Thoughts on Near-Death Experiences

There is a very interesting Medscape article on Near Death Experiences (NDEs), “Young Doctor Explores Near-Death Experiences – Medscape – Jan 13, 2022.” The story was written by Stephanie Lavaud. It was a transcript of an interview with a general practitioner from, Francois Lallier, MD, PhD, from Reims University Hospital in France. He conducted a retrospective study on NDEs for his general medicine dissertation. He discussed the results in his book, Le mystere des experiences de mort imminente (translation: The Mystery of Near-Death Experiences).

It has so far collected several interesting comments. I submitted a couple.

One of them was about a teacher and colleague of mine, Dr. Russell Noyes, Jr, MD, Professor Emeritus University of Iowa. He published several articles about NDE related to traumatic accidents, mainly in the 1970s. Lallier used the Greyson Near-Death Experience Scale for his study, and this scale was based on the work of Noyes and others.

He also participated in a Iowa Public Radio Show in 2018. Dr. Noyes collected over 200 personal accounts of NDEs but declined to publish them. I don’t recall that Dr. Noyes ever discussed his interest in this area with me.

My other comment was a correction to a mistake in my first comment, in which I said no patient I saw in my career as a consult-liaison psychiatrist ever reported a Near-Death Experience to me. I remembered one later. It occurred decades ago but I had forgotten about it. I included the patient’s NDE self-report in a grand rounds presentation, which was not mainly about NDEs.

As a consultation-liaison psychiatrist, I saw many patients with severe medical illness and I can recall only one patient who described an experience of NDE. Delirium was a common syndrome in most of the patients I saw, especially those in the intensive care units.

I think it’s possible that some of the cases of NDE might be attributable to delirium. Vivid and compelling hallucinations and delusions are common symptoms of delirium. The catatonic variant of delirium, which can be caused by severe benzodiazepine withdrawal and other psychiatric disorders can lead to the rare Cotard’s syndrome, marked by the nihilistic delusion that one is dead or even paradoxically immortal, has lost one’s body, is rotting internally or is without limbs and other body parts. The line between NDEs and neuropsychiatric disease can sometimes be thin. However, I don’t categorically dismiss NDEs as mental illness.

Dr. Noyes was very familiar with delirium. He was one of my first teachers in the practice of consultation-liaison psychiatry. He taught me and countless other trainees and early career psychiatrists about anxiety, somatoform disorders, and delirium. He knew the difference between neuropsychiatric illness and NDEs.

In the National Public Radio interview, he explained that after consulting with an attorney who cautioned about the possibility of lawsuits related to breach of confidentiality (obtaining releases of information consents after so much time had passed would have been next to impossible), he decided against publishing his collection of personal accounts of NDEs.

The Medscape article author pointed out that many doctors usually take little interest in the issue of NDEs with patients. Lallier said this is because it’s not normally a part of medical school curriculum. On the other hand, one doctor pointed out in the comment section that he had been conducting NDE research for a decade and had published a series of articles in a peer-reviewed journal. Dr. John Hagan III reported that the articles were included in a medical textbook for physicians in 2017, The Science of Near-Death Experiences, copyrighted by the Missouri State Medical Association (MSMA). Dr. Hagan added that the MSMA passed a resolution which was sent to the national US medical organizations asking that all medical school curricula include education on NDEs.

Even the titles of the books I mention in this post are interesting: The Mystery of Near-Death Experiences and The Science of Near-Death Experiences. The mystery vs the science—or the mystery and the science? They seem almost analogous to bookends, or maybe the Janus head, which is fun to speculate about.

The Janus head used to be the logo for the Academy of Consultation-Liaison Psychiatry (ACLP). It was replaced by some nondescript design for reasons I don’t understand. It reminds me of waves, which could lead to seasickness.

Janus was a god in Roman mythology and is typically represented as having two heads, each facing opposite directions. Janus was the god of doors, gateways, and transitions. He held a key in one hand to open gates and a staff in the other to guide travelers. He is said to represent the middle ground between the abstract and the concrete, between life and death—and perhaps between mystery and science.

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