Appendix - Why They Aren't NDEs

Some skeptics claim that near-death experiences are hallucinations resulting from a variety of drugs, psychological phenomena, or physiological stress.

To offer a balanced viewpoint, I am presenting these drugs and other phenomena that the debunkers claim can cause NDE-like experiences and a synopsis of the medical research showing what each does.

As you will be able to see from the scientific research, none of these mimics the powerful experiences revealed in this book.

Lysergic Acid (LSD): LSD, a drug that was popular in the sixties, is a crystalline form of acid known to cause hallucinations. LSD frequently causes a sensation of leaving the physical body and often leaves one with the feeling of having had a religious experience. LSD has inconsistent traits, but basically, it causes distortions of body image, visual hallucinations of colors and patterns, and a variety of bizarre emotions and images. NDEs have a consistent core experience of leaving the physical body and traveling up a tunnel that is not experienced by those who take LSD.

The difference is also one of perception. People who take LSD know they are on a drug and not experiencing reality. People who have NDEs perceive them as being vivid, intensely real experiences.

Morphine and Heroin: The hallucinations experienced from morphine and heroin are nothing like NDEs. The hallucinations are rarely perceived as being real, but are usually recognized as narcotically induced.

More important, volunteers who have taken these narcotics describe nausea, vomiting, drowsiness, inability to concentrate, and even decreased vision.

For many, narcotics are a blissful and heavenly experience. But it does not involve traveling up a tunnel, seeing the Light, or having concrete visions of spirits, heaven, and God.

As a physician who paid his dues in Seattle's tough Harborview Hospital Emergency Room, I can confidently state that overdoses of narcotics do not create hallucinations that resemble NDEs. Here are one doctor's record of a test subject being given heroin:

"Fifteen minutes after injection, the subject began to laugh uncontrollably. He stated: 'I was seized by laughter and funny thoughts. Time sense for reading and counting was lost. Thoughts came in waves. I was saying things I didn't want to do or ought not to do. (He made sexual advances on another subject.) I talked and talked and talked. I had some coffee and felt that I could kill someone. I felt I must have a psychiatric disorder, that this was my real true personality, which was evil, and coming out. I felt that I had no soul. (Monitors of the experiment) assured me that it was only the drug that I was taking. I wept.' '

It is possible to pick out elements of this experience that are similar to NDEs, just as it is possible to pick out notes that children play on a piano that are used in Mozart's work. But on the whole, the two experiences can't compare.

"Recreational" Drugs: Research clearly shows that such drugs as marijuana, cocaine, PCP, amphetamines, and barbiturates do not cause NDE-like experiences.

In studies conducted at Stanford University, a great deal of paranoia was aroused in people who smoked high doses of both hashish and marijuana. One researcher reported that "Disorientation, speech disturbances, loss of control of thoughts, poor memory, depression, and outright fear were common."

A case study presented in the Journal of the American Medical Association of marijuana psychosis that occurred to a soldier in Vietnam offers an extreme example of drug paranoia at its worst:

"A 19-year-old, single, white soldier, private first class was referred for examination by another psychiatrist. He was alleged to have shot and killed an individual while on guard duty.

"Sworn statements and formal judicial investigation revealed that while on guard duty the victim shared a 'marihuana cigarette' with the subject, the subject's first. The victim was described as a joker whose humor was sometimes 'a little sick and cruel.' Shortly after having the cigarette the victim began to pick on some nearby Vietnamese children.

He reportedly told them that he was 'Ho Chi Minn' and fired his weapon near them. Although the subject questioned if he was Ho Chi Minn, when the victim showed him the name on his shirt, the subject became terrified and fired his rifle. He then left his guard post and entered the base camp in a confused fashion, saying that he had killed Ho Chi Minh.

Upon saying this he displayed a T-shirt with that name written on it and urged those around him to accompany him to see the body. On the way, he spoke in a disjointed and confused fashion. Upon arrival at the guard post, actually an observation tower, the bare-chested body of a Negro soldier, with several gunshot wounds on the left anterior portion of the chest, was found. ... Upon examination the patient was confused and apprehensive, but quite proud of having killed Ho Chi Minh.

"The psychiatrist's opinion was that the subject was delusional and suffering from an acute toxic psychosis."

Although I admit that this is an extreme example of a drug-induced psychosis, it illustrates the paranoia that is frequently seen with drug usage and, in my experience, never seen in patients who have near-death experiences.

Anesthetic Agents: The most commonly used anesthetic agents, such as halothane, surital, nitrous oxide, narcotics, and Nembutal, simply do not cause hallucinations.

Following any surgical procedure, the patient may remember events and conversations heard during surgery and may become confused. For example, while under anesthesia my wife overheard a nurse discussing the death of her cat and became convinced that they were actually talking about her.

For this reason, such medications as Valium are given to create an amnesia for the time of the operation. Mystical hallucinations are simply not described in large studies of what patients recall while under anesthetic. Often patients remember music being played in the operating room, brief snatches of conversations, and the moods and emotions of the surgeon.

Ketamine: An anesthetic agent, Ketamine is no longer used because of its adverse psychological effects. Patients treated with Ketamine would frequently report frightening out-of-body episodes, not the pleasurable ones reported during NDEs. Also, their out-of-body experiences were of the autoscopic variety in which they saw mirror images of themselves and not the type experienced during an NDE in which a person hovers above an operating table, watching the action around him.

The following is an account of a patient who underwent minor surgery with Ketamine: "My mind left my body and apparently went to what some describe as a second state. I felt I was in a huge well-lit room, in front of a massive throne draped in lush velvet. I saw nothing else, but felt the presence of higher intelligences tapping my mind of every experience and impression I had gathered. I begged to be released, to return to my own body. It was terrifying."

Ketamine hallucinations differ greatly from NDEs. There is a fearful and paranoid flavor not seen in NDEs. Also, patients know they are on drugs, and as a result, the experience does not seem real.

Transient Depersonalization: This theory states that patients who have near-fatal experiences become emotionally detached from their bodies. For them, life loses its meaning and intensity. There is a loss of emotion and time, and their own thought processes seem strange and unreal.

Swiss mountain-climbing journals contain excellent descriptions of depersonalization by climbers who fell from great heights but survived. Time slowed down for these climbers, and the entire experience seemed unreal as though the person were detached from the event.

This response allows a life-threatened person to handle a situation without panic and could permit him or her to initiate life-saving measures.

Dr. Russel Noyes of the University of Iowa is the main proponent of the theory that NDEs are transient depersonalizations. However, in my research with children, I have not found them to report any of the aspects of depersonalization.

Memories of Birth: Carl Sagan, the Cornell University astronomer, explains near-death experiences as memory that is leftover from the experience of birth.

In his best-selling book, Broca's Brain, Sagan writes:

The only alternative, so far as I can see, is that every human being, without exception, has already shared an experience like that of those travelers who return from the land of death: the sensation of flight; the emergence from darkness into light; an experience in which, at least sometimes, a heroic figure can be dimly perceived, bathed in radiance and glory. There is only one common experience that matches this description. It is called birth.

The theory that NDEs are memories of the birth experience has been challenged by many researchers, most notably Carl Becker, a philosophy professor from Southern Illinois University. Using existing research into infant perception and how much of the experience can actually be retained, he concludes that children have neither the eyesight nor the mental capacity to know or remember what is occurring during the birth process.

I have to wonder if the birth process, if it could be remembered at all, would be recalled in such a positive context. When one is pulled from a warm, supportive environment, and then cut with scissors to sever the umbilical cord is not a pleasant event to remember.

Also, the tunnel experience in an NDE involves rapid passage toward a light. In the birth experience, the child's face is pressed against the walls of the birth canal. The child can't see anything as he approaches life outside the womb.

Autoscopic Hallucinations: Autoscopy is the psychological event of seeing one's double. Although most people have never heard of it, it occurs in about two percent of the population.

This is actually seeing a mirror image of oneself. The image is dressed the same, and its movements usually mimic the person's own movements.

The double is often superimposed on reality. So if it walks in front of a window, the beholder cannot see out that window.

Autoscopy is usually associated with brain tumors, strokes, and migraine headaches. In fact, President Abraham Lincoln reported seeing his double hovering above him as he lay on a couch recovering from one of his frequent migraine headaches.

Some skeptics mistake out-of-body experiences for autoscopy. There is a great difference, however. In an out-of-body experience, a person sees himself from outside of his own body and from a perspective that is usually above. And he is seeing reality. The double is a hallucination projected upon reality.

Jung's Collected Papers on Analytical Psychology contains a report of a woman who had an autoscopic hallucination while having a splinter removed from her finger.

Without any kind of bodily change she suddenly saw herself sitting by the side of a brook in a beautiful meadow, plucking flowers. This condition lasted as long as the slight operation and then disappeared spontaneously.

This experience differs greatly from an out-of-body experience in that the subject saw a facsimile of herself. In an out-of-body experience, the subject is actually outside his body watching activities that are going on in the room. For instance, here's an intriguing one from Dr. Raymond Moody's work:

"As a resident, I was working in the emergency room when an elderly woman was brought in who was unconscious from a heart attack. I was giving her closed heart massage on an emergency room examining table and the nurse assisting me ran into another room to get a vial of medication that we needed.

"It was a glass-necked vial that you're supposed to hold in a paper towel while breaking off the top so you don't cut yourself. When the nurse returned, the neck was broken so I could use the medicine right away.

"When the old woman came to, she looked very sweetly at the nurse and said, 'Honey, I saw what you did in that room, and you're going to cut yourself doing that.' The nurse was shocked. She admitted that in her haste to open the medicine, she had broken the glass neck with her bare fingers.

"The woman told us that while we were resuscitating her, she had followed the nurse back to the room to watch what she was doing."

As you can see, an autoscopic hallucination and an out-of-body experience associated with an NDE are quite different.

The Endorphin Model: Endorphins are morphine-like chemicals produced in the brain to alleviate pain. They are responsible for such events as "the runner's high," that pleasurable feeling one has after exercise.

Endorphins were first related to NDEs by Dr. Daniel Carr of Massachusetts General Hospital. He states: "Within our brains is a neurotransmitter which acts similarly to morphine or heroin. This is a natural chemical, made by the brain, to respond to times of great pain. This is a natural high that is created by exercise, or creative energies, or religious faith.

Any severe stress will create these natural 'endorphins' and they have many complex functions which can be summarized as reducing stress in the brain. No one has actually measured these endorphins or presented any sort of evidence at all that they are actually the chemicals created by the agonies of death, still, it is certainly reasonable to assume that the stresses of dying produce a lot of endorphins." The Carr model is based on three points:

1. The brain, after being subjected to the sudden and unexperienced stress of dying, has the time to actually create a "large dose" of these morphine-like chemicals. In many of the instances cited in this book, the brain would have to produce these chemicals within two or three minutes.

2. Morphine-like chemicals can actually generate near-death experiences.

3. The limbic lobe syndrome caused by these brain-produced chemicals is similar to NDEs.

There is no evidence in the medical literature that the stresses of dying actually produce significantly greater amounts of endorphins in the brain. In studies of animals dying of bacteria on the brain, small amounts of these chemicals are documented, yet their significance is unclear.

Most animal studies indicate that the brain becomes depleted of these endorphins, which makes sense since their main function is to alleviate pain and therefore would be depleted quickly. No evidence exists to prove that the dying brain makes large quantities of these chemicals.

Even Dr. Carr qualifies his theory by stating that there is no reason to suppose that endorphins are the main neurotransmitters involved in NDEs. He merely uses them as an example of a possible neurotransmitter.

Hypoxia: Simply stated, hypoxia is a lack of oxygen to the brain. In itself, it can certainly cause death, but does lack of oxygen necessarily cause death?

In our studies, we carefully examined medical records to see if there was a lack of oxygen in the blood gases. None of the patients who experienced NDEs was any more deprived of oxygen than the control groups that did not have NDEs.

In light of hypoxia, it is interesting to note the work of Dr. L.J. Medune, a professor of psychiatry at the University of Illinois School of Medicine in the 1940s and 1950s. Medune's theory was that mental illness represented a biochemical dysfunction within the brain and that treatments should be aimed at correcting that dysfunction.

To do that, he had patients inhale high concentrations of carbon dioxide for a period of several minutes. Called "the Medune mixture," its namesake predicted that general practitioners would be able to cure neurotics in their offices after a single, half-hour treatment. This would greatly benefit the poor, he declared, because they could easily afford this bottled psychiatric treatment as opposed to long-term psychotherapy.

The use of the Medune mixture was stopped in the sixties.

It is my hypothesis that such a high concentration of carbon dioxide caused the brain to trigger an NDE.

The Medune mixture certainly had the transformative effect of NDEs on its patients. And many of their descriptions of what happened while breathing the gas are in keeping with the stories told by NDEers.

Target Of Reductionism

After reading the data on these drug experiences and physiologic states, you might wonder why they are mistaken for NDEs. It is my feeling that near-death studies have become the target of reductionism because many researchers are frustrated at not being able to explain this spiritual phenomenon. So for instance, a hallucination researcher such as Dr. Ronald Siegel studies the effects of drugs on the human mind and breaks down the hallucinations into very basic elements in an effort to understand the basic vocabulary of human hallucination.

He can point to drugs that cause tunnel experiences in some patients, or another drug that creates a variety of hallucinatory images, one of which is a bright star, and so on.

But near-death experiences appear to be a cluster of events so that one cannot understand the total by looking at its various pieces. One cannot understand music by studying the various frequencies of sound that generate each note, nor does one need to have a deep understanding of acoustical physics to enjoy Mozart. The near-death experience remains a mystery.