-Sai Lavanya Patnala, Intern, Apollo Institute of Medical Sciences and Research, Hyderabad

Ascent of the Blessed by Hieronymus Bosch, circa 1504-1505


For decades now, scientists have asked the question of where a person’s consciousness lies once a person dies. Significant cultural beliefs of after-life and the essence of life not being limited to a physical embodiment have always prodded into these questions. A phenomenon that makes scientists question whether the seat of consciousness lies in the most evolved organ on the planet: the brain or the non-physical spiritual world etched into our ancestry through religious and other metaphysical beliefs is the NDE’s or Near-death experiences described by many.


According to Wikipedia, a near-death experience (NDE) is a profound personal experience associated with death or impending death which researchers describe as having similar characteristics.

A number of contemporary sources report the incidence of near-death experiences as 17% amongst critically ill patients and 10–20% of people who have come close to death like cardiac arrest survivors. [1]

These experiences were reported to be highly lucid, “realer than real,” and common to people from diverse cultural and religious backgrounds [7]


The earliest mention of NDE’s in known literature goes back to 1740 when Pierre-Jean du Monchaux, a military physician from northern France, described a case of near-death experience in his book “Anecdotes de Médecine.” He speculated that too much blood flow to the brain could explain the mystical feelings people report after coming back to consciousness.[2]

Dr.Christof Koch analysed a series of accounts including the one described by Sir Francis Beaufort, who nearly drowned in 1791 and described how a feeling of “tranquillity succeeded the most tumultuous sensation” [3]

In the 1890s, French psychologist and epistemologist Victor Egger introduced the equivalent French term experience de mort imminente (“experience of imminent death”).

Albert Heim first described this phenomenon as a clinical syndrome in 1892 describing a series of subjective observations by workers falling from scaffolds, war soldiers who suffered injuries, climbers who had fallen from heights or other individuals who had come close to death (near drownings, accidents)[1]


Scientific investigation of NDEs has accelerated over the past decades in part because of the improvement of resuscitation techniques. Therefore, these non‐ordinary states of consciousness have been increasingly reported, with an incidence estimated around 10–23% after recovery from cardiac arrest but only in 3% after traumatic brain injury.[4]

Psychologist Chris French has grouped approaches to explain NDEs in three broad groups: spiritual theories (also called transcendental), psychological theories, and physiological theories that provide a physical explanation for NDEs. [1]

Altered activity in the medial temporal area and the temporoparietal junction has been studied as a possible mechanism underlying NDEs-like. Both direct cortical stimulation and altered functioning (e.g., due to damage or seizures) of these brain regions might produce NDE-like features. [5]

A 2019 large-scale study found that ketamine, Salvia divinorum, and DMT (and other classical psychedelic substances) are linked to near-death experiences.[1]

A retrospective study was done in the Neurointensive care unit at University of Michigan since 2023 analyzed the EEGs of four dying patients before and after the clinical withdrawal of their ventilatory support and found that the resultant hypoxia was responsible for the surge of gamma oscillations (>25Hz) in both local, within the temporo–parieto–occipital (TPO) junctions, and global between the TPO zones and the contralateral prefrontal areas.[7]


Dr Moody described nine stages of an NDE, although most events do not contain every stage. In the context of a person who is agonal or clinically moribund, the patient may report:

–        Sudden peace and relief from pain.

–        Perception of a relaxing sound or other-worldly music.

–        Consciousness or spirit ascending above the person’s body and remotely viewing the attempts at resuscitation from the ceiling (autoscopy).

–        The person’s spirit leaving the earthly realm and ascending rapidly through a tunnel of light in a universe of darkness.

–        Arriving at a brilliant “heavenly place.”

–        Being met by “people of the light,” who are usually deceased friends and family, in a joyous reunion.

–        Meeting with a deity that is often perceived just as their religious culture would have perceived them or as an intense mass emitting love and light.

–        In the presence of the deity, the person undergoes an instantaneous life review and understands how all the good and bad they have done has affected them and others.

–        The person returns to their earthly body and life, because either they are told it is not their time to die, or they are given a choice and they return for the benefit of their family and loved ones.[6]

An out-of-body experience (OBE) is always part of an NDE, but an OBE may occur in other settings. Fainting, deep sleep, and alcohol or drug use may cause a person to report an OBE, during which they leave their body and view it briefly from a position outside the body, without the other phases of an NDE.[6]

The correct approach to both diagnose and treat NDE patients is simple: Ask, Listen, Validate, Educate, Refer. [6]


NDE’s represent a biological paradox that challenges our fundamental understanding of the dying brain, which is widely believed to be non-functioning under such conditions.[7]

At present, there is limited understanding of the NDE phenomenon and many scientists use different descriptions that likely lead to distinct conclusions concerning the phenomenon and its causes. Advances in classical NDE understanding require that the concepts of wakefulness, connectedness, and internal awareness are adequately untangled. Because this raises numerous important neuroscience and philosophical questions, the study of NDEs holds great promise to ultimately better understand consciousness itself. [4]








7. https://www.pnas.org/doi/10.1073/pnas.2216268120#bibliography

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