This installment appears a few days earlier than usual because we will take a week of vacation visiting the Caribbean.

As the November elections finally draw nearer the American public is deluged by claims and counterclaims from the two major parties. These tend to leave the average citizen in a state of bewilderment, unless one is a faithful party hack who does what one is told. But for those of us who like to think for ourselves the question of: what is fact and what is fiction? does become important. I shall deal with the dilemma of the American voter, which results from this problem, in next month’s installment and intend to limit myself here to how we perceive reality or, if you like, the truth. This is the fundamental issue from which all else flows.

In May of 1980 I published in The Journal of Nervous and Mental Disease an article on, “The Reality of Death Experiences. A Personal Perspective.”  It was prompted by a rash of publications on near-death experiences, which were taken as proof for survival of the soul after death. The question whether we are simply electro-magnetic-biochemical machines, which have to decay and perish, or whether there is an additional element in the human being which survives the destruction of the body is obviously important for how we conduct ourselves in our lives. Inasmuch as the idea of “ashes to ashes” as the end all and be all has always been unpopular, religious thinkers and philosophers have come up with various models of an afterlife. In our skeptical and agnostic society these ideas have lost credence because scientific evidence for retention of consciousness after destruction of the brain is lacking. The near-death experience by survivors of catastrophic life situations was, therefore, hailed as the long sought proof. Reputable physicians and psychologists published books on the narrations of these obviously sincere people who stated that during the time when they were regarded clinically dead, or were in extreme life-threatening circumstances, had been aware that they had died. They were welcomed by deceased relatives or other helpers, but were eventually told to return to earth, which they reluctantly agreed to. The near-death experience (NDE) had all the intensity, if not more, of waking life rather than dream consciousness and became the ultimate reality for the particular person. It affected future conduct because fear of death was lost and the people directed their lives with foremost regard to the benefit of others, rather than strictly selfish purposes.  

I would not have written the article had I not experienced earlier in life the knowledge of, “I am dead, I am free,” accompanied by an indescribable feeling of bliss. The circumstances under which this arose are detailed in the paper (reprint available on request) and need not be repeated here but the important aspect is the word “knowledge.” I did not “believe” that I was dead; I “knew” that I was dead and it was wonderful. The subsequent awakening in a hospital bed, wracked with pain, was a severe disappointment. I never talked about it to anyone except for my wife, Martha, who stood at the bedside and heard me say as my first words, “let me die, let me die.”  

The experience convinced me that the people who claimed to have had a NDE were indeed truthful and had experienced something that is out of the realm of the ordinary; but it also demonstrated the fallibility of human knowledge. The knowledge of that moment, which I will remember for the rest of my life, was wrong because I had not died I only thought so. Life altering as the experience was it also confronted me, as a neurologist, with: what do we call knowledge or reality? If absolute knowledge, experienced as beyond any shadow of a doubt, can subsequently be proven patently wrong it behooves us to look for the reasons. I tried to come to grips with the problem in the mentioned paper because it was obvious that the NDE phenomenon cannot be taken at face value for survival of the soul after death.  Although the experience occurs under clearly altered brain function, the brain is not dead and the question what consciousness, if any, survives a dead brain remains unanswerable.

This problem is, however, not urgent and is likely to remain unsolvable in the foreseeable future. The question of how we perceive our internal and external environment can be examined, however, and conclusions can be drawn. In the mentioned paper I made a distinction between: subjective reality, shared subjective reality and objective reality. In my own situation I was dead subjectively but alive objectively to everybody else. Thus, subjective and objective reality can be vastly different and should not be confused. In everyday life we tend not to make this distinction. Subjective impressions tend to be relegated to dreams, daydreams and fantasies and we act as if they were unimportant. The fact that our subjective reality, unconscious bias resulting from previous life experiences, flavors how we perceive objective reality is only rarely fully acknowledged. We believe that we act on objective reality, or facts, when we actually conduct our lives on shared subjective reality. This fundamental point needs to be grasped and kept hold of.

As mentioned we like to think that we conduct ourselves in an objective, dispassionate, manner most of the time, but this is a fallacy. Unless we are engaged in a specific task which requires fullest concentration our thoughts wander into daydreams and fantasies. These tend to reinforce each other and provide the background for how we meet the next life situation.  Thus the question arises: how do we know when something, anything, represents objective reality? The term is defined here as an observable fact, which does not involve judgment, and is verifiable by anyone with a healthy central nervous system who uses the same means by which the particular fact was arrived at in the first place. For instance the content of this essay is my subjective reality, which you may or may not share, but that it contains a definable number of words can be verified by anyone and is objective reality. This is, of course, what science strives for but this is not how we live our daily lives because it would require pure reason and that commodity is not readily used by the human being most of the time.

This brings up another question: how do we know what we think we know? As a result of the experience mentioned above I began to examine my thoughts in the waking as well dreaming state rather carefully and the result was quite surprising. In general we do not accord to dreams the same reality as to waking consciousness. So: how do we know that a dream is “only a dream” rather than waking reality? Recently the movie “Oh God,” with John Denver as a supermarket assistant manager and George Burns as God, was shown again on television and I was struck by the following conversation:

Denver: “How do I know that you are real and I’m not just dreaming this?

Burns: “What color are my eyes?”

Denver: “Blue”

Burns: “Do you dream in color?”

Denver: “No.”

Burns: “So, there you have it.”  

Well, for me and some others this type of reality testing would not work as the following example shows. I dreamt that it is a Saturday morning. I am heading down the pier at the marina to my sailboat to get ready for the race when the thought hits me, “could this be a dream?” Then I look up and say to myself, “No; the sky is so blue, the clouds are so white, I feel the wind on my cheek; this can’t be a dream.” When I woke up eventually I found out that it wasn’t Saturday after all and I had to go to work. Thus, this type of reality check doesn’t work. With continued examination of my dreams I found out that during the dream it is impossible to draw a distinction between waking and dream consciousness. Whatever test one may devise is futile as another example shows: It is a Thursday afternoon and I find myself walking around in my neighborhood rather than being at work. I have no memory whatsoever why I am not a work and this raises serious concerns. The neurologist then confronted himself with two possibilities: either I have a serious brain disorder or I am dreaming. I concluded that I was dreaming, woke up contentedly in the knowledge of having dreamt and got up to shower. But even this was merely a continuation of the dream as I found out when the alarm went off at 7 a.m. 

There are also sometimes so called “lucid dreams” where the dreamer realizes in the dream that he is dreaming. This has happened to me on a few occasions and was actually quite hilarious. For instance: I am talking with a group of people when the knowledge hits me: this is a dream! I then proceed to tell the bystanders that they don’t really exist; they are just pictures in my brain. You can readily imagine the expressions on their faces that resulted.

This fundamental fact of life that we cannot tell during the dream whether we operate on dream or waking consciousness has profound repercussions for our last moments of life. The distinction that “it was a dream” becomes apparent only upon awakening, but when we die there is no awakening, at least not on planet earth, and whatever pictures our brains choose to conjure up during the process of dying will be taken as objective reality although it exists only in our heads. This leads to the remarkable conclusion that we are indeed immortal to ourselves. By definition the human being cannot experience unconsconsciousness. Even if the thought, “I am unconscious” were to occur it would be a conscious experience. Since we are subjectively immortal to ourselves the content of consciousness during our dying moments may be of crucial importance but that is for each individual to ponder about.

The reason why we cannot distinguish objective from subjective reality in our dreams is probably due to relative absence of activity in what is called the prefrontal lobes. These portions of our brains are the latest acquisition in human development and are present only to a rudimentary extent in the monkey. They endow us with foresight, judgment, concentration, critical thinking and what is generally called executive function. The prefrontal lobes, rather than the rest of the brain, enable us to act potentially as Homo sapiens. The tragedy of the human race is that they are not always put into gear. We tend to operate on automatic pilot and this is where perception comes in.

When a sensory impulse travels from its specific peripheral receptor organs via specific pathways to the specific central receptor stations it does not remain there but gets subsequently relayed to a variety of other brain structures. These may or may not allow the sensory impression to reach consciousness. It could be shown experimentally that there are two types of responses in the brain to a peripheral stimulus. These have been called the primary and the secondary. While the primary is limited to the specific brain sensory area, the secondary response is widespread and can be changed by conditioning. Pavlov has shown this in his animals more than a hundred years ago on a behavioral level and we can now study its electrophysiological basis. Conditioning is not limited, however, to producing salivating dogs at the ring of a bell but goes on constantly in our brains. This is how habits are formed and this is the grist for the mill of politicians who want to us to think the way they do. Conditioning proceeds in an entirely unconscious manner and there is nothing we can do about it unless we are fully aware that it is indeed happening to us. Once this insight is reached we can act in a rational rather than impulsive, conditioned, manner. We stop being, in the words of our President, “gut-players” and put our prefrontal lobes into gear.

How can this be done? Buddhist philosophy provides the answer. The seventh point of the “Eightfold Noble Path” is “Right Mindfulness.” I have always had a problem with the precise meaning of the term until I came across a book by Nyanaponika Thera. The Heart of Buddhist Meditation (available on amazon.com) is a superb example of how a Ceylonese monk, who explains two thousand five hundred years old thoughts, can benefit modern Americans. The first and most important aspect is the effort needed to “Know Thyself;” an admonition which also graced Apollo’s temple at Delphi. Only when we understand how we as individuals operate can we hope to understand others by noting the similarities and differences. To achieve this goal the Buddha has proclaimed the “Four Foundations of Mindfulness.” They deal with the accurate perception of one’s internal world. Namely: one’s body, one’s feelings, one’s state of mind, and the pictures the mind produces. Once this has been accomplished one can deal appropriately with the external world. For the purposes of this essay only the first three aspects dealing with action will be discussed at this time. These are: bare attention, clear perception of purpose, and clear perception of suitability of means for achieving that purpose.

Bare attention exhorts us to register only the primary sense impression without jumping immediately to the conditioned secondary responses which are judgmental. For instance when one is stuck in traffic one is not supposed to get exercised over the consequences of being late to wherever one is headed but instead register the fact and direct one’s attention to the car ahead of one. Its color, its make, its license plate and so on can be examined in detail. All of this is to be done in a objective way as if one were expected to report it to someone else. In essence: look at each event as it occurs with a scientific, detached mind and move on when the situation changes. Immediate judgment, which is the conditioned response, needs to be held in abeyance. This is also what “living in the present” really means. When a new action needs to be initiated, the second principle ought to be adhered to and one should ask oneself immediately: “what is the purpose?” Once that question has been examined and a decision has been made to move ahead the final question arises: are the means to be employed to achieve this purpose really appropriate?

When we look at our world in this manner we can immediately see how wrong the Bush administration’s response to the 9/11 tragedy was. Had our leadership been reared on the above stated principles instead of the Old Testament they would have spared us and the world untold suffering. Bare attention would have registered as: Two buildings were completely destroyed, one partially, four commercial jets were lost and nearly three thousand people were killed. Those were the facts and our so-called Judeo-Christian heritage cried out for vengeance. Not on the people who actually committed the crime, because they were dead already but on those who had sent them on their mission. Some response was obviously required and this is where the next two aspects of mindfulness should have come into play.

The prime purpose of a reaction should have been to a) compensate, to the extent possible, the victims and b) take measures that will minimize the chances of a recurrence. A fund for the victims was indeed set up but the measures to prevent a recurrence did not take “suitability of means” into account. The appropriate means to deal with bin-Laden’s organization would have been through international cooperation to deprive it of its finances, as well as limited specific special forces operations to destroy his sanctuary in Afghanistan, and make life difficult for him, wherever he moved to subsequently. Only the financial route was pursued but for the rest ulterior motives came into play. The Taliban regime had to disappear and for good measure the whole Middle East has now to be turned into reliable American satellite states under the name of democracies. Clear perception of purpose and especially “suitability of means” would immediately label these fantasies as serious delusions.

This brings us back to shared subjective reality. Since the vast majority of the American public has only limited awareness of Buddhist thought it can easily become prey to propaganda which feeds feelings of vengeance, fear, and pride. Our reality is not supposed to be dominated by rational thought but by emotions and conditioned reflexes. This is the true evil in our society and it will destroy us unless taken cognizance of.

The next two months may become some of the most dangerous in the history of our republic. If the “swift boat” attack on Senator Kerry misfires, Karl Rove may yet push for some Iran mission to save his boss’s re-election, or engineer some homeland disaster. The way he has been described is that for him winning is everything and defeat is “not an option.” The book Bush’s Brain by James Moore, which depicts the workings of Rove’s mind, has now been made into a movie and one hopes that it will be widely shown. Only when the bright light of public awareness is directed into the murky shadows of the corridors of power, where policies are hatched in secrecy, can we hope that a more reasoned approach to world affairs will emerge. In this way reality perception will stick closer to observable facts and we can rationally develop proper solutions to our problems.