Reynolds

The NDE of Pam Reynolds

A risky and complex operation of neurosurgery

This case was reported in the book by Michael Sabom Light and Death (1998). Pam Reynolds Lowery (1956-2010) was a child with a particular talent for playing violin and piano. After a training as a virtuoso in the classical repertoire, she began a career as a singer, author and arranger in the world of pop music. Mother of 3 children, in 1991, at the age of 35, Pam had to undergo a delicate brain surgery for the removal of a large arterial aneurysm, located near the brain stem, which put her in danger of life, since the breaking of the aneurysm would cause the destruction of the trunk and death. The size and position of the aneurysm precluded its removal through the usual neurosurgical techniques, so Pam was referred to a neurosurgeon, Dr. Robert F. Spetzler, at the Barrow Neurological Institute in Phoenix, Arizona, who had pioneered a daring surgical procedure known as deep hypothermic cardiac arrest. It allowed Pam's aneurysm to be excised with a reasonable chance of success. This operation, nicknamed standstill by the doctors who perform it, required Pam's body temperature to be lowered to 15.5°C (60°F) through a circulatory bypass, both her heartbeat and breathing to be stopped, her encephalogram to be flat, and her blood to be aspirated from the patient's brain. This happened to Pam who, in everyday terms, was put into a state of clinical death.

Technique of evoked potentials

Once brought into the surgery room, she was given a general anesthesia, which involves the use of a mixture of various drugs to keep the state of deep sleep, to paralyze the muscles and to prevent the perception of pain. A person in these conditions can not move, speak or breathe, and is therefore connected to an artificial respirator. During the anesthesia, the patient's mental state was monitored by an encephalogram (which had to be flat) and by the measurement of the brain's response to a sound emitted periodically from two earphones inserted into Pam's ears. This technique (called evoked potentials) checks the functioning of the brain stem and is an effective indicator of the depth of the anesthesia. The absence of these potentials indicates that the brain stem is not working.

Artificial cardiac arrest

Pam's head was fixed in the most suitable position and the rest of her body was covered with sterile drapes. As the neurosurgeon Robert Spetzler started working on the head, another cardiac surgeon (Dr. Murray) began a groin surgery to insert the heart bypass tubes into the blood vessels. In this way it was possible to let flow Pam's blood in a refrigerating machine up to bring it to the right low temperature. The temperature drop produced the expected cardiac arrest, so the blood circulation was maintained by the bypass. Once the body of Pam had cooled to 60°F, the blood circulation was stopped and the aneurysm was successfully removed. At this temperature the metabolism of the heart and the brain is slowed to such an extent that the blood circulation can be interrupted for about 45÷60 minutes without the tissues being damaged. After the aneurysm was removed, the cardiac bypass machine was restarted and the temperature returned to 37°C (98°F). The heartbeat was reactivated, the bypass was removed and Pam was brought back to life. During the period of anesthesia, Pam had an NDE. Her descriptions of some details of the operation observed from an out-of-body position, later proved to be rather accurate.

State of artificial death and unconsciousness

Pam's case is considered by some as an evidence of the truthfulness of observations in NDE status, for the patient's ability to effectively describe some specific and unusual surgical tools and procedures used, despite her brain being deemed inactive. To summarize how brain death is declared, we usually refer to three clinical tests. The first consists of the classic encephalogram (EEG) that measures brain wave activity. A flat EEG denotes the non-functioning of the cortex (the outermost part of the brain). Secondly, the absence of evoked potentials in response to the signals produced by the earphones indicates a state of total unconsciousness. Finally, the documentation of lack of blood flow to the brain indicates a generalized absence of brain functions. During the operation, Pam's brain was inactive for each of these three clinical tests (EEG was flat, the evoked potentials were absent and there was no blood flow in his brain). Yet during the operation Pam had an intense and profound NDE. When the vital functions of Pam were arrested by the anesthesia, the surgeon switched on the surgical saw and began to cut through the patient's skull. During this phase, Pam reported that she felt herself pop outside her body and hover above the operating table. Then she watched the doctors working on his lifeless body for a while. From her out-of-body position she saw the surgeon sawing into her skull with what looked to her like some sort of electric toothbrush. Pam heard and reported later what the nurses in the operating room had said and exactly what was happening during the operation. At that time, the monitors connected to Pam's body apparently did not register any brain activity.

Pam's NDE

At some point, Pam's consciousness floated out the operating room and ttraveled down a tunnel which had a light at the end of it, where her deceased relatives and friends were waiting, including her long-dead grandmother. Pam's NDE ended when her deceased uncle led her back to her body for her to reentered it. Pam compared the feeling of reentering her dead body to «plunging into a pool of ice». The following is Pam Reynolds' account of her NDE in her own words. (Source: www.near-death.com).

The next thing I recall was the sound: It was a natural D (music note). As I listened to the sound, I felt it was pulling me out of the top of my head. The further out of my body I got, the more clear the tone became. I had the impression it was like a road, a frequency that you go on... I remember seeing several things in the operating room when I was looking down. It was the most aware that I think that I have ever been in my entire life... I was metaphorically sitting on (the doctor's) shoulder. It was not like normal vision. It was brighter and more focused and clearer than normal vision... There was so much in the operating room that I didn't recognize, and so many people.

The shape of the saw with which the skullcap of Pam Reynolds was opened.
The patient's observations from her out-of-body position were quite accurate.

I thought the way they had my head shaved was very peculiar. I expected them to take all of the hair, but they did not…The saw-thing that I hated the sound of 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... And the saw had interchangeable blades, too, but these blades were in what looked like a socket wrench case... I heard the saw crank up. I didn't see them use it on my head, but I think I heard it being used on something. It was humming at a relatively high pitch and then all of a sudden it went: wrrrrrrrrr! like that.

Someone said something about my veins and arteries being very small. I believe it was a female voice and that it was Dr. Murray, but I'm not sure. She was the cardiologist. I remember thinking that I should have told her about that... I remember the heart-lung machine. I didn't like the respirator... I remember a lot of tools and instruments that I did not readily recognize. There was a sensation like being pulled, but not against your will. I was going on my own accord because I wanted to go. I have different metaphors to try to explain this. It was like the Wizard of Oz – being taken up in a tornado vortex, only you're not spinning around like you've got vertigo. You're very focused and you have a place to go. The feeling was like going up in an elevator real fast. And there was a sensation, but it wasn't a bodily, physical sensation. It was like a tunnel but it wasn't a tunnel.

At some point very early in the tunnel vortex I became aware of my grandmother calling me. But I didn't hear her call me with my ears... It was a clearer hearing than with my ears. I trust that sense more than I trust my own ears. The feeling was that she wanted me to come to her, so I continued with no fear down the shaft. It's a dark shaft that I went through, and at the very end there was this very little tiny pinpoint of light that kept getting bigger and bigger and bigger. The light was incredibly bright, like sitting in the middle of a light bulb. It was so bright that I put my hands in front of my face fully expecting to see them and I could not. But I knew they were there. Not from a sense of touch. Again, it's terribly hard to explain, but I knew they were there.

Figures in the light

I noticed that as I began to discern different figures in the light – and they were all covered with light, they were light, and had light permeating all around them – they began to form shapes I could recognize and understand. I could see that one of them was my grandmother. I don't know if it was reality or a projection, but I would know my grandmother, the sound of her, anytime, anywhere. Everyone I saw, looking back on it, fit perfectly into my understanding of what that person looked like at their best during their lives. I recognized a lot of people. My uncle Gene was there. So was my greatgreat-Aunt Maggie, who was really a cousin. On Papa's side of the family, my grandfather was there... They were specifically taking care of me, looking after me. They would not permit me to go further... It was communicated to me – that's the best way I know how to say it, because they didn't speak like I'm speaking – that if I went all the way into the light something would happen to me physically. They would be unable to put this me back into the body me, like I had gone too far and they couldn't reconnect. So they wouldn't let me go anywhere or do anything.

Energetic nourishment

I wanted to go into the light, but I also wanted to come back. I had children to be reared. It was like watching a movie on fast-forward on your VCR: You get the general idea, but the individual freeze-frames are not slow enough to get detail. Then they (deceased relatives) were feeding me. They were not doing this through my mouth, like with food, but they were nourishing me with something. The only way I know how to put it is something sparkly. Sparkles is the image that I get. I definitely recall the sensation of being nurtured and being fed and being made strong. I know it sounds funny because obviously it wasn't a physical thing, but inside the experience I felt physically strong, ready for whatever. My grandmother didn't take me back through the tunnel, or even send me back or ask me to go. She just looked up at me. I expected to go with her, but it was communicated to me that she just didn't think she would do that.

The return

My uncle said he would do it. He's the one who took me back through the end of the tunnel. Everything was fine. I did want to go. But then I got to the end of it and saw the thing, my body. I didn't want to get into it... It looked terrible, like a train wreck. It looked like what it was: dead. I believe it was covered. It scared me and I didn't want to look at it. It was communicated to me that it was like jumping into a swimming pool. No problem, just jump right into the swimming pool. I didn't want to, but I guess I was late or something because he (the uncle) pushed me. I felt a definite repelling and at the same time a pulling from the body. The body was pulling and the tunnel was pushing... It was like diving into a pool of ice water... It hurt! When I came back, they were playing Hotel California and the line was You can check out anytime you like, but you can never leave. I mentioned (later) to Dr. Brown that that was incredibly insensitive and he told me that I needed to sleep more. When I regained consciousness, I was still on the respirator.

The opinion of an anesthesiologist

Regarding this case, it was observed that the period during which Pam Reynolds remained under anesthesia was much longer than that of clinical death strictly necessary for the removal of the aneurysm. It may be interesting to read the opinion of a Dutch anesthesiologist, Dr. Gerald Woerlee, who in his book Mortal Minds: The Biology of Near Death Experiences (2005), explains how, from a neurological point of view, there are sometimes cases in which a condition of the patient, perceived from the outside as unconscious even with the aid of monitoring devices, corresponds instead to a conscious and alert inner state. A particularly significant (and dramatic) example is the locked-in syndrome, in which the patient's body is unable to show any signal indicating the presence of a conscious state, while consciousness is active, and the conscious Ego is able to perceive, feel and think. But it is especially when complete anesthesia is practiced that some of the substances of which the anesthetic is composed can have only a partial effect, without the anesthesiologist noticing it or that the instruments adequately monitor the ineffectiveness of sedation. Sometimes it happened that patients suffered excruciating pain during an operation (the so-called conscious anesthesia), without their body being able to make the slightest movement to signal the condition of consciousness. If you are interested in the subject, you can visit Woerlee's website, www.neardth.com.

Doubts about the functioning of the brain in some cases of NDE

There are, however, other researchers, such as Dr. Pim van Lommel (see the page on medical evidence), who claim that, in some cases, NDEs have occurred in conditions in which the brain activity that determines the conscious experiences and their memory retention should be absent, or at least significantly reduced. Total anesthesia and the recording of a flat electroencephalogram should constitute a sufficient guarantee of a condition of total unconsciousness, in which no signal processed by the brain should reach the patient's consciousness. Regarding the NDEs occurring concurrently with these conditions, the supporters of the thesis that all NDEs are determined by brain activity, however, suggest one of the following explanations:

NDEs do not occur during total unconsciousness, but probably in the initial or in the awakening phase of anesthesia.
The substances that determine the patient's sleep and loss of consciousness have not been administered in the right dose or have not proven effective (without being detected due to defective instruments).
The instruments that record the electroencephalogram have not been calibrated well or do not work well, so what appears to be a flat electroencephalogram is not really so.

None of these explanations can be considered entirely convincing in light of the large number of experiences examined by medical specialists during the surveys. In the case of Pam Reynolds, her NDE seems to have started coinciding with the opening of the skullcap and the preparatory phase of blood cooling, and ended with the return of ordinary consciousness when the operation was over: in the central phase of the operation there was a period of more than an hour during which the blood was drained from the patient's brain to allow the removal of the aneurysm, and the electroencephalogram was absolutely flat. Despite this, Reynolds' NDE seems to have a consistent continuity that should also include the phase of absence of cerebral activity, unless we hypothesize that it took place in two stages, before and after this phase, and that the two parts were then united in a single experience. Ultimately, attentive and intellectually curious readers can obtain their own information about NDEs from various sources, such as the texts written by Dr. van Lommel or those of Dr. Woerlee, both well-known specialists, and then practice examining their own arguments and the reactions induced by their psyche for or against one or the other thesis. Nothing more can be done, because the very fact that experienced and competent researchers express such different convictions is symptomatic of the current limits of our knowledge concerning the brain functioning and the resulting mental states.