Sunday, January 27, 2013

What Happens When You Die?

     Doctors listen to all kinds of stories from patients, adding them to the compendium of anecdotal knowledge from which we draw strength for making diagnostic leaps.  One of the most intimate is the return-from-death-and-lived-to-talk-about-it stories.  There aren't many:  in twenty years, I've been graced with ten.
     What happens when you die?  It's hard to believe that people aren't thinking about this all the time.  I know I am:  What happens at the moment of death?  Is it a "moment"?  After that, then what? Why do we die?  Why are we here?  What's the point?
     The "why?" questions are philosophical, and of course they're interesting, more or less.  But what's more compelling, for flesh-and-bones people, is Who-Am-I, after I take my last breath?  What will I feel?  Should I be scared?  Will it hurt?
     I'm sure that last question, Will it hurt? is a big one for people.  After all, it's exactly what they want to know when I load a 3-cc syringe with lidocaine and a tiny, 30-gauge needle to numb a sphere of skin around an area I'm about to biopsy.  It's even the main thing on their minds when I flick off a few skin tags--again, using a local anesthetic--a procedure that takes a matter of seconds.
     "Hey, Doc, is this gonna hurt?" they ask, with false bravado.  If removing a skin tag triggers the question about pain, shouldn't the fear of one's own death be practically unspeakable?
     So, when I probe this topic, death--which doctors are supposed to do with everyone--I like to do more than fill out the absurdly simplistic form called the "Living Will," especially as patients get close to the end.  "Are you worried?"  I ask.  "What do you think happens when you die?"  and "Are you wondering how it feels?"
     Most people don't want to talk about death, so I let it go.
     Some have fixed notions about what will happen, and I don't mess with them, either.
     "I know what's going to happen:  I'm going to meet my maker in heaven," they tell me.   Perhaps they have the trip planned, and the scenery is already familiar, having been mapped out in advance through a version of guided imagery, reinforced in church each week.  They know, in a way that is the essence of faith, and don't need or want interference.  The subject has to do with God, not men.
     But this is such a secular age that many of us become disoriented around the topic of death, mainly our own deaths, which makes that "last great adventure" (as some patients refer to it) a terrifying prospect.  Hence, the escape into worldly things:  food, drink, drugs, adventure, obsession, drama, Fox News, and tabloids about other people's deaths, or near-deaths.  As long as we're busy, we don't have to think about our personal deaths.  And why bother?  Life is for living, they say.
     But when they die--and come back--it becomes a pressing, intimate topic.  They do want to talk about it--but only in respectful company.  It's not parlor chatter.  It's not fishing-boat, golf course, or dinner table material.  It's too personal.  It's too real.
     Here's the story of one man, my patient, who "died" after cardiac surgery, and had to be resuscitated three times.

     First, I was moving fast through space, and it was dark except for where I was headed.  I wasn't scared.  Instead, I felt weightless, and in a state of bliss.  I didn't want to go back to the world, which seemed to me, in those moments, to be a vessel of pain. 
     Then, I was taken to a room lined with purple velvet.  The ceiling, floor and walls were cushioned with it, and the velvet was very soft, and glowed.  I didn't question anything.  There was no need for questions.  I was at peace.  I've never felt such peace in my life.  I knew that everything was going to be fine.  I knew that all the things that had happened to me in my past were as they should be, and that the world was part of something big, like universal love.  It was all right and good.
     The purple room was a holding-place.  I was kept there because decisions were being made, but there was no urgency or sense of doom.  After awhile, I was transported along a long corridor, at the far end of which was a bright light.  I was being guided by a presence--it could have been an angel, whom I felt but could not see.  I was surrounded by great love-- filled to the brim with it.  It was the most wonderful experience imaginable--and now I know that there is nothing to fear, ever.  
     Whatever happens to me in life, I can't be harmed--not really.  Nothing can touch what is truly me, because it's being kept safe in that place, by that love, which is all there is.

     Having to return to the earthly world, he said, wasn't the aversive jolt some return-to-lifers describe, because he understood it was part of the "great plan."
    I couldn't deny that the irascible, impatient man I had known before his near-death experience had undergone a dramatic personality change.  He no longer complained.  He was serene.  He smiled continuously.  His face seemed to contain light. 
     The patients who shared their death experiences with me have given me permission to repeat them to others, which is sometimes a comfort to those who are fearful, at the end.  I have accompanied many patients along the last stretch of their lives--and some to the very brink--but then they let go, and are carried far away.
     I think of them in that purple room, cushioned by love, watched over by angels, dissolving into the light of oneness, and I, too, am comforted. 


  1. I love the image of a purple cushioned glowing room.

    I'd be interested in learning more about what happens physically and biologically to people who appear to die and then return to life.

    On the one hand, it seems as though they could not have really died, because under one understanding of death, once your body is dead you stay dead. So if they returned to life, they could not really have died in the first place.

    But what is death? I have heard the term 'brain dead.' Is that the true legal and medical definition? Has anyone ever returned from that? How is it defined?

    Were these people who returned to life proclaimed dead by someone? How long were they gone?

    Could it be they were only in a coma? Perhaps they are only reporting dreams of death they had while in a coma? I've dreamed of my own death too, but I don't think that's what these folks are claiming happened to them.

    Also, do some people who die and come back report bad experiences that turned them into worse human beings? It seems like we only hear about good death stories but maybe that really is the way things are for everyone when they die.

    I have one theological quibble with Dr. Colasante's recent post, but because what I have written is too long, I will continue this in a second note.

  2. This is the second part, the continuation of what I wrote above.

    In speaking about religious people who appear certain about what happens after death, Dr. Colasante wrote: "They know, in a way that is the essence of faith, and don't need or want interference."

    The essence of faith is not knowledge. It might seem as though if you have really strong faith, the object of your faith can become as certain as knowledge, but that is not true. Faith and knowledge describe two different relationships to two entirely different kinds of realities.

    We can have knowledge about our world, other people, anything that can be perceived by our 5 senses. We can have knowledge 'about' God, too, by learning the tenets of creeds or religious doctrines.

    But there are other realities that cannot be perceived by our five senses or reasoned out with logic and therefore cannot be known in the same sense.

    "Faith is the assurance of things hoped for, the conviction of things not seen." (Hebrews 11:1).

    If Abraham had 'known' where God was telling him to go, "known' he would thrive in this strange land he had never seen and 'known' that he would finally have a son even though he was old and Sarah past menopause, "known' that at the last minute God would not require him to kill this son Isaac, then it would not have been faith and we would not call Abraham the father of faith. This would diminish, not enhance, what is so powerful and admirable about Abraham. Abraham trusted God to take him to places and do things he had no understanding of.

    You cannot convert faith into knowledge without distorting and losing the essence of faith. I am suspicious of people who do this because I believe they are succumbing to our culture's over-valuation of knowledge and thereby degrading a powerful reality our culture tends to disrespect: faith.

    It is not clear to me why it is that God wants us to know God primarily by faith, rather than by knowledge. For many believers, human reason is one of God's greatest gifts. Reason can help us to know God indirectly in some ways, by learning about Creation, for example, but it is inferior, ultimately to faith. Faith is the only way to obtain direct access to God. Why is that?

    St. Thomas Aquinas asked if theology, or knowledge about God is inferior to scientific knowledge, since knowledge of God is less certain than other kinds of knowledge because it rests on faith. He answered no, because the object of faith is so much more sublime than the objects of scientific knowledge. Even though faith is less certain and clear, even though we can't even speak about faith as 'knowledge,' the object of faith is of infinitely greater importance and majesty than anything we can know with our senses.

    God wants us to 'know' and love God by faith; our human reason plays an important but secondary role. It is a puzzle. Maybe it is because God wants us to realize that the highest measure of reason is for reason to be aware of and to accept its inherent limits.....

  3. Thank you for your erudite comments. I hope the prosecutors read this. Perhaps it will inspire them to go back and read some more St. Thomas Aquinas.

    1. I will address your other questions, about the physical and biological occurrences at death, and what constitutes "death" as it is meant by coroners, in an upcoming post.