Episode Transcript
[00:00:00] Speaker A: And what struck me so much is that this return of the person is truly a return of the person.
It's not an abstract self, like an atman or, you know, some impersonal. It's this person with this biography what he or she lived through, succeeded in, strived for, suffered and so on. Yeah. So all that's why I mentioned dignity. It's very hard to look at these 450 case cases. Yeah. You see something scientifically interesting and immensely human.
[00:00:36] Speaker B: ID the Future, a podcast about evolution and intelligent design.
[00:00:44] Speaker C: Why would the human mind sometimes appear strongest when the brain is weakest? Welcome to Idea the Future. I'm your host, Andrew McDermott. Well, today I welcome to the show neurosurgeon Dr. Michael Egnor and co author with Denise O' Leary of the recent book the Immortal A Neurosurgeon's Case for the Existence of the Soul. And Alexander Bhattiani, a leading researcher on terminal lucidity and author of Terminal Lucidity and the Border between Life and Death.
We're going to discuss the phenomenon of terminal lucidity today, what it is, what the evidence shows, and how it relates to debates about consciousness, mind and human identity.
Welcome gentlemen, to ID the Future.
[00:01:28] Speaker B: Thank you, Andrew.
[00:01:30] Speaker A: Thank you for having us. Thank you.
[00:01:32] Speaker C: Absolutely. Yeah. I'm excited about this discussion. Alexander, let's, or if I may, Alex, let's begin unpacking here. We're going to spend a couple of episodes unpacking this topic and the insights that both of you bring to the table today. My goal is to help our audience clearly understand what terminal lucidity is and why it doesn't fit comfortably with standard brain based explanations of the mind.
Now let's start at the beginning. First, what is terminal lucidity, Alex, and how did you become interested in studying it?
[00:02:04] Speaker A: Well, I mean, terminal lucidity refers to the fact that and it has been observed ever since humans took care of humans, so for a very long time. In other words, as long as we are human, that, that it sometimes happens, that I mean we all observe our vulnerability, that certain diseases can rip us of certain abilities, mainly cognitive abilities, such as the dementias. But there are also a couple of other diseases, brain disorders, and it has been reported and Only very recently, 2009 or so, it has begun to become a new topic on the landscape of science, that sometimes what people always told us in the hospices and so on, that sometimes people, when they're getting closer to dying, let's say people with dementia, different types of dementias or brain Tumors. So a whole variety of disorders, it seems to be not dependent on. It's not a function of a basic disorder that they sometimes make where the relatives say they come back. Yeah.
And that's, I think, the easiest description.
Slightly better one would be that some people do have a return of spontaneous, meaningful and relevant communication at a time when the textbooks would tell us that that's no longer possible, given their brain state.
Yeah.
Or severely compromised brain function. So it might be the real structure of the brain, such as in the dementias, or it might be more functional.
And that is basically terminal lucidity. It happens. There are two words. There's. One is paradoxical lucidity, which refers to something very similar, but not so close to the actual death of a patient.
But currently, I mean, as I said, it's fairly fresh field, so we are lacking data. I, by NOW collected about 450 cases, which sounds like a lot, but given how many people have dementias and so on, it's still a tiny proportion.
[00:04:17] Speaker B: Yeah.
[00:04:18] Speaker A: But in our database it's about 90% that they will die within 48 hours, approximately. So we observe it a few days to a few minutes before people actually die.
And that's the phenomenon. I mean, and, and phrasing it like this sounds interesting. It's very moving when people tell us what they experienced. Yeah. Because of course, it's. What usually happens is that the hospice or the nursing home calls and says, you know, the physiologic parameters of this person's person seemed to suggest he or she might die soon. If you want to say goodbye, come. Yeah. And most hopefully, if the family is working, they will come, but won't expect too much because these are patients who didn't recognize their daughters, sons, grandchildren for a long time. Yeah. And then comes the great surprise. Often it happens that the nurse already tells them when they enter the home something is totally different today.
And then they come and they're recognized and you see it in the eyes. You see if somebody's there or not. They're always there, but I mean, in, in a present way, and that is what's happening. And to come back to your second question, how did I become interested in this?
Because I experienced this with my own grandmother who was living in Geneva. I was a student in Vienna. And she had a number of strokes which rendered her basically incapable of having a conversation. And we didn't quite know how much does she understand or not. It's very, you know, there's a certain inaccessibility. People lose their words and with them, you don't know how much else is lost. Yeah. And one day my mother calls me, I think I was just writing my PhD thesis and told me, call Geneva, call your grandmother. She's back again.
And indeed she was. And she was.
I mean, for a year we couldn't talk because she wasn't able to. Yeah. And when I. When I phoned her, there was very gentle, very elegant in a way, you know, woman back once again. Yeah. And I was utterly unprepared, of course, because the term turn lucidity didn't exist. And I mean, who would tell you. Yeah. I wasn't utterly unprepared. And so far as I was and am a student of Viktor Frankl in Vienna, founder of Lugotherapy. Yeah. And he always told us, almost preached to us, that a person is always more than his or her behavior because what you see is what you measure. But the real essence, the noetic person, the core of being personhood is, according, he said, is indestructible. You can disturb it, but you can't destroy it. So at least as an idea, this was present. But it's very different when you have this on the phone than when you know it from the textbooks.
[00:07:18] Speaker B: Yeah.
[00:07:19] Speaker C: Yeah. Now, this topic has been the subject of some public debate in recent weeks involving major thinkers like political science scientist Charles Murray and cognitive psychologist Steven Pinker. Can you just briefly touch on how that came up? And that's part of the reason we decided to talk about it today.
[00:07:37] Speaker A: Yes. So one day a friend of mine sends me a article by Charles Murray in the Wall Street Journal.
And what I didn't know, but now I do know that Murray wrote a very nice book called Taking Religion Seriously. Yeah. In which he describes his, I would say, long path, long winding path from being, what I believe, a non believer to a believer in Christianity. Yeah. And he gives a number and it's a very nice book. And so far as he looks through very different topics from, you know, how valid is physicalism or materialism. Yeah.
How much does it explain? Or not. Rather not in this case, when it comes to consciousness.
And one of the reasons for his path is, I'm afraid to say, in all humility, my book and the work I've been doing. And.
Yeah. So this is when we came to.
Yeah. This he published in the Wall Street Journal. Yeah. And I think Steven Pink didn't very much. I mean, given his beliefs or philosophical background. Yeah.
Didn't really want to agree to that, which I found interesting.
Not so much because there's Disagreement. No surprise about that. Yeah.
But the point with terminal lucidity or tl, if I may, is that it is, it is a very strong indication. I wouldn't say proof. You'd need more for proof. Yeah. But it's still, it's, it's not what materialism would predict. Yeah. So if you, if you put this forth and say, look, we have a severely disordered hypo functional brain and very important structures of this brain are severely out of function, otherwise there wouldn't be dementia. Yeah.
And then suddenly you have a reg.
You know, memory and so on.
And we do know that neurons don't grow back so fast and if they do, usually it's cancer, but not, not a healthy regrowth. Yeah.
[00:09:47] Speaker C: Yeah.
[00:09:49] Speaker A: Not that orderly, if you want. Yeah.
So this is not what you, what you would expect. And I think this issue was something Pinker tried to, a bit offhand say, look, these are only anecdotes and what do you want? Yeah.
And in all fairness, I do agree these are mainly anecdotes. I mean, there are a few prospective studies now underway and one is finished. And I think by now it's hard to dismiss the phenomenon. Yeah.
But to a certain degree, where I'm coming from, I would say that never underestimate what is an anecdote because it means it's a personal experience.
And, and, and Pinker said basically his, his idea. Suggestion was that these are just some random movements by demented people. Yeah. And our bias makes it, turns it into something meaningful. Yeah. Now I think you can uphold this idea as long as you don't look at the anecdotes or case histories, which would be the better word for it. Yeah. And then you see wonderful conversations and I had to, I mean, in this case I was an eyewitness myself and heavily misrepresented and misunderstood. And the phenomenon also. Yeah. When he said, you know, it's only some random movements and then we like, we see in the clouds some figures. So somehow it's like a rocha, an ink blood test, if you want. Yeah. Which we're thinking.
[00:11:16] Speaker B: Yeah.
[00:11:17] Speaker A: So.
Well, anyway, I wrote a reply. I contacted Charles More or Hemi, I think I contacted him and he said, well, if you want to reply, reply. And was he drunk? Was kind enough to print the reply. And then there was a follow up and so on. And from a European perspective, I didn't know that philosophy could be such a war zone. Yeah.
In Europe we are much more used to it, but not that much. And it's really A confrontation of believers. And that's what I also said in my. In all due respect, but materialism is as much as a belief is anything else. Yeah. Because how would you prove that everything. And so on and so forth. Yeah. Clearly with measurement, you only measure what can be measured. And since these are material devices, you'll only get material data. To therefore say that there's only matter is a shortcut. Which is hilarious, actually.
But once again, I didn't know that this is such a new. But I didn't know it, that it's such a serious war zone.
[00:12:26] Speaker C: Well, and this is what's exciting about releasing books and putting your work out into the public square and into the marketplace of ideas is you don't know who's going to be able to wrestle with them and what kind of debates are going to ensue. So I'm glad you did that. Now, Michael, I do want to drill down into what these episodes look like just so listeners, viewers can get a good idea. But before that, Michael, for those not familiar with your work, can you tell us briefly about your background as a neurosurgeon and how you became interested in the evidence for mind and soul?
[00:12:59] Speaker B: Sure.
I'm a neurosurgeon. I've been a professor of neurosurgery for about 35 years.
And I started out my life as an atheist and as a materialist. I was raised in kind of a secular environment, and I was fascinated by science as a child and almost worshiped science instead of God. And I went to college and majored in biochemistry and went to medical school and then fell in love with neuroscience and neuroanatomy and neurophysiology and decided to become a neurosurgeon in part because I was fascinated by the relationship between them, mind and the brain. And I thought that if I understood the brain in sufficient detail that I would understand everything there was to know about the mind, that I would understand everything that made us human.
So I began my neurosurgical practice and I started encountering patients who didn't fit the materialist paradigm.
I had a number of patients who were missing major parts of their brain. I had one little girl was born missing about two thirds of her brain. And I told her family that I was very pessimistic as to how well she would do in life. And she's grown up entirely normally. I saw her in the clinic about two months ago, and she's a businesswoman, works in New York City, perfectly normal person.
And I have a fair number of people who have very significant anatomical abnormalities in their brains, who really function very, very well.
And this is a well recognized phenomenon.
I had an experience about 30 years ago. I was doing what's called awake brain surgery. And it's an operation where a patient is awake during the time the surgery is being done. So we can map the surface of the brain using electrical stimulation to find out what areas are vital and what areas are not vital. So, for example, if we're removing a tumor, we can remove the tumor safely and not damage important, important parts of the patient's brain.
The brain feels no pain, and we can anesthetize the scalp so there's no pain involved. So I was operating on a woman in her early 40s who had a brain tumor that was infiltrating a major part of her left frontal lobe, which was near her speech area.
So in order to map her brain, I had to talk with her during the operation so I could determine where her speech area was located. Exactly.
And as I operated, so I was having this conversation, the operation took about five hours, and we had a wonderful conversation about her family, about the hospital, about the weather, about her life. And it was wonderful as I was removing major parts of her left frontal lobe to get this tumor out. And she never turned a hair. She was perfectly normal through the whole procedure, which is a common experience in these kind of operations. And I really pondered that. I said, that's not in any of the textbooks. All the materialist textbooks I had read. Nobody says you can take out major parts of frontal lobes, and people don't change. And not only don't they change, they don't change as you're taking them out, let alone going forward.
So I began looking at the medical literature, and I particularly was interested in the work of Wilder penfield, who's a neurosurgeon in Montreal, who pioneered seizure surgery. And penfield, like me, started out as a materialist. And he asked a question earlier in his career that fascinated me. It still fascinates me. I think it's the most important question in cognitive neuroscience. And the question is, does the brain explain the mind completely?
That is, does everything that's true of the mind happen as a direct proximate result of brain activity?
And Penfield started out his career thinking, well, that's probably true as I started out mine. And he ended his career saying, that's certainly not true, and I feel the same way.
And Penfield made some observations that I think are absolutely fascinating.
The first observation he made, and I've looked Further into this and found exactly the same thing he found is that a significant fraction of seizures don't produce unconsciousness. That is, you can have a seizure and still be conscious.
And when you look at what people do when they're having a seizure, what's. What's called the ictus of the seizure, there really are only four things that people do. And Penfield noted this.
People can have movement. You can have a limb that shakes. You can have a sensation like tingling on your skin. You can have a memory. Sometimes seizures present as recurrent memories, or you can have an emotion. There are several kinds of seizures that cause powerful emotions, but seizures never cause abstract thought. They never cause free will. That is that when people are having seizures and they're awake, they never think about mathematics or logic or philosophy. Philosophy. They never think about the Ten Commandments.
They never think about what occupies a lot of our thought all the time. The very thing we're doing here never shows up in a seizure.
And I calculated that there had been about a quarter of a billion seizures that people have had in the modern era of neuroscience, which is about 200 years. And there's not a single report in the medical literature of any seizure evoking reason or free will.
And Penfield noted this too. And he said, well, maybe that tells us that reason and free will don't come from the brain, that the brain isn't the source of that. Maybe the brain is permissive of the expression of reason and free will. Maybe the brain is in some sense necessary for the normal expression, but it's not sufficient.
There's something deeper going on in human beings, particularly in our capacity for abstract thought, for reflection, for all the things that make us human.
So Penfield himself studied that with awake brain surgery. He did 1100 weight brain operations where he mapped the brain and he found exactly the same thing. He could not evoke reason or free will anywhere in the brain. And he concluded that means it doesn't come from the brain.
And in addition, there are patients who've had split brain surgery where they've had intractable seizures. And we go in and we split the hemispheres of the brain, so they're disconnected.
And what we find is with those patients is that there is a split of perceptual abilities in the patients. Although the patients feel unified, they actually feel totally normal afterwards. And the only way you can find this evidence of split is with very careful research.
The original research was done by Roger Sperry, who won the Nobel Prize for it. But these are overtly normal people. Whose brains are split in half.
And there's been some intriguing research done, particularly by Justine Surgent and Alice Cronin at mit, and Jair Pinto, who is a neuroscientist from the Netherlands, who have looked at the ability of patients to integrate the perceptions in the two hemispheres. And what they find is that patients cannot integrate pure perceptions. That is that, for example, the left hemisphere is usually the speech hemisphere. Using the visual fields, if you present an object to the left hemisphere in a split brain patient, they can tell you what that object is. They can say, that's an apple or that's an orange, but if you present it to the right hemisphere, they know what it is, but they can't say it because it doesn't connect to the left hemisphere. But what surgeon Cronin and Pinto have shown is that if you present concepts to one hemisphere, both hemispheres get the concept. That is, you can integrate concepts but not percepts.
And specifically, one example of surgeons that I think is fascinating is that she would show letters to each hemisphere and she'd ask people to press buttons if they see a K or if they see an A, whatever. And that showed the usual hemispheric split.
The perception of the object was limited to the hemisphere that initially saw it in split brain patients. But then she would say, if you see a vowel anywhere, any vowel, push a button. And that was not dependent upon hemispheric splitting.
That is, the whole person knew if it was a vowel, even though only one hemisphere or the other knew the actual letter. So what she found, what surgeon found, Cronin has found a similar thing. Pinto has found a similar thing, is that the capacity for reason, for abstract thought, it doesn't seem to be split when you split the brain, which again implies that there's an agency in human beings of reason and free will that doesn't come from the brain.
And curiously, this is exactly, or almost exactly what Aristotle said. Aristotle didn't realize the brain was the organ of the mind, actually. But Aristotle said that reason and will are immaterial powers of the human soul. And that's Thomas Aquinas taught that that's the standard Christian way. And Maimonides taught that there's a long history going back thousands of years of philosophers and theologians pointing out that there's a spiritual nature to human beings that is particularly present in the capacity for reason and for free will. And modern neuroscience backs that up. And you see phenomena like terminal lucidity or like near death experiences that really point out again that the linkage between the brain and the mind, or the brain and the soul is not as tight as we've been led to believe. So I think materialism is wrong in linking everything in the mind to the brain. And terminal lucidity, as Alex's fascinating work and fascinating book has shown, points to aspects of the mind and aspects of the soul that are to some extent independent of brain function.
[00:23:34] Speaker C: Fascinating. Alex, did you want to comment on anything that Mike said here before we move on?
[00:23:41] Speaker A: Well, that's beautiful. I mean, I agree to most in my book, not only my book, in my work I try when I'm asked, what in the end do you think this means for the mind body relationship?
Yeah.
I tend to say that physicalism or materialism seems to be out because it's just, you know, I mean, how do you falsify a hypothesis? By showing that, you know, there's data which contradict it. Yeah.
And I think that in this case, at least for the moment, seems to be fairly obvious. Yeah. When it then comes to how. No, what does it actually mean? And how do we translate this into a mind, body or brain? Mind theory.
The beautiful thing about Aristotle and Thomas and so on is that it's a bit more sophisticated than a blunt, easy dualism, which is almost like a vulgar dualism or you know, that there's this and there's that.
And obviously I think.
Let me put it like this once. I mean, first of all, we should point out that the very fact of consciousness, the subjective experience. Yeah.
Puts a certain stop to the victory of physicalism. Yeah. The fact that we have first person perspective. Yeah.
So I would start perhaps even a bit earlier. Yeah.
I do agree that when it comes to the function, and also to put a word which doesn't sound so analytical and still it is very much interwoven to us. Our dignity, for example, is not only the fact that we are aware of, because also very many animals seem to be aware, but that we have a certain way of dealing with our awareness. So we know that we are conscious. More importantly, we even know that other people are conscious and therefore we have a certain morality and there comes free will. I mean, I think it's. What I want to say is that in contrast to easy dualism, which is a bit like Descartes, but also the new age, if you want, it's far too easy.
There are functions of the soul, or however you call the non material part of us, functions, perhaps even obligations and so on. And there comes a whole new field which is not on the landscape of the natural Sciences, but very much on the landscape of what it means to be a human person and also to survive as a human society and look at art and so on. And I mean, there's so much to say.
And still, what I'm making a long detour. What I wanted to say is that in the book, I don't favor one theory of consciousness.
I only say that it seems to be fairly obvious that blunt materialism doesn't work. Yeah.
Quite frankly, I think it didn't work even before that. Yeah.
[00:26:46] Speaker B: It's just the final nail in a coffin. Yeah, right. Exactly. Yeah.
[00:26:49] Speaker A: I mean.
[00:26:49] Speaker B: Right.
[00:26:50] Speaker A: It's. It's a cumulative case, of course. Yeah. You can't take one finding and say this is every. But still, I mean, there are stronger and less strong findings. I. I would count the L among the more interesting findings because it so obviously contradicts.
And what I find.
I don't want to take the podium, but what I want to say is. Is important.
Yeah, that. And what struck me so much is that this return of the person is truly a return of the person.
It's not an abstract self, like an atman or, you know, and some impersonal. It's this person with this biography, what he or she lived through, succeeded in, strived for, suffered, and so on. Yeah. So all that's why I mentioned dignity.
It's very hard to look at these 450 case. Cases. Yeah. You see something you.
Scientifically interesting and immensely human, which you can't subtract, you know, because these are not abstract data. These are persons. And the whole idea of personhood, I think, needs to.
Needs to be rehabilitated. Yeah.
[00:27:59] Speaker B: We.
[00:28:00] Speaker A: So that we don't no longer talk about minds and brains, but we talk about persons.
[00:28:04] Speaker B: Yeah.
[00:28:04] Speaker A: Someone. Not something.
[00:28:05] Speaker C: Yeah.
[00:28:06] Speaker B: Right.
[00:28:07] Speaker C: And I am glad that this is coming to a point where we are studying this more scientifically and rigorously.
All due respect to Mr. Pinker, you know, one of the reasons that it might be easily dismissed is that it happens in the home. It happens in the center where caregiving occurs. There are no researchers present. There are no scientists. It's family members. It's those who are caring for others. It's those who love others, and they don't necessarily know what to do with the phenomenon other than to experience it and cherish it. Perhaps.
But I'm glad it's starting to be studied more rigorously now. Alex, you've spent years talking directly with people who witnessed these moments, and I did promise our audience a really clear understanding of what is happening. In these episodes, what do families and caregivers actually observe?
How long are these episodes and to what extent have you found the consistency of descriptions across what you've studied?
[00:29:11] Speaker A: Yeah, I mean, earlier on, the near death experience was mentioned and it's similar. I think they're cousins, they're somehow related because they happen at a time and so on.
But in contrast to the nde, these cases are fairly uniform when it comes to what is happening. Yeah.
In the sense of that there are certain recurring topics.
So number one, length. It can take anything from the longest we had was 24 hours, which is the longest stretch you can take as far as I know.
It's mostly anything between a few hours and half an hour or so, rarely less.
Which also speaks against the pink theory of it being an inkblood test. And believers will see something. So it's too long to be just reflexes. And I said it's relevant communication. In other words, people are really talking and they're not just talking, they're talking to someone. Once again, personhood means I and thou, so that we can relate and that we know who we are and who the other is.
And, um, then there are different. I mean, in 80 to 85% in of our cases, we have like a scoring system. Yeah. How much, how coherent are these persons? Yeah. Fully back or partially, partially back and so on. And in about 85 to 87%, close to 90. Therefore, they make a full return of their abilities and of the memories.
And what then comes through is very, very individual. So I had an art historian who seemingly borrowed many books from his colleagues and friends.
And as you know, as it is like with books, we tend to borrow them and forget that we have them or others forget that they have ours.
But on his deathbed, he was a very meticulous person. He said, after he said farewell to his family and they asked him, is there anything else? He said, yes, please give this book to this, that person, that book to this. And also I've got this valuable, you know, old first editions. I think he might enjoy it. So therefore. And they're very much in the world, back again in the world. In contrast to the nde, where you take, you know, where you almost leave the world, they come back. It's a return. Yeah.
And then there are the more subtle notes, which are not scientific and yet I think, equally important that, you know, when it's our last hour or so, something important happens. Life, earthly life, comes to its closing. Yeah. And this is a very dignified and very valuable moment. And therefore you see very different.
Very different things which are said. I mean, I had one case recently and it's really. And I also shared it with my wife and even my daughters. It was a very religious mother and her daughter. And the mother was having a, cancer B, dementia. Yeah. And she was absent, I mean, mentally absent for a long time. For a year and a half or so. Yeah. And then it was clear that she was about to die. So therefore the nursing home, a Catholic home, called her and said, if you want to say goodbye, it's now would be the time. Yeah. And then she comes to the nursing home and she visited her mother fairly often, even though she wasn't there. Yeah. There is a dignity even, which is not dependent on how functional we are. It's being persons which gives us her dignity.
And the nurse said, you won't recognize your mother. Something is utterly. You won't believe it. And she didn't believe it.
And then she went there and she could talk to her mother. She was back again.
[00:33:08] Speaker B: Yeah.
[00:33:08] Speaker A: And both being very believing persons, they prayed together. They forgave what was to be forgiven. They were grateful for what, you know, they said thank you.
And then they called a priest. I don't know, I'm Catholic, but I don't know the English word for the last sacrament where you get the last anointment, I think it's called.
And everything was done.
And then in principle, this would have been the perfect ending. But she was still there around.
And finally the daughter said, you know, is there anything else I can do for you? And the mother said, yes, you can, if you go outside and get me a piece of chocolate.
And so the daughter went, bought a piece of chocolate, and then she observed her mother eating the chocolate and she said, it was like never in my life have I seen a person celebrating a piece of chocolate like my mother did before she.
It was like heaven and earth touching. And first of all, the prayer, the saying thank you, and so on. And then. So in this, I think the whole spectrum of what we observe is fairly well covered by this one story.
So it might be very trivial and not yet trivial because we are persons or very holy and everything in between.
[00:34:26] Speaker B: And the people that I've encountered. I've not myself seen terminal acidity, but I know many people who have.
Denise o', Leary, my co author of our book, her father had an episode of terminal acidity.
And I've met many nurses and colleagues I work with in the hospital who've seen it, and Stephen Post, who is a medical ethicist. That I work with actually has also written a very good book about it.
And I thought Steven Pinker's comments in the Wall Street Journal were really flippant and were kind of an embarrassment from the standpoint of a scientist of his stature, as Alex is, I think, truthfully pointed out.
People who've seen this and have had these experiences, this is not a misunderstanding. That is, the people who have terminal lucidity are radically, dramatically their old self again in a way that is not just a matter of some misunderstanding or wishful thinking.
And so these are powerful, powerful events. And they are anecdotal only in the sense that we haven't studied them adequately. But I think we are beginning to. We're really beginning to do some good research on this.
But these things are real. There's something going on that doesn't fit the materialist paradigm.
[00:35:53] Speaker C: Well, here's a question for both of you. Memory seems to be a key aspect of terminal lucidity. How can memories, though, be intact if the physical brain is severely impaired or destroyed?
[00:36:06] Speaker B: Well, that's, I mean, memory in Penfield's paradigm of what the brain does is a brain function. And there's no question that the formation of short term memories, for example, is very much dependent upon the hippocampus and various structures related to it.
And you can have a syndrome where you're unable to form new memories just because of brain damage.
But philosophers have talked about this over thousands of years and there seems, I think there's a difference between knowledge and memory. That is that knowledge is the capacity to do something, the capacity to like. If you say, like, I know how to play chess, very good example, I know how to play chess, but that doesn't mean that I'm thinking about chess continuously.
And so my knowledge of how to play chess simply means that I can do it if asked.
On the other hand, memory of chess may involve, for example, memorizing the appearance of a chessboard in a particular situation or something, which is kind of a different thing.
So the knowledge is a little different from memory per se. Memory is the retention of an image, whereas knowledge is a potential to do something.
And I think retention of images can be damaged when you have brain damage, when you have problems like Alzheimer's. But knowledge is a much deeper issue, and I think it goes to the soul.
It's something that is not completely dependent upon brain function.
And so when we remember things, we also obtain knowledge of those things.
It's the knowledge part of it, which is, I think, is a spiritual or immaterial power of the soul that enables us to bring back these aspects of our lives.
[00:38:20] Speaker C: And Alex, I mean, memory seems to be gone for many patients, but in these episodes comes back or is on full display.
[00:38:28] Speaker A: Let's put it this way, it is gone. I mean, when you don't.
And let's not forget. I think that's also an important point we might come to later on now, is that TL is a rare event. Yeah. It just tells us something like, you know, like a musical genius might be a rare event, but it proves that there's musicability. I mean. Yeah.
So but when it comes to memory, I mean, we are speculating and I'm by training a philosopher and then psychologist, but mainly to be fairly honest, I mean, there are two things about memory which I believe lead us straight into metaphysics rather than physics.
Next to the fact that the brain is involved, namely our memory is very reconstructive.
But if you look at memory as a phenomenon, it means that something has happened and we know about it.
Yeah. So the idea that my past is only in my brain, whereas, you know, having been, you know, that something has been, is also an ontological statement.
It doesn't mean gone, it just means it's not now, but it has been. Yeah.
So the past is out there, so to speak. Yeah. Only the question is, what is the relation then of me?
It gets metaphysical when we think about one fact, namely that memory means, if it's from the first person perspective, it's my past and somehow it belongs to me.
Why? Because I experienced it or I co created it by what I did and how I decided and so on.
Which in a very specific way makes me me now. Yeah, it's the outcome of what happened to me, but also how I decided. Yeah, but it went. When it comes to the knowledge of my past, who says, who ever had the idea that the past is only in the brain when the brain is only reconstructing it? Anyway. Yeah. So it's. The brain is not a storage of the past. It's a good point.
So. And therefore I think, and perhaps the time has come that even the natural sciences come to terms with the fact that metaphysics doesn't begin on Sunday, but it is there Monday, Tuesday, Wednesday. So it's interwoven into what we are talking about, if only because consciousness is in it and physicalism doesn't have a good idea of consciousness.
So therefore I think it's a bit more complex.
But the short answer would be that it's very likely that most during our normal everyday Life, our memories is dependent on our brains, but that doesn't mean that it's only dependent on. Neither does it say that the memory is only in the brain, because the past is not only in the brain. And therefore.
[00:41:46] Speaker B: Yeah, I think that that's a very deep insight. One of my favorite aphorisms about neuroscience, about materialist neuroscience, and I paraphrase, was said by Roger Scruton, who's a wonderful philosopher, who actually passed away recently. And Scruton said that, and again, I paraphrase that materialist neuroscience is a vast trove of answers with no memory of the question.
That is, that it's all this data that neuroscientists have accumulated.
But there is kind of an innocence among the neuroscientists of the metaphysical framework that they're working in. And very often, I don't even think that they realize that they're working in a purely materialistic framework, but it greatly limits the understanding of reality. So scientists need metaphysics, as Alex very, very honestly said, every day, because we all work from a metaphysical perspective.
And I think materialism is a really inadequate metaphysical framework for understanding the world.
[00:42:56] Speaker C: Now, some have sought to explain terminal lucidity with reference to physiological surges at the point of death. How would you evaluate that?
Is that a good way to look at it?
[00:43:07] Speaker A: There's an enormous temporal mismatch between these surges, which do happen at the process of dying, Whereas we observe TL 48 hours to a few minutes before death, not at death.
So the surges are interesting in their own right.
Speaking in a more romanticized manner, I would say it tells us death is not an easy event. It's not only that something is shut off. Obviously something. Something happens. And if you've gotten enough other indications, it will tell us. We are not surprised that it might be more complex process than just, you know, switching the lights off. Yeah. Obviously more needs to be done. Yeah.
But turn lucidity, I think, can the surges do happen at the wrong time? Yeah. And if there's a very strong. And we talk about hours to 48 hours mismatch. Yeah.
And so I don't think it's usable.
It won't explain. It's not relevant, in a way.
[00:44:16] Speaker B: Yeah, Yeah, I agree. And I think that it's kind of almost nonsense in a neuroscientific way, to attribute the remarkable coherence and clarity and lucidity of people who have these episodes to a surge of anything. And it's not a surge. I mean, we know what surges are. Surges are seizures. I mean, seizures happen.
In addition, there's a very common experience of people awaking from coma who do have surges.
And we have tons of experience with that. I see it every day in the intensive care unit. And when patients are coming out of coma, they invariably go through a period of severe agitation. Their blood pressure goes up, their heart rate goes up, they'll thrash, they're irrational.
If they're extubated and can speak, they make no sense at all.
So we have a lot of experience with surges in the setting of brain injury and brain damage. And they don't make you more coherent. They make you less coherent.
They disturb your neurological functioning.
Pinker was really flippant and unprofessional, I think, in what he had to say about Murray's.
Murray's beliefs on terminal lucidity. And Pinker, in his letter to the Wall Street Journal, said that he could get his grad students to simulate thermal lucidity on a computer very, very well.
And that's absolute nonsense.
What Alzheimer's disease is in a computer simulation.
It's not a bunch of grad students programming the computer in detail. It's pouring acid on the hard drives of the computer, so it's progressively destroying the central processing unit and the hard drive of the computer. So I challenge Pinker that if he wants to develop a computer model of terminal lucidity, he needs to take his laptop, pour some sulfuric acid on the hard drive, and then run the laptop and see if he gets intervals where the computer works perfectly, which is not going to happen.
So we have a ton of experience in neurology, neurosurgery, neuroscience, with surges of neurotransmitters, surges of action potentials, and the surges show up as seizures, number one, or as extreme agitation, panic, lack of coherence. That happens as a normal part of waking up from coma.
What you do not see is people do not in coma suddenly become very, very clear and very, very lucid as a result of any surge. So the surge theory is just scientific nonsense?
[00:47:12] Speaker C: Well, one more question for each of you before we close this first session. Alex, you point out that terminal lucidity hasn't been studied nearly as much as it should be. If researchers were taking it seriously, what kind of studies might actually help us learn more?
[00:47:28] Speaker A: I mean, prospective studies would be wonderful. And once again, they're on the way.
Otherwise, there are certain limits to what you want to do and can do.
Why?
Because if, you know, let's say you've got one Hour of this person saying farewell to husband and granddaughter and so on and so forth.
You can't take them away and say, we need some neuroimages. It would be nice.
[00:47:57] Speaker B: It'd be wonderful. It would be wonderful.
[00:47:58] Speaker A: It would be. But especially if you're encountering a phenomenon which so much points towards the sanctity of personhood, you at least as a researcher, need to apply your own principle, otherwise it would be worthless.
And that makes it a bit difficult. What we do have, and I recently received a few neuroimages from a medical doctor in Germany who had a patient who was fairly well studied because of the diagnostics and so on, and he had a lucid episode and they looked at his brain afterwards. Now, unsurprisingly, there wasn't any structural change because that alone would have been a miracle. Worthwhile another term.
But we do know that neurons don't grow so fast and not so orderly and so on. I didn't.
But so what we need prospective studies. And I think there's a very interesting trace to look inside the brain, namely language. How do people talk? Yeah. We do know that from cognitive ability studies that the way we use words and how long our sentences are and the structure and so on, it gives us an insight into brain function.
And I received a few videos from caregivers, two from nurses and three from relatives. Yeah. Who said, you know, this was so enormous, what we observed. So we picked up our phone and made videos. And then what you see usually is an elderly. Mostly it's elderly people because most of our patients were dementia patients, but alive. And the language was. And this I also observed with my grandmother, who before her dementia, before her strokes, cardiovascular dementia, had an enormous command of language and a very beautiful way of expressing herself. Yeah, a very typical and very beautiful. And all of this was there again.
Yeah. So it's not that, you know, that they're doing the bare necessity of communicating. Yeah. It's really the whole beauty of a person.
At least that's what I observed. And now five videos, which suggests I was not the only one who had the grace of experiencing this.
So this would be something for further studies that we somehow video it. And what I also believe is important is that we look closer into the different types of lucid episodes.
I think at the moment we are not fine tuning enough. There are differences depending on what I don't know.
Also, I should say that a small number at 5% of our cases are incapable of speaking, perhaps because they've got an oxygen. Many different. Or stroke or whatever.
And these are the cases where it's more difficult to say whether this was truly a lucid episode.
And yet the relatives insist that the way the mother of a daughter had a certain way of touching the daughter when she was sad, and when dementia came, she was very shy of being touched. On her last day, the daughter sat there, started to cry, and suddenly she feels the hand of the mother once again in a very typical way.
And then the sister comes. And so these are more.
This we need to look into, that we don't miss so many cases. And I'm sure we miss a lot of cases. Cases, maybe there might be very short ones.
And I don't blame anyone, anyone who ever has watched how busy people in the hospice or nursing home are.
It can easily happen that you are in a dementia ward and you hear a single room, somebody's talking, and you think, well, he or she is talking to herself. It won't make any sense. How do we know? Maybe they are, you know, maybe they want to communicate.
[00:52:06] Speaker B: Yeah.
[00:52:07] Speaker A: And. Yeah. So therefore, there are many areas or many layers on what needs to be done also for caregivers, how do we help relatives cope with this?
Because what we observe, and it's understandably so, sometimes people, when a loved one does have a severe brain disorder, say farewell during their lifetime, in other words, because they don't want to rediscover every morning this person is trained, is gone. And dementia not only means being forgetful, it can mean very disinhibited. And so there are many not so nice. You know, sometimes it's very difficult.
And then suddenly the person comes back and they, you know, some of them tell me, you know, with one eye I'm laughing, with the other, I'm crying because I don't know, did I give him or her up too early?
Would he have had a comeback earlier if I was around for a longer time? And so on. And these are very, very important questions because they tell us a lot, or they could inform us deeply about what it means to take care of other humans. And once again, this does sound a bit lofty, but it is what makes us function and survive. This is not, not theory. This becomes.
So there's an ethical and moral dimension to it from the very beginning until the very end.
And so there's a very large spectrum of questions, as you see.
[00:53:38] Speaker C: Yeah.
Well, Mike, what have you observed about how seriously terminal lucidity is being taken among fellow neurosurgeons and in the field.
[00:53:46] Speaker B: Of neuroscience, among clinical doctors and nurses and people who actually deal with patients.
I think it's taken very seriously, accepted as real. I mean, it's part of the care of these patients. I don't think there's anyone, in my view, no one who's actually had experience with these situations and with these patients believes that these are just misunderstandings on the part of the family or surges of anything.
And the people who believe that are people who haven't seen it.
And so, yeah, I think the clinical people take this, I mean, very seriously. And I found that some of the deepest insights that people have of situations like this are the people at the bedside, the nurses who are doing the daily care, the nurses in the icu, the nurses aides and so on. They see this in detail and I think they know more than the scientists know in many ways.
[00:54:52] Speaker C: Well, we're going to leave it there today, but in the next episode we'll go deeper. We're going to ask what terminal lucidity might tell us about the relationship between mind and brain. A little bit more than we've touched on today and how it compares to near death experiences. You know, that that cousin phenomenon that has been mentioned and what kinds of explanations really fit the evidence. We'll go as far as we can with that. Gentlemen, thank you for your time today.
[00:55:16] Speaker A: Thank you.
[00:55:17] Speaker B: Thank you, Andrew. Thank you, Alex.
Thank you, Mark.
[00:55:20] Speaker C: Well, audience, if you'd like to learn more about this topic and others in the mind brain debate, consider getting copies of the books at hand today. The Immortal Mind, A Neurosurgeon's Case for the Existence of the Soul and Terminal Lucidity and the Border Between Life and Death. Find them anywhere good books are sold. And don't forget to join us for part two of this discussion in a separate episode for ID the Future. I'm Andrew McDermott. Thanks for joining us.
[00:55:46] Speaker B: Visit us at idthefuture. Com and intelligentdesign. Org. This program is Copyright Discovery Institute and recorded by its center for Science and Culture.
