Heroes Not Zombies

I was really struck by an article in The Observer the other day. Dr Sam Parnia, a doctor specialising in resuscitation techniques, has studied the experiences of patients who die and are later brought back to life.

Pardon? Yes, people whose heart stops (a cardiac arrest) and whose brains stop working due to oxygen lack, but who are successfully resuscitated and fully recover. Not only does the person return but he has found that about half of them report very similar death experiences (people refer to these experiences as NDEs – “near death experiences” – but he says they are, in fact, ADEs – “actual death experiences”). These two phenomena raise interesting questions – where does the “person” go while they are dead? And how does this “person” observe and remember observations which they make while they are dead?

This particular paragraph really gripped me –

All I can say is what I have observed from my work. It seems that when consciousness shuts down in death, psyche, or soul – by which I don’t mean ghosts, I mean your individual self – persists for a least those hours before you are resuscitated. From which we might justifiably begin to conclude that the brain is acting as an intermediary to manifest your idea of soul or self but it may not be the source or originator of it… I think that the evidence is beginning to suggest that we should keep open our minds to the possibility that memory, while obviously a scientific entity of some kind – I’m not saying it is magic or anything like that – is not neuronal

Now, I’m very familiar with the idea that whilst there are neuronal correlates of mental activity, we cannot say that its the neurones which produce the thoughts, feelings, and indeed consciousness which we all experience. But what a way to put it!

That the mind uses the brain to express itself.

I had to get the book. (The Lazarus Effect. Dr Sam Parnia. ISBN 978-1-84604-307-9)

I raced through it. In the book, Dr Parnia describes his work in resuscitation and reports on his AWARE study into the reported experiences of those who return. The heart of the book, for me, is Chapter 6, “What it’s like to die”, which describes many of these reports in detail. I’ve read this kind of thing before but I had never, ever read reports from children as young as 3 years old. Those stories stunned and moved me. They are amazing. And the story told by the Consultant of his first experience of a patient’s cardiac arrest where he tells how once recovered the patient told him in detail not only what the doctor had done in the room whilst the patient was unconscious, but even what the doctor had thought, but hadn’t verbalised…….

Dr Parnia goes through the possible scientific explanations for these reports and shows how none of them actually credibly explain them. He believes we will uncover a scientific explanation one day, but not until we start to accept these phenomena as real.

Here are a couple of sentences which really struck me

Reality is not neurologically determined, then, but rather it is largely socially determined.

and

The bottom line is that no brain-based chemical change can define whether a sensation or feeling is real or not

I don’t see things exactly as he does – for example, he uses a machine model to explain how the body works – it isn’t a machine, its a complex adaptive system – and the crucial difference is that only complex adaptive systems demonstrate both emergence and self-organisation – ie the whole cannot be explained by the parts. And he says “the goal of Medicine is cure” – well, I wish! But in fact, what does Medicine these days cure? Rather, Medicine manages disease – there are no cures for asthma, multiple sclerosis, Parkinsons Disease, etc etc etc

However, these are not the key points of the book.

Let me just finish with a reference to Chapter 5, “The Orphan” where he says

Asthma has a home in pulmonary medicine. Cancer is in the domain of oncology. Parkinson’s belongs to the neurologist. But cardiac arrest is an orphan by virtue of the fact that it cuts across many specialities because it is death, and death happens in all specialities of medicine but is parented by no-one.

See, this is what I find so wrong about health care – we divide health care into specialities which focus on parts and diseases – not only does death then become an orphan, but so does health.