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Book review: “To Heaven & Back” by Mary C. Neal, MD (Great read but it raises many concerns)

To Heaven & BackI am like many of you reading this fascinated by unusual happenings and accounts including NDEs (near death experiences), UFOs, Bigfoot, and so forth. Actually so long as a claim does not violate the established laws of physics or chemistry and has not already been convincingly refuted by contrary evidence, one must allow that the phenomenon or what-have-you in question might one day garner sufficient proof to compel acknowledging its reality. However, until the jury is in (solid evidence) it is usually prudent to remain agnostic on the matter (With the exception of things believed on the basis of faith and not testable using the tools of science — such as the existence of God).

There is nothing, for example, to disallow the existence of Bigfoot (Sasquatch) or a Yeti. The existence of such primates do not require a violation or suspension of the laws that govern the natural world nor even quality as extraordinary in the same sense, say, as an alien or fairy or ghost would. The problem with Bigfoot and the Yeti lies in a lack of evidence. There has been lots of frauds and biological samples that turned out to be from cows and bears and such, but no hair or tissue DNA (much less corpses) that reveal a previously unknown bipedal primate.


Terrorist beheadings and other forms of inflicted, violent death: Are victims aware of what is happening around them after their heart and lungs have stopped working?

The many beheadings carried out by insurgents in Iraq during the past year or so not unexpectedly generated expressions of revulsion and denunciation far and wide. It is difficult for all but the most callous souls not to feel pangs of anguish for those who have been dealt this grisly fate. No doubt many of you have at one time or another found yourself trying to imagine the thoughts and feelings of the victims prior to and during decapitation. And then thinking, “Were they aware of anything following this despicable act?”

This concern has a lot to do with our human capacity to emphasize and sympathize with others, but there is an element of “enlightened self-interest” in our curiosity and even fascination with dying and death. When we ask “What did that poor soul experience?”, we are in some way seeking in the death of others some idea of what we might sense or think or visualize as we go through our own final, irreversible “systems failure”.

Modern science has amassed a great deal of evidence that the dying brain can and often does generate a wide range of images and such, not unexpectedly reflective of individual beliefs, expectation, and history. But what of the period immediately following cessation of heart and lungs? For example, does the brain of a just severed head continue to function?

Consider this account tendered by a French physician named Beaurieux who attended the state-sanctioned guillotining of a criminal named Languille during the early morning hours of June 28th, 1905 (France abolished the death penalty in 1981):

“I consider it essential for you to know that Languille displayed an extraordinary sang-froid and even courage from the moment when he was told, that his last hour had come, until the moment when he walked firmly to the scaffold. It may well be, in fact, that the conditions for observation, and consequently the phenomena, differ greatly according to whether the condemned persons retain all their sang-froid and are fully in control of themselves, or whether they are in such state of physical and mental prostration that they have to be carried to the place of execution, and are already half-dead, and as though paralyzed by the appalling anguish of the fatal instant.

“The head fell on the severed surface of the neck and I did not therefore have to take it up in my hands, as all the newspapers have vied with each other in repeating; I was not obliged even to touch it in order to set it upright. Chance served me well for the observation, which I wished to make.

 “Here, then, is what I was able to note immediately after the decapitation: the eyelids and lips of the guillotined man worked in irregularly rhythmic contractions for about five or six seconds. This phenomenon has been remarked by all those finding themselves in the same conditions as myself for observing what happens after the severing of the neck…

“I waited for several seconds. The spasmodic movements ceased. The face relaxed, the lids half closed on the eyeballs, leaving only the white of the conjunctiva visible, exactly as in the dying whom we have occasion to see every day in the exercise of our profession, or as in those just dead. It was then that I called in a strong, sharp voice: “Languille!” I saw the eyelids slowly lift up, without any spasmodic contractions – I insist advisedly on this peculiarity – but with an even movement, quite distinct and normal, such as happens in everyday life, with people awakened or torn from their thoughts.

Next Languille’s eyes very definitely fixed themselves on mine and the pupils focused themselves. I was not, then, dealing with the sort of vague dull look without any expression, that can be observed any day in dying people to whom one speaks: I was dealing with undeniably living eyes which were looking at me. “After several seconds, the eyelids closed again, slowly and evenly, and the head took on the same appearance as it had had before I called out.

“It was at that point that I called out again and, once more, without any spasm, slowly, the eyelids lifted and undeniably living eyes fixed themselves on mine with perhaps even more penetration than the first time. The there was a further closing of the eyelids, but now less complete. I attempted the effect of a third call; there was no further movement – and the eyes took on the glazed look which they have in the dead.

 “I have just recounted to you with rigorous exactness what I was able to observe. The whole thing had lasted twenty-five to thirty seconds.

 A Little Background

 The human brain is a complex assembly of interactive biological modules (as it were) that make it possible for us to do a myriad of things that favor our survival like eating, drinking, getting about, making love, and… thinking (Among just a few of its many faculties and features). When specific components of this system shut down we sleep and dream. When certain others do so, we lose our sense of time, space and position and can even experience disembodied states (Out-of-body, near-death, etc.), “oneness with God, the universe, and everything” (Mystical episodes), and similar wonders. These varying shades and expressions of this “neural network” — this brain-generated, emergent faculty we call mind and consciousness – fascinates us to the point of obsession. We all want to know how it is all this hardware in our heads comes together to work in the way it does, as well as what kind and degree of consciousness we muster after our brain ceases to receive life-sustaining oxygen and glucose.

For most of human history,…in most cultures of the world… the matter of consciousness and such was primarily if not exclusively the province of philosophers, theologians and mystics. With the expansion and refinement of the probing, powerfully explanatory tools and methodology of science, this state-of-affairs shifted. We are gradually, inexorably moving closer and closer to fathoming what was once unfathomable; to making explicable what was once perplexing and stupefying to the point of being “magical” and “miraculous”.

Here is but a few examples of things that have come to light through scientific exploration and testing:

Brain scans of people deep in prayer or meditation have revealed activity in specific brain regions that correlate with states that range from “enlightened insight” to awe to oceanic bliss (transcendence) to ecstatic visions. The areas of the brain involved and the way in which they are activated actually creates a blurring of the demarcation between self and “not-self” that gives rise to a boundary-lessness the brain experiences and interprets as a state of oneness with the universe. These brain states appear normative for our species and not pathological (There are conditions such as frontal lobe epilepsy and certain forms of schizophrenia in which hyper-religiosity, visions, delusions and such appear, but these manifestations are markedly different from what transpires in folks who have no brain disease or disorder present). 

  • Out-of-body experiences have been linked (in part) to malfunctions in the angular gyrus, a part of the brain that plays an important role in the way the brain analyzes sensory information that informs how we perceive our own bodies. In a 2002 paper published in the prestigious journal, Nature, scientists stimulated this structure in the brain of a 43 year old woman who had an 11 year history of epileptic seizures. During periods when electrical stimulation was applied, the woman spoke of seeing herself “lying in bed, from above, but I only see my legs and lower trunk.” She also described “floating” near the ceiling above her (A distance of 72 inches or so).
  • Near Death Experiences (NDEs) including  traveling down a tunnel towards a bright light and such have been duplicated by persons using an audio system called the Hemi-Sync® developed by the Monroe Institute. In addition, Laurentian University neuroscientist Michael Persinger, Ph.D. has done some pioneering lab work that supports his contention that temporal lobe instability can produce OBE and NDE-like episodes and that these can be set off by various naturally occurring phenomena and events (Dying being one of them).

It seems likely that science will in the fullness of time demonstrate that all OBEs, NDEs, mystical experiences, and such are manifestations of physiological activity in the human brain evoked by external and internal influences and processes. But as proving a negative such as “there is no life after death” is virtually impossible — and given that whatever lies well beyond brain death cannot be probed or accessed by the tools of science — there is a point at which disbelief (as in “you die and that’s it”) or conversely faith in a post-mortem existence share a level playing field.

 However, the focus and concern of this foray is not what lies well beyond cessation of all brain activity – electrical, biochemical, etc. – but rather what might be transpiring in the 4-10 minutes or more in which the brain is oxygen and glucose starved, is dying but yet has not reached that state of equilibrium or inactivity that is total brain death. And more pointedly, what does the dying brain perceive and experience, especially in the wake of having been placed in this state by a violent, terror-filled act?              

Consciousness at death

Despite the fact scientists have not reached a consensus on the nature of consciousness or the complete neurological network and its interactions that give rise to it, we possess enough information and insight to determine various states and degrees of consciousness, e.g., aroused and alert v. asleep, epileptic, drugged, etc.  In the context of this minor tome, “awareness of self and what is happening to self” is a good working definition of what it is to be conscious. This view is consistent with what one neuroscientist has posited:

“The content of consciousness, also known as awareness, represents the sum of cognitive and affective mental functions, and denotes the knowledge of ones existence, and the recognition of the internal and external worlds. It has been argued that consciousness has two dimensions: wakefulness and awareness. Awareness is the same as the content of consciousness. Wakefulness is provided by the arousal. 

“Normal conscious behavior requires both arousal and awareness. Patients in coma are unconscious because both arousal and content of consciousness are disturbed.

“According to these important facts that show the relevance of the interaction of both components of consciousness (arousal and awareness) to govern conscious behavior in humans, I have recently presented a definition of human death. I used the term capacity for consciousness as synonym for arousal. To prevent possible nomenclature misunderstandings, it is better to use the term arousal. Awareness is a synonym for content of consciousness.

“The irreversible loss of both components of consciousness, arousal and awareness”

From “A new definition of death based on the basic mechanisms of consciousness generation in human beings” by Calixto Machado, M.D., Ph.D.

Head of the Department of Clinical Neurophysiology at the Institute of Neurology and Neurosurgery, Havana, Cuba


 Arousal and awareness requires that at least 2 brain structures be fully interconnected and up and running: The activating reticular formation and the cerebral cortex (Some researchers dispute the need for the cerebral cortex except for planning and conscience, but for now we will posit that both it and the activating reticular formation are needed to generate the kind and degree of waking consciousness we would recognize as being “fully operational”).

This brings us to the big question: Do these 2 structures continue to function pretty much true-to-form following cessation of heart and lung activity? And if they do,  for how long after death?

According to Laurence Schneiderman, M.D. a bioethicist at the University of California, San Diego,   “You have in your brain the cerebral cortex, which is actually a very thin structure on the outer surface of your cerebral hemispheres. Four to six minutes of anoxia, lack of oxygen, destroys that completely. The rest of your brain, particularly the brain stem, can survive for fifteen or twenty minutes without oxygen. That disparity accounts for what we now see in as many as 30,000 to 40,000 people being kept alive in permanent unconsciousness.”

So using his statement, the cerebral cortex and reticular activating formation can both continue to function for 4-6 minutes before the latter deteriorates and “disengages”. So we have the potential at least for the continued operation of the physiologic “essentials of consciousness” in a fuel (oxygen and glucose) deprived brain – for at most 6 minutes or so.

It can be argued that the cerebral cortex may indeed be functioning following immediate cessation of blood and oxygen flow, but not fully normally. Especially when death is sudden and traumatic. But what are we to make of case history accounts of folks who died suddenly – car wrecks, for example – remained clinically dead for 6 minutes or so —  were resuscitated – and who report they had cogent thought patterns and a level of awareness that did not differ greatly from normal day-to-day life? This alone suggests that the cerebral cortex functions in a normal fashion for 4-6 minutes or so following clinical death.

Coming full circle: Are those who decapitated by terrorists aware of the murderous act being inflicted on them, as well as what takes place thereafter?  

 Given the fact the reticular activating system and cerebral cortex function in an apparently normal fashion until lack of oxygen disengages the latter (6 minutes or so after clinical death), it isn’t difficult to surmise (however tentatively) that people subjected to murderous deaths – be it by hanging, gassing, decapitation, etc. — are conscious of most if not all that is taking place (Again, at least up to 6 minutes of so following clinical death). Unless, that is, the crucial brain structures involved in generating consciousness are obliterated by the violent act – a bullet sent careening through consciousness-vital neurological structures, for example – or by administration of drugs or other compounds that suppress the function of one or more of these physiologic areas prior to clinical death.

This line of reasoning suggests that those poor souls who were decapitated by terrorists in Iraq did experience a meaningful degree and kind of consciousness for at least 6 minutes or so following their demise.  Not unlike what was suggested by the post-decapitation reactions of Languille in 1905.

A final thought

Those who decapitate non-combatants in wartime are criminals, plain and simple. If these terrorists do drug their victims prior to dispatching them, it does not excuse or mitigate their criminal culpability or their lack of humanity. But it might in some way console the victim’s family and such – which would constitute a tiny decency in the midst of a malignant indecency. 

But what of state-sanctioned executions? Can our brief foray into the nature of consciousness at and immediately following death help inform this aspect of national policy? I think it can.

Whether one believes that state-sanctioned executions are ethically or morally right – or not* – it is a legal recourse that prevails in many states and countries and apparently will do so for some time to come.  In light of what we know and can conjecture concerning the nature of consciousness at death and afterwards, executions that involve obliterating consciousness prior to lethal act would seem more humane than those that do not. As such, the use of drugs which render prisoners unconscious prior to the administration of lethal drugs or such are probably sparring them undue suffering and anguish. It is a kindness – however convoluted or oxymoronic the whole concept of “humane execution” itself may be.

 * I do not – based on a conclusion I reached as a boy: The state should never take from a citizen what it cannot later restore.  If this were universal and fully enforced by the member nations of the world community, state-sanctioned genocide and such would seldom if ever occur. 


© 2005 by Dr. Anthony G. Payne. All rights reserved.

Dr. Payne can be reached by e-mail at  


To learn more

For more on the history and folklore surrounding the guillotine:   

 To learn about the Monroe Institute’s Hemi-Sync® audio system : (Dr. Payne has no commercial or other interest in this company or device)

Neuroanatomy of the Brain Stem Reticular Formation:

This website looks at NDEs as representing more than a manifestation of a dying or otherwise dysfunctional brain:

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