The October 8, 2012 issue of Newsweek carried on its cover page a picture of a hand stretched out beyond heavenly clouds to the cosmos, with the captions:
“Heaven is real. A doctor’s experience of the afterlife.” http://www.thedailybeast.com/newsweek/2012/10/07/proof-of-heaven-a-doctor-s-experience-with-the-afterlife.html. The article discussed a neurosurgeon’s, Dr. Eben Alexander III, experiences during coma from bacterial meningitis which left him to conclude that heaven and the afterlife are real and scientists better face up to that fact. Although a nominal Christian he, just like most other scientists, had adhered to the current concept that consciousness is a result of brain function and cannot occur in its absence. Yet

“In the fall of 2008, however, after seven days in a coma during which the human part of my brain, the neocortex, was inactivated, I experienced something so profound that it gave me a scientific reason to believe in consciousness after death…. When I entered the emergency room that morning, my chances of survival in anything beyond a vegetative state were already low. They soon sank to near nonexistent. For seven days I lay in a deep coma, my body unresponsive, my higher-order brain functions totally offline…. There is no scientific explanation for the fact that while my body lay in coma, my mind—my conscious, inner self—was alive and well. While the neurons of my cortex were stunned to complete inactivity by the bacteria that had attacked them, my brain-free consciousness journeyed to another, larger dimension of the universe: a dimension I’d never dreamed existed and which the old, pre-coma me would have been more than happy to explain was a simple impossibility. 

But that dimension—in rough outline, the same one described by countless subjects of near-death experiences [NDE] and other mystical states—is there. It exists, and what I saw and learned there has placed me quite literally in a new world: a world where we are much more than our brains and bodies, and where death is not the end of consciousness but rather a chapter in a vast, and incalculably positive, journey….

All the chief arguments against near-death experiences suggest that these experiences are the results of minimal, transient, or partial malfunctioning of the cortex. My near-death experience, however, took place not while my cortex was malfunctioning, but while it was simply off. This is clear from the severity and duration of my meningitis, and from the global cortical involvement documented by CT scans and neurological examinations. According to current medical understanding of the brain and mind, there is absolutely no way that I could have experienced even a dim and limited consciousness during my time in the coma, much less the hyper-vivid and completely coherent odyssey I underwent…”

          The article was actually part of a promotion for his about to be published book, “Proof of Heaven. A Neurosurgeon’s Journey into the Afterlife,” Inasmuch as I had previously published, in the scientific literature as well as on this site, my views on NDE’s I ordered the book from Amazon to find out what “proof” Dr. Alexander could offer the scientific community for his assertions.

          Since the book itself switches back and forth between snippets of biography, the experience itself, the genesis of the book, medical observations, scientific data including quantum mechanics and assertions about consciousness and reality, I shall be more systematic here and take the essential points in sequence followed by a personal assessment.

          His experience during coma consisted of three parts. First he found himself disembodied, with no recollection of his actual life, underground “like being a mole or earthworm buried deep in the ground.”  There were also some visions of what he regarded as roots which then changed to grotesque faces and accompanied by a roar and foul smell. Near panic set in and this part he subsequently called “the earthworm’s eye view.”

He was rescued by pure white filaments, tinged with gold, spinning around at the center of which was an opening. This was accompanied by the “richest, most beautiful music you’ve ever heard.” He realized that he had to move up through this entrance, which he later called the “gateway.” He went through and “found myself in a completely new world. The strangest, most beautiful world I’d ever seen.” He was flying over a valley populated by happy people and then realized that he was actually on a wing of a butterfly accompanied by a beautiful young woman who reassured him that, “You are loved and cherished, dearly, forever;”  “You have nothing to fear;” There is nothing you can do wrong.” These were not spoken words but direct thought transfers. They were surrounded by millions of other butterflies and there was synaesthesia of beautiful sound and vision without separation as well as a sense of oneness.

As he moved forward he entered the third phase which he called “the Core.” “[I] found myself entering an immense void, completely dark, infinite in size, yet also infinitely comforting. Pitch black as it was, it was also brimming over with light: a light that seemed to come from a brilliant orb that I now sensed near me. An orb that was living and almost solid, as the songs of the angel beings had been.” He then compared his situation with that of a fetus floating in the womb except that “the ‘mother’ was God, the Creator, the Source who is responsible for making the universe and all in it. This Being was so close that there seemed to be no distance at all between God and myself. Yet at the same time, I could sense the infinite vastness of the Creator, could see how completely miniscule I was by comparison.” “The Orb was a kind of ‘interpreter’ between me and this extraordinary presence surrounding me.” His questions were immediately answered telepathically and he was provided with knowledge which surpasses terrestrial understanding; the words to transmit it simply don’t exist in our vocabulary. “The knowledge given me was not ‘taught’ in the way that a history lesson or a math theorem would be. Insights happen directly, rather than needing to be coaxed and absorbed. Knowledge was stored without memorization, instantly and for good.” Eventually he returned through the same stages and found himself again in the earth-worm’s view but this time it was no longer accompanied by fear.

When he came out of coma he experienced paranoid psychotic ideation for several days, but he clearly differentiates the reality of the “experience” from his psychosis, which lacked this feature. He believes the psychosis was a result of the neocortex, which in his opinion had been dead, gradually returning to its pre-coma functions.

Let us now look at some of the biographical snippets, in order to see to what extent they might have flavored the above cited experience. There are two aspects which stand out. One is that he was, since adolescence, a dedicated skydiver which may have contributed to the second stage of his experience. The other, namely the message that he is “loved and cherished, dearly, forever” was wish fulfillment. His biologic mother was 16 when he was born and he had been adopted by the Alexanders (Dr. Eben Alexander II was a prominent neurosurgeon, whose obituary can be found on Wikipedia) at the age of 4 months. He insists that he had always known about the adoption and was clearly loved by his new parents. Nevertheless he had a lifelong feeling of having been abandoned by his biologic parents. “For in fact, ‘thrown away’ was, on a deep level, how I had indeed felt all through my life–in-spite of the best efforts of all of my family to heal that feeling through their love.”

Over the years Dr. Alexander had made several efforts to find his biologic parents and in February of 2000 he discovered that his biologic parents had actually married several years after his birth and that he had two sisters and a brother. One other sister had died in 1997. When he tried to contact his birth mother she refused to see him. It was a devastating blow. His career as well as family life began to take a nose dive. His work suffered and he left Harvard. The accompanying guilt over having disappointed the expectations of his renowned adoptive father was a further complicating factor. He had been brought up in the Christian religion and had tried to hang on to his belief in God in spite of the doubts a scientific life creates in this regard. But after this rejection he lost the remnants of his faith entirely. The situation changed, however, in 2007 when he succeeded in contacting one of his biologic sisters and thereafter the rest of his family, although he did not meet the father until summer of 2008. Good relationships with his biologic mother and siblings persisted but he could never get over the loss of the sister who had died.

 Although the book always emphasizes the reality and even “super-reality” of the experience, the author does admit to intermittent nagging doubts because the NDE literature emphasizes that one is met by deceased friends or relatives in the afterlife. This had not happened in his case. Since he was close to his adoptive father who had died four years earlier he wondered why he had not met him. Inasmuch as the presence of deceased relatives is taken in the literature as evidence for an afterlife, their absence was worrisome. This problem resolved itself when he received a photograph of his deceased sister Betsy in the mail. “She looked so strangely hauntingly familiar. But of course she would look that way. We were blood relations and had shared more DNA than any other people on the planet with the exception of my other two biologic siblings.” He put the photo on the dresser but made no mental connection to his experience. This changed dramatically when he read the next morning in the book On Life After Death by Dr. Kuebler-Ross an account of a 12 year old girl who had a NDE. At first she had kept it from her parents but then told her father of “traveling to an incredible landscape full of love and beauty, and how she met and was comforted by her brother. ‘The only problem’ the girl told her father, ‘is that I don’t have a brother.’ Tears filled her father’s eyes. He told the girl about the brother she did indeed have, but who had died just three months before she was born. After reading this account when Dr. Alexander looked at the photo on the dresser it was clear to him that the deceased sister was indeed the young woman who had accompanied him during the second and third stage of his voyage. “In that one moment, in the bedroom of our house, on a rainy Tuesday morning, the higher and the lower worlds met.”

Genesis of the book. After his health had reconstituted to some extent he was, of course, confronted with the dilemma of how to explain what he had experienced because it violated current scientific principles. At first he thought that he would study the literature on NDEs but his son, Eben Alexander IV, who was a college student at the time, told him that he should first set down in writing what he had experienced. He followed the advice and “For the next six weeks [approximately the beginning of December to middle of January 2009] or so most days went the same. I woke up at 2 or 2:30 a.m. feeling so ecstatic and energized by simply being alive that I would bound out of bed. I’d light a fire in the den, sit down in my old leather chair and write. I tried to recall every detail of my journeys in and out of the Core and what I had felt as I learned its many life-changing lessons. Though tried [italics in the original] isn’t really the right word. Crisp and clear, the memories were right there where I had left them.”

For further information one has to go the Acknowledgment section of the book. There one finds that among others “Raymond Moody and Ken Ring, pioneers in the near-death community, whose influence on me has been immeasurable.” He also cites additional “thought leaders" of the “Virginia Consciousness” movement and gives thanks to “My God-sent literary agent Gail Ross and her wonderful associates, Howard Yoon and others at the Ross Yoon agency. Ptolemy Tompkins for his scholarly contributions from unparalleled insight into several millennia of literature on the afterlife, and for his superb editorial and writing skills, used to weave my experience into this book, truly doing it the justice it deserves.”

When I looked up Mr. Tompkins on the Internet I found that he has a webpage http://ptolemytompkins.net which announces: “Welcome – sort of

My name is Ptolemy Tompkins and this is my website. A website which, to be perfectly honest, I didn’t want to create, and which I still have my misgivings about, now that it’s pretty much done.” As far as his belief system goes he states: “If a label must be produced, then “Reincarnational crypto-Christian with some Buddhist/Taoist leanings but Stronger Hindu ones, with a pronounced interest in current ideas about the evolution of consciousness such as put forth by people like Owen Barfield, Ken Wilber, Jean Gebser, Rudolf Steiner, Douglass Fawcett, Michael Whiteman, and (with reservations) Teilhard de Chardin, who also believes very much in the Persian/Islamic metaphysical model of the personal imagination as outlined by Henry Corbin will do as well as any.” When one looks up Mr. Tompkins on Wikipedia he is referred to as “the collaborative ghost author of Dr. Eben Alexander’s Proof of Heaven.” He has published several books and the most recent one carries the title: The modern book of the dead: A Revolutionary Perspective on Death, the Soul, and What Really Happens in the Life to Come; which obviously alludes to the well-known Tibetan Book of the Dead and possibly also The Egyptian Book of the Dead.

                Dr. Alexander’s book was published in late October 2012, an interval of nearly four year since the experience, and we don’t know when the actual writing took place. But it is apparent that he had immersed himself during that time in what might be called “new-age mysticism” rather than resuming medical/scientific work. In this connection it is also of interest that “Gateway,” the word he used for the second phase of his journey is apparently linked to the Monroe Institute in Faber, Virginia, which devotes itself to the study of Out of Body experiences. Wikipedia tells us that the main method of inducing these sensations is “a program called Gateway Voyage, a training course that uses binaural soundtracks to facilitate exploration and replication of specific altered states of consciousness known as Focus levels. Gateway Voyage is a six-day intensive [set?] of exercises using custom-designed sound booths (CHEC units), talks, and group interaction.” Dr. Alexander was familiar with the institute, which is within easy driving distance of slightly over 40 miles from his home in Lynchburg, and describes how the Hemi-Sync techniques not only helped him in his recovery period but also to recreate some of the aspects of his coma experience.

          There is an additional point about the bibliography which deserves to be mentioned. The overwhelming majority of books and articles listed were published between 1995 and 2011. The earliest is a 1952 publication and one looks in vain for Dr. Maurice Bucke’s Cosmic Consciousness – A Study in the Evolution of the Human Mind which was originally published in 1901, but has since been reprinted several times and is available on amazon. Likewise, one fails to find William James’ The Varieties of  Religious Experiences – A Study in Human Nature  which consists of The Gifford Lectures on Natural Religion delivered in Edinburgh 1901-1902. There is also no mention of the Tibetan Book of the Dead yet all three are classics which serious students of human consciousness need to familiarize themselves with. As far as the title of the Dr. Alexander’s book is concerned, he had intended to call the book N of 1 to emphasize the uniqueness of his case but was persuaded by his agent to adopt, for commercial reasons, the current one.

          The medical facts which are presented to justify the opinion that consciousness can exist in the absence of a functioning brain; that we are immortal; and a loving God cares deeply for each one of us, are scant. Appendix A contains a brief statement by Dr. Scott Wade, who was the major attending physician. It consists of only one and one third of a page and merely tells us that Dr. Alexander had E. coli meningitis and that the prognosis for recovery was quite poor. The key sentences are: “Dr. Alexander presented to the hospital with seizures and a markedly altered mental status both of which are risk factors for neurological complications or death (mortality over 90 per cent).” After six days of coma the mortality rate was regarded as having risen to 97 per cent and “the fact that he went on to have a full recovery from this illness after being in a coma for nearly a week is truly remarkable.” No further details are given about the depth of coma, the seizure types and their treatment as well as the laboratory tests that were performed throughout this week apart from CT and spinal fluid examination.

          This information one has to retrieve from pieces which are distributed through the various chapters of the book. I shall now try to reconstruct the course of his illness. Although the diagnosis is always referred to as simply “meningitis” he had a sub-form which is called “subpial toxic encephalopathy.” Since the bacteria do not penetrate the immediate thin covering of the brain (pia mater) but accumulate above in the subarachnoid space and ventricular fluid, the damage is assumed to be toxic in nature. The textbook symptoms are: confusion, stupor, coma, and convulsions all of which occurred in Dr. Alexander’s case and we can therefore safely refine the diagnosis to this condition.

Although the book ascribes the coma exclusively to the meningitis there were other factors at play namely seizures and their treatment. That part of the coma had been iatrogenic is hinted at in a conversation Dr. Wade had with family members just before the patient emerged from the coma. It is in the chapter called The Rainbow and represents the memory of Dr. Alexander’s wife, Holley. She was told that her husband had not properly responded to the antibiotic treatment and if the coma persisted for another twelve hours he would at best end up in a vegetative state. Under these circumstances it might be better to discontinue the antibiotics and let him die as a result of the meningitis. The wife protested, “’But I saw his eyelids move yesterday, really they moved. Almost as if he was trying to open them. I am sure of what I saw.’” Dr. Wade replied: “’I don’t doubt you did. His white blood cell count has come down as well. That’s all good news, and I don’t for a minute want to suggest that it isn’t. But you have to see the situation in context. We’ve lightened Eben’s sedation considerably [italics mine] and by this point his neurological examination should be showing more neurological activity than it is.’”

          The first seizures (apparently status epilepticus) had occurred on Monday (the day of admission) and had a focal onset in one hemisphere, rather than the brainstem. This is not stated as such in the book but apparent to an epileptologist because the book says that “Just as troubling to Laura [the ER physician] as the seizures was that I seemed to show an asymmetry in the motor control of my body. That could mean that not only my brain was under attack but that serious and possibly irreversible brain damage was already under way.” What he described here are focal onset seizures which then led to temporary postictal paralysis of one or both extremities on the opposite side of the body (Todd’s paralysis). Todd’s paralysis is independent of the cause of seizures and has an excellent prognosis It also disappeared promptly in Dr. Alexander’s case.  

He continued to have intermittent seizures during hospitalization but these are poorly described apart from having occurred “early in the week” and he was given “more sedation.” He reported of having shown divergent strabismus when his wife passively opened his eyelids, a finding which is common in purulent meningitis but, contrary to his assertion, not in other causes of coma. As far as laboratory tests are concerned we are only told about the results upon admission and one further spinal tap in the middle of the week. Upon admission the spinal fluid examination was typical for purulent meningitis and a CT scan had shown that “the meningeal lining of my brain was dangerously swollen and inflamed. A breathing tube was put in my trachea, allowing a ventilator to take over the job of breathing for me–twelve breaths a minute exactly–and a battery of monitors was set up around my bed to record every movement within my body and my now all-but-destroyed brain [italics added].” I have used italics to highlight the sense of drama which is conveyed throughout the book. The statement was hardly applicable to the first day.

          The premise of the book is that during the coma “the brain hadn’t been working improperly. It hadn’t been working at all [italics in the original].” Retention of consciousness while the brain is not functioning at all is one of his chief arguments against current scientific theories which postulate the necessity of the brain for mental activities. Yet, the crucial evidence for absence of hemispheric activity is missing! The word “electroencephalogram (EEG)” never shows up, but it is the single most reliable laboratory test for assessment of the physiological capabilities of the brain. In as much as this is my professional specialty and it is routine practice to obtain EEGs when a patient has seizures, or is comatose, the question immediately arises why we are not given the results. CT scans provide evidence for structural changes, but tell us nothing about residual function. The EEG on the other hand provides objective facts on current brain activity down to the millisecond range. At this time I could only speculate why this vital piece of information is missing but will refrain from doing so because I shall first try to obtain facts and report on them thereafter.

During the years when I was in charge of the EEG laboratory at Childrens Hospital of Michigan in Detroit, and later at Harper Hospital, the EEG was routinely used to establish cerebral death, which is difficult to do with certainty when patients are on respirators. We certified patients as “brain dead” when two consecutive EEGs over at least a 24 hour period showed no cerebral electrical activity i.e. the tracings were “flat.” It is highly unlikely that Dr. Alexander ever had a prolonged “flat EEG” which was not related to seizure treatment because the family would have been notified of that fact and discontinuation of the respirator would have been advised. This leaves us with three other main possibilities: the EEG could have shown diffuse slow wave activity with or without spikes in various regions, PLEDS (periodic lateralized epileptiform discharges) or burst-suppression. Although these findings indicate a very sick brain they do not justify the statements in the book that his “brain wasn’t working at all;” or “no neocortex functioning.”

Although the book provides no evidence for nonfunctioning hemispheres Dr. Alexander makes this the central thesis and repeats it in all interviews he gives as well as in a second Newsweek article. It was published on November 18, 2012 to answer critics of the book which had been published on October 23, 2012. In that article, entitled The Science of Heaven, one finds statements such as: “complete absence of neural activity in all but the deepest most primitive portions of my brain;” “the only difference between my experience [near-death, NDE] and those of others is that my brain was, essentially, deader than theirs;” “Most people who had them were in bad shape, but they weren’t really near death. But I was. My synapses–the spaces between the neurons of the brain that support the electrochemical activity that makes the brain function–were not simply compromised during my experience. They were stopped [italics in the original]. Only isolated pockets of deep cortical neurons were still sputtering, but no broad networks capable of generating anything like what we call ‘consciousness.’”

Assessment of the claims. From a neurologic point of view the opinion on absence of hemispheric functions cited above is not sustainable because as mentioned no evidence for it is provided at any time. Yet, it is the hallmark of all of Dr. Alexander’s current presentations and interviews. The statements are made to impress a lay audience and possibly non-specialists but carry no weight among neuroscientists. Dr. Sam Harris, whose work was discussed in Our Atheists (May 1, 2010), as well as Dr. Oliver Saks, published rebuttals, but these are ignored. The book has been a bestseller since its publication and Dr. Alexander’s website, states that translations into numerous foreign languages are pending.

There are a number of aspects in the book I agree with, such as: that subjective mental activity can persist when patients are comatose, especially during the process of emerging from coma; that our purely materialist view which permeates current scientific work is not adequate; that science and a spiritual outlook on life are not incompatible; that all of us are connected to a larger universe; that scientific exploration of this interconnectedness is needed; and that he has “a responsibility to tell my story right.”

As readers of this site know, I have been interested in what came to be called the NDE phenomenon and its reality for decades and, therefore thought that a dialogue between us on this topic would be useful. I, therefore, sent him, after having read the first Newsweek article, an autographed copy of The Jesus Conundrum, directing him to the chapter on What is Truth? as well as the Conclusions. I also asked him to write to me after he had a chance to peruse the material. The book was never returned as undeliverable, but there was also no acknowledgement of its receipt. Since we are both neuroscientists a doubt about his sincerity began to arise.

In preparation for this essay I looked at his website and as a matter of fact there are actually two. One is the “personal” one “Life Beyond Death” http://www.lifebeyonddeath.net/ and the other for Eternea, an organization Dr. Alexander founded prior to the publication of the book. I shall return to Eternea http://www.eternea.org/ later. What struck me on the personal site was the first sentence one reads when going to “About the Author.” It states: “Dr. Alexander, a renowned academic neurosurgeon, spent 54 years honing his scientific worldview.” Inasmuch as he was born in 1953 this is obviously not correct. When one looks at his CV one finds, based on papers published, that his scientific career started in 1980 and ended in 2001. Furthermore of the 97 papers which are listed, he is first author on only 15. The current inflation of co-authors has been commented upon previously. One other point is that he lists under academic appointments: 2008-present Assistant Professor of Research in Neurological Surgery University of Virginia Medical School, Charlottesville. 

On the Eternea site, which is devoted to “The Convergence of Science and Spirituality,” one finds under “Medical Background” that his appointment ended in 2010 but the CV on the same site had not been changed. More important, however, is how Eternea operates. It offers three “options” for membership: Friends of Eternea, Frontier Science Forum and Blue Butterfly Society. You can join Friends of Eternea as a “supporter” “advocate,” “angel” and “archangel” with dues ranging from a minimum of $50 for the supporter to a minimum of $1200 for the Archangel. The Frontier Science Forum has Bronze, Silver and Gold members with minimum dues ranging from $150-$1200 for the various levels. The Blue Butterfly Society has minimal annual dues of at least $10,000 or more. For an annual contribution of at least $25,000, or a one-time contribution of at least $50,000 one can become a “governor” of the society.

I have listed these facts because they show that Dr. Alexander no longer works as a scientist but crass commercialism has taken over his life. His book and the websites represent an “objective reality” in the sense that anybody can check on what is written there. But since they are not trustworthy for scientific assessment how can we trust his subjective coma reality? Yet, the topic of consciousness, or mind, is of major importance for our understanding of who we are and what we are doing on this planet. It clearly deserves rigorous investigation.

What should be done now? For the sake of truth and scientific integrity Dr. Alexander should 1) authorize Lynchburg General Hospital to make the entire medical documentation in regard to his coma week public. He has forfeited his right to privacy because he is earning a living and giving lectures on his illness. These provide dogmatic statements but, as mentioned, crucial medical details are missing. Most importantly we must be able to see the EEG results and those of the CT scan(s). The EEG(s) will show the functional state of the brain and the CT(s) the degree of pathology. Only when these objective data become available can we place his experience into the proper context. As mentioned on an earlier occasion the deliberate use of half-truth is the most vicious lie. 2) He should also publish the unedited version of his initial six weeks of documentation. These contained genuine personal information and were not yet influenced by other interests. Currently we are given an exaggerated account, which was in part written by Mr. Tompkins, and we don’t have enough objective medical facts. But these are required before the scientific community can accept his assertions.

There is no doubt that Dr. Alexander had a profound subjective life-changing religious experience which led him to abandon his profession of neurosurgery and become a missionary for his belief.  But subjective and objective reality can be quite different. The problem of how we know what we think we know and what NDE’s might be able to teach us will be taken up in the March 1 issue.