Series of interviews with leading near-death experience skeptics show no plausible medical explanation for afterlife experiences. The idea of an afterlife doesn't sit well with the science-minded. Our mind is our brain and when we die we die they claim. But as conventional medical explanations for near-death experiences fall flat, and NDE research progresses, tradition-minded scientists are facing the impossible notion that the afterlife may be real. Join Skeptiko host Alex Tsakiris for his second interview with near-death experience skeptic and author of Mortal Minds, Dr, G.M. Woerlee. During the 30-minute interview Dr. Woerlee continues his assertion that near-death experiences have normal medical explanations. When presented with the case of a young woman who suffered a severe a gunshot wound and was pronounced clinically dead by her doctor only to be miraculously revived after two unsuccessful rounds of defibrillation Dr. Woerlee concluded, "No, she was not dead... if she was dead the doctors would not have resuscitated her. She would have remained dead." As to her amazing near-death experience during which she left her body and was able to look down on medical stuff during their frantic attempt to revive her, Woerlee offered this explanation, "...she hears the conversations. She feels the sensations. And she also is a woman who also has seen films and she knows how these things go. She hears the conversations, why? Because she is awake. That does not surprise me." Dr. Woerlee's claims contradict the accounts of medical staff on the scene. They indicated she was clinically dead, "what we call sheet-faced", and under heavy anesthesia making it medically impossible for her to have a consciousness memory of the experience. Read Kieth Wood's critique of Dr. Woerlee's claims Play it: Download MP3 (33:20 min.) Read it: Alex Tsakiris: Today we welcome back Dr. G.M. Woerlee, an anesthesiologist in the Netherlands and a NDE skeptic and the author of several books, including Mortal Minds: The Biology of Near-Death Experiences. Dr. Woerlee, welcome back to Skeptiko. Dr. G.M. Woerlee: Thank you very much. I'm glad to be here. Alex Tsakiris: It's good to have you back. As I mentioned during our last visit, I think it's good and it's really useful to have this give-and-take, back-and-forth over a couple of sessions because it really takes a couple of rounds to dialogue on these issues properly. Here's where I'd like to start today. As many Skeptiko listeners will know, of course, we've had this series of discussions on near-death experiences. We've talked to a number of NDE researchers as well as qualified skeptics like yourself. The last time around, you presented the evidence for your claims regarding the possibility that near-death experiences can be explained by normal processes that are understood by physicians like yourself. Since then, we've heard from Dr. Jeffrey Long, and we've also heard from some other folks who posted on the website. They have some push-backs and doubts about your claims. The principle claim that you make against the NDE researchers is that they've ignored the fact that these patients who have this horrendous brush with death, that they're receiving CPR. They're receiving chest compressions. Someone's coming around and pounding on their chest and that's pumping blood into their brain and this flow of blood is causing them to regain consciousness. Kind of a NDE by CPR theory, if you will. And here's the quote from your actual website. You say, "And then Jeffrey Long proceeds to make the same unbelievable assumption, as just about every other doctor publishing studies on near-death experience during cardiac arrest. He forgets to tell us that all those who survived cardiac arrest underwent cardiac massage." So that's where I really want to start digging into that statement: "...all those all those who survived cardiac arrest underwent cardiac massage." As I think we touched on before, but which has become even more clear since then, that's not really accurate. In fact, it's not really even that close. One of the papers I sent you was from Keith Wood, a Skeptiko listener. What he pointed out, and I thought this was interesting the way he did it, he went into the Pim von Lommel study that you cited on your site. In that, he states that 81% of the patients he looked at suffered cardiac arrest, it was in the hospital, and within two minutes they were resuscitated. As we know, that means they were most likely resuscitated by defibrillator. So it's reasonable to assume that most of those people weren't administered cardiac massage. Further, he points out that only 21% of the patients who were outside of the hospital received CPR before they got to the hospital. So let me stop there and see if we can nail this down. Do you still maintain that all those who survived cardiac arrest in these NDE studies all underwent cardiac massage? Dr. G.M. Woerlee: No. But then I'll just go on about this critique and I believe you're referring to that article by Keith Wood which you posted on another part of your site as a 12 page long PDF. Actually, Keith Wood does a very good analysis. He actually has read the articles he cites, which is very good. He also points out very correctly something that was an oversight of mine, that 81% of the people who in the Lommel report in his article were actually people resuscitated in coronary care units. Now, then we go on further because he is quite correct in many of these aspects. He also referred to his sister, who is a qualified coronary care, intensive care nurse and who does primary resuscitation in these units. The big problem is this: that most people who are resuscitated from a cardiac arrest are actually not in a coronary care unit or an intensive care unit. Most of them are outside such a place. What happens is that when you must always make a very big distinction between people who are resuscitated in coronary care/intensive care versus people who are resuscitated elsewhere in the hospital, and people resuscitated on the street or at home. You look at the mortality of the different resuscitations and you see immediately what the difference is. A person in a coronary care unit or an intensive care unit is already attached to an ECG monitor with a central bank of monitors which are continually observed by the nurses and doctors present at the time, who are on duty. They see an arrhythmia which needs treatment and they immediately jump upon the patient and if it's necessary, defibrillate. If that does not work, then what they do is start cardiac massage. They have to think about what to do next or start the defibrillator for another go. In other words, some of these people do receive cardiac massage because in such situations, if you do not do any cardiac massage these people are severely brain-damaged. Alex Tsakiris: Right. And I don't think we'd really see much of a disagreement between you and any of the NDE researchers on that description of what's going on. What I want to hone in on, because in your article I do have to say you make quite a bit of a fuss about this point, and this point that you're now backing off of, which is great. Everyone should be allowed to back off and say, "Hey, I didn't mean all when I said all." But that is what you said. You said, "Here's the big missing link in this argument is that all those who survived cardiac arrest underwent cardiac massage, underwent chest compressions." Now we're saying, "No." I don't know, but it seems to me from the Pin von Lommel study and also Dr. Long's research, all of his is published on the website. I went in there and searched for the accounts, just roughly estimating how many people received chest compressions as opposed to the paddles and the shock treatment. It's maybe 50-50. So where does that really leave us in your argument if only half the people are associated with people who had heart massage? Dr. G.M. Woerlee: There are a number of factors here. In fact, I still maintain that most of them would have received the cardiac massage for the very simple reason that you lose consciousness within 4 to around 30 seconds after a real ventricular fibrillation begins, or asystole, in other words, no heartbeat at all, begins. So what happens is that within that time people lose consciousness. It is not a matter of minutes for something like that if you do lose consciousness. It's sustained for minutes, continually, but is not a ventricular fibrillation but a ventricular brachycardia. Why is that? Because that can sustain circulation for some time. Real ventricular fibrillation does not. In other words, what you actually have is a very selective group of patients who do report their story. And that actually coincides with that article of Wood in the sense that the only people who give a coherent near-death experience story are those who have been well-resuscitated. In other words, resuscitated on time and adequately. Alex Tsakiris: No, that's not true. That doesn't conform. Here's the other thing I wanted to do before we get too far in. Let me read you an account so we're talking about the same thing, because sometimes when we talk in abstract terms and certainly when you get into medical terms, which you're extremely well-versed on and you obviously have a lot of expertise in that, but I don't. And I don't think a lot of listeners do. I think we get away from the actual data that we're talking about. This data in this case are the survey results from all these people who Long talked about. So let me throw this on the table. It's going to touch on a couple of points that we're going to talk about, including resuscitation and including anesthesia and including the accuracy and the details that someone provides. If I can, let me read this into the record here. It will take a minute or two, but I think it will be interesting. This is from a girl named Kimberly who was shot during an attempted rape, horribly enough. Here's her account: "I had never once lost consciousness or went into shock, which amazed everyone. I can still remember everything in perfect detail. As the helicopter landed, I did feel sleepy. They told me not to go to sleep and began running with me down a long hallway in the hospital. I remember counting the lights on the ceiling as they whizzed by to stay awake. They took me into the operating room and began to prepare me for surgery. The last thing I remember was them putting a mask over my face and telling me to count backwards from ten. The last number I remember was eight." That should sound familiar to you. Dr. G.M. Woerlee: Yeah, well. That business of counting to ten is ridiculous, but anyway. Alex Tsakiris: That's how they did it in Houston, Texas back then. Dr. G.M. Woerlee: More like television. Okay. Keep going. Alex Tsakiris: "Then I felt like I was walking backwards with my eyes closed. Then I felt like I bumped into a wall with my back. I opened my eyes to a very bright, although strangely not blinding, white, misty light that covered everything. Slowly, the mist started to move away and I saw myself lying on the operating table." So she's having an out-of-body experience. "It looked like I was many, many stories high and looking down on myself. I saw them working on me. I noticed that I heard, not with my ears but more like with my spirit, something like singing voices or speaking, but I couldn't make out the words. It was all around me. At this point, I turned around and saw what was the tunnel. I started toward the tunnel in a motion. It seemed like as soon as I entered the tunnel I was on the other side that quick. I noticed the same bright light and mistiness of the surroundings. I also noticed that I wasn't alone. There seemed to be a dozen people standing in a horseshoe formation which I was standing in the center of. I could not recognize anyone because I saw no features. They were more like shadows. Then I was told 'No' by a voice. The strange thing was that it was neither male nor female, but held an enormous amount of authority. Then, with my stubbornness that I carry to this day, I asked, 'Why can't I come home?' I was told, 'You cannot come home yet.' I continued to try and go forward and it kept telling me, 'No, not yet. It's not your time.' Then I felt completely compelled to turn back and look at the tunnel. That's when I was transported back through out the other side of it." Now that's rather long, but here's the part that I think is really going to be important for our discussion. "I looked down and that's when I saw them bringing a paddle machine over to my body." So she's going to be defibrillated. "I saw the doctor grab the paddles, say something to the person standing next to him. Then they turned some knobs. The doctor put them on my chest and hit me once with the shock. I saw my body jump, but I felt nothing. Then I saw the doctor say something to them again. They moved the knobs again and hit me a second time. Nothing. Then I saw..." Okay, so again, an out-of-body experience. "Then I saw the doctor put the paddles back together for a moment as if saying a prayer and then said something to the person again. This person shook their head in disagreement, but went ahead with the doctor's insistence and moved the knobs again. Then he hit me a third time and I awoke in the ICU. My parents were told by the doctor that I had died. I was what they call 'sheet-faced' and they took a chance by hitting me with the paddles a third time. He admitted (this is the doctor) to not being a religious man, but he felt that he was being told not to quit so he didn't." So the particularly relevant part of this story that I wanted to talk about, and this is not a unique story. This isn't like one account. Again, he collected all this data from 1,000 people and he analyzed it in a number of different ways. But it clearly shows someone who, if you read the whole account - which I didn't bother doing - she never received heart massage because she was losing blood really badly and that's why they thought she was going to die. Dr. G.M. Woerlee: Well, if we talk about this specific case, what you actually have is a woman who is shot, brought into the hospital losing blood rapidly, had to undergo surgery for that because either - I'm not sure where she was shot - but in any case, usually there is some blood loss and they do an exploratory laparotomy or fluorocotomy, open up the chest or open up the abdomen to see where the blood loss is and to repair any damage that might be there. Now the thing is, this experience of walking backwards with her eyes closed and this white light - there is no real difficulty with that. These are the appropriate sensitive experiences of falling asleep sometimes. Usually there's black, but some people can experience white because with open eyes they see operating theatre lamps. That's not a big problem. She sees also her out-of-body experience. Now, actually, out-of-body experiences do occur during anesthesia. There have been a reasonable number described also in the scientific literature. Usually that is basically due to the - how do you call it - I'd say proprioceptive effect, but that doesn't mean anything to your listeners. Proprioception is the sense of knowing where your body is and which way your body parts are. Now the problem with anesthetic drugs, and you see it when you speak to patients, is that some of them have very strange effects -- if they're awake, that is. And also, the effects of anesthetic drugs tested with awake people, they lose their sense of body position. Sometimes due to stimulation they can get muscle special movement sensory stimulation whereby out-of-body experiences can occur. There is a particular drug which actually induces a lot of these out-of-body experiences. This is actually not so difficult to explain. What you then have is after a near-death experience is some people, even under anesthesia, during induction and especially during traumatic moments like this, there have been one or two cases reported even in scientific literature of ecstatic experiences. So this does not surprise me. The other problem is with this woman, she has lost a lot of blood so the anesthetic is, of course, very light. All anesthetic drugs depress the heart; they depress the circulation. So what the anesthetists do when the blood pressure falls away is administer drugs to increase the blood pressure and improve the heart action. But when that fails, they're light on the anesthesia. This is commonly what happens with multi-traumas. In fact, the incidents of awareness during anesthesia for multi-traumas are up to around 43% in some series. So I'm not surprised this woman had a form of awareness which she interpreted together with the effects of the anesthetic drugs as this and the out-of-body experience. Yeah, that can happen because of the proprioceptive changes. As for this tunnel, there are many different explanations for tunnel experiences. I have one Dr. Blackmore proposed also a very good reasonable explanation for that in her book in 1991. As for these visionary experiences of meeting people at the other side and them saying, "It is not your time," this is a fairly typical American transcendental experience. Alex Tsakiris: But Dr. Woerlee, what we're dealing with here, what I think most people would focus on, especially in the context of our conversation is this woman died. Her doctor has reported that she died. They hit her with the paddles three times. And just like in all the other discussions we've had, she's viewing this from above and she's seeing everything happening. There isn't a good medical explanation for how you could see them preparing and defibrillating your body while you're dead. Dr. G.M. Woerlee: The thing is that she hears the conversations. She feels the sensations. And she also is a woman who also has seen films and she knows how these things go. She hears the conversations, why? Because she is awake. That does not surprise me. Alex Tsakiris: But she's dead. That's why they're defibrillating her. Dr. G.M. Woerlee: No, she is not dead. Why do you say she is dead? Alex Tsakiris: Because the doctor says that she had died when she comes back and that he hit her with the defibrillator three times because she wasn't responding the first two times. That's what I read into this account. Dr. G.M. Woerlee: What I read is this: they started resuscitation. The defibrillator is not standard in an operating theatre. It just isn't present. That always has to be hauled from a central place in the operating theatre complex. So until such a defibrillator arrives, they do apply cardiac massage. Second, at the same time, the anesthetist lightens the anesthetic. That means he stops administering any anesthetic gases and any other drugs he may be administering. So the anesthesia lightens. This is the reason why there is such a high incidence of awareness among people undergoing operations for multi-trauma. That means a severe injury. Therefore, accordingly, this woman was just awake, admittedly under anesthesia according to many people, but this was not so because the anesthesia was lightened. But even if she was under anesthesia, she would have still had the effect of muscle relaxant drugs. Muscle relaxant drugs, when they are administered to awake people in concentrations high enough to cause them to be totally paralyzed so they cannot breathe or move or do anything, they do cause loss of body image in many people. That is, together with any residual effects of any anesthetic drugs, that people also cannot move. This has also been experimentally determined. Other things, residual effects of low concentrations of any of the anesthetic gases, they can cause transcendental experiences. This is also known. For instance, laughing gas is a well-known one. Now, as to whether she can hear and see and build up a mental image, she is awake, true, affected by the effect of anesthetic drugs, but awake enough to observe with her ears and senses. She does not report any cardiac massage for the very simple reason she was not awake at that time. But she would have certainly had it. I cannot even imagine that that would not have been done. She would not have been awake during that time and have observed it. Alex Tsakiris: I guess this is where we get to the point where we just have to kind of back off and leave it to people to decide, because to me that just sounds like a rather fantastic interpretation of this particular case in particular, and the overall data in general. And that's where statistics can be useful. We've talked plenty about statistics, the chances that someone would be aware... Dr. G.M. Woerlee: One thing on this particular case: Alex Tsakiris: Certainly. I understand what you're saying, but that gets into a definition of what dead is. Certainly from the description here where they're hitting her the first time, nothing's happening. They're adjusting the knobs. I don't know what adjusting the knobs means... Dr. G.M. Woerlee: They're increasing the charge of the capacitor in the... Alex Tsakiris: That's what I figured. So obviously she's not responding from this and she's for all intents and purposes what most of us would call dead, but... Dr. G.M. Woerlee: She had no heartbeat but she was not dead. Alex Tsakiris: Okay, so she had no heartbeat and yet she's observing all of this from above her body. So again, I think we just get to the point where we just have to step back and say what you're continuing to claim is that the statistics, even though they're unbelievably lop-sided against your claim -in this case, let's look at the statistics. What are the chances that someone has anesthesia-awareness? One in 1,000. What are the chances that that person wouldn't have any of the effects that they normally see under anesthesia-awareness...? Dr. G.M. Woerlee: No, no. On the statistics I can also mention something. During anesthesia in American, in the USA, around 40 million operations take place every year. That is according to the anesthesia quality studies. If you have 1 in 1,000 or 2 in 1,000 they are statistics which are actually cited in modern studies of awareness. I can even give you the references if you like. That means that per year in the United States alone, there are 40,000 to 80,000 people who have an experience of awareness during anesthesia. Alex Tsakiris: Yes, but in this sample what we're talking about, and again, I think we're just going to drown people in a bunch of statistics that don't really mean a lot because in this case, Dr. Long look at 1,000 cases. He looked at about 200 cardiac arrests. If we were to talk to some cardiologist, some surgeon and say, "What are the chances?" Forget the anesthesia for a minute. "What are the chances that someone during a heart attack had a very lucid, very real memory of their heart failure and their resuscitation?" They would put those odds at very, very high, 1 in 1,000, 1 in 10,000. And yet you're suggesting that of all the people that he looked at, the chances that they had this just lined up perfectly to fit this data. I just don't think many people are going to find that very believable. Dr. G.M. Woerlee: I think basically what you're looking at saying is this: to begin with, you should never ask a surgeon about this type of thing because surgeons just don't know. There's a joke about surgeons. How do you ask them to commit suicide? To jump from their ego to their IQ. That's something else. The big problem is that with 40,000 to 80,000 people per year have an awareness under surgery. Dr. Long has collected in all these years with his excellent database of patients who have awareness under anesthesia together with a near-death experience, and they do occur under anesthesia. There's a very good one in a scientific article a few years ago of a young boy. But that means that he has collected over 20 years only 23 cases of awareness or a near-death experience during general anesthesia and a near-death experience as defined by the Near-Death Experience Index of Bruce Grayson, which is actually a good index. That is over 20 years. In other words, 20 years by 40,000 people. In other words, you have a potential base of around 800,000, maybe more patients out of which to choose. And 23 of which actually registered their experience with Dr. Long. In other words, you're speaking about a statistical probability. Alex Tsakiris: I don't want to go there because I don't think you can really do the calculations that way. That wasn't the population that he was drawing from. Dr. G.M. Woerlee: No, he has spontaneous cases. These people registered their cases or their experiences with him. That is out of a potential many hundreds of thousands of people who have awareness. Alex Tsakiris: The other way of looking at this in a way that I think is more of a fair way of looking at it is to say that let's look at the cardiac arrest patients he looked at. There are 200 of them. We know from the Pim von Lommel study and many other near-death experience research studies that let's say 10% to 15% of people who have cardiac arrest have some sort of near-death experience. So just extrapolating out what we can say is this is a population of about 2,000 that he looked at. So he looked at 200. That represents about 2,000 patients. Then the chances that in that 2,000 any of the things that you're talking about would occur are just astronomically high - that they'd occur as frequently as they do. His stats, again 76% of these people report that it's a realer than real experience. The accuracy rate over 90%. It just doesn't add up. And then when we read this particular case, I was listening to your explanation for it. I don't know. I think at this point we just have to leave it up to the listeners. If listeners accept your explanation of Kimberly's case, the woman who was shot, then I guess they just have to go with it. For me, it satisfies me to the extent that I'm very glad that you came on and were able to offer your specific response to a case that represents a lot of cases in the database. I think that clarifies things. Dr. G.M. Woerlee: Actually, it is an interesting case. But then we talk about cardiac arrests. Now the only people our people talked to and whose experiences we know of, are the ones who survived cardiac arrest. As I said, that's around 40% of people - 40%, 45% of people in coronary care units, and around 20% of people in the general hospital ward. And only 7% in some situations to 2% of people who are resuscitated at home or on the street. In other words, there are a lot more people who actually die than survive. Then out of those survivors, many are brain-damaged. In other words, they cannot tell any story at all. In fact, this article of Keith Wood said they suffer all the effects of brain damage due to oxygen starvation as a result of cardiac arrest. The ones who are very efficiently resuscitated, they tell a coherent story, a good story and many of them have even undergone a near-death experience. ...damage and the ones that can tell a very good story are those who suffer some effects of severe oxygen starvation and they are confused, uncertain. So in other words, what we're speaking about here is a very select small group of patients out of the many, many thousands who have been resuscitated. Alex Tsakiris: I think you've done a great job of summing up your case and your points. Are there any other points that we haven't touched on that you'd like to add before we wrap things up? Dr. G.M. Woerlee: I was reading that article by Keith Wood. It was actually a good thing. He's missed a number of points and I'd like to compliment him on his work for reading and doing a careful analysis of the papers he did. The only problem is that he did miss out on the concept of averages with cerebral blood flows, etc. But for the rest I think that as you say, basically what we would have here is differences of opinion as regards many things. Dr. Long mentioned at the end of his last conversation with you that I tend to look at only one aspect, basically that I have an aspect of cardiac massage and cerebral blood flow. Another critic that you once interviewed, a certain Dr. Nelson, looks at REM intrusion and he mentions I did not mention this. That is because this was not brought up in the discussion at the time. As I say, I believe neither of these experiences are a common product of many different causes. As I say, oxygen starvation is one. Awareness during anesthesia is another. Fear and other anxiety states, another. And you could go on and on. In other words, there is no one single explanation for the cause of the near-death experience. The final result is what we all know as the near-death experience. That's my last word on the matter. Alex Tsakiris: I think that's a good wrap-up and explanation of why there are so many explanations. Dr. Woerlee, again, thanks for coming back on and we'll get this out so that we can keep the dialogue going. Dr. G.M. Woerlee: Thank you very much.
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