00:00:09.730 --> 00:00:14.470
I was climbing in the
Andes in a snowstorm

00:00:14.470 --> 00:00:21.790
at a very high altitude, and
I started to get very winded.

00:00:21.790 --> 00:00:24.130
Then I felt, because
I always feel

00:00:24.130 --> 00:00:27.850
when I have an abnormal
rhythm, I felt it coming on,

00:00:27.850 --> 00:00:37.510
and I sort of braced,
and then nothing.

00:00:37.510 --> 00:00:40.975
[MUSIC PLAYING]

00:00:45.430 --> 00:00:49.880
I could have gone either
way at that point.

00:00:49.880 --> 00:00:51.950
That was the first time.

00:00:51.950 --> 00:00:57.920
It then happened over the next
10 years another six times,

00:00:57.920 --> 00:01:00.485
so I've had seven
cardiac arrests.

00:01:15.180 --> 00:01:18.900
There is one certainty in
life, and that is death.

00:01:18.900 --> 00:01:21.210
Though most of us
may try to ignore it,

00:01:21.210 --> 00:01:24.120
the reality of our
inevitable mortality

00:01:24.120 --> 00:01:26.970
only becomes real when
we lose a loved one

00:01:26.970 --> 00:01:29.100
or experience a
personal tragedy.

00:01:29.100 --> 00:01:32.460
An accident, an illness,
or simply aging.

00:01:32.460 --> 00:01:36.870
And it's suddenly in those rare
moments of confusion or fear

00:01:36.870 --> 00:01:40.020
or acceptance that we
begin to really think

00:01:40.020 --> 00:01:42.720
about questions that
have plagued humanity

00:01:42.720 --> 00:01:45.100
for thousands of years.

00:01:45.100 --> 00:01:46.860
What is death?

00:01:46.860 --> 00:01:49.140
What happens when we die?

00:01:49.140 --> 00:01:53.460
Where does our consciousness,
our self, go after death,

00:01:53.460 --> 00:01:55.620
and is there anything beyond?

00:01:55.620 --> 00:01:58.710
After all, much of
what defines living

00:01:58.710 --> 00:02:02.750
is derived from what
happens when we die.

00:02:02.750 --> 00:02:05.690
Up until now, death
has been perceived

00:02:05.690 --> 00:02:09.410
as impossible to study
with scientific rigor.

00:02:09.410 --> 00:02:12.740
How do we study a phenomenon
that ultimately results

00:02:12.740 --> 00:02:15.140
in the loss of our subjects?

00:02:15.140 --> 00:02:18.620
The good news is that advances
in science and medicine

00:02:18.620 --> 00:02:20.750
have afforded us
with the opportunity

00:02:20.750 --> 00:02:24.410
for the empirical study of
what happens when we die,

00:02:24.410 --> 00:02:28.190
and this is the remarkable
scientific story of death.

00:02:38.980 --> 00:02:42.970
Death is a concept that
is continuing to evolve.

00:02:42.970 --> 00:02:48.670
If you go back 100 years
ago, really, if I as a doctor

00:02:48.670 --> 00:02:52.120
came across someone and
their heart wasn't beating,

00:02:52.120 --> 00:02:56.980
I just would say, they're dead,
and it was as simple as that.

00:02:56.980 --> 00:03:00.640
When cardiac activity
stopped, that was death.

00:03:00.640 --> 00:03:03.550
Death has generally
and traditionally

00:03:03.550 --> 00:03:06.430
been diagnosed clinically.

00:03:06.430 --> 00:03:10.660
So the physician will
attempt to find a pulse,

00:03:10.660 --> 00:03:15.070
will assess for breathing,
assess the patient's pupils,

00:03:15.070 --> 00:03:18.610
and generally if the
patient's pupils are fixed,

00:03:18.610 --> 00:03:22.150
dilated, there is no breathing,
and there is no pulse,

00:03:22.150 --> 00:03:25.390
it is the clinical
definition of death.

00:03:25.390 --> 00:03:29.410
Death happens when any
illness or an accident

00:03:29.410 --> 00:03:33.760
becomes so severe that it causes
the heart to stop beating.

00:03:33.760 --> 00:03:37.120
This is medically
called cardiac arrest.

00:03:37.120 --> 00:03:41.140
When this happens, blood
flow stops in the whole body,

00:03:41.140 --> 00:03:45.940
and breathing, brain function,
and all signs of life are lost.

00:03:45.940 --> 00:03:49.150
Now, throughout time,
nobody could come back

00:03:49.150 --> 00:03:53.410
from this event, which meant the
permanent and irreversible loss

00:03:53.410 --> 00:03:56.050
of life, or death.

00:03:56.050 --> 00:03:59.410
For the first time
around 1960, doctors

00:03:59.410 --> 00:04:02.770
discovered a way to restart
the heart after it had stopped

00:04:02.770 --> 00:04:05.410
by pressing hard and
fast on the chest

00:04:05.410 --> 00:04:09.520
and giving high amounts of
oxygen, drugs, and electricity.

00:04:09.520 --> 00:04:12.910
Cardiopulmonary resuscitation,
if you think about it,

00:04:12.910 --> 00:04:14.920
is an outrageous concept.

00:04:14.920 --> 00:04:22.660
It's humanity's attempt to
reject the age old notion

00:04:22.660 --> 00:04:26.320
that when your heart stops
beating, that defines death.

00:04:26.320 --> 00:04:28.240
And literally the
idea is we're going

00:04:28.240 --> 00:04:34.900
to just pound on the chest, move
air into and out of the chest,

00:04:34.900 --> 00:04:38.650
and literally pump
the blood physically

00:04:38.650 --> 00:04:41.080
through the body to
the heart and brain

00:04:41.080 --> 00:04:44.500
while we try to get to some
definitive intervention

00:04:44.500 --> 00:04:46.240
to bring life back.

00:04:46.240 --> 00:04:50.170
As a result of this system of
cardiopulmonary resuscitation,

00:04:50.170 --> 00:04:53.140
or CPR, some people
who would otherwise

00:04:53.140 --> 00:04:57.070
have been permanently dead
could be brought back to life,

00:04:57.070 --> 00:05:00.030
and this started to challenge
the way we think of death.

00:05:00.030 --> 00:05:03.000
Society largely dealt
with this challenge

00:05:03.000 --> 00:05:06.630
by simply referring to
this same event using

00:05:06.630 --> 00:05:08.530
two different terms.

00:05:08.530 --> 00:05:11.010
So we call it
cardiac arrest when

00:05:11.010 --> 00:05:13.680
doctors are actively trying
to restart the heart,

00:05:13.680 --> 00:05:16.410
and we call it death
when they've stopped

00:05:16.410 --> 00:05:19.970
or they've decided not to
intervene in the first place.

00:05:19.970 --> 00:05:23.270
This distinction, which
is largely semantic,

00:05:23.270 --> 00:05:26.510
has helped avoid public
confusion between life

00:05:26.510 --> 00:05:31.010
and death, but they're referring
to the same biological process.

00:05:31.010 --> 00:05:33.620
Now, at the same
time, around the birth

00:05:33.620 --> 00:05:37.130
of intensive care medicine
in the 1950s and '60s,

00:05:37.130 --> 00:05:39.650
something else also
started to challenge

00:05:39.650 --> 00:05:41.700
our understanding of death.

00:05:41.700 --> 00:05:45.680
There are two ways to
die, two modes of death.

00:05:45.680 --> 00:05:50.690
The principle one that we all
know about is cardiac death,

00:05:50.690 --> 00:05:54.590
when the patient's
heart stops beating,

00:05:54.590 --> 00:05:56.360
there's no oxygen
going to the brain,

00:05:56.360 --> 00:05:59.810
and you're pulseless apneic,
which means not breathing

00:05:59.810 --> 00:06:01.370
and you're dead.

00:06:01.370 --> 00:06:06.050
Starting in the late
1960s, we recognized

00:06:06.050 --> 00:06:07.640
there was another
way to die, which

00:06:07.640 --> 00:06:12.590
is brain death or death
by neurological criteria.

00:06:12.590 --> 00:06:16.820
Brain death happened because
of medical technology.

00:06:16.820 --> 00:06:19.340
It happened because
of life support

00:06:19.340 --> 00:06:22.100
and respirators,
and was recognized

00:06:22.100 --> 00:06:27.080
that after catastrophic brain
injuries, trauma leading

00:06:27.080 --> 00:06:32.660
into your brain, these diseases
could effectively kill off

00:06:32.660 --> 00:06:35.720
the brain permanently
to the point

00:06:35.720 --> 00:06:39.590
that there's zero brain
function and no blood

00:06:39.590 --> 00:06:42.890
flowing to the brain
at all, yet the heart's

00:06:42.890 --> 00:06:47.090
still beating because
the ventilator is sending

00:06:47.090 --> 00:06:49.340
the oxygen into the lungs.

00:06:49.340 --> 00:06:54.740
So around 1968,
formal criteria were

00:06:54.740 --> 00:06:57.860
written recognizing
and endorsing

00:06:57.860 --> 00:07:01.670
brain death as an entity,
a valid way to die.

00:07:01.670 --> 00:07:07.130
So today, the vast majority of
people, 98% of the population,

00:07:07.130 --> 00:07:11.150
are declared dead by
cardiopulmonary criteria.

00:07:11.150 --> 00:07:13.190
That is when the
heart stops beating.

00:07:13.190 --> 00:07:18.020
And 2% are declared dead by
neurological criteria or brain

00:07:18.020 --> 00:07:19.370
death criteria.

00:07:19.370 --> 00:07:22.490
But in order to understand
what happens to us with death,

00:07:22.490 --> 00:07:25.550
we need to understand
what happens to the brain

00:07:25.550 --> 00:07:28.160
after the heart stops.

00:07:28.160 --> 00:07:32.440
The brain is 2% of
the body's weight

00:07:32.440 --> 00:07:37.910
but consumes 20% of the oxygen.
So it's very high maintenance.

00:07:40.480 --> 00:07:42.300
So when a human
being is deprived

00:07:42.300 --> 00:07:47.880
of oxygen in a cardiac arrest,
the brain gets hit hardest

00:07:47.880 --> 00:07:52.860
and starts to become
irreversibly damaged earliest.

00:07:52.860 --> 00:07:55.800
That process begins.

00:07:55.800 --> 00:08:01.650
What we thought was that
as early as five minutes

00:08:01.650 --> 00:08:04.650
after the initial
deprivation of oxygen,

00:08:04.650 --> 00:08:08.160
the brain cells start to
die, and they're dead.

00:08:08.160 --> 00:08:10.720
And once they're dead,
they can't come back.

00:08:10.720 --> 00:08:16.650
What we understand now is that
the cells are recoverable,

00:08:16.650 --> 00:08:20.250
but the initial five
minutes of lack of oxygen

00:08:20.250 --> 00:08:27.730
triggers an active dying process
that plays out over hours.

00:08:27.730 --> 00:08:30.180
The fact that brain
cells don't die quickly

00:08:30.180 --> 00:08:34.020
after oxygen deprivation
and death in a cadaver

00:08:34.020 --> 00:08:36.929
is a major scientific
paradigm shift.

00:08:36.929 --> 00:08:39.480
It contrasts with
everything that scientists

00:08:39.480 --> 00:08:42.360
have believed for
decades, which is

00:08:42.360 --> 00:08:45.510
that brain cells die within
just a few minutes of oxygen

00:08:45.510 --> 00:08:47.130
deprivation.

00:08:47.130 --> 00:08:51.000
That has progressively been
shown to not be true at all.

00:08:51.000 --> 00:08:53.730
But then came another challenge.

00:08:53.730 --> 00:08:57.150
When doctors restarted
the heart after CPR

00:08:57.150 --> 00:08:59.520
and put oxygen back
into the brain,

00:08:59.520 --> 00:09:03.300
they found that the oxygen
itself became toxic and caused

00:09:03.300 --> 00:09:05.190
the brain cells to die quickly.

00:09:05.190 --> 00:09:08.970
That opened up a
new field of science

00:09:08.970 --> 00:09:11.850
called reperfusion injury.

00:09:17.570 --> 00:09:21.320
How did I bring the
oxygen back to my brain?

00:09:21.320 --> 00:09:24.500
If we do it, I'm going
to say very carefully,

00:09:24.500 --> 00:09:27.620
we know that five
minutes can be stretched,

00:09:27.620 --> 00:09:32.690
and scientists now know
that the reperfusion injury

00:09:32.690 --> 00:09:38.930
is a big part of why people die
when we try to bring them back

00:09:38.930 --> 00:09:40.130
to life.

00:09:40.130 --> 00:09:43.760
For decades, now scientists have
been looking at different ways

00:09:43.760 --> 00:09:47.000
to improve the chances
of restarting the heart

00:09:47.000 --> 00:09:51.020
and to also reduce the oxygen
deprivation that the person has

00:09:51.020 --> 00:09:52.760
after the heart stops.

00:09:52.760 --> 00:09:55.490
Some of these involve the
use of special machines

00:09:55.490 --> 00:09:59.240
that can deliver better chest
compressions than what people

00:09:59.240 --> 00:10:01.460
can deliver by hand manually.

00:10:01.460 --> 00:10:03.650
One of the most
promising methods,

00:10:03.650 --> 00:10:07.310
which can also substantially
reduce oxygen deprivation

00:10:07.310 --> 00:10:09.530
after the heart
stops beating, is

00:10:09.530 --> 00:10:14.210
called extracorporeal
membrane oxygenation or ECMO,

00:10:14.210 --> 00:10:17.870
and this is a system, which
involves siphoning blood out

00:10:17.870 --> 00:10:20.600
of the body using special
catheters in the groin

00:10:20.600 --> 00:10:23.240
and the neck, putting
it through a membrane,

00:10:23.240 --> 00:10:26.150
giving it oxygen, and then
pumping it around the body

00:10:26.150 --> 00:10:27.170
again.

00:10:27.170 --> 00:10:32.480
After a lifetime in the field
of resuscitation science,

00:10:32.480 --> 00:10:39.200
my concept and understanding of
death has changed considerably.

00:10:39.200 --> 00:10:45.290
I've been lucky enough to be
involved with a newer approach

00:10:45.290 --> 00:10:48.950
to resuscitation called ECMO.

00:10:48.950 --> 00:10:54.500
It is a life support, and I've
been involved for the past 15

00:10:54.500 --> 00:10:59.600
years applying this technology
to patients in cardiac arrest.

00:10:59.600 --> 00:11:03.350
And we have been
able to demonstrate

00:11:03.350 --> 00:11:08.330
a 45% neurologically
favorable survival

00:11:08.330 --> 00:11:10.740
in that patient population.

00:11:10.740 --> 00:11:14.480
So throughout my lifetime, we
have gone from three minutes

00:11:14.480 --> 00:11:18.950
without oxygen to
now over an hour.

00:11:18.950 --> 00:11:22.010
There are also ways to
prevent cells from decaying

00:11:22.010 --> 00:11:24.470
and to fight the
reperfusion injury.

00:11:24.470 --> 00:11:26.630
One of those, perhaps
the most prominent,

00:11:26.630 --> 00:11:30.800
is hypothermia, which involves
chilling and cooling the body

00:11:30.800 --> 00:11:32.810
in an effort to
preserve the cells,

00:11:32.810 --> 00:11:36.860
much like how we do when we put
something in the refrigerator.

00:11:36.860 --> 00:11:39.740
There are also medications
that can augment this effect

00:11:39.740 --> 00:11:41.160
and enhance it.

00:11:41.160 --> 00:11:43.130
So in this way,
physicians can keep

00:11:43.130 --> 00:11:47.480
people whose hearts have stopped
in a sort of hibernation state.

00:11:47.480 --> 00:11:49.700
They're dead, but
they're hibernating,

00:11:49.700 --> 00:11:51.920
and this will then
potentially give doctors

00:11:51.920 --> 00:11:55.440
time to go and fix the
underlying issue that

00:11:55.440 --> 00:11:58.790
had caused the person to die,
assuming that it's fixable,

00:11:58.790 --> 00:12:01.580
and then try to restart
the heart again.

00:12:01.580 --> 00:12:04.790
Hypothermia we've
known for a long time

00:12:04.790 --> 00:12:09.500
decreases the need for
oxygen in major organs

00:12:09.500 --> 00:12:13.190
and the whole body,
and the colder

00:12:13.190 --> 00:12:17.270
you get, the lower the
demands for oxygen are.

00:12:17.270 --> 00:12:21.140
So emergency preservation
and resuscitation or EPR

00:12:21.140 --> 00:12:24.710
is the technique that we've
been working on for many years

00:12:24.710 --> 00:12:30.380
now to try to utilize mostly
hypothermia to try to decrease

00:12:30.380 --> 00:12:32.750
the oxygen needs for
the brain and the heart

00:12:32.750 --> 00:12:35.060
to allow surgeons
to quickly stop

00:12:35.060 --> 00:12:36.980
the bleeding in
somebody who's had

00:12:36.980 --> 00:12:39.080
a cardiac arrest from trauma.

00:12:39.080 --> 00:12:44.450
What can happen, though, is when
we then restore the blood flow,

00:12:44.450 --> 00:12:48.020
cells and major organs
are kind of primed to then

00:12:48.020 --> 00:12:52.400
have what's called a reperfusion
injury, re-oxygenation injury,

00:12:52.400 --> 00:12:54.770
and obviously it's a big
challenge because you've

00:12:54.770 --> 00:12:58.470
got to restore blood flow,
and kind of the question is,

00:12:58.470 --> 00:13:02.090
is there a way to do that
that's safer for cells,

00:13:02.090 --> 00:13:05.600
better for cells, than
just quickly giving

00:13:05.600 --> 00:13:07.070
blood and oxygen back to cells?

00:13:07.070 --> 00:13:10.430
And that's certainly a big
area of interest in science.

00:13:10.430 --> 00:13:13.010
The fact that brain
cells don't die quickly

00:13:13.010 --> 00:13:15.890
after we all die
and become a cadaver

00:13:15.890 --> 00:13:18.860
has another major
scientific ramification.

00:13:18.860 --> 00:13:21.450
It has meant that over
the past 20 years,

00:13:21.450 --> 00:13:25.370
scientists have been able to
routinely go to the mortuary

00:13:25.370 --> 00:13:28.370
and take pieces of
dead people's brains,

00:13:28.370 --> 00:13:32.100
some four to five hours
after the person had died,

00:13:32.100 --> 00:13:34.490
and then grow brain
cells, or what

00:13:34.490 --> 00:13:37.520
we call mini brains, small,
tiny little brains, which

00:13:37.520 --> 00:13:41.780
are referred to as brain
organoids, in the laboratory.

00:13:41.780 --> 00:13:44.210
And they're doing
this in a quest

00:13:44.210 --> 00:13:47.270
to discover new treatments
for severe brain

00:13:47.270 --> 00:13:50.690
diseases such as Parkinson's
disease or stroke.

00:13:50.690 --> 00:13:53.930
Brain stem cells, I mean,
they are quiescent stem cells

00:13:53.930 --> 00:13:57.750
that resides in specific
regions of the brain,

00:13:57.750 --> 00:13:59.300
such as the hippocampus.

00:13:59.300 --> 00:14:00.770
And, of course,
I mean, when they

00:14:00.770 --> 00:14:03.830
are deprived for nutrients,
they go quiescent

00:14:03.830 --> 00:14:05.660
and they just stay
there, but they

00:14:05.660 --> 00:14:08.520
are ready to come back under
the proper environment.

00:14:08.520 --> 00:14:10.430
So the experiments
with cadaveric brains

00:14:10.430 --> 00:14:13.730
show us that if you provide
them with the right environment,

00:14:13.730 --> 00:14:17.660
they will start to
proliferate again.

00:14:17.660 --> 00:14:20.600
So it's not that they were
dead, they were just quiescent.

00:14:20.600 --> 00:14:22.400
They were silent hibernation.

00:14:22.400 --> 00:14:26.990
You can bring them back and
stimulate them to proliferate.

00:14:26.990 --> 00:14:30.650
This simple experiment gave
rise to a whole new field.

00:14:30.650 --> 00:14:33.920
I mean, if you can take stem
cells from the human brain that

00:14:33.920 --> 00:14:37.190
is already post-mortem, can
we reconstruct the brain

00:14:37.190 --> 00:14:38.840
using those stem cells?

00:14:38.840 --> 00:14:41.660
For more than 20
years, science has

00:14:41.660 --> 00:14:45.710
shown that we can take pieces
of the brain from dead people

00:14:45.710 --> 00:14:49.430
and grow mini functioning
brains in the laboratory.

00:14:49.430 --> 00:14:53.090
But it's one thing to get
brain cells to grow again

00:14:53.090 --> 00:14:56.810
after death, but a key question
that had remained for decades

00:14:56.810 --> 00:14:59.750
has been, can we ever
get the whole brain

00:14:59.750 --> 00:15:01.250
to work again after death?

00:15:01.250 --> 00:15:03.410
That is a much bigger challenge.

00:15:03.410 --> 00:15:09.210
Every 5 or 10 years,
a study will come out,

00:15:09.210 --> 00:15:13.490
and by the end of
the day it comes out,

00:15:13.490 --> 00:15:17.570
the emails are pinging
all over the world,

00:15:17.570 --> 00:15:20.240
and this was one
of those studies.

00:15:20.240 --> 00:15:22.610
This was outrageous.

00:15:22.610 --> 00:15:25.710
This was the pig study.

00:15:25.710 --> 00:15:29.460
So what did these
researchers at Yale do?

00:15:29.460 --> 00:15:32.210
They went to a
slaughterhouse and they

00:15:32.210 --> 00:15:37.130
got that decapitated
heads of dead pigs,

00:15:37.130 --> 00:15:40.880
and these pigs had
been decapitated

00:15:40.880 --> 00:15:44.090
some number of hours
before, and they

00:15:44.090 --> 00:15:47.180
have this contraption
where they plug

00:15:47.180 --> 00:15:51.650
in effectively an artificial
circulation to the dead pig

00:15:51.650 --> 00:15:55.250
head and do all this
metabolic monitoring,

00:15:55.250 --> 00:15:59.330
electrical monitoring,
and they proved

00:15:59.330 --> 00:16:05.720
that they could restore
life and metabolic function

00:16:05.720 --> 00:16:08.480
to the brains of these pigs.

00:16:08.480 --> 00:16:11.960
That is an amount of
time that no scientist

00:16:11.960 --> 00:16:14.720
would believe would be
something that would bring back

00:16:14.720 --> 00:16:17.360
normal brain function ever.

00:16:17.360 --> 00:16:22.850
They were able to restore
a heck of a lot of function

00:16:22.850 --> 00:16:24.170
to the brain.

00:16:24.170 --> 00:16:27.920
The scientists was so concerned
with the ramifications

00:16:27.920 --> 00:16:29.930
of the discovery that
dead brains could

00:16:29.930 --> 00:16:32.780
be revived again
hours after death

00:16:32.780 --> 00:16:36.500
that they had prepared
drugs to sedate the dead pig

00:16:36.500 --> 00:16:39.440
brains in case they had
become conscious again.

00:16:39.440 --> 00:16:41.450
They actually stopped
the experiment,

00:16:41.450 --> 00:16:45.350
downplayed their own findings,
and declared that the dead pig

00:16:45.350 --> 00:16:48.140
brains had not been
conscious again

00:16:48.140 --> 00:16:51.380
but were in fact, metabolically,
in other words biologically,

00:16:51.380 --> 00:16:55.170
active but not alive, which
doesn't make a lot of sense

00:16:55.170 --> 00:16:57.700
because if the brain
is biologically active,

00:16:57.700 --> 00:16:59.220
then it must be alive.

00:16:59.220 --> 00:17:02.250
Now, while the world
media reported on this,

00:17:02.250 --> 00:17:05.369
they and most other
people did not quite

00:17:05.369 --> 00:17:08.280
realize the huge
ramifications that this

00:17:08.280 --> 00:17:10.560
and other recent
scientific breakthroughs

00:17:10.560 --> 00:17:14.609
were having on our understanding
of what happens when we die.

00:17:14.609 --> 00:17:18.770
I can only imagine that this
is translated to other species

00:17:18.770 --> 00:17:19.270
as well.

00:17:19.270 --> 00:17:22.619
I don't think there is anything
special about the pig brains,

00:17:22.619 --> 00:17:26.280
so I would assume that the same
is true for the human brains.

00:17:26.280 --> 00:17:29.910
So if you are to
reproduce his experiments

00:17:29.910 --> 00:17:31.980
with the human brain,
I think you would

00:17:31.980 --> 00:17:34.540
achieve very similar results.

00:17:34.540 --> 00:17:36.040
So what does that mean for us?

00:17:36.040 --> 00:17:38.580
So what it means is
that for the people who

00:17:38.580 --> 00:17:42.190
are really thoughtful, it means
there's now this gray zone.

00:17:42.190 --> 00:17:44.640
It might be death but
it might not be death.

00:17:44.640 --> 00:17:46.410
It's the gray zone.

00:17:46.410 --> 00:17:48.360
My own belief as
a scientist, it's

00:17:48.360 --> 00:17:51.210
going to depend on how
we restore function.

00:17:51.210 --> 00:17:56.070
It's that process of bringing
the computer back online

00:17:56.070 --> 00:17:59.790
after it's been turned off
for a period of time that

00:17:59.790 --> 00:18:03.360
is going to determine whether
we do it successfully or not.

00:18:03.360 --> 00:18:09.420
Those are the frontiers of
brain death and recovery

00:18:09.420 --> 00:18:14.220
and avoidance of brain death
that we're now looking at.

00:18:14.220 --> 00:18:18.960
In principle, by thinking of
death not so much as an end

00:18:18.960 --> 00:18:21.600
but as the beginning
of a new process

00:18:21.600 --> 00:18:24.300
and entry into
uncharted territory,

00:18:24.300 --> 00:18:27.120
instead of giving
up, doctors can now

00:18:27.120 --> 00:18:31.170
start to actively look for new
and novel treatments to halt

00:18:31.170 --> 00:18:35.150
and then reverse death
before it gets too late.

00:18:35.150 --> 00:18:38.210
However, many people
find it very hard

00:18:38.210 --> 00:18:40.790
to accept the notion
of a gray zone

00:18:40.790 --> 00:18:45.980
after death in which people are
dead but can still come back,

00:18:45.980 --> 00:18:48.980
and they believe that a person
who has returned to life

00:18:48.980 --> 00:18:51.230
was never truly dead.

00:18:51.230 --> 00:18:54.050
But experts are
showing and suggesting

00:18:54.050 --> 00:18:56.570
that medically
speaking, people could

00:18:56.570 --> 00:18:59.210
be dead from a
biological perspective

00:18:59.210 --> 00:19:01.760
and still be brought
back to life again.

00:19:01.760 --> 00:19:04.520
And so this then leads
to the natural question,

00:19:04.520 --> 00:19:06.875
where did they go during
this period of death?

00:19:10.320 --> 00:19:12.950
I think the study of
consciousness in cardiac arrest

00:19:12.950 --> 00:19:17.090
research is one of the most
important questions, and it I

00:19:17.090 --> 00:19:19.700
think really touches
upon questions

00:19:19.700 --> 00:19:22.370
of what does it
mean to be human,

00:19:22.370 --> 00:19:25.790
what does it mean
to be alive, how

00:19:25.790 --> 00:19:27.710
do we formulate an identity.

00:19:27.710 --> 00:19:31.910
I think that we know
very little about what

00:19:31.910 --> 00:19:34.910
is going on for this person
and this person's awareness

00:19:34.910 --> 00:19:37.940
during the time of
a cardiac arrest.

00:19:37.940 --> 00:19:41.090
People have described
things afterward and kind

00:19:41.090 --> 00:19:43.280
of recalled things
from the room when

00:19:43.280 --> 00:19:45.890
they were in cardiac
arrest or kind of

00:19:45.890 --> 00:19:48.710
described seeing their lives
flash before their eyes or kind

00:19:48.710 --> 00:19:53.760
of other very vivid experiences,
and what is happening there

00:19:53.760 --> 00:19:55.050
we just don't know.

00:19:55.050 --> 00:19:58.370
And I think it is a
very important question

00:19:58.370 --> 00:20:01.850
to explore in the care
of these patients.

00:20:01.850 --> 00:20:05.090
While seemingly not conscious
from the perspective of others

00:20:05.090 --> 00:20:07.310
who are looking at
this person and others

00:20:07.310 --> 00:20:09.260
who might even be
attempting to revive

00:20:09.260 --> 00:20:12.860
the individual medically, from
the perspective of the person

00:20:12.860 --> 00:20:14.870
who's going through
death and who's

00:20:14.870 --> 00:20:18.530
entered into this state of
coma, paradoxically, there

00:20:18.530 --> 00:20:20.930
seems to be a continuation
of lucid thought

00:20:20.930 --> 00:20:24.740
processes and consciousness
without physical pain

00:20:24.740 --> 00:20:26.210
or distress.

00:20:26.210 --> 00:20:29.630
What if during this period
of seeming unconsciousness

00:20:29.630 --> 00:20:32.300
from the outside
world's perspective,

00:20:32.300 --> 00:20:36.410
a fascinating, lucid,
transcendent, meaningful, and

00:20:36.410 --> 00:20:39.560
purposeful experience
emerges that follows

00:20:39.560 --> 00:20:42.570
a very specific narrative?

00:20:42.570 --> 00:20:45.830
There are accounts of what we
now call near-death experiences

00:20:45.830 --> 00:20:48.120
from ancient Greece and Rome.

00:20:48.120 --> 00:20:50.240
And, in fact, every
culture in which people

00:20:50.240 --> 00:20:52.910
have looked for histories
of near-death experiences,

00:20:52.910 --> 00:20:55.490
they found accounts of these.

00:20:55.490 --> 00:20:57.980
It was Raymond Moody,
actually, a medical student

00:20:57.980 --> 00:21:02.510
at the time in 1975, who used
the term near-death experience

00:21:02.510 --> 00:21:06.740
for the first time in English,
and he had in medical school

00:21:06.740 --> 00:21:10.370
asked his patients who had
been close to death what they

00:21:10.370 --> 00:21:12.680
remembered of the experience.

00:21:12.680 --> 00:21:16.010
He found about 150 of
these cases in his patients

00:21:16.010 --> 00:21:17.960
during the course of
his medical school,

00:21:17.960 --> 00:21:22.280
and in 1975 he wrote a book
called Life After Life in which

00:21:22.280 --> 00:21:26.840
he used the term near-death
experience and the acronym NDE,

00:21:26.840 --> 00:21:30.290
and that was the name that
stuck for better or worse.

00:21:30.290 --> 00:21:32.810
Based on the scientific
and medical advancements

00:21:32.810 --> 00:21:35.120
of recent years,
we have evidence

00:21:35.120 --> 00:21:37.190
to believe that many
of the people who've

00:21:37.190 --> 00:21:39.890
described their
experiences had gone

00:21:39.890 --> 00:21:42.320
beyond the gray zone
of death and returned

00:21:42.320 --> 00:21:44.280
to tell their stories.

00:21:44.280 --> 00:21:47.660
So this means that the
term near-death experience

00:21:47.660 --> 00:21:51.830
is in fact a misnomer, which
is why recent studies have

00:21:51.830 --> 00:21:54.770
re-established a new
terminology for referring

00:21:54.770 --> 00:21:56.570
to these phenomena.

00:21:56.570 --> 00:22:00.855
We now call them recalled
experiences of death or REDs

00:22:00.855 --> 00:22:01.355
for short.

00:22:04.140 --> 00:22:06.920
It was my first day as a doctor.

00:22:06.920 --> 00:22:11.060
I was, I think
justifiably, terrified.

00:22:11.060 --> 00:22:14.930
I had a second year resident
who was supervising me,

00:22:14.930 --> 00:22:20.210
who promised me that
he would cover my back

00:22:20.210 --> 00:22:24.540
and be present throughout
the entire 36 hour period.

00:22:24.540 --> 00:22:28.820
So I went up, I introduced
myself to this patient,

00:22:28.820 --> 00:22:32.720
and the patient's eyes rolled
up in the back of his head

00:22:32.720 --> 00:22:36.710
and he fell back onto
the bed lifeless.

00:22:36.710 --> 00:22:41.750
So I dove on his chest, I
started CPR, and initiated

00:22:41.750 --> 00:22:43.700
resuscitation practice.

00:22:43.700 --> 00:22:47.130
Eventually his wife showed up
and the nurse came in and said,

00:22:47.130 --> 00:22:48.950
will you please
talk with the wife?

00:22:48.950 --> 00:22:51.590
I'll shock the patient
if he rearrests.

00:22:51.590 --> 00:22:55.310
So I went out and talked to
her and was not very optimistic

00:22:55.310 --> 00:22:58.580
in my discussion with her.

00:22:58.580 --> 00:23:02.750
About 11:30, his
lunch showed up.

00:23:02.750 --> 00:23:06.180
Well, I hadn't had breakfast
and I hadn't had lunch,

00:23:06.180 --> 00:23:08.690
so I went ahead
and ate his lunch.

00:23:08.690 --> 00:23:11.810
Finally, about 1:00,
1:30 in the afternoon,

00:23:11.810 --> 00:23:15.260
he finally stabilized,
had a return of pulse,

00:23:15.260 --> 00:23:17.780
and that pulse was stable.

00:23:17.780 --> 00:23:21.020
The patient had a very rocky
course, was in the hospital

00:23:21.020 --> 00:23:24.560
about a month after
this, and on the last day

00:23:24.560 --> 00:23:27.780
I walked into his room, he
said, Tom, please sit down,

00:23:27.780 --> 00:23:29.900
shut the door.

00:23:29.900 --> 00:23:33.840
And I did that, and I said,
well, what can I do for you?

00:23:33.840 --> 00:23:37.460
And he said, I had an
experience during this arrest

00:23:37.460 --> 00:23:41.820
that has been bothering me for
a month and I need your help.

00:23:41.820 --> 00:23:44.570
He then explained that
he had left his body,

00:23:44.570 --> 00:23:47.420
and he explained
everything that I

00:23:47.420 --> 00:23:53.480
had done, that I was
doing CPR, the shocks.

00:23:53.480 --> 00:23:57.470
He followed me down the hallway
to my discussion with his wife,

00:23:57.470 --> 00:24:00.680
and he said, you know, I thought
you were pretty pessimistic

00:24:00.680 --> 00:24:04.250
about my options, and you should
have been more optimistic,

00:24:04.250 --> 00:24:07.070
Dr. Aufderheide.

00:24:07.070 --> 00:24:10.430
He said, and if that
wasn't bad enough,

00:24:10.430 --> 00:24:13.190
you had to eat my lunch.

00:24:13.190 --> 00:24:19.130
So that all was
a insight for me,

00:24:19.130 --> 00:24:21.290
but then he really
said something

00:24:21.290 --> 00:24:23.400
that got my attention.

00:24:23.400 --> 00:24:27.440
And he said, and I thought
it was unusual that here I

00:24:27.440 --> 00:24:31.610
was dying in front of
you, and you were feeling

00:24:31.610 --> 00:24:34.220
sorry for yourself
because your second year

00:24:34.220 --> 00:24:39.890
resident had left you alone
and wasn't supervising you.

00:24:39.890 --> 00:24:47.540
Now, I had never verbalized that
embarrassing thought to anyone,

00:24:47.540 --> 00:24:53.160
but he told me what
I thought, and that

00:24:53.160 --> 00:24:55.500
really got my attention.

00:25:04.090 --> 00:25:09.800
My adventure began
in January of 1999.

00:25:09.800 --> 00:25:12.760
We went to South America
with friends of ours

00:25:12.760 --> 00:25:16.030
for a week of kayaking,
of whitewater kayaking.

00:25:16.030 --> 00:25:21.190
We kayaked for the first week
and had a wonderful time,

00:25:21.190 --> 00:25:25.110
and on what was going to be our
last day of whitewater kayaking

00:25:25.110 --> 00:25:29.670
anyway, we decided to paddle
a section of river that's

00:25:29.670 --> 00:25:32.190
well known for its waterfalls.

00:25:32.190 --> 00:25:36.630
I went down this drop
or this waterfall,

00:25:36.630 --> 00:25:40.380
and the front end of my
boat became pinned or stuck

00:25:40.380 --> 00:25:43.170
in the rocks and the
underwater features,

00:25:43.170 --> 00:25:46.770
and while I was still
upright in my boat,

00:25:46.770 --> 00:25:51.690
the water then completely
submerged me and the boat.

00:25:51.690 --> 00:25:53.760
And as the time
ticked on, I knew

00:25:53.760 --> 00:26:00.240
that I was in a bit of a
predicament, and at that moment

00:26:00.240 --> 00:26:06.930
I was immediately overcome by
a very, very physical sensation

00:26:06.930 --> 00:26:10.440
of being held and
comforted and reassured

00:26:10.440 --> 00:26:12.000
that everything was fine.

00:26:12.000 --> 00:26:13.560
My husband would be fine.

00:26:13.560 --> 00:26:16.800
My young children would
be fine regardless of

00:26:16.800 --> 00:26:19.260
whether I lived or died.

00:26:19.260 --> 00:26:26.460
And I was still me I still had
my same pragmatic, analytical

00:26:26.460 --> 00:26:30.150
sense about me, and
I was experiencing

00:26:30.150 --> 00:26:36.010
this incredible sense of
not just calm and peace,

00:26:36.010 --> 00:26:41.490
but this incredible
sense of absolute love.

00:26:41.490 --> 00:26:44.010
I really was sort of amazed.

00:26:44.010 --> 00:26:47.380
I was thinking,
wow, I'm not afraid.

00:26:47.380 --> 00:26:49.080
I don't feel panic.

00:26:49.080 --> 00:26:51.790
I feel great.

00:26:51.790 --> 00:26:53.610
And then I was
taken through a life

00:26:53.610 --> 00:27:00.540
review that was like nothing I
personally could have imagined.

00:27:00.540 --> 00:27:02.640
One collection of
phenomena are changes

00:27:02.640 --> 00:27:04.410
in your thought processes.

00:27:04.410 --> 00:27:07.410
Your thoughts seem to be
going faster than usual,

00:27:07.410 --> 00:27:11.160
they're clearer than usual,
they're more vivid than usual.

00:27:11.160 --> 00:27:15.030
You may have a complete
review of your entire life,

00:27:15.030 --> 00:27:19.020
and this is happening again
in the context of likely brain

00:27:19.020 --> 00:27:23.280
damage or at least severely
restricted oxygen to the brain,

00:27:23.280 --> 00:27:26.710
when you would not expect
much of an experience at all,

00:27:26.710 --> 00:27:31.710
let alone hyperacute senses
and rapid, clear thinking.

00:27:35.770 --> 00:27:40.250
23 years ago, I had a
horrific automobile accident.

00:27:40.250 --> 00:27:41.680
The whole family was in the car.

00:27:41.680 --> 00:27:45.490
It was myself, my wife,
and our two young sons.

00:27:45.490 --> 00:27:50.530
When the car came to a stop,
I was completely conscious.

00:27:50.530 --> 00:27:53.770
All I knew is I had
crashed the car.

00:27:53.770 --> 00:27:57.080
My young seven-year-old
was crying hysterically.

00:27:57.080 --> 00:27:58.220
I couldn't move.

00:27:58.220 --> 00:27:58.930
I was pinned.

00:27:58.930 --> 00:28:01.130
I couldn't get to him.

00:28:01.130 --> 00:28:05.930
And yet that was
the brutal reality,

00:28:05.930 --> 00:28:07.580
that no one else was crying.

00:28:07.580 --> 00:28:11.180
My wife and my youngest
son had both passed.

00:28:11.180 --> 00:28:14.490
They were both killed
instantly at the scene.

00:28:14.490 --> 00:28:17.520
But it was in that
darkest, darkest moment

00:28:17.520 --> 00:28:22.110
that something very
profound happened.

00:28:22.110 --> 00:28:24.750
It felt like a light came to me.

00:28:24.750 --> 00:28:28.920
I literally felt like light
came and surrounded me,

00:28:28.920 --> 00:28:31.620
and the light felt
tangible, almost comforting,

00:28:31.620 --> 00:28:34.830
and it felt as if I was
rising above the scene

00:28:34.830 --> 00:28:36.850
of the accident.

00:28:36.850 --> 00:28:40.410
My wife, who I knew was
deceased at the accident,

00:28:40.410 --> 00:28:43.500
she was there in
the light with me,

00:28:43.500 --> 00:28:45.990
and we began to have this
conversation where she

00:28:45.990 --> 00:28:48.570
was emphatic that I go back.

00:28:48.570 --> 00:28:49.920
You can't come.

00:28:49.920 --> 00:28:51.150
You've got to go back.

00:28:51.150 --> 00:28:55.320
And we were literally having
a very intense conversation

00:28:55.320 --> 00:29:00.820
about the fact that I had a
small son, a seven-year-old son

00:29:00.820 --> 00:29:03.190
in the back seat of
that car that was OK.

00:29:03.190 --> 00:29:06.310
And if I went with her,
he would be orphaned.

00:29:06.310 --> 00:29:09.580
And I literally made a choice.

00:29:09.580 --> 00:29:12.925
I made a choice to come
back into this realm.

00:29:19.430 --> 00:29:23.120
When I was 20 years old, I
gave birth to my first child.

00:29:23.120 --> 00:29:26.690
It was a very traumatic
labor through which

00:29:26.690 --> 00:29:30.020
I lost a huge amount of
blood and I was required

00:29:30.020 --> 00:29:31.940
to have a blood transfusion.

00:29:31.940 --> 00:29:35.810
And within a couple of hours of
the blood transfusion starting,

00:29:35.810 --> 00:29:38.900
I started to have a reaction.

00:29:38.900 --> 00:29:41.570
The next thing I knew, there
was an oxygen mask on my face

00:29:41.570 --> 00:29:44.240
and that's when I was
just mentally thinking

00:29:44.240 --> 00:29:45.500
to myself, what's happening?

00:29:45.500 --> 00:29:48.470
And I noticed that my
nails were turning blue,

00:29:48.470 --> 00:29:54.170
and that's about the point
where I thought, oh, I'm dying.

00:29:54.170 --> 00:29:58.430
Pretty much straight after that,
I was I'm going to say flying.

00:29:58.430 --> 00:29:59.540
I'm definitely going up.

00:29:59.540 --> 00:30:01.040
I'm going forward.

00:30:01.040 --> 00:30:03.170
There's a presence
with me, and we're

00:30:03.170 --> 00:30:05.630
shooting up and forward
in what I can only

00:30:05.630 --> 00:30:07.680
describe as a tunnel.

00:30:07.680 --> 00:30:10.220
We did that for a
while, and then we

00:30:10.220 --> 00:30:14.250
stopped and the scene
completely changed.

00:30:14.250 --> 00:30:18.020
I was in a room without walls,
without ceiling or a floor,

00:30:18.020 --> 00:30:21.290
and yet it felt
enclosed and personal.

00:30:21.290 --> 00:30:25.280
A big screen appears, you
could call it a screen,

00:30:25.280 --> 00:30:28.280
and it was playing my life.

00:30:28.280 --> 00:30:31.400
And I was watching it and
then I was reliving it

00:30:31.400 --> 00:30:35.480
and I was in that moment as if
I had just traveled back in time

00:30:35.480 --> 00:30:37.640
straight into that second.

00:30:37.640 --> 00:30:41.240
And with my new awareness
and this perspective

00:30:41.240 --> 00:30:45.300
that was vastly different to
the one I had while in my body,

00:30:45.300 --> 00:30:46.820
I was sort of judging myself.

00:30:46.820 --> 00:30:50.690
I was just exploring
each moment with,

00:30:50.690 --> 00:30:52.580
how did I respond
in that situation?

00:30:52.580 --> 00:30:54.120
Could I have done
that differently?

00:30:54.120 --> 00:30:59.060
Was there a better, more loving
approach to that situation?

00:30:59.060 --> 00:31:02.000
I would relive these
heated arguments

00:31:02.000 --> 00:31:04.460
feeling in the perspective
of the other person

00:31:04.460 --> 00:31:06.830
who's at the brunt
of my harsh words

00:31:06.830 --> 00:31:09.920
as I'm launching them
without real thought,

00:31:09.920 --> 00:31:12.920
and I would then stand in the
other person's perspective,

00:31:12.920 --> 00:31:16.430
perhaps it was my
mother or my father,

00:31:16.430 --> 00:31:20.690
and really feel how
hurtful that was,

00:31:20.690 --> 00:31:23.610
and that stayed with me as well.

00:31:23.610 --> 00:31:27.900
In this life review, the
most horrible, painful events

00:31:27.900 --> 00:31:34.460
of my life in which I very
deeply hurt someone else sort

00:31:34.460 --> 00:31:40.790
of went across I'll say the sky,
but it wasn't really the sky,

00:31:40.790 --> 00:31:43.310
but it was kind of here.

00:31:43.310 --> 00:31:47.240
When the event unfolded and
I was once again absorbed

00:31:47.240 --> 00:31:49.970
into that event,
intellectually I

00:31:49.970 --> 00:31:55.020
could recognize and remember
my emotional response to it,

00:31:55.020 --> 00:32:00.050
meaning remembering
the guilt or remorse

00:32:00.050 --> 00:32:04.790
that I felt after I had hurt
someone else or that anger.

00:32:04.790 --> 00:32:10.460
There was this absolute
shift in time, dimension.

00:32:10.460 --> 00:32:15.260
I could experience
thousands of things

00:32:15.260 --> 00:32:20.950
all at the same moment in
time, but I was experiencing

00:32:20.950 --> 00:32:25.670
each of them independently.

00:32:25.670 --> 00:32:29.300
I knew too much time had
gone by to still be alive,

00:32:29.300 --> 00:32:34.490
but I never had the experience
of feeling alive and then dead.

00:32:34.490 --> 00:32:38.090
I had the experience of
feeling alive and then

00:32:38.090 --> 00:32:42.380
more alive, conscious
and then more conscious,

00:32:42.380 --> 00:32:50.270
because this experience was
absolutely more real, more

00:32:50.270 --> 00:32:54.170
intense, more
vivid than anything

00:32:54.170 --> 00:32:55.805
I've experienced here on Earth.

00:32:59.010 --> 00:33:04.020
Who I am on this Earth,
Robert Montgomery,

00:33:04.020 --> 00:33:09.870
is in a way like the Earth,
and this other consciousness

00:33:09.870 --> 00:33:12.870
is like the cosmos.

00:33:12.870 --> 00:33:16.980
And I think that we're
not aware of that

00:33:16.980 --> 00:33:21.300
because it's just
too vast to imagine,

00:33:21.300 --> 00:33:27.170
and that's how it
felt. And I think

00:33:27.170 --> 00:33:29.660
it's drowned out by a light.

00:33:32.960 --> 00:33:37.660
And it was always like
that, the same every time.

00:33:43.050 --> 00:33:45.450
When these experiences
were first described

00:33:45.450 --> 00:33:48.990
almost 50 years ago, which
is a few years after CPR

00:33:48.990 --> 00:33:52.650
was discovered, many initially
tried to dismiss them,

00:33:52.650 --> 00:33:55.770
or they categorized them as
a sort of a brain disorder,

00:33:55.770 --> 00:33:59.070
an unreal experience that
was related to the trauma

00:33:59.070 --> 00:34:03.310
or accident or illness that had
been sustained by those people.

00:34:03.310 --> 00:34:06.210
But today we recognize
that that's not correct.

00:34:06.210 --> 00:34:09.120
The paradoxical
presence of lucidity

00:34:09.120 --> 00:34:13.590
and the ability to recall
real, verifiable events as well

00:34:13.590 --> 00:34:16.889
as a meaningful, accurate
review of their lives

00:34:16.889 --> 00:34:19.469
suggests these
can't be dismissed

00:34:19.469 --> 00:34:21.570
as unreal experiences,
whether you

00:34:21.570 --> 00:34:24.600
want to categorize them as
hallucinations, illusions,

00:34:24.600 --> 00:34:26.790
or delusions.

00:34:26.790 --> 00:34:29.400
Because people have these
visual experiences sometimes

00:34:29.400 --> 00:34:33.498
in their mystical states,
the implication some people

00:34:33.498 --> 00:34:35.790
draw from when they hear that
is that they're not real.

00:34:35.790 --> 00:34:36.748
And we don't find that.

00:34:36.748 --> 00:34:37.864
People don't report that.

00:34:37.864 --> 00:34:39.239
I want to move
away from the fact

00:34:39.239 --> 00:34:42.210
that people just see this as
a host of hallucinations that

00:34:42.210 --> 00:34:44.610
have nothing to do with
consensus, reality,

00:34:44.610 --> 00:34:46.889
that are a drug effect.

00:34:46.889 --> 00:34:49.830
More importantly, it seems to
be something along the lines of,

00:34:49.830 --> 00:34:51.870
everything is within the
psyche, and the psyche

00:34:51.870 --> 00:34:55.230
can produce profound
images and even

00:34:55.230 --> 00:34:58.590
visualizations that
may have meaning

00:34:58.590 --> 00:35:02.220
versus frank hallucinations
that may not be connected

00:35:02.220 --> 00:35:03.480
in some way to insight.

00:35:03.480 --> 00:35:06.150
Many patients have
a delirium or will

00:35:06.150 --> 00:35:09.660
have hallucinations
due to severe life

00:35:09.660 --> 00:35:10.920
threatening illness.

00:35:10.920 --> 00:35:15.420
Those patients are generally
confused, they are disoriented,

00:35:15.420 --> 00:35:20.460
and it is distinctly
different than what

00:35:20.460 --> 00:35:23.130
people with a near-death
experience report.

00:35:23.130 --> 00:35:27.000
People with a near-death
experience report with clarity.

00:35:27.000 --> 00:35:32.880
They will return with very
clear, focused messages

00:35:32.880 --> 00:35:36.300
and a purpose to their life.

00:35:36.300 --> 00:35:40.320
This is completely different
from an acute confused,

00:35:40.320 --> 00:35:42.930
delusional state.

00:35:42.930 --> 00:35:45.420
What we're seeing is
something completely bizarre,

00:35:45.420 --> 00:35:48.210
that what we're seeing is as
the brain is shutting down,

00:35:48.210 --> 00:35:51.750
this shutting down, this
disinhibition of brain

00:35:51.750 --> 00:35:55.230
processes is leading to the
activation of certain parts

00:35:55.230 --> 00:35:59.910
of the brain that are enabling
us to access realities

00:35:59.910 --> 00:36:02.040
in ways that we
couldn't do before,

00:36:02.040 --> 00:36:04.560
and that these people are
now coming back and reporting

00:36:04.560 --> 00:36:06.540
something that they
would otherwise not

00:36:06.540 --> 00:36:09.120
have been able to
access, and all of this

00:36:09.120 --> 00:36:11.850
leads to the natural
question, how

00:36:11.850 --> 00:36:15.420
are the brain, mind, and
consciousness connected?

00:36:15.420 --> 00:36:18.960
This is, of course,
an ancient question.

00:36:18.960 --> 00:36:22.350
The question of consciousness
is as old as humanity.

00:36:22.350 --> 00:36:25.890
But if we take an arbitrary
kind of starting point

00:36:25.890 --> 00:36:30.030
in the beginning of
Western philosophy

00:36:30.030 --> 00:36:33.990
and think about Plato and
Aristotle and ancient Greece,

00:36:33.990 --> 00:36:39.990
the language is really about
body and psyche, and later

00:36:39.990 --> 00:36:41.670
body and soul.

00:36:41.670 --> 00:36:45.360
The contemporary kind of
debates around consciousness

00:36:45.360 --> 00:36:48.810
are often talked about in
terms of the hard problem

00:36:48.810 --> 00:36:51.540
of consciousness and
then the easy problems

00:36:51.540 --> 00:36:54.420
of consciousness, which
is maybe misleading

00:36:54.420 --> 00:36:58.020
because they probably
are all hard problems,

00:36:58.020 --> 00:37:01.710
but I think what's meant by the
hard problem of consciousness

00:37:01.710 --> 00:37:06.300
is the relationship
between the physical brain

00:37:06.300 --> 00:37:10.560
and consciousness.

00:37:10.560 --> 00:37:14.220
So it just dates right back
to this ancient problem

00:37:14.220 --> 00:37:16.950
of psyche and body
or mind and body

00:37:16.950 --> 00:37:20.870
and how to bring
the two together.

00:37:20.870 --> 00:37:24.230
But when exactly is a
being said to be conscious?

00:37:24.230 --> 00:37:25.670
What about the pig study?

00:37:25.670 --> 00:37:28.010
Did those brains ever
become conscious again

00:37:28.010 --> 00:37:29.270
after they'd been dead?

00:37:29.270 --> 00:37:32.460
And what about patients who
are in a vegetative state?

00:37:32.460 --> 00:37:33.920
Are they conscious?

00:37:33.920 --> 00:37:36.890
In fact, how do we even
define consciousness

00:37:36.890 --> 00:37:38.675
and what is its
connection to the brain?

00:37:42.060 --> 00:37:46.910
There's two big ways that you
can approach consciousness,

00:37:46.910 --> 00:37:50.780
a monist approach or
a dualist approach,

00:37:50.780 --> 00:37:54.620
and monist approach says
there's only one kind of thing

00:37:54.620 --> 00:37:57.230
in the universe, fundamentally.

00:37:57.230 --> 00:38:02.750
And maybe that thing is just
physical stuff, space and time

00:38:02.750 --> 00:38:07.190
and particles, in which
case consciousness will have

00:38:07.190 --> 00:38:08.783
to in some sense be dismissed.

00:38:08.783 --> 00:38:10.700
You think that you have
conscious experiences,

00:38:10.700 --> 00:38:14.060
but you're really just
a bunch of particles.

00:38:14.060 --> 00:38:19.280
Dualism says there's two kinds
of stuff in the universe.

00:38:19.280 --> 00:38:23.090
There's physical stuff like
space and time and particles

00:38:23.090 --> 00:38:26.540
and there's consciousness
stuff, and that

00:38:26.540 --> 00:38:30.260
is more stuff like
experiences of headaches,

00:38:30.260 --> 00:38:35.390
the smell of garlic, the feeling
of velvet, the feeling of love,

00:38:35.390 --> 00:38:38.000
the sound of a trumpet,
those kinds of experiences.

00:38:38.000 --> 00:38:40.290
The physicalist approach
to consciousness,

00:38:40.290 --> 00:38:43.340
which says that brain
activity causes consciousness,

00:38:43.340 --> 00:38:46.670
does face a problem with
the new empirical results

00:38:46.670 --> 00:38:49.220
that we're getting from
resuscitation of patients

00:38:49.220 --> 00:38:52.340
after an hour of
no brain activity,

00:38:52.340 --> 00:38:56.450
and these patients
routinely are reporting

00:38:56.450 --> 00:38:59.000
very, very clear
conscious experiences

00:38:59.000 --> 00:39:04.070
of seeing a white light, a
tunnel, a life review, and so

00:39:04.070 --> 00:39:04.770
forth.

00:39:04.770 --> 00:39:08.090
And so all of the
physicalist theories

00:39:08.090 --> 00:39:11.780
of how brain activity could
cause conscious experiences

00:39:11.780 --> 00:39:15.320
are completely
incapable of explaining

00:39:15.320 --> 00:39:17.000
these conscious experiences.

00:39:17.000 --> 00:39:19.790
There is a huge
element of unknowns

00:39:19.790 --> 00:39:22.280
around this question
of what is happening

00:39:22.280 --> 00:39:24.050
at the time of cardiac
arrest, and when

00:39:24.050 --> 00:39:26.850
people are doing CPR
on somebody's body,

00:39:26.850 --> 00:39:29.122
where is that person's
consciousness?

00:39:29.122 --> 00:39:30.080
What is happening then?

00:39:30.080 --> 00:39:34.040
And people frequently come
out after an event like that

00:39:34.040 --> 00:39:36.590
and can describe things that
were happening in the room,

00:39:36.590 --> 00:39:40.340
can describe vivid, vivid
experiences and memories

00:39:40.340 --> 00:39:43.070
that they were having, and this
goes against everything that we

00:39:43.070 --> 00:39:45.650
know about how brains function.

00:39:45.650 --> 00:39:47.930
In the brainstem,
there is a pathway

00:39:47.930 --> 00:39:50.450
that kind of sends
impulses up to the brain

00:39:50.450 --> 00:39:53.600
and kind of consistently is
sending alertness messages,

00:39:53.600 --> 00:39:56.600
and this is called the ascending
reticular activating system.

00:39:56.600 --> 00:39:59.030
You have to have that
intact to be awake,

00:39:59.030 --> 00:40:01.910
and then in order to
experience conscious awareness,

00:40:01.910 --> 00:40:06.350
we think you also need a variety
of higher level brain networks.

00:40:06.350 --> 00:40:07.970
In the setting of
cardiac arrest,

00:40:07.970 --> 00:40:10.490
where presumably most
of those are offline,

00:40:10.490 --> 00:40:12.050
how are people
having these events?

00:40:12.050 --> 00:40:14.990
How are people laying down
memories when the memory

00:40:14.990 --> 00:40:17.750
networks are not working?

00:40:17.750 --> 00:40:21.050
Death is still a
mystery, but what we do

00:40:21.050 --> 00:40:25.880
know is that neither
biological nor mental processes

00:40:25.880 --> 00:40:30.170
seem to end with death, and that
with the exploration of death,

00:40:30.170 --> 00:40:34.340
we are now charting into
a new territory in science

00:40:34.340 --> 00:40:37.400
and medicine, much like
charting into the deepest

00:40:37.400 --> 00:40:41.850
depths of space and into
the complete unknown.

00:40:41.850 --> 00:40:45.030
What exactly happens to our
consciousness, ourselves,

00:40:45.030 --> 00:40:49.920
after death remains unclear,
but science does at a minimum

00:40:49.920 --> 00:40:53.520
suggest we do not seem
to become annihilated

00:40:53.520 --> 00:40:57.670
when we cross over into death
and into the great unknown,

00:40:57.670 --> 00:41:02.010
and that perhaps human actions,
human thoughts, and intentions

00:41:02.010 --> 00:41:02.625
do matter.

00:41:06.070 --> 00:41:09.640
I've certainly seen
patients close to death

00:41:09.640 --> 00:41:15.490
have that kind of eye-opening
awareness experience.

00:41:15.490 --> 00:41:18.070
I've seen instances
of patients who

00:41:18.070 --> 00:41:20.650
were minimally conscious
for days who came out

00:41:20.650 --> 00:41:26.650
of it hours or a day before
dying having absolutely

00:41:26.650 --> 00:41:30.070
lucid conversations
with their loved ones,

00:41:30.070 --> 00:41:32.170
going into the depths
of their relationship

00:41:32.170 --> 00:41:34.580
that they hadn't
ever done before.

00:41:34.580 --> 00:41:38.590
So I could see how that
intensification of awareness

00:41:38.590 --> 00:41:42.610
happens in a way that we would
have difficulty accomplishing

00:41:42.610 --> 00:41:46.900
on our own without that
moment of death facing us.

00:41:46.900 --> 00:41:50.950
Patients have told us things
that we can't explain,

00:41:50.950 --> 00:41:56.650
and so our temptation is to
just sort of brush it off

00:41:56.650 --> 00:42:00.850
in one way or another, and
I think that that's probably

00:42:00.850 --> 00:42:03.850
not the most helpful way
and it's not, certainly,

00:42:03.850 --> 00:42:06.290
the most scientific
way to approach it.

00:42:06.290 --> 00:42:09.370
I think instead we should
try to understand it more

00:42:09.370 --> 00:42:12.880
and learn what we can about
some of those stories that

00:42:12.880 --> 00:42:18.270
are some pretty hard to
explain stories otherwise.

00:42:18.270 --> 00:42:20.790
Based on the experience
and as I look at my life,

00:42:20.790 --> 00:42:23.770
it did change me.

00:42:23.770 --> 00:42:26.340
I'm not afraid of death
anymore, I know that.

00:42:26.340 --> 00:42:28.800
I mean, I quite look
forward to it sometimes.

00:42:28.800 --> 00:42:31.740
It's like, yeah, let's
be done with this

00:42:31.740 --> 00:42:33.630
and move on to the next thing.

00:42:33.630 --> 00:42:37.410
I did emerge from these
experiences kind of questioning

00:42:37.410 --> 00:42:39.790
why I had survived.

00:42:39.790 --> 00:42:41.820
I had this sort of
very clear feeling

00:42:41.820 --> 00:42:47.060
that there was work,
earthly work that was undone

00:42:47.060 --> 00:42:51.360
and hadn't reached where
it was intended to go.

00:42:51.360 --> 00:42:56.216
And so I feel very
driven by that,

00:42:56.216 --> 00:42:59.690
that there's some reason
why I'm still here,

00:42:59.690 --> 00:43:02.420
and I need to find
out what that is.

00:43:11.510 --> 00:43:14.120
Science and medicine
have significantly

00:43:14.120 --> 00:43:16.130
evolved our
understanding of death,

00:43:16.130 --> 00:43:19.100
and that includes ways to
prevent it and now perhaps even

00:43:19.100 --> 00:43:20.570
ways to reverse it.

00:43:20.570 --> 00:43:23.180
Although systematic
studies have not

00:43:23.180 --> 00:43:26.090
been able to absolutely
prove the reality

00:43:26.090 --> 00:43:28.490
or meaning of
people's experiences

00:43:28.490 --> 00:43:31.340
and claims of awareness
and consciousness

00:43:31.340 --> 00:43:33.470
in relation to
death, it has been

00:43:33.470 --> 00:43:35.540
impossible to
disclaim them either.

00:43:35.540 --> 00:43:38.120
We may not have all
the answers yet,

00:43:38.120 --> 00:43:40.340
but for now, what
we know definitively

00:43:40.340 --> 00:43:43.280
is that there is one
certainty in life,

00:43:43.280 --> 00:43:45.410
and that is death,
and that death

00:43:45.410 --> 00:43:48.440
itself is not what we
thought, and it simply

00:43:48.440 --> 00:43:50.690
seems to be the beginning
of something new.

00:43:56.990 --> 00:44:00.340
[MUSIC PLAYING]