This story originally ran on Beliefnet on December 15, 2001.

Just because mid-morning TV talk shows believe in it, does this mean it can't be true? Many skeptical people take that attitude toward the notion of the "near death experience," in which a person who almost dies - usually, a heart-attack victim - after revival reports not terror but beautiful visions, inner calm and even a sense of a door opening to an afterlife. Generally, the near death experience gets the most play on sensationalist talk shows and drek like "Crossing Over with John Edward," the supposed talk-to-the-dead program that, critics never fail to point out, airs on the Sci-Fi Channel. Respectable medical researchers have had comparatively little to say about the near death experience.

Until now, that is. A study just published in The Lancet, England's most prestigious medical journal, provides what may be the first hard-science confirmation that many people who almost die do experience something haunting at the boundary of life. Conducted by Pim van Lommel, a cardiologist at an Amsterdam hospital, the study concerned 344 patients who were resuscitated following cardiac arrest in Dutch hospitals. Some 18 percent of the patients told interviewers they had a near death experience; 12 percent had what van Lommel called a "core experience," not just warm feelings but elaborate perception of the beginning of an afterlife.

What's important about the new study is that it was done "prospectively." Most near death research is "retrospective," involving seeking out people who claim to have had such an experience, and talking to them months or years after the fact. From a research standpoint, subjects like this are "self-selected" - people who already think something, not a random trial - and the delay means they may have had plenty of time to imagine things. The Dutch effort, in contrast, involved interviewing everyone who had been resuscitated in 10 local hospitals during the study period, and simply asking them if they had any recollections. Interviews were conducted as soon as the patients were well enough to talk, and patients were not told the topic of the study, merely that researchers wanted to know if they remembered anything. This avoided any "prompting" effect.

Thus a finding that 18 percent of men and women revived at the point of death had impressions of light or beauty seems important. Something, must be going on. And it's going on more and more. If it seems to you that reports of near death experiences are increasing - you're right, they are. Only in recent decades did physicians acquire the ability to resuscitate patients at the point of death. Now that this happens in hospitals every day, there are thousands of people walking around who have been almost dead. Eventually there may be millions.

The something going on in near death cases might be physiological, of course. Researchers have previously speculated that the near death experience might be an artifact of cerebral anoxia, or lack of oxygen to the brain. As oxygen falters, this thinking goes, the brain begins to shut down, and misfirings of synapses create illusions of light or music. The Dutch study seems to rule out this idea, however. All patients in the study suffered some degree of cerebral anoxia before revival, but only 18 percent had a near death experience. As The Lancet, notes, if the near death experience is caused by cerebral anoxia, "most patients who have been clinically dead should report one." Instead most of the clinically dead patients did not report a near death experience. Brain oxygen problems therefore seem unlikely as the cause.

Skeptics of near death claims also point out that ketamine, an anesthetic, sometimes causes surgery patients to experience visions of beauty or light. This must be a physiological response. But the subjects in the Dutch study were heart-attack victims, not surgery patients: they were not administered ketamine.

What happened to van Lommel's subjects who did have near death experiences? They reported visions of beauty or light, loss of fear of death, a sense of being welcomed to a wonderful place, and in one case an "out of body" experience. The last involved a 44-year-old man brought to the hospital comatose; as resuscitation began, a nurse removed dentures from his mouth. Later when the patient has recovered he sees the nurse and asks for his dentures back. But the only time the nurse had been in his presence, he had been unconscious and near death; how did he know what the nurse looked like?

Anecdotes like that, which are staples of mid-morning TV, rarely show up in controlled clinical studies. But what's most intriguing about the Dutch research is the number of patients reporting loss of fear of death. Fear of death is hard-wired into our mind by millions of years of evolution: our ancestors would not have survived without it, and the ones who reproduced - that is, passed along their genes - were likely to have been the ones most keenly afraid of dying, and therefore most cautious. People might overcome the fear of death through philosophical or religious contemplation. But for this fear simply to vanish at a moment of near death doesn't make much sense in terms of evolutionary psychology. Something must be going on.

Van Lommel did not attempt to study whether that something is broadly psychological. Men and women grow up thinking that heaven is white light and angels have wings; as death approaches, the brain sees what it expects to see, perhaps generating visions of an afterlife as a sort of last-second self-defense mechanism, to protect the dying mind from experiencing terror. This has always seemed to me the most likely non-supernatural explanation of the near death experience, and it awaits research.

Still, you're being closed-minded if you don't consider that what is happening may be related to an afterlife. What haunted me after plowing through the pages of the Lancet study was this: the majority of the patients van Lommel studied recovered fully and are still with us, but of those who had the "core" experience of the door to another life being opened, most died within 30 days.

It was as if their time had come, then a physician intervened, and then their time did come, and the hand holding the door the first time they approached it had known they were the ones who should be shown what was next. People with many years left to live given proper medical care - that is, the bulk of the patients in the Dutch study - wouldn't have a near death experience because they were not yet at the moment when "the time has come." A person sure to die soon regardless of medical care would have the experience. Call it eerie; this is what the Dutch statistics show.

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