One foot in the afterlife. Victim stories

2024 Author: Seth Attwood | [email protected]. Last modified: 2023-12-16 15:55

In March 2015, baby Gardell Martin fell into an icy stream and was dead for over an hour and a half. In less than four days, he left the hospital safe and sound. His story is one of those that prompts scientists to reconsider the very meaning of the concept of "death".

At first it seemed to her that she just had a headache - but in a way that she had never had before. 22-year-old Karla Perez was expecting her second child - she was six months pregnant. At first, she was not too scared and decided to lie down, hoping that her head would pass. But the pain only got worse, and when Perez vomited, she asked her brother to call 911.

Unbearable pain twisted Carla Perez on February 8, 2015, closer to midnight. An ambulance took Karla from her home in Waterloo, Nebraska to the Methodist Women's Hospital in Omaha. There, the woman began to lose consciousness, her breathing stopped, and the doctors inserted a tube into her throat so that oxygen continued to flow to the fetus. Computed tomography showed that extensive cerebral hemorrhage created enormous pressure in the woman's skull.

Karla suffered a stroke, but the fetus, surprisingly, did not suffer, his heart continued to beat confidently and evenly, as if nothing had happened. At about 2 a.m., a repeat tomography showed that intracranial pressure had irreversibly deformed the brain stem. “Seeing this,” says Tiffani Somer-Sheli, a doctor who observed Perez in both her first and second pregnancies, “everyone realized that nothing good could be expected.”

The woman found herself on a shaky line between life and death: her brain stopped functioning with no chance of recovery - in other words, she died, but the vital activity of the body could be artificially maintained, in this case - to enable the 22-week-old fetus to develop to the stage when it will be able to exist independently.

People who, like Carla Perez, are in a borderline state, every year there are more and more, as scientists more and more clearly understand that the "switch" of our existence does not have two on / off positions, but much more. and between white and black there is room for many shades. In the "gray zone" everything is not irrevocable, sometimes it is difficult to define what life is, and some people cross the last line, but return - and sometimes talk in detail about what they saw on the other side.

"Death is a process, not an instant," writes resuscitator Sam Parnia in his book "Erasing Death": the heart stops beating, but the organs do not die immediately. In fact, the doctor writes, they can remain intact for quite some time, which means that for a long time, "death is completely reversible."

How can someone whose name is synonymous with ruthlessness be reversible? What is the nature of crossing this “gray zone”? What happens with this to our consciousness? In Seattle, biologist Mark Roth is experimenting by putting animals into artificial hibernation using chemicals that slow the heartbeat and metabolism to levels similar to those seen during hibernation. Its goal is to make people facing a heart attack "a little immortal" until they overcome the consequences of the crisis that brought them to the brink of life and death.

In Baltimore and Pittsburgh, trauma teams led by surgeon Sam Tisherman are conducting clinical trials in which patients with gunshot and stab wounds have their body temperature lowered to slow bleeding for the time it takes to get stitches. These doctors use cold for the same purpose that Roth uses chemical compounds: it allows them to temporarily "kill" patients in order to ultimately save their lives.

In Arizona, cryopreservation specialists keep the bodies of more than 130 of their clients frozen - this is also a kind of "border zone". They hope that sometime in the distant future, perhaps in a few centuries, these people can be thawed and revived, and by that time medicine will be able to cure the diseases from which they died.

In India, neuroscientist Richard Davidson is studying Buddhist monks who have fallen into a condition known as tukdam, in which biological signs of life disappear, but the body does not seem to decompose for a week or longer. Davidson is trying to record some activity in the brains of these monks, hoping to figure out what happens after the circulation stops.

And in New York, Sam Parnia enthusiastically talks about the possibilities of "delayed resuscitation". According to him, cardiopulmonary resuscitation works better than generally believed, and under certain conditions - when the body temperature is low, chest compressions are correctly regulated in depth and rhythm, and oxygen is supplied slowly to avoid tissue damage - some patients can be returned. to life even after they have had no heartbeat for several hours, and often without long-term negative consequences.

Now the doctor is exploring one of the most mysterious aspects of returning from the dead: Why are so many clinically deadly people describing how their minds were separated from their bodies? What can these sensations tell us about the nature of the "border zone" and about death itself? According to Mark Roth of the Fred Hutchinson Cancer Research Center in Seattle, the role of oxygen on the border between life and death is highly controversial. “As early as the 1770s, as soon as oxygen was discovered, scientists realized that it was necessary for life,” says Roth. - Yes, if you greatly reduce the concentration of oxygen in the air, then you can kill the animal. But, paradoxically, if you continue to lower the concentration to a certain threshold, the animal will live in suspended animation."

Mark showed how this mechanism works using the example of soil-dwelling roundworms - nematodes that can live at an oxygen concentration of only 0.5 percent, but die when it is reduced to 0.1 percent. However, if you quickly pass this threshold and continue to reduce the oxygen concentration - to 0.001 percent or even less - the worms fall into a state of suspended animation. In this way, they are saved when harsh times come for them - which reminds animals that hibernate for the winter.

Deprived of oxygen, fallen into suspended animation, creatures seem to be dead, but they are not: the spark of life still glimmers in them. The mouth tries to control this condition by injecting experimental animals with an "elemental reducing agent" - for example, iodine salt - which significantly reduces their oxygen demand. In theory, this method is capable of minimizing the damage that post-heart attack treatment can cause to patients.

The idea is that if the iodide salt slows down oxygen exchange, it can help avoid ischemia-reperfusion damage to the myocardium. This kind of damage due to excess supply of oxygen-enriched blood to where it was previously lacking, is the result of treatments such as balloon angioplasty of the vessels. In a state of suspended animation, the damaged heart will be able to slowly feed on oxygen coming from the repaired vessel, and not choke on it.

As a student, Ashley Barnett was involved in a serious car accident on a highway in Texas, far from major cities. She had fractured pelvic bones, a torn spleen, and she was bleeding. At these moments, Barnett recalls, her consciousness was slipping between two worlds: in one, rescuers were pulling her out of a crumpled car using a hydraulic tool, chaos and pain reigned there; in the other, a white light shone and there was no pain or fear. A few years later, Ashley was diagnosed with cancer, but thanks to her near-death experience, the young woman was sure that she would live. Today Ashley is a mother of three and she consults crash survivors

A matter of life and death, according to Roth, is a matter of movement: from the point of view of biology, the less movement, the longer life is, as a rule. Seeds and spores can live for hundreds or thousands of years - in other words, they are practically immortal. Roth dreams of the day when with the help of a reducing agent like iodine salt it will be possible to make a person immortal "for a moment" - at the very moment when he needs it most of all, when his heart is in trouble.

However, This method would not have helped Carla Perez, whose heart never stopped beating. The day after the horrific results of a computed tomography were obtained, doctor Somer-Sheli tried to explain to the shocked parents, Modesto and Berta Jimenez, that their beautiful daughter, a young woman who adored her three-year-old daughter, surrounded by many friends and loved to dance, had died. brain.

The language barrier had to be overcome. The native language of the Jimeneses is Spanish, and everything that the doctor said had to be translated. But there was another barrier, more complicated than the language one - the very concept of brain death. The term emerged in the late 1960s, when two advances in medicine coincided in time: life support equipment appeared that blurred the line between life and death, and advances in organ transplantation made it necessary to make this line as clear as possible.

Death could not be defined in the old way, only as the cessation of breathing and heartbeat, since the artificial respiration apparatus could maintain both for an indefinitely long time. Is a person connected to such a device dead or alive? If you turn him off, when is it morally right to remove his organs in order to transplant them to someone else? And if the transplanted heart beats again in the other breast, can it be considered that the donor was really dead when his heart was excised?

To discuss these delicate and complex issues in 1968 at Harvard, a commission was assembled, which formulated two definitions of death: traditional, cardiopulmonary, and a new one based on the criteria of neurology. Among these criteria, which are used today to establish the fact of brain death, there are three most important: coma, or a complete and persistent lack of consciousness, apnea, or inability to breathe without a ventilator, and the absence of brain stem reflexes, which is determined by simple tests: you can rinse the patient's ears with cold water and check if the eyes are moving, or squeeze the nail phalanges with a hard object and see if the facial muscles are not responding, or act on the throat and bronchi to try to induce a cough reflex. This is all pretty simple and yet contrary to common sense.

“Patients who have brain death do not appear dead,” wrote James Bernath, a neurologist at Dartmouth College of Medicine, in 2014 in the American Journal of Bioethics. "This is contrary to our life experience - to call a patient dead, whose heart continues to beat, blood flows through the vessels and internal organs are functioning."

… Two days after Karla Perez's stroke, her parents, together with the father of the unborn child, arrived at the Methodist Hospital. There, in the conference room, 26 employees of the clinic were waiting for them - neurologists, specialists in palliative therapy and ethics, nurses, priests, social workers. The parents listened intently to the words of the translator, who explained to them that the tests showed that their daughter's brain had ceased to function. They learned that the hospital offers to support Perez's body until her fetus is at least 24 weeks old - that is, until the chances of his survival outside the mother's womb are at least 50-50. will be able to maintain vital activity even longer, with each week increasing the likelihood that the baby will be born.

Perhaps at this moment Modesto Jimenez recalled a conversation with Tiffani Somer-Sheli - the only one in the entire hospital who knew Karla as a living, laughing, loving woman. The night before, Modesto took Tiffani aside and quietly asked just one question. “No,” said Dr. Somer-Sheli. "Chances are, your daughter will never wake up." These were possibly the most difficult words of her life.

“As a physician, I understood that brain death is death,” she says. "From a medical point of view, Karla was already dead at that moment." But looking at the patient in the intensive care unit, Tiffany felt that it was almost as difficult for her to believe this indisputable fact as it was for the parents of the deceased. Perez looked like she had just had a successful operation: her skin was warm, her breasts were rising and falling, and a fetus was moving in her stomach - apparently completely healthy. Then, in a crowded conference room, Karla's parents told the doctors: yes, they realize that their daughter's brain is dead and she will never wake up. But they added that they would pray for an un milagro - a miracle. Just in case.

During a family picnic on the shores of Sleepy Hollow Lake (Sleepy Hollow) in upstate New York, Tony Kikoria, an orthopedic surgeon, tried to call his mother. A thunderstorm started, and lightning hit the phone and went through Tony's head. His heart stopped. Kikoria recalls that he felt himself leaving his own body and moving through the walls towards a bluish-white light in order to connect with God. Returning to life, he suddenly felt attracted to playing the piano and began to record melodies that seemed to "download" by themselves into his brain. In the end, Tony became convinced that his life was saved so that he could broadcast "music from heaven" to the world

The return of a person from the dead - what is it if not a miracle? And, I must say, such miracles in medicine sometimes happen. The Martin couple know this firsthand. Last spring, their youngest son Gardell traveled to the realm of the dead, falling into an icy stream.

The large Martin family - husband, wife and seven children - lives in Pennsylvania, in the countryside, where the family owns a large tract of land. Kids love to explore the area. On a warm March day in 2015, the two older boys went for a walk and took Gardell, who was not even two years old, with them. The kid slipped and fell into a stream flowing a hundred meters from the house. Noticing the disappearance of their brother, the frightened boys tried for some time to find him themselves. As time went…

By the time the rescue team got to Gardell (he was pulled out of the water by a neighbor), the baby's heart had not been beating for at least thirty-five minutes. The rescuers began to do external heart massage and did not stop it for a minute along the entire 16 kilometers separating them from the nearest Evangelical Community Hospital.

The boy's heart could not start, his body temperature dropped to 25 ° C. Doctors prepared Gardell for transport by helicopter to the Geisinger Medical Center, located 29 kilometers, in the city of Danville. My heart still didn't beat. “He showed no signs of life,” recalls Richard Lambert, the pediatrician responsible for administering pain medications at the medical center, and a member of the resuscitation team that was waiting for the plane. "He looked like … Well, in general, the skin darkened, the lips are blue …". Lambert's voice fades as he recalls this terrible moment. He knew that children drowned in icy water sometimes come back to life, but he never heard this happen to babies who did not show signs of life for so long. To make matters worse, the boy's blood pH was critically low - a sure sign of imminent functional organ failure.

… The resuscitator on duty turned to Lambert and his colleague Frank Maffei, director of the intensive care unit of the children's hospital at the Geisinger Center: maybe it's time to give up trying to revive the boy? But neither Lambert nor Maffei wanted to give up. Circumstances were generally appropriate for a successful return from the dead. The water was cold, the child was small, attempts to resuscitate the boy began within a few minutes after he drowned, and have not stopped since then. “Let's continue just a little more,” they told colleagues. And they continued. Another 10 minutes, another 20 minutes, then another 25. By this time Gardell was not breathing, and his heart had not been beating for more than an hour and a half. “A limp, cold body with no signs of life,” Lambert recalls. However, the resuscitation team continued to work and monitor the boy's condition.

The doctors who performed external cardiac massage were rotated every two minutes - it is a very difficult procedure if done correctly, even when the patient has such a tiny chest. Meanwhile, other resuscitators inserted catheters into Gardell's femoral and jugular veins, stomach, and bladder, injecting warm fluids into them to gradually raise body temperature. But there seemed to be no sense from this. Instead of stopping resuscitation altogether, Lambert and Maffei decided to move Gardell to the surgical ward to be connected to a heart-lung machine. This most radical way of warming the body was a last-ditch attempt to get the baby's heart to beat again. After treating their hands before the operation, the doctors checked the pulse again. Incredible: he appeared! Palpitations were felt, at first weak, but even, without the characteristic rhythm disturbances that sometimes appear after prolonged cardiac arrest. Just three and a half days later, Gardell left the hospital with his family in prayer to heaven. His legs almost did not obey, but the rest of the boy felt great.

After a head-on collision of two cars, student Trisha Baker ended up in a hospital in Austin, Texas, with a broken spine and severe blood loss. When the operation began, Trisha felt herself hanging from the ceiling. She clearly saw a straight line on the monitor - her heart stopped beating. Baker then found herself in a hospital corridor where her grief-stricken stepfather was buying a candy bar from a vending machine; it was this detail that later convinced the girl that her movements were not a hallucination. Today, Trisha teaches writing skills and is sure that the spirits that accompanied her on the other side of death guide her in life

Gardell is too young to tell what he felt when he was dead for 101 minutes. But sometimes people saved thanks to persistent and high-quality resuscitation, returning to life, talk about what they saw, and their stories are quite specific - and frighteningly similar to one another. These stories have been the subject of scientific study on several occasions, most recently as part of the AWARE project, led by Sam Parnia, head of critical care research at Stony Brook University.

Since 2008, Parnia and his colleagues have reviewed 2,060 cardiac arrest cases in 15 American, British and Australian hospitals. In 330 cases, patients survived and 140 survivors were interviewed. In turn, 45 of them reported that they were in some form of consciousness during resuscitation procedures.

Although most could not recall in detail what they felt, the stories of others were similar to those that can be read in bestsellers like "Heaven is Real": time accelerated or slowed down (27 people), they experienced pacification (22), separation of consciousness from body (13), joy (9), saw a bright light or golden flash (7). Some (the exact number is not given) reported unpleasant sensations: they were scared, it seemed that they were drowning or that they were being carried somewhere deep under water, and one person saw "people in coffins who were buried vertically in the ground."

Parnia and his coauthors wrote in the medical journal Resuscitation that their research provides an opportunity to advance understanding of the varied mental experiences that are likely to accompany death after circulatory arrest. According to the authors, the next step should be to examine whether - and, if so, how - this experience, which most researchers call near-death experiences (Parnia prefers the wording “post-death experience”), does not cause he has cognitive problems or post-traumatic stress disorder. What the AWARE team did not investigate was the typical NDE effect - the heightened sense that your life has meaning and meaning.

This feeling is often talked about by survivors of clinical death - and some even write entire books. Mary Neal, an orthopedic surgeon in Wyoming, mentioned this effect when she spoke to a large audience in 2013 at the Rethinking Death Symposium at the New York Academy of Sciences. Neil, author of To Heaven and Back, recounted how she sank 14 years ago while kayaking down a mountain river in Chile. At that moment, Mary felt the soul separating from the body and flying over the river. Mary recalls: “I was walking along an amazingly beautiful road leading to a magnificent building with a dome, from where, I knew for sure, there would be no return - and I was eager to get to it as soon as possible.”

Mary at that moment was able to analyze how strange all her sensations were, she recalls how she wondered how long she had been under water (at least 30 minutes, as she later found out), and consoled herself with the fact that her husband and children would good without her. Then the woman felt her body being pulled out of the kayak, felt that both of her knee joints were broken, and saw how she was given artificial respiration. She heard one of the rescuers call her: "Come back, come back!" Neal recalled that upon hearing this voice, she felt "extremely irritated."

Kevin Nelson, a neurologist at the University of Kentucky who took part in the discussion, was skeptical - not about Neal's memories, which he recognized as vivid and authentic, but about their interpretation. “This is not the feeling of a dead person,” Nelson said during the discussion, arguing against Parnia’s point of view as well. "When a person experiences such sensations, his brain is quite alive and very active." According to Nelson, what Neal felt could be explained by the so-called "invasion of REM sleep", when the same brain activity that is characteristic of him during dreams, for some reason, begins to manifest itself in any other unrelated circumstances - for example, during a sudden oxygen deprivation. Nelson believes that near-death experiences and the feeling of separation of the soul from the body are caused not by dying, but by hypoxia (oxygen deficiency) - that is, loss of consciousness, but not life itself.

There are other psychological explanations for NDEs. At the University of Michigan, a team led by Jimo Borjigin measured electromagnetic waves from the brain after cardiac arrest in nine rats. In all cases, the high-frequency gamma waves (those that scientists associate with mental activity) became stronger - and even more distinct and orderly than during normal wakefulness. Perhaps, the researchers write, this is a near-death experience - an increased activity of consciousness that occurs during the transition period before final death?

Even more questions arise when studying the already mentioned tukdam - the state when a Buddhist monk dies, but for another week, or even more, his body does not show signs of decay. Is he conscious at the same time? Is he dead or alive? Richard Davis of the University of Wisconsin has been studying the neurological aspects of meditation for many years. He has been interested in all these questions for a long time - especially after he happened to see a monk in a tukdam at the Deer Park Buddhist monastery in Wisconsin.

“If I walked into that room by accident, I would think he was just sitting in deep meditation,” Davidson says, a note of awe in his voice on the phone. "His skin looked completely normal, not the slightest sign of decay." The sensation caused by the close proximity of this dead person encouraged Davidson to begin researching the tukdam phenomenon. He brought the necessary medical equipment (electroencephalographs, stethoscopes, etc.) to two field research sites in India and trained a team of 12 Tibetan doctors to examine the monks (starting when they were unquestionably alive) to see if their brain activity after death.

“Probably many monks go into a state of meditation before they die, and after death it somehow persists,” says Richard Davidson. "But how it happens and how it can be explained eludes our everyday understanding."

Davidson's research, based on the principles of European science, aims to achieve a different, more subtle, understanding of the problem, an understanding that could shed light not only on what happens to the monks in Tukdam, but also on anyone who crosses the border between life and death.

Decomposition usually begins almost immediately after death. When the brain ceases to function, it loses its ability to maintain the balance of all other body systems. So in order for Carla Perez to continue carrying the baby after her brain stopped working, a team of more than 100 doctors, nurses and other hospital staff had to act as conductors of sorts. They monitored blood pressure, kidney function, and electrolyte balance around the clock, and continually made changes to the fluids given to the patient through the catheters.

But, even performing the functions of Perez's dead brain, doctors could not perceive her as dead. Everyone, without exception, treated her as if she were in a deep coma, and entering the ward, they greeted her, calling the patient by name, and when leaving, they said goodbye.

In part, they behaved like this, respecting the feelings of Perez's family - the doctors did not want to create the impression that they treated her as a "container for a baby." But sometimes their behavior went beyond the usual politeness, and it became clear that the people caring for Perez, in fact, treated her as if she were alive.

Todd Lovgren, one of the leaders of this medical team, knows what it means to lose a child - his daughter, who died in early childhood, the oldest of his five children, could have turned twelve years old. “I wouldn’t respect myself if I didn’t treat Karla like a living person,” he told me. “I saw a young woman with nail polish, her mother was combing her hair, she had warm hands and toes … Whether her brain was functioning or not, I don’t think she stopped being human.”

Speaking more like a father than a doctor, Lovgren admits that he felt as if something of Perez's personality was still present in the hospital bed - even though after the CT scan he knew that the woman's brain was not just not functioning; significant parts of it began to die off and decay (However, the doctor did not test for the last sign of brain death, apnea, as he feared that by disconnecting Perez from the ventilator even for a few minutes, he could harm the fetus).

On February 18, ten days after Perez's stroke, it was discovered that her blood had stopped clotting normally. It became clear: the dying brain tissue penetrates into the circulatory system - another evidence in favor of the fact that it will no longer recover. By then, the fetus was 24 weeks old, so the doctors decided to move Perez from the main campus back to the obstetrics and gynecology department of the Methodist Hospital. They managed to cope with the problem of blood coagulation for a while, but they were ready to have a cesarean section at any moment - as soon as it became clear that they could not hesitate, as soon as even the appearance of life that they managed to maintain began to disappear.

According to Sam Parnia, death is in principle reversible. The cells inside the human body, he says, usually do not die right away with it: some cells and organs can remain viable for several hours and maybe even days. The question of when a person can be declared dead is sometimes decided according to the doctor's personal point of view. During his studies, Parnia says, they stopped doing heart massage after five to ten minutes, believing that after this time, the brain would still be irreparably damaged.

However, resuscitation scientists have found ways to prevent the death of the brain and other organs, even after cardiac arrest. They know that this is facilitated by a decrease in body temperature: Gardell Martin was helped by ice-cold water, and in some intensive care units, each time before starting a massage, the patient's heart is specially cooled. Scientists also know how important persistence and perseverance are.

Sam Parnia compares resuscitation to aeronautics. Throughout human history, it seemed that humans would never fly, and yet in 1903, the Wright brothers took to the skies in their airplane. Amazingly, Parnia notes, only 66 years passed from that first flight, which lasted 12 seconds, to the landing on the moon. He believes that similar successes can be achieved in intensive care. As for the resurrection from the dead, the scientist thinks, here we are still at the stage of the first airplane of the Wright brothers.

Yet doctors are already able to win life from death in amazing, hopeful ways. One such miracle happened in Nebraska on Easter Eve, late in the afternoon of April 4, 2015, when a boy named Angel Perez was born by caesarean section at a Methodist Women's Hospital. Angel was born because doctors were able to maintain the vital functions of his mother, whose brain was dead, for 54 days - enough time for the fetus to develop into a small, but quite normal - surprising in its normality - newborn weighing 1300 grams. This child turned out to be the miracle that his grandparents prayed for.