‘came round,’’ she was furious with her mother for not placing her on the floor as they’d been taught by the doctor.
Mother:
But when she came back, I mean, she had told me what I had done and how I did it wrong and what I’d said.
Narrator to child:
Where do you go?
Child:
Up in the ceiling.
Narrator:
Up in the ceiling! Can you tell me what it’s like?
Child:
I see Mommy helping me.

There are good reasons for studying childhood NDEs. Very few children will have been exposed to the idea of NDEs. Young children especially have a poorly formed view of the idea and permanence of death. Children whose parents have no religious views or convictions are even less likely to have been told about what to expect at death. In his 1989 paper, Harvey Irwin suggested that children who had had no religious instruction would be ideal to test the sociocultural conditioning hypothesis against the paranormal-spiritual hypothesis. In other words, if kids who do not know about NDEs have an NDE, you cannot explain it by saying they have learnt about it as a cultural experience.

Our Study of Cardiac Arrest Survivors’ NDEs

The first published prospective study that included cardiac arrest patients, Michael Sabom’s 1982 study, also included patients who had been in other near-death circumstances, such as severe traumatic injury or comas from metabolic disorders or systemic illness, and also included patients whose arrests had occurred both in and out of hospital. To my knowledge, the first published prospective study focusing entirely on cardiac arrests that occurred in the hospital was the one that Sam Parnia and I did at Southampton University (Parnia, Waller, Yeates, and Fenwick, 2001). We wanted to ask two questions about near-death experiences. Firstly, would people who had had cardiac arrests report having NDEs at the time of their arrest? That is, our first question was whether NDEs would be found in our prospective study. The second question was: Do these experiences occur before unconsciousness, during unconsciousness, during recovery, or after recovery?

Those questions were absolutely crucial. They were not only crucial for NDE research, but they were also crucial for neuroscience as a whole, because neuroscience has come up against a block. The problem is that neuroscientists do not know what consciousness is and have no theories to explain its nature. That is because our science is the science of the external world, a hangover from the time of the Renaissance, and it does not deal with subjective experience, or with consciousness. This is the main problem facing neuroscience at the moment, and it may well be that NDE research will be one way of filling the ‘‘consciousness gap’’ in neuroscience.

So what did we do? We studied cardiac arrest survivors over the age of 18. To qualify for our study, when questioned after their cardiac arrest they had to be lucid, not confused; they had to agree to be interviewed; and their medical team had to allow us to ask them questions. Of course, we used Greyson’s (1983) NDE Scale; there isn’t a better instrument for assessing the presence or absence and the depth of an NDE.

What did we find? We found prototypical NDEs: feelings of peace and joy, sense of harmony, bright lights, heightened senses, encounters with mystical beings, encountering barriers of no return, and so on. Out of a base group of about 220 people who were admitted to the unit after a cardiac arrest, only 63 people survived. Of those 63 survivors, 56 (89 percent) had no memories during their arrest; and 7 (11 percent) had memories. Of these latter 7, four (6.3 percent) met the Greyson criteria for an NDE, and the other two, although not meeting the Greyson criteria, did have NDE features which made us put them in the NDE group. So our rate is about 10 percent, so one can generalize to cardiac arrest as a whole and say that about 10 percent of survivors of cardiac arrest will report NDEs.

Our conclusions from the study were that cardiac arrest NDEs were classical; rates were similar to previous estimates; and patients said that the experiences occurred during unconsciousness. Now, that is important because neuroscience maintains that conscious experience is not possible during physical unconsciousness. We also found that NDEs were not due to medication, electrolytes, or blood gases. So something interesting is going on.

Other Recent Prospective Cardiac Arrest NDE Studies

There are now four recent prospective cardiac arrest NDE studies. There is ours in 2000, and we found an incidence of about 10 percent NDEs among survivors (Parnia, Waller, Yeates, and Fenwick, 2001). Pim van Lommel and his Dutch colleagues in 2001 found about 12% percent (van Lommel, van Wees, Meyers, and Elfferich, 2001). In Janet Schwaninger’s American study published in 2002, a higher rate of 23 percent was found (Schwaninger, Eisenberg, Schechtman, and Weiss, 2002). Greyson, in his study about a year later (2003a), found 10 percent. And one of my Ph.D. students, Penny Sartori, in an unpublished study, found about 25 percent. So, you can say that of people who will have heart attacks, between 10 and 20 percent will have NDEs, and I doubt those figures are going to change very much.

So you can calculate straight away that over one million Americans have stood in the light: very powerful. Think of all those people who have experienced an altered state of consciousness. The world is changing. But not only that: more defibrillators and pacemakers are being implanted into hearts, and as the heart quite often stops in this process, this means that even more people are going to have NDEs and their aftereffects.

I want now particularly to mention van Lommel’s Dutch study (van Lommel, van Wees, Meyers, and Elfferich, 2001). This was a huge study, with 344 cardiac arrest survivors in 10 hospitals. Forty-one survivors reported NDEs. The occurrence of NDEs was not influenced by the duration of either unconsciousness or cardiac arrest, or by medication. So that is really interesting: you do not have to be unconscious for long, but there may be a critical limit; we do not know. More NDEs were reported in the group of survivors who actually died shortly after their experience, so it looks as though the closer you are to death, the more likely you are to get an NDE.

This study also had an 8-year follow up, the longest follow up that has ever been published. It enabled the researchers to ask, first, whether the memory of an NDE changes across time, and second, what happens to people who do not have NDEs: do they have any of the change in personality that NDErs show? If you look at Table 1, you can see straightaway that, in fact, there are interesting changes after a cardiac arrest even amongst the people who did not have an NDE. Positive scores indicate an increase in the personality changes, and the larger the number, the larger the increase overall for that group. Negative numbers indicate a decrease in the personality changes, and the larger the number, the larger the decrease.

I just want you to look closely at this table. Do you see those changes in the nonNDErs? The changes are greater overall in the NDErs, certainly. But I want you to understand that not only NDErs change, because a heart attack in itself is a very powerful, important event, and here is clear evidence that people who have heart attacks change, whether or not they report having had an NDE. Note that after eight years, the nonNDErs scored higher than the NDErs on understanding the purpose of life! So, having a heart attack in itself is significant. NDErs became less fearful of death after their NDEs, but so did nonNDErs. So one thing that has been learnt from this study is that even people who do not have an NDE may have their consciousness changed just by the fact that they have had a heart attack. Interestingly, spirituality decreased in nonNDErs after their heart attacks but increased in the NDErs.

 

Table 1
Changes in cardiac arrest survivors at 2-year and 8-year follow-up
(from van Lommel, van Wees, Meyers, Elfferich, 2001)
   
2-year follow-up
8-year follow-up
  Life Change Inventory Item
NDE
(n=23)
no NDE
(n=15)
NDE
(n=23)
no NDE
(n=15)
Social attitude
  Showing own feelings

42

16

78

58

  Acceptance of others

42

16

78

41

  More loving, empathic

52

25

68

50

  Understanding others

36

8

73

75

  Involvement in family

47

33

78

58

Religious attitude
  Understand purpose of life

52

33

57

66

  Sense inner meaning in life

52

25

57

25

  Interest in spirituality

15

-8

42

-41

Attitude to death
  Fear of death
-47
-16
-63
-41
  Belief in life after death
36
16
42
16
Other
  Interest in meaning of life

52

33

89

66

  Understanding oneself

58

8

63

58

  Appreciation of ordinary things

78

41

84

50

Moving on to the Schwaninger study, 30 cardiac arrest survivors were interviewed over three years (Schwaninger, Eisenberg, Schechtman, and Weiss, 2002). Twenty-three percent had NDEs, all of which were pleasurable; there were no ‘‘negative’’ NDEs. She found no difference in demographic variables, so, again, there is nothing special about people who get NDEs. How people interpreted their NDEs, however, was, as we know, based on personal, cultural, and religious views. An interesting point was that they needed psychosocial support before hospital discharge. And at 6-month follow-up – not as long as van Lommel’s, but the results show the same trend – spiritual and religious views changed, as did attitudes towards others, personal understanding, and social customs.

Greyson’s (2003a) American study was of 1,595 patients admitted to a cardiac care unit with heart trouble. He found an incidence of 10 percent NDEs among cardiac arrest survivors and found that the more severe the illness, the more likely the survivor was to report an NDE. And what he said is this: ‘‘The paradoxical occurrence of heightened, lucid awareness and logical thought processes during a period of impaired cerebral perfusion [absence of blood flow to the brain] raises particularly perplexing questions for our current understanding of consciousness and its relation to brain function’’ (p. 275). So that is now in the literature. And based on that, Sam Parnia and I have a paper being reviewed for Neuroscience Letters in which we propose the experiment which I am going to show you. Whether or not they will publish it, I do not yet know.

An important finding from Greyson’s study was that patients admitted to intensive care without coronary arrest reported NDEs 10 times less often than coronary arrest patients, and the non-arrest NDEs contained fewer sensations of the light, less enhanced cognitive function during the experience, and less positive emotion. Now, my Ph.D. student, an intensive care nurse, has done a study – again, it is not published – and the rates she found for NDEs in an intensive care unit were almost the same as Greyson’s. So, if you go to any intensive care unit, 1 percent of non-arrest patients have NDEs and 10 percent of people with cardiac arrest.

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