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The Sixth Sense

How could the patient have seen and heard them when she was clinically dead?

By any clinical measure Sarah was dead. Her body had cooled, her heart had stopped, her brain waves had disappeared. During her seventeen minutes as a corpse, a surgical team worked quickly yet carefully to seal off her brain aneurysm.

Photo by Ryan McVay<br/>Photodisc/Getty ImagesIn a planned cardiac arrest, a cardiopulmonary bypass machine replaces the heart’s vital pumping function. Surgery for Sarah’s basilar aneurysm required blood flow to stop completely, however, so her surgeons cooled her brain to allow it to tolerate this cessation.

During Sarah’s suspended animation, a microphone picked up several murmured conversations. In one, the surgeon asked the perfusionist whether the bypass machine was ready to be restarted; the perfusionist replied that he needed to “blow” it first—to fire it up to ensure any bubbles in the system would clear. In another exchange, a nurse recounted her marriage proposal the night before: the posh restaurant, the oneand-a-half-carat diamond ring, the swain on bended knee, the waiter who tripped over him and fell into the wine case.

When the pump cleared, the perfusionist said, “Thar she blows, captain.” The bypass machine churned, and Sarah’s blood began flowing again. Her body was gently warmed, and her heart resumed beating. Within minutes, a normal, healthy brainwave pattern reappeared on the EEG. The operation had proceeded flawlessly.

After several hours in the intensive care unit, Sarah’s head cleared. When she sat up to greet her surgeon, she asked whether her aneurysm had blown. He reassured her that the surgery had been “textbook perfect.”

“Well, I thought I remembered hearing something ‘blow,’” Sarah said. “I thought someone said, ‘Thar she blows.’ Like in Moby Dick.”

Her surgeon paled. After explaining his conversation with the perfusionist, he asked whether she had remembered anything else. Not realizing the sheer impossibility of what she had just said, Sarah went on to describe the nurse’s proposal, recounting the anecdote nearly word for word, right down to the restaurant’s name, the diamond’s carat weight, and the waiter’s stumble and fall.

It was utterly impossible, from a biochemical, metabolic, or physiologic point of view, for Sarah to have created any memories during her moments of suspended animation. Her brain had been devoid of any discernible electrical activity. Yet she had stored and recalled not only accurate auditory memories, but visual ones as well. She was able to describe the perfusionist’s beard, the blonde tendril escaping from the cap of the newly betrothed nurse, and the bypass machine’s location in the operating suite—even though the unit had been wheeled in after she had been under general anesthesia for more than two hours.

I was one of many doctors and researchers who soon flocked to Scottsdale, Arizona, to interview Sarah. We pored over the records, listened to the audio track, and watched the video footage of the surgery. Sarah was the equivalent of a valuable archeological find, and we wanted to leave the site fully explored, yet undisturbed. Not only were OR personnel interviewed independent of one another, but they were not allowed contact with Sarah, who was interviewed and videotaped separately.

We began our inquiry with a vague, almost smug, scientific curiosity, confident we’d find an explanation for this mystery. But as rational explanations faded one by one, we began to wonder whether we had encountered something unique, wondrous even. Could we be looking at the neurophysiologic equivalent of the Holy Grail?

According to one theory, Sarah’s brain—and the conscious mind it produced—had traveled beyond its physical and physiological confines. A group of physics researchers posited another notion, as radical as the first: that the OR conversations had survived as discrete quanta of energy, available for later plucking as memories.

No matter how we sought to explain it, Sarah’s experience seemed to suggest that the mind, the essential repository of consciousness, could separate from the very brain that created it and live without neuronal support, like a light bulb illuminated without any source of power.

What, I wondered, should those of us in the medical field do with such unsettling disturbances, such seeming ripples of the supernatural? Ignore them? Or should we declare them simply to be a puzzling mixture of science and spirit? Can we not allow ourselves to entertain the possibility that the supernatural, the divine, and the magical may all underlie our physical world? Can we not admit that we yearn to glimpse the mystery of the spirit?

I’m reminded of a carved angel perched near the top of the spire of the Notre Dame Cathedral in Paris. Turned away from the cross just above her, she is shielding her eyes with her arm, as if fearful of being struck blind while witnessing the glory of God. Perhaps Sarah’s experience offers a glimpse into the mysteries of our minds, but one that upends our world of scientific convention and constraints.

Like the cautious angel, we must content ourselves with oblique glimpses and trust that as much as we can withstand has been revealed. We cannot grasp the mystery. Or measure it. Or map it. But maybe that has to suffice for now.

Allan J. Hamilton ’82 is a professor of neurosurgery and a clinical professor in the radiation oncology, psychology, and computer and electrical engineering departments at the Arizona Health Sciences Center in Tucson. This essay was excerpted and adapted from The Scalpel and the Soul: Encounters with Surgery, the Supernatural, and the Healing Power of Hope, by arrangement with Jeremy P. Tarcher, a member of Penguin Group (USA) Inc., ©2008.


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