This second article about Dr. Sam Parnia’s book “Erasing Death” is focused on the AWARE STUDY INITIAL FINDINGS.
Toward the end of the book the author presents the initial results from the AWARE Study, a trial involving approximately 15 hospitals, carried out between 2008-2012, which examined the occurrence of awareness and memories of cognitive processes during cardiac arrest while attempting to objectively verify claims of awareness using specific tests. These consisted in images installed in hospital areas where patients are more likely to suffer from cardiac arrest (e.g. intensive care units). These images were only visible from a point above (at the ceiling) and could not thus be seen by the medical personnel. If patients claimed to have been at the ceiling looking down and could recall these images, then what they say may have been real. In the opposite case, their perceptions could be questioned and be hallucinatory or illusory.
The study was confronted with numerous challenges such as, to name only a few:
- the fact that only 10-15% of patients who get resuscitated live long enough to be interviewed. The reasons for this are complex and reflect numerous challenges including the establishment of optimal resuscitation methods.
- that out of these, only 10% have some recall of memories of their experience compatible with NDEs
- that cases of awareness during cardiac arrest (i.e. patients observing their own resuscitation procedure, seeing their own body, recalling conversations of the medical personnel etc …) are only 1% of those who survive a cardiac arrest
This means that only 1 out of a thousand cardiac arrest patients has such an experience, will remember it and will have lived long enough to describe it.
Despite these challenges, the AWARE study has been completed (and also published - see (1) ). Also, worthy of mention, one patient was reported to recall seeing and hearing during cardiac arrest, albeit in an area with no images installed. This specific patient, despite having had a cardiac arrest (due to ventricular fibrillation – a severely abnormal heart rhythm that can be life-threatening) was able to clearly explain to professor Parnia hearing the automated defibrillator issue two separate instructions to "Shock the patient". These voice alerts (given by the machine) were up to 3 minutes apart and his brain could not have been functioning at that time otherwise the machine would not have detected ventricular fibrillation ... yet he heard them clearly and remembered them and also had other well-structured thoughts. If the patient had been awake and conscious (in a normal way) when the shocks were delivered, then he would have felt the pain ... which is variously described (by those unfortunate to be incorrectly shocked) as like being kicked by a mule or having your insides torn out. But the patient reported none of that. The man also described relocating to the corner of the room where he observed things that he previously wasn't able to see etc …
Parnia stresses that according to current neuroscience this is a paradox and should not be possible. It is in every sense the study of what happens after we die.
THE FUTURE OF THE AWARE STUDY
Parnia also explains how as AWARE Study (I) is completed, plans are in place to develop a more robust study. Any new study (such as Aware II) promises to lead to further improvements in cardio-pulmonary resuscitation (CPR), as well as further insights into the process of dying and some of its mental concomitants.
CONSCIOUSNESS, MIND, SOUL AND PSYCHE
Worthy of notice is Parnia’s writing on questions about the relationship between the human mind, the psyche, consciousness, or what people have classically called the soul, in other words the self, and its interaction with the brain. The author takes the reader back to the first diatribe, in ancient Greece, between Plato and Aristotle, the former claiming that consciousness / the psyche / the mind / the soul is an independent entity and the latter describing it as a product of the brain. These opposing views continue till now days since there is no scientific evidence, no scientific explanation that could show how a brain or a brain cell could generate thoughts, consciousness, feelings, emotions, everything that makes us into who we are. There are many things held to be true by scientists that are simply "beliefs" such as the fact the mind is limited to the brain that there's no such thing as free will.
Though this question is left open and despite most scientists argue that consciousness is simply a byproduct of chemical and electrical function in the brain, Dr Parnia points out that there is evidence which hints that this may not be correct at least in the immediate period after a cardiac arrest. This has been shown:
- during the Aware study (1), where the individual verified report of visual and auditory awareness (referred to sometimes as an out of body experience) during cardiac arrest was not typically consistent with a hallucination, illusion and instead corroborated with actual and real events.
- During a recent Dutch study (3) where at least one patient accurately reported being able to watch and recall events from his own cardiac arrest (compatible with conventional out of body experiences), and the validity of his claim were corroborated by hospital staff.
- In another recent study during cardiac arrest (2) and deep hypothermic circulatory arrest (4) that indicated that conscious awareness may paradoxically occur at a time when brain function ceases.
The book is a must read for anyone interested by the current state of research in the field of NDEs (ADEs) which is a new area of science. Rigorously written, with no religious content whatsoever, Sam Parnia, brings a lot of authority to this field of investigation since he is one of the few scientists actually doing research and publishing in scientific peer reviewed journals and since he has been working in this field for decades. This is unique since most people only have a very anecdotal knowledge of the literature and simply express personal opinions or philosophical views.
Finally, the author, whilst explaining difficult medical concepts in a language accessible to the layman, offers a rigorous and balanced view of the science which is rare.
As Parnia himself explained (5) “science works within a framework that people have developed over hundreds of years prior to any given moment in time. Everyone accepts reality as what is being confined within that framework. The problem is that if we only study what is within that framework we never advance, so you need to have people who are going to go to look for new things. Many of these may never come to fruition but if you never explore and ask the question, then you are never going to move up. But most people feel very uncomfortable and if you look at any scientific discovery people are always laughed at the beginning. That’s the way it is, unfortunately it is a bias in the system.”
So, kudos to Sam Parnia for his courage and perserverance!!
(1) Parnia, S., K. Spearpoint, G. de Vos, et al. 2014 AWARE-AWAreness during Resuscitation- a prospective study. Resuscitation. Doi: 10.1016/j.resuscitation.2014.09.004.
(2) Parnia, S., D. Waller, R. Yeates & P. Fenwick. 2001. A qualitative and quantitative study of the incidence, features and aetiology of near-death experiences in cardiac arrest survivors. Resuscitation 48: 149-156.
(3) Van Lommel P, van Wees R, Meyers V, Elfferich I. Near-death experience in survivors of cardiac arrest: a prospective study in the Netherlands. Lancet. 2001 Dec 15;358(9298):2039-45.
(4) Beauregard, M., E.L.St-Pierre, G. Rayburn & P. Demers. 2012 Conscious mental activity during a deep hypothermic cardiocirculatory arrest ? Resuscitation 83: e19.
(5) Sam Parnia. Do reports of consciousness during cardiac arrest hold the key to discovering the nature of consciousness? Medical Hypotheses. Volume 69, Issue 4, Pages 933-937, 2007.