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In Shakespeare’s most famous soliloquy, while Hamlet is asking whether it is better to be or not to be, he imagines the potential consequences of death. He envisions death as a long sleep and he wonders, in that sleep of death, what dreams may come.
It’s a question that has plagued humanity for thousands of years, maybe longer. In our myths and stories, our many religions and funeral rituals throughout human history, there is nearly always some imagined state of continued existence after our physical bodies fade back into the dust.
Those four words from Hamlet perfectly encapsulate the wonder and curiosity we tender toward death and what, if anything, happens after. That’s why they were the perfect title for Richard Matheson’s novel about the afterlife, and the subsequent movie of the same name.
Our stories about the afterlife are likely built on a foundation of reported experiences, delivered firsthand by individuals who have flirted with death. So-called near-death experiences aren’t a new phenomenon, but our understanding of them is pretty recent.
As we gain knowledge about the experience of death, it might be necessary for us to reconsider what we’ve learned as it relates to the way we treat patients in the moments leading up to and following their deaths. With that in mind, an international team of doctors and scientists recently published a statement and guidelines, published in the Annals of the New York Academy of Sciences.
Historically speaking, there have been a greater number of near-death experiences in recent decades than there have been at any other point in human history, both in terms of raw numbers and percentage of the population. That’s due in large part to the advent of CPR and other medical interventions which have improved our ability to restore people to life after events which previously would have killed them.
According to the statement and guidance, which was built on a review of the accumulated scientific evidence to date, recalled experiences of death have a number of common criteria which appear to be mostly universal. Those events are often similar regardless of the individual’s geographical location, cultural experience, or other defining demographic.
Among the common touchstones are a sense of separation from the body and recognition of having died, a sensation of movement toward a destination, a life review — commonly referred to as having one’s life flash before their eyes — a feeling of peace or a sense of being home, followed by a return to life. That last experience is necessarily present in those individuals who return to life and report their experience, but may not be a requirement in order for the other experiences to occur.
Moreover, similar experiences were relayed, albeit in age-appropriate terms, by children three-years-old or younger. The scientists give special weight to these relayed experiences because of the children’s young age. It’s unlikely, though not impossible, that children that young would have their understanding of death colored by cultural expectations and thus, their reports might be at least a little purer.
Of course, it’s unclear what greater meaning, if any, these experiences have. It should be noted that the presence of an experience during the process of death definitionally cannot tell us anything about what happens after the process of dying is completed.
The statement also illustrates that gamma activity and electrical spikes in the brain occur in correlation with the process of death and may be responsible for the heightened sense of awareness and experiences being reported.
While death was once thought of as a discrete flip of a switch, we now know that isn’t the case. Instead, death happens over the course of minutes, hours, or even days. According to the statement, brain cells are more resilient in the face of decreased blood flow and oxygen than we previously believed and may continue firing for a significant amount of time post-mortem.
These guidelines should help direct the way we deal with patients who have died, even if they can’t tell use anything about happens to us after we die. Whatever may come, we hope it’s something dreamy, or at least not terrible.