Well, thank you Hitendra, I'm delighted to be joining you today.

A near-death experience is a profound and primarily spiritual event. That may include things like a sense of leaving the physical body, a sense of overwhelming peace and well-being, often finding themselves in some otherworldly realm. They may then encounter other beings – usually, a warm, loving light that they interpret as a deity. Sometimes they see other entities they interpret as deceased loved ones. They often have a review of their entire lives. At some point, they may come to a point where they decide to return to life or are told to return against their will. For me, as a psychiatrist, one of the most interesting parts of the experience is not the experience itself but how it transforms people's lives afterward. And I've been able to follow some of these people now for many decades. The changes in their attitudes, beliefs, values, and behavior are quite remarkable and long-lasting.

Of course, and it continues to be a challenge for me because it raises questions about our very beliefs, about the mind and the brain, and about how we fit into the universe. I started life as a scientist, as a materialist. My father was a chemist. In my family, as we grew up, we never talked about anything non-physical. The idea of anything spiritual, anything religious, was never talked about in our family. We assumed that what you see is what you get. The physical world is all there is, and that when you die, that's the end. That was fine with us. There was no reason to complain about that. That's just the way it was. So I went through college and medical school with the materialistic mindset that we are physical beings like other animals.

After I finished medical school, in the first months of my psychiatric training, I was asked to evaluate a patient in the emergency room who had overdosed. I went to see her, and she was unconscious. I tried to arouse her, speak to her, move her limbs around. She had no response at all. But her roommate, who had brought her in, was waiting to talk to me in another room 50 yards down the hall.

I talked to the roommate and got information about the patient, what was going on in her life, what she might have taken, and we talked for about 15 minutes. Then I went back to the patient, and she was still unconscious. So she was admitted to the intensive care unit overnight. I went to see her the following morning after she awoke. Well, when I went to see her, she was barely awake. She could barely open her eyes. I introduced myself, and she said to me, "I know who you are. I remember you from last night." Well, that startled me because I thought she was unaware of me last night." So I told her that. I said, "I thought you were asleep. I didn't realize you could see me." And then she opened her eyes and told me, "I saw you talking to my roommate, Susan, down the hall." Well, that just made no sense to me at all. The only way she could have done that is if she had left her body and come down the hall with me. I couldn't understand that. As far as I could tell, I was my body. How can I leave it? So she sensed my confusion and went on to tell me about the conversation I had with her roommate, where we were sitting, and what we were wearing, the questions I asked her, her answers, and it just blew me away. I couldn't understand this. But I couldn't deal with my confusion, and my job was to help her with her confusion.

So I had to kind of stuff my feelings aside and try to work with her in my psychiatric role, and as the days passed, I tried to reflect on what happened here, but I couldn't accept it. It didn't make any sense to me. It didn't fit my worldview. I tried to tell myself I misheard what she said. I misinterpreted it. A trick had been played on me. I don't know how, but I just stuffed that way. It wasn't until several years later, in 1975 when Raymond Moody published a book called Life After Life, that he gave us the name for these phenomena. Fortunately, he was working at the University of Virginia with me at the time. So I was able to read his book and talk to him. I realized that what this one patient had told me was not one event from one psychiatric patient but part of a huge phenomenon that millions of people all over the world were talking about. I still couldn't understand it, but I couldn't deny that it was happening. As a scientist, I thought it was my responsibility to look into this. You can't be a skeptic if you don't become skeptical of your viewpoints as well. So because it challenged everything I thought, I had to devote my life to or at least some of it to try to understand it. Here, 50 years later, I'm still trying to understand it.

When we first started looking into this, we collected stories that individual people told us. And, of course, I realize that one story does not prove anything. But when you collect a lot of stories, and I'm talking about hundreds or thousands of stories. You can start looking at patterns that consistently emerge in these accounts. You can statistically analyze what they say and find out the currents that go across cultures and religions. What are the consistent commonalities in these experiences? Then you can develop hypotheses about them that you can test. For example, most of these things happen when people are either pronounced dead or very close to death. So being a materialist, I thought about what things go on in the body or in the brain that may be related to this. The first thing that comes to mind is that you have a lack of oxygen going to the brain because no matter how you come close to death, that usually happens.

We were able to look at the data, and it turns out that when you're close to death, if you have a near-death experience, you have more oxygen to the brain than if you don't report a near-death experience, and it was the same way with drugs that were given to patients. Many patients are given drugs, of course, as they're nearing death. But it turns out that the more drugs you're given, the less likely you are to report a near-death experience. So drugs and lack of oxygen do not seem to be causing the experience. If anything, they're inhibiting the experience. We've tested theory after theory about this, about brain surges of electricity, maybe chemicals produced in the brain. Every time we've been able to collect data, they've contradicted these theories. Now, of course, some of them we can't test. One of the prominent theories is that there's some sort of hallucinogenic drug produced in the brain at the point of death, and that's a nice theory. It's plausible, but there's no way to test it because you're talking about a chemical that's released in tiny amounts for a short period of time. We don't even know where in the brain to look for it, and how are you going to do that when someone's in a near-death crisis, and you're trying to resuscitate them?

Sure. Many people have a life review of some sort in the near-death experience. By that, I mean they come to a point where they sometimes relive their entire lives, sometimes just highlights from their life. It's not like watching a movie. It's feeling like you're reliving the experience. They often feel like they judge themselves or what things they did as they go through this event. What things they might not have done quite right. They usually don't report feeling judged by some other entity, but it's a self-judgment. From that, they learn about mistakes they've made and things they want to change if they come back. The ones we talked to, always did. What's striking is that in a good number of these life reviews, the experiencer relives the event not only through their own eyes but through the eyes of someone else as well.

Let me give you an example of this. Tom Sawyer had a near-death experience in his 30s when a truck he was working under fell and crushed his chest. As part of his near-death experience, he had a very elaborate life review in which he relived many things in his life. But one thing that stands out to me is when he was 17 years old, a hot-tempered teenager, he was driving his truck downtown, and a drunk man happened to walk out in front of his truck. And Tom almost hit him. He was furious. So he rolled down, stopped his truck, rolled down the window, and started yelling at the man, and the man, unfortunately being drunk, reached his hand in the window of the truck and slapped Tom across the face. Well, that was too much for Tom. So he opened the truck door, got out and started pounding the guy mercilessly with his fists until he left him a bloody mess. And he calmly got back in his truck and drove away.

Well, in his life review, he lived that from the eyes of the drunk man. And he saw his face, Tom's face getting redder and redder, and then felt Tom's fists coming into his face. "Thirty-two blows," he said, and he felt his nose getting bloodier and bloodier, and he felt his teeth going through his lower lip. He felt the humiliation of being beaten by this young kid.

Tom came away from this experience, realizing that we're all in this together and not ultimately separate individuals, but we're all interconnected. It's like if you look at your hand, if you look at just the fingers, it looks like they're all separate. If you look at the whole thing, you see that they're all interconnected and that what you do to somebody else, you're ultimately doing to yourself. After they return from the life review, they realize that we're all the same and that the way to get through life is by following the golden rule. Do unto others as you would have them do unto you. That's a precept of almost every religion we have. There's a reason for that. I think that's because most religions were influenced by experiences like near-death experiences, mystical experiences in which this basic truth is told to them. But the experiences say to me that for them, the golden rule is no longer just a guideline we're supposed to follow. They realize it's a law of the universe, like gravity. You can't avoid it. This is the way things are. So if you want to get along in the world, you need to live according to that.

There are often things that you haven't thought about in decades. Some things you have forgotten about come back to you. They also report that when they relive these events, they are aware of so many more things. For example, I've been told that when someone remembers the scene, they can count the mosquitoes hovering around them. They couldn't do that when they were living it. But going through the life review, time slowed down, and they perceived all the things they didn't perceive as they were living through it. It's as if time seems to expand or stop existing in the life review, and they can take all the time in the world to relive this experience.

Sometimes, they are stunned by the things that they remember. For example, George Ritchie, a psychiatrist, actually had a near-death experience with a heart attack. He had a life review in which he wouldn't remember the highlights, like becoming an Eagle Scout in the Boy Scouts and graduating from medical school. He said those things weren't important at all. The things that were highlighted in his life review were simple day-to-day events where he was helping somebody do this or things previously considered trivial. But in his life review, these were the essential things, the way he treated other people.

Definitely. Barbara Arise had an experience when she had a respiratory arrest in the hospital. She had a life review, and she remembered vividly having been abused as a child by her mother. This was not something she repressed. She remembered it. She also remembered it through her mother's eyes, and she saw that her mother was suffering as much as she was and reliving the abuse her mother had as a child and was caught in this pattern. She didn't know how else to relate to mothers and children. What Barbara got from this was that this was a pattern she and her mother and probably her grandmother had been trapped in. She was determined not to continue that with her children, which changed her as a mother. So many people learn from the near-death experience things they were doing that were mistakes. Interestingly, they never talk about the concept of sins. They always say I was doing this wrong, and now I know how to do it.

It's not just not your life, but other parts of the experience that help you reassess what you've been doing in your life. People often change their careers. Relationships break up after a near-death experience because people are so transformed by it. Let me give you an example of that. One fellow I knew, Steve Price, was kind of a tough guy. He had been a high school bully, and his life goal was to be in the Marines. He got to join the Marines. He became a sergeant in Vietnam, and he was leading a platoon in battle. He was shot in the chest, and he had shrapnel throughout his lungs. He was then evacuated to a hospital in the Philippines for surgery. During the surgery, he had a near-death experience in which he had had a confrontation with deceased loved ones on-duty and came back with this feeling again that we're all in this together, we're all part of something greater than ourselves. We have difficulty with ourselves, and it's the same as the divine.

When he returned from his near-death experience and after rehabilitation, he was sent back into Vietnam and found that he couldn't fire his rifle. The idea of hurting someone else was just unthinkable to him now. So he ended up having to leave the Marines. He ended up coming back to the States to train to be a medical technician. But I've heard similar stories from people who were police officers who, after a near-death experience, couldn't go back into the field and fire their guns. I've heard from cut-throat businessmen who used to get ahead at other people's expense come back from a near-death experience saying it just makes no sense to me anymore. They tend to run their businesses in a much more compassionate way. I've known people in organized crime in the same way, and I've known people who were addicts who transformed their lives after this near-death experience. So it's a transformative event, and as you can imagine, it often creates a lot of havoc in their lives if their families and friends don't particularly like these changes.

Well, in terms of our earthly time, it often seems to last just for a matter of seconds or minutes. It's a very short amount of time. But when you ask them what happened, it takes them hours and hours to tell you about it. They say quite frequently that there is no time in the near-death experience. They say that time didn't exist or that they were aware that there was earth time, but it didn't apply to them. Time seemed to dilate, and things were all happening at once. That doesn't quite make sense to me living in Earth time. So I say, look, when you're describing your near-death experience, you're describing it as a sequence of events. This happened, then this happened, and this happened, and yet you say there's no time.

How can you have a sequence of events without time? They just shrug and say, well, I know it's a paradox here, and I think we're back on the Earth in our brains. But it wasn't a paradox there. Everything made perfect sense there. This change between the way you think in the near-death experience and how you think here on Earth extends way beyond that. They often say that what happened to them is indescribable. They can't put it into words. There are no words to describe it. One person said it's like trying to draw an odor with a crayon. You can't do it. And then we say to them, sure, great. That's great. Tell me all about it. So we make the experiences distorted by putting them into words. By doing that, it sometimes doesn't make sense in words. They say there are just so many words that don't come close to conveying what happened. So we know we're not getting a literal description of what happened. We're getting a metaphorical description. We're getting the feelings, but not the facts, if there are facts.

Many of them give up trying to use words, and they will try to put it into art painted or try to draw it or try to write music that would convey the sense, but they don't feel words can do it.

Sure. That one particular one was someone described walking down a dark road. It's raining, and you can't see very much, and all of a sudden, there's a flash of lightning, and the whole world gets illuminated. You see what's on the side of the road. You can see the trees. You can see everything around you, and when the lightning flashes over, you're left in the dark again, and you can't see it anymore. But you remember what was there. You remember what you saw. Many people have used an analogy like this. Anita Moore had a near-death experience when her body was ravaged with tumors. They didn't think she was going to survive. She has a beautiful analogy of us living in a huge warehouse with the lights out, and you have a little flashlight that you can hold and point at different things, but you don't have any idea of what's really in the warehouse. Suddenly someone turns the light on, and you see that it goes on row after row, hundreds of feet long, and all these wonderful things you never dreamt of were there. And the light goes out again, and you're left back with your flashlight, but you can't see everything but remember what's there, and you come back with that knowledge.

Well, that's a great question. When we do studies to quantify how often they happen, we generally find that people who have a documented cardiac arrest with a heart stop between 10 and 20 percent of people like that will report a near-death experience, which means 80 to 90 percent don't. So why is that? We've looked at all the different physiological things that are going on during a heart attack. We looked at personality traits and can't find anything that will tell us who will have a near-death experience or what kind they will have when they come close to death. So we don't know why some people have them, and some people don't.

Now, I've asked the same question. Why do you think some people have them as some people don't? And actually, many of them will have more than one close brush with death. They all have a near-death experience at one of those, but not with the others. And they struggle with that. What they say is often something to the effect of you get what you need at the time. Or you get what you can handle at the time. Someone out there knows what you need or what you can handle, and they give it to you when you need it, not when you're not ready for it and not when you already know it, but just when you need it, you get it. I have no way of testing. That's not a scientific hypothesis. That's just what they tell me.

Ken Ring and I were two of the four co-founders of the International Association for Near-Death Studies. He started the Journal of Near-Death Studies and did some pioneering work in the early 1980s on outlining these experiences and how they affect people.

Well, most people who have this experience talk about the positive benefits of the after-effects, how it set them on the right track in life. It is like they were sent back to get a second chance to do it right this time, and they talk about reshaping their lives so they can do that. And sometimes, that means changing your profession. Sometimes it means just doing your profession differently and being more compassionate and how you treat your co-workers and your clients and so forth. People also talk about the challenges that this poses for them. And often, a spouse will not appreciate the changes, and it's often a mixed picture. I mentioned Tom Sawyer before. His wife and his kids said, "Well, he doesn't care about material things anymore. We desperately need a new car." He's been so much more compassionate since the experience so it was a mixed blessing for her, but I do know that many marriages do break up after a near-death experience. It's as if one partner has had a religious conversion, and the other one hasn't. It's hard to deal with that. Often getting into couples therapy has been very helpful. There are support groups for near-death experiences, about 50 of them are in this country, and they're all over the world. Many of them are sponsored by the International Association for Near-Death Studies. Often families will come to those support groups and talk with other families who have gone through the same thing and figure out how they dealt with these changes. But they are the very challenges for the experience themselves to figure out how to live this new life and be true to yourself and still be in the physical world. And it's hard sometimes to figure it out. It causes a lot of distress for them internally. Some are very unhappy about being back here. If those didn't choose to come back, they might feel depressed about it or angry about it being brought back, and it may take them a while to learn how to integrate the things they've learned in their experience into this life.

That's true. Now that I've been doing this work for so many years, I can do long-term studies and go back to interview people again. They interviewed in the late 1970s and early 1980s and saw whether their accounts of the experiences changed over time. And what we have found is that neither one has changed. What they tell us now about the experience is the same as what they told us 30 years ago. Absolutely no differences, and similarly, the after-effects are the same. They are driven to pursue these new goals now, as they did when they first had the experience. It doesn't fade over time.

Jeff Long, who is a radiation oncologist who runs the Near-Death Experience Research Foundation, found in his sample, which is several thousand near-death experiences, that 97 percent insist that the near-death experience is more real than this physical world. I have heard that from one experience after another. One fellow that I worked with was a college student who had schizophrenia. He heard the voice of Satan telling him that he was Satan's spawn. So he climbed up to the roof of his dorm and jumped off the roof. And he said to me that halfway down as he was falling, God spoke to him and reassured him that he was not the devil spawn. He was the child of God. And God was not going to let him die like this. And he ended up breaking several bones but not dying.

Now, when I talked to him in the hospital after that, I said, wait a minute, you're telling me that you heard two voices that no one heard except you. And you're saying that the voice of Satan was a hallucination from your schizophrenia, and the voice of God was real. How can you tell them apart? What he said to me was, I can't explain to you except to say that God's voice was more real than yours is right now. I've heard that from experience after experience, that they say what happened, in the end, had a poetic realness to it that this world just doesn't have.

You also asked about the connection with meditation and others. Now, of course, the new death experience is not the only way of reaching this mystical state, if you want to call it that—this otherworldly realm. There have been mystical traditions throughout the ages from different religions, different spiritual traditions to get to this other state. So I think the near-death experience is just one of the most reliable ways we have now of getting there, but of course, the most traumatic way as well. But you can certainly get the same experience, the same message from other means as well.

However, one difference is that when you engage in a spiritual tradition to get there, you usually have the training to do it. You have the intent to get there. You're trying to do it. And you have guides either in person or in writing to help you understand and integrate that into your life. Whereas the near-death experience comes to you unexpected and unbidden, you don't look for it. It just comes upon you. You're unprepared for it, and you don't have a guide to help you understand it when you come back. So I think for that reason, some of the after-effects may be different because it was so unexpected and something you didn't prepare for. It may have a more profound impact for that reason because you weren't trying to get it. Sometimes, when you try to take psychedelic drugs to have an experience, you may say, well, it wasn't really real when you came back. And with the near-death experience, you don't have that excuse to say, no, it wasn't real because I did this or that. It was just there. It was an experience you had that you weren't trying to have.

Indeed, they are. As word gets out about these near-death experiences, we hope that they may eventually affect our culture and society and the people in power directing our society. Prominent world figures have had near-death experiences, often due to a heart attack, which made them change their behavior and policies. Anwar Sadat, the president of Egypt, who, after his near-death experience, engaged in the peace talks that Jimmy Carter orchestrated between Israel and Egypt. Another was Mikhail Gorbachev of the Soviet Union, who, after his near-death experience, worked with Ronald Reagan to tear down the Berlin Wall. So there are examples of this, but often it comes not from the top, but from below, from the common people. Enough of them have enough of a change, becoming more enlightened. And that brings about a change in society.

They didn't say it was linked to that. I'm just drawn to that because it did happen right after their near-death experience. That raises another point in my mind that some people said that this is just the effect of coming off almost losing your life, and that makes you re-evaluate what happens, and that's true. But people who almost lose their life and don't have any death experience, don't have all the same range of after-effects as near-death experiences do. They tend to value life more dearly after they've almost lost it? But that often makes them more cautious, more frightened of losing their lives, and more conservative in their behavior. Whereas near-death experiences lose their fear of death and dying, they come back having an increased joy of life because they're not afraid of losing it. So they end up engaging more fully in life, living more in the present, and taking more chances because they're not afraid of losing it. They end up living a life that's more meaningful and fulfilling than otherwise.

Well, many people do come close to death or maybe pronounced dead but don't have any conscious experience that they can remember. So we can't call those near-death experiences nor near-death events. Whereas people who have a near-death experience, when they have this close brush with death, they have this experience of being in another realm or leaving their bodies or having the life review and engaging in the act of thought, which alone is amazing that they can have this complex experience when their brains are not functioning very well. We have no explanation for how that could be.

They feel that in this other realm, they still existed and felt wonderful without the usual labels that we put on ourselves here. I'm an American. I've got a certain political affiliation or religious affiliation, maybe. And those things were not part of who they were in the afterlife, yet they felt better without them. So they come back no longer valuing all those distinctions that make us different from other people. They value the things that make us the same as every other one, every other person, the same universal feelings. Everyone has the same sense of connection to everyone else. They feel that they come back realizing that they are part of something greater than themselves.

As a psychiatrist, this was driven home to me when I heard near-death experiences say that they're no longer afraid of death. I started worrying if I would make people more suicidal because I know people tired of this life are often deterred from taking their lives because they're afraid that something will happen if they die. So I did a study of people who made suicide attempts. They compared those who had a near-death experience with those who didn't. What we found was that people who had a near-death experience after their suicide attempt were far less suicidal after it than people who didn't have a near-death experience, and again, Ken Ring repeated a study with another population who found the same thing.

When I asked the experiencers why this was, they said again, when you lose your fear of dying, you lose your fear of living, and you come back with a sense of the purpose of everything that goes on here. Even my suffering becomes something I'm supposed to learn from, not something to run away from. You can gain from every experience you have. So they tend to dig into life and explore everything they're doing in great detail and get the most out of it. They live their lives much more intently, intensively, much more mindfully, and they get more fully involved and find it much more fulfilling. And that makes their life seem so much more worth living than it was before.

I grew up without any type of religious or spiritual background, and I didn't have any of that. And as far as I could tell, I wasn't missing anything, and I didn't see the need for that. But I've seen from the near-death experiences how important that aspect of life is to enriching your life and making it as complete as it can be. I think other people have this experience or sense of spirituality without realizing it. It's just a sense of there being something greater than the physical world. And the fact that you are something more than just this physical body, there's more to you than just that. And beyond this physical body, everyone else has the same divinity they're made of. If you realize that and live that, then you see the divinity in everyone else as well. That makes you more compassionate towards other people who may seem on the surface to be very different from you. But now they are the same as you.

I grew up in a scientific tradition. But I've also come to appreciate the spiritual approach as I've gone through the decades of this research. I feel that both science and spirituality are both trying to get at the truth, using a different set of tools. I've come to appreciate that using one alone does not give you a full picture of the universe. You need to see both sides. I find that great scientists like Albert Einstein and great spiritual leaders like the Dalai Lama also say the same thing, that science and spirituality are complementary. They're not conflicting at all. They're both different ways of helping us understand ourselves and our role in the universe, and we need to appreciate both approaches to understand what's going on.

Yes.

Well, of course, I started without any sense of what the spiritual world was like anyway, and I had serious doubts when I first started doing this work. We did several studies to differentiate this mystical experience from mental illness. We found there was no overlap at all. When you look at what's going on with these two, I've published several papers referenced in my book documenting the differences between fantasies and dreams and hallucinations and these near-death experiences. So I've come to appreciate over the decades that we need to understand spirituality and be open to this.

When I started, I was a hardcore materialist scientist. I thought we were going to have all the answers before too long. Now I'm very comfortable with the idea that we're not going to have the answers, and that's fine. We don't have to understand it because our brains are too simple to understand it. Maybe when we leave our brains, we will appreciate it fully. I don't know what will happen when we die because people who have been there and back tell me that there are no words for it. So how can I possibly understand it? And I believe that. I'm still a skeptic at heart and this part of me that says you're misinterpreting this whole thing. There's a very simple explanation for it. I can't imagine what it is, but I have those doubts, of course. But I think the preponderance of the evidence suggests to me that death is not the end and that even though I don't know what happens afterward, I'm fairly confident that something is waiting for us out there. And it's not something to be feared.

Well, I think I feel very good at this. The next step will not be mine. There is a new generation of near-death researchers all over the world, a large group in Belgium, a large group in New Zealand. They're all over the world pursuing this with different areas of expertise than I have and different outlooks than I have. So I can't imagine what the next steps will be because they're beyond my level of expertise. But I feel confident that the work is going to go on for a long period of time.

Thank you, Hitendra. I've enjoyed this very much.