Now, I'm not saying explicitly that the below article is the correct version of events, but it is presented merely as information to counter the claim that her experiences were paranormal, thus, it is refutable. Unfortunately, the scientific/medical side of this story is a little too technical for me to consider it an enjoyable subject.
"As Michael Sabom recounts in Light and Death, in August 1991 a then 35-year-old woman he called "Pam Reynolds" (a pseudonym) underwent an innovative procedure to remove a brain aneurysm. The procedure—inducing hypothermic cardiac arrest or "standstill"—involved lowering Pam's body temperature to 60°F, stopping her heart and breathing, and draining the blood from her brain to cool it and then reintroduce it. When her body temperature had reached 60°F and she had no electrical activity in her brain, her aneurysm was removed. About 2 hours after awaking from general anesthesia, Pam was moved into the recovery room still intubated (Sabom, "Light" 46-47). At some point after that, the tube was removed from her trachea and she was able to speak. She reported a classic NDE with a vivid OBE, moving through a "tunnel vortex" toward a "pinpoint of light" that continually grew larger, hearing her deceased grandmother's voice, encountering figures in a bright light, encountering deceased relatives who gave her "something sparkly" to eat, and being 'returned' to her body by her deceased uncle (Sabom, "Light" 42-46).
The case was quickly celebrated because of the lack of synaptic activity within the procedure and Pam's report of an apparently veridical OBE at some point during the operation. But it has been sensationalized at the expense of the facts, facts which have been continually misrepresented by some parapsychologists and near-death researchers. Although hailed by some as "the most compelling case to date of veridical perception during an NDE" (Corcoran, Holden, and James), and "the single best instance we now have in the literature on NDEs to confound the skeptics" (Ring, "Religious Wars" 218), it is in fact best understood in terms of normal perception operating during an entirely nonthreatening physiological state.
Two mischaracterizations of this case are particularly noteworthy, as their errors of fact greatly exaggerate the force of this NDE as evidence for survival after death. First, in their write-up of the first prospective study of NDEs, van Lommel and colleagues write:
Sabom mentions a young American woman who had complications during brain surgery for a cerebral aneurysm. The EEG [electroencephalogram] of her cortex and brainstem had become totally flat. After the operation, which was eventually successful, this patient proved to have had a very deep NDE, including an out-of-body experience, with subsequently verified observations during the period of the flat EEG [emphasis mine] (van Lommel et al. 2044).
Second, in his Immortal Remains—an assessment of the evidence for survival of bodily death—Stephen Braude erroneously describes the case as follows:
Sabom reports the case of a woman who, for about an hour, had all the blood drained from her head and her body temperature lowered to 60 degrees. During that time her heartbeat and breathing stopped, and she had both a flat EEG and absence of auditory evoked potentials from her brainstem.... Apparently during this period she had a detailed veridical near-death OBE [emphasis mine] (Braude 274).
But anyone who gives Sabom's chapters on the case more than a cursory look will see two glaring errors in the descriptions above. First, it is quite clear that Pam did not have her NDE during any period of flat EEG. Indeed, she was as far as a patient undergoing her operation could possibly be from clinical death when her OBE began. Second, she had no cerebral cortical activity for no longer than roughly half an hour. Both of these facts are nicely illustrated in Figure 1 below.
Fig. 1. Timeline of Pam Reynolds' general anesthesia. The colored areas represent changes in body temperature: Green indicates a life-sustaining temperature; yellow, the mechanical cooling or warming of blood; red, the constant temperature of her deepest hypothermia. Most times marking events or temperatures are derived from Michael Sabom's account of Pam Reynolds' procedure provided in Chapters 3 & 10 of Light & Death.
Despite accurately reporting the facts, Sabom himself has encouraged these misrepresentations. Though he informs the reader that Pam's experience began well before standstill, he reveals this incidentally, so that a careful reading of the text is required to discern the point. For instance, just after describing Pam's recollections of an operating room conversation, he notes, almost as an afterthought, that "[h]ypothermic cardiac arrest would definitely be needed" [emphasis mine] (Sabom, "Light" 42). He then goes on to assert that the very features of her experience which cannot be timed happened during standstill. At first, Sabom only implies this by describing the cooling of blood leading to standstill prior to describing the remainder of Pam's near-death experience (42-46). Then Sabom turns to a discussion of whether Pam was "really" dead during a portion of her standstill state:
But during "standstill," Pam's brain was found "dead" by all three clinical tests—her electroencephalogram was silent, her brain-stem response was absent, and no blood flowed through her brain. Interestingly, while in this state, she encountered the "deepest" near-death experience of all Atlanta Study participants....
With this information, can we now scientifically assert that Pam was either dead or alive during her near-death experience? Unfortunately, no. Even if all medical tests certify her death, we would still have to wait to see if life was restored [emphasis mine] (Sabom, "Light" 49).
Of course, the issue of whether Pam was "really" dead within standstill is an extraordinarily misleading red herring in this context. And it is blatantly irresponsible for Sabom to explicitly state that her NDE occurred "while in this state." As Sabom's own account reveals, her standstill condition had absolutely nothing to do with the time when we know that her near-death OBE began: A full two hours and five minutes before the medical staff even began to cool her blood, during perfectly normal body temperature! (Again, see Figure 1.)
Unlike the other elements of her NDE, we can precisely time when Pam's OBE began because she did accurately describe an operating room conversation. Namely, she accurately recalled comments made by her cardiothoracic surgeon, Dr. Murray, about her "veins and arteries being very small" (Pam's words) (Sabom, "Light" 42). Two operative reports allow us to time this observation. First, in the head surgeon's report, Dr. Robert Spetzler noted that when he was cutting open Pam's skull, "Dr. Murray performed bilateral femoral cut-downs for cannulation for cardiac bypass" (185). So at about the same time that Dr. Spetzler was opening Pam's skull, Dr. Murray began accessing Pam's blood vessels so that they could be hooked up to the bypass machine which would cool her blood and ultimately bring her to standstill. Second, Dr. Murray's operative report noted that "the right common femoral artery was quite small" and thus could not be hooked up to the bypass machine. Consequently, Murray's report continues, "bilateral groin cannulation would be necessary: This was discussed with Neurosurgery, as it would affect angio access postoperatively for arteriography" (185). And although Pam's mother was given a copy of the head surgeon's operative report (which she said Pam did not read), the report did not say anything about any of Pam's arteries being too small (Sabom, "Shadow" 7).
Many have argued that Pam's accurate recall of an operating room conversation is strong evidence that she really did leave her body during the procedure. But there is at least one peculiar fact about Pam's recollections—in addition to the timing of her experience—which makes a physiological explanation of her OBE much more likely.
General anesthesia is the result of administering a trio of types of drugs: sedatives, to induce sleep or prevent memory formation; muscle relaxants, to ensure full-body paralysis; and painkillers. Inadequate sedation alone results in anesthesia awareness. Additionally, if insufficient concentrations of muscle relaxants are administered, a patient will be able to move; and if an inadequate amount of painkillers are administered, a patient will be able to feel pain (Woerlee, "Anaesthesiologist" 16). During a typical surgical procedure, an anesthesiologist must regularly administer this trio of drugs throughout the operation. But just prior to standstill, anesthetic drugs are no longer administered, as deep hypothermia is sufficient to maintain unconsciousness. The effects of any remaining anesthetics wear off during the warming of blood following standstill (G. Woerlee, personal communication, November 8, 2005).
About one or two in a thousand patients undergoing general anesthesia report some form of anesthesia awareness. That represents between 20,000 and 40,000 patients a year within the United States alone. A full 48% of these patients report auditory recollections postoperatively, while only 28% report feeling pain during the experience (JCAHO 10). Moreover, "higher incidences of awareness have been reported for caesarean section (0.4%), cardiac surgery (1.5%), and surgical treatment for trauma (11-43%)" (Bünning and Blanke 343). Such instances must at least give us pause about attributing Pam's intraoperative recollections to some form of out-of-body paranormal perception. Moreover, for decades sedative anesthetics such as nitrous oxide have been known to trigger OBEs.
Sometime after 7:15 AM that August morning, general anesthesia was administered to Pam Reynolds. Subsequently, her arms and legs were tied down to the operating table, her eyes were lubricated and taped shut, and she was instrumented in various other ways (Sabom, "Light" 38). A standard EEG was used to record activity in her cerebral cortex, while small earphones continuously played clicks into her ears to invoke auditory evoked potentials (AEPs), a measure of activity in the brain stem (39).
Sabom considers whether conscious or semiconscious auditory perceptions were incorporated into Pam's OBE imagery during a period of anesthesia awareness, but dismisses the possibility all-too-hastily:
Could Pam have heard the intraoperative conversation and then used this to reconstruct an out-of-body experience? At the beginning of the procedure, molded ear speakers were placed in each ear as a test for auditory and brain-stem reflexes. These speakers occlude the ear canals and altogether eliminate the possibility of physical hearing (Sabom, "Light" 184).
But is this last claim really true? Since Sabom merely asserts this (and has an obvious stake in it being true), we have little reason to take him at his word—especially on such a crucial point. What is the basis for his assertion? Does he have any objective evidence that the earphones used to measure AEPs completely cut off sounds from the external environment?
Since Sabom does not back up this claim in Light and Death, I did a little research and discovered that his claim is indeed false. According to the National Institute of Neurological Disorders and Stroke, as a matter of procedure, a patient who is monitored by the very same equipment to detect acoustic neuromas (benign brain tumors) "sits in a soundproof room and wears headphones" (NINDS). But a soundproof room would be unnecessary, of course, if the earphones used to measure AEPs "occlude the ear canals and altogether eliminate the possibility of physical hearing." It is theoretically possible that the earphones used in 1991 made physical hearing impossible, whereas the earphones used today do not. However, it highly unlikely, as it would be far cheaper for medical institutions to continue to invest in the imagined sound-eliminating earphones, rather than soundproofing entire rooms to eliminate external sounds. As Gerald Woerlee points out, "earplugs do not totally exclude all external sounds, they only considerably reduce the intensity of external sounds," as demonstrated by "enormous numbers of people ... listening to loud music played through earplugs, while at the same time able to hear and understand all that happens in their surroundings" (Woerlee, "Pam").
After being prepped for surgery, Pam's head was secured by a clamp. By 8:40 AM, her entire body was draped except for her head (the site of the main procedure) and her groin (where blood vessels would be hooked up to the bypass machine to cool her blood). In the five minutes or so to follow, Dr. Spetzler would open her scalp with a curved blade, fold back her scalp, then begin cutting into her skull with a Midas Rex bone saw (39-41). At this point, about an hour and a half after being anesthetized, Pam's OBE began (185). She reported being awakened by the sound of a natural D, then being "pulled" out of the top of her head by the sound (41).
"But," Sabom asks, "was Pam's visual recollection from her out-of-body experience accurate?" (186). That is indeed the question to ask regarding the veridicality of her report.
Pam reported that during her OBE, she was able to view the operating room from above the head surgeon's shoulder, describing her out-of-body vision as "brighter and more focused and clearer than normal vision" (41). In her report of the experience, she offered three verifiable visual observations. First, she said that "the way they had my head shaved was very peculiar. I expected them to take all of the hair, but they did not." Second, she reported that the bone saw "looked like an electric toothbrush and it had a dent in it, a groove at the top where the saw appeared to go into the handle, but it didn't." Finally, she noted that "the saw had interchangeable blades ... in what looked like a socket wrench case" (41). Subsequently, she only reported auditory observations—hearing the bone saw "crank up" and "being used on something"—but most notably the operating room conversation initiated by Dr. Murray.
Given such vivid 'perceptual capabilities' during her OBE, we would expect there to be no confusion about what Pam saw during the experience. So her visual observations provide an interesting test of the notion that her soul left her body while under general anesthesia during normal body temperature. Let us look at each of these in turn.
First, there is the observation that only part of her head was shaved. Perhaps she could have guessed this at the time of her experience, but there is no need even for this in order to account for the reported observation. Surely Pam would have noticed this soon after awaking from general anesthesia—by seeing her reflection, feeling her hair, or being asked about it by visitors. And she certainly would have known about it, one way or the other, by the time she was released from the hospital. Indeed, if her hair had been shaved presurgery, or at any time prior to her general anesthesia, she would have known about it well before her OBE. And patients undergoing such a risky procedure are standardly given a consent briefing where even the cosmetic effects of surgery are outlined—if not explicitly in a doctor's explanation, then at least incidentally in any photographs, diagrams, or other sources illustrating what the procedure entails. So Pam may have learned (to her surprise) that her head would be only partially shaved in a consent briefing prior to her experience, but 'filed away' and consciously forgot about this information given so many other more pressing concerns on her mind at the time. That would be exactly the sort of mundane, subconscious fact we would expect a person to recall later during an altered state of consciousness. And although we are not given the exact date of the operation, Sabom reports that the procedure took place in August 1991 (38). He later tells us that he interviewed Pam for the first time on November 11, 1994 (186). That leaves over three years between the date of Pam's NDE and Sabom's interview—plenty of time for memory distortions to have played a role in her report of the experience. So there is nothing remarkable about this particular observation.
Second, there is her description of the bone saw. But the very observation that provides the greatest potential for supporting the notion that she actually left her body during her OBE actually tends to count against that hypothesis. As Sabom recounts,
Pam's description of the bone saw having a "groove at the top where the saw appeared to go into the handle" was a bit puzzling.... [T]he end of the bone saw has an overhanging edge that [viewed sideways] looks somewhat like a groove. However, it was not located "where the saw appeared to go into the handle" but at the other end.
Why had this apparent discrepancy arisen in Pam's description? Of course, the first explanation is that she did not "see" the saw at all, but was describing it from her own best guess of what it would look and sound like (187).
Precisely! Except that, of course, Pam didn't need to guess what the bone saw sounded like, since she probably heard it as anesthesia failed. An out-of-body discrepancy within Pam's NDE prima facie implies the operation of normal perception and imagination within an altered state of consciousness. Indeed, this explanation is so straightforward that Sabom considers it before all others. And it is telling that the one visual observation that Pam (almost) could not have known about other than by leaving her body was the very detail that was not accurate.
Let us turn to the report of Pam's final visual observation during her OBE, her comment that the bone saw used "interchangeable blades" placed inside something "like a socket wrench case." This detail was also accurate; however, one need not invoke paranormal perceptual capabilities to explain it. As Woerlee notes,
[S]he knew no-one would use a large chain saw or industrial angle cutter to cut the bones of her skull open.... Pneumatic dental drills with the same shapes, and making similar sounds as the pneumatic saw used to cut her skull open, were in common use during the late 1970s and 1980s. Because she was born in 1956, a generation whose members almost invariably have many fillings, Pam Reynolds almost certainly had fillings or other dental work, and would have been very familiar with the dental drills. So the high frequency sound of the idling, air-driven motor of the pneumatic saw, together with the subsequent sensations of her skull being sawn open, would certainly have aroused imagery of apparatus similar to dental-drills in her mind when she finally recounted her remembered sensations. There is another aspect to her remembered sensations—Pam Reynolds may have seen, or heard of, these things before her operation. All these things indicate how she could give a reasonable description of the pneumatic saw after awakening and recovering the ability to speak (Woerlee, "Anaesthesiologist" 18).
And, predictably enough, the dental drills in question also used interchangeable burs stored in their own socket-wrench-like cases.
During anesthesia awareness, and as far from standstill as a person under general anesthesia can be, Pam could have heard her surroundings, but not seen them, since her eyes were taped shut. And the facts of her case strongly suggest that this is exactly what happened. Information that she could have obtained by hearing was highly accurate; at the same time, information that was unavailable to her through normal vision was the very information which was inaccurate. More precisely, her visual descriptions were only partially accurate: accurate on details she could have plausibly guessed or easily learned about subsequent to her experience, and inaccurate on details that it would be difficult to guess correctly.
In other words, OBE imagery derived from hearing and background knowledge, perhaps coupled with the reconstruction of memory, fully accounts for the most interesting details of Pam Reynolds' NDE report. After awakening from inadequate anesthesia by the sound of the bone saw revving up, her mind generated a plausible image of what the bone saw used during her operation looked like, rendered from her prior knowledge of similar-sounding dental drills. But her best guess about the appearance of the bone saw was inaccurate regarding the features of the bone saw that only true vision could discern: whether there was a true groove in the instrument, and where it was located.
Moreover, the fact that Pam's NDE began during an entirely nonthreatening physiological condition—under general anesthesia at normal body temperature—implies that there was no particular physiological trigger for the experience (such as anoxia/hypoxia). Rather, it appears that her NDE was entirely expectation-driven. Before going into surgery, Pam was fully aware that she would be taken to the brink of death while in the standstill state. Awakening from general anesthesia by the sound of the bone saw appears to have induced a fear response, which in turn caused Pam to dissociate and have a classic NDE. Indeed, this makes sense of her otherwise odd report of being pulled out of the top of her head by the sound of the saw itself.
At least five separate studies (Gabbard, Twemlow, and Jones; Stevenson, Cook, and McClean-Rice; Gabbard and Twemlow; Serdahely, "Variations"; Floyd) have documented cases where fear alone triggered an NDE. As Ian Stevenson, Emily Williams Cook (now Emily Williams Kelly), and Nicholas McClean-Rice conclude, "an important precipitator of the 'near-death experience' is the belief that one is dying—whether or not one is in fact close to death" (Stevenson, Cook, and McClean-Rice 45). They go on to label those (otherwise indistinguishable) NDEs precipitated by fear of death alone "fear-death experiences" (FDEs). Physiologically, such NDEs might be mediated by a fight-or-flight response in the absence of an actual medical crisis. In a case reported by Glen Gabbard and Stuart Twemlow, an NDEr dislodged the pin of a dummy grenade he thought to be a live one, producing a classic NDE similar to the one Pam experienced:
A marine sergeant was instructing a class of young recruits at boot camp. He stood in front of a classroom holding a hand grenade as he explained the mechanism of pulling the pin to detonate the weapon. After commenting on the considerable weight of the grenade, he thought it would be useful for each of the recruits to get a "hands-on" feeling for its actual mass. As the grenade was passed from private to private, one 18-year-old recruit nervously dropped the grenade as it was handed him. Much to his horror, he watched the pin become dislodged as the grenade hit the ground. He knew he only had seconds to act, but he stood frozen, paralyzed with fear. The next thing he knew, he found himself traveling up through the top of his head toward the ceiling as the ground beneath him grew farther and farther away. He effortlessly passed through the ceiling and found himself entering a tunnel with the sound of wind whistling through it. As he approached the end of this lengthy tunnel, he encountered a light that shone with a special brilliance, the likes of which he had never seen before. A figure beckoned to him from the light, and he felt a profound sense of love emanating from the figure. His life flashed before his eyes in what seemed like a split-second. In midst of this transcendent experience, he suddenly realized that grenade had not exploded. He felt immediately "sucked" back into his body (Gabbard and Twemlow 42).
Gabbard and Twemlow conclude that "thinking one is about to die is sufficient to trigger the classical NDE" (42). After comparing experiences that occurred in nonthreatening conditions with those where subjects were actually close to death, they also concluded that no particular elements were "exclusive to near-death situations," but "several features of the experiences were significantly more likely to occur when the individual felt that death was close at hand" [emphasis mine] (42). That expectation alone can trigger NDEs in certain individuals, then, is well-documented.
If Pam had truly been out of body and perceiving, both her auditory and visual sensations should've been accurate; but when it came to details that could not have been guessed or plausibly learned after the fact, only her auditory information was accurate. Moreover, it is significant that as her narrative continues beyond the three visual observations outlined above, the remainder of her reported out-of-body perceptions are exclusively auditory. Finally, it is interesting that Pam reports uncertainly about the identity of the voice she heard when her OBE began: "I believe it was a female voice and that it was Dr. Murray, but I'm not sure" (Sabom, "Light" 42).
These facts strongly imply anesthesia awareness, and tend to count against the idea that Pam's soul left her body during the operation. If her soul had left her body, the fact that her account contains out-of-body discrepancies doesn't make much sense. But it makes perfect sense if she experienced anesthesia awareness, particularly when one looks at which sorts of information that she provided were accurate and which were not. Pam Reynolds did not report anything that she could not have learned about through normal perception, and this is exactly what we would expect if normal perception alone was operating during her OBE. It is little wonder that Fox concludes that "the jury is still very much out over this case" (Fox 210)." http://www.infidels.org/library/modern/ ... HNDEs.html