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Review of The Spiritual Doorway in the Brain (2011)

Dan Ferrisi


Review: Kevin Nelson. 2010. The Spiritual Doorway in the Brain: A Neurologist's Search for the God Experience. New York, NY: Dutton. 326 pp.

Those who are spiritually inclined diverge sharply from those with a strictly rationalist perspective over an afterlife, "the immortal soul," and near-death experiences. Nevertheless, it seems probable that all people—including those in the latter camp, in which I fall—have some difficulty confronting death as the genuine end of existence as an individual. Although people certainly pay lip service to the idea of pondering death, I suspect it is the rare individual who truly explores the idea—indeed, the reality—that one day, whether distant or close at hand, he will have become but a lifeless body, perhaps being probed by a medical examiner or prepared for viewing by a funeral director. It seems downright bizarre to think that each of us, full of thoughts and ideas and ambitions, will have our life—and with it our consciousness—permanently extinguished.

The strange, depressing nature of contemplating the end of existence as an individual has contributed to the frenzied interest in near-death experiences, those extraordinary and often spiritual episodes that occur when one is on the precipice of death. This, in turn, has inspired Kevin Nelson, M.D., to write The Spiritual Doorway in the Brain, a book that attempts to make sense of this puzzling phenomenon. Nelson, a professor of neurology at the University of Kentucky, marshals his more than three decades of experience to examine the nexus of science and spirituality—analyzing, for example, whether out-of-body experiences could genuinely be instances of the soul detaching from the body, or whether near-death encounters with deceased relatives are veridical. The result is a fascinating (if occasionally challenging) work that shines light upon the brain and the oddness of which it is capable.

Though written for the nonspecialist, The Spiritual Doorway in the Brain does not shy away from delving deep into the brain, discussing which regions of this most highly evolved organ are responsible for which motor and mental functions. It is divided into three principal parts: "The Architecture," "At the Doorway," and "The Other Side." If the casual reader were to have any difficulties with Nelson's book, it would be with Part One ("The Architecture"), where (with the help of engaging and well-conveyed anecdotes) Nelson describes how the brain works and how—in extraordinary circumstances, as a result of disease, or in other rare instances—perception and reality can become disconnected.

Nelson recounts the story of patient Steve, who manifested "alien limb" when taken to the emergency room with traces of an early stroke. "Alien limb" is a condition in which "the specialized nerve circuitry controlling the arm is cut off from other brain areas, leaving the disconnected area isolated but functioning in an often bizarre or autonomous manner" (p. 70). It is as if one's arm is beyond one's control. Another phenomenon, extra limbs, was displayed by a woman who suffered a brainstem stroke. Nelson writes: "When she recovered sufficiently to be able to describe what she felt while she was paralyzed, she said an extra arm had formed on her left side. She could move it, although at times it seemed to have a mind of its own and it felt as though it were trying to strangle her" (pp. 75-76). He also touches on Cotard's syndrome, an exceedingly rare disorder in which a living person becomes convinced that he is dead.

Much of Part One is not directly relevant to Nelson's theories about near-death experiences, but the material serves a twofold purpose. First, Nelson skillfully lays out the neurological foundation for his more complex theories. Second, he illustrates quite effectively how the brain is capable of confabulating extraordinary sensations and experiences even when they have no connection to reality. Beyond that, Nelson's discussion of Phineas Gage inspires questions about the degree to which "the self"—understood in terms of key elements like personality and character—is malleable. (One also wonders what content a "soul" might have if one's very nature is brain-centered.) Gage, a railway foreman in the mid-19th century, suffered a horrific brain injury when an iron bar was blasted through his skull. According to Nelson, "once his wound healed, his damaged frontal lobes transformed him from a hardworking, socially responsible, law abiding, and reliable person into someone who was notoriously capricious, profane, lazy, and irresponsible" (p. 77). So early on Nelson shows us that the brain is capable of playing bizarre and sometimes cruel tricks on us, and controls our fundamental personality.

Early in Part Two Nelson enumerates the most common elements of a near-death experience, among them feelings of peace, seeing a brilliant light, entering another world, vivid sensations, and, curiously, out-of-body experiences. To home in a bit on a specific example, we can examine the case of Pam Reynolds. Her near-death experience, often alleged to have occurred while she had a flat EEG, has achieved near-legendary status as "proof" of mind separated from body and, perhaps, of life after death. As a young woman, Reynolds suffered a huge aneurysm in a major artery at the base of her brain. The condition required extremely delicate surgery in which all of the blood would be drained from her brain so that surgeons could safely operate. Her brain temperature was lowered to 60°F and barbiturate sedatives were administered liberally. The reduction in brain metabolism that followed allowed her blood flow to be halted for a prolonged period without her brain dying.

After the administration of anesthesia and commencement of surgery, Nelson notes:

To reach the brain and blood vessels, a skull flap had to be removed with a bone saw, which is a handheld device, pneumatically powered like a jackhammer. As the saw cut through her skull, Pam awoke, and came to view her surgery as if she were sitting on the neurosurgeon's shoulder. First she heard what she said was the sound of a musical note being played. It felt as though the sound was pulling her out of the top [of] her head. She recalls looking down at herself from above in the operating room, and a feeling of acute awareness, "the most aware I have ever felt in my life." Then she found herself looking at the proceeding as if she were sitting on her surgeon's shoulder. Her vision was bright and clearer than "normal vision." She saw them turn the saw back on and she heard the whirring sound it made.

After he finished sawing, the neurosurgeon removed the bone flap, exposing Pam's brain and its coverings. While this was taking place, other surgeons struggled to find the large arteries in Pam's groin so her blood could be drained. Pam said she was aware that the doctors were having trouble finding her veins and arteries. She said she felt as though she was being pulled upward in a vortex, spinning around. She noted that it was "like a tunnel but it wasn't a tunnel." At that point, she heard her grandmother calling to her. She didn't so much hear it, "it was a clearer hearing than with my ears," she says. Her grandmother beckoned to her and she went toward her down a "dark shaft" at the end of which a light burned brighter and brighter. (p. 145)

The mystical experience continued until Reynolds was "pushed" back toward her body. According to Nelson, it was near this time that her brain was put into "suspended animation" as her body temperature was being lowered to 60 degrees. The essential fact here, Nelson argues, concerns the timeline of events; in particular, it pertains to exactly when the brain became electrically silent. "How would I explain her vivid experience while she had a 'flat EEG'?" he asks rhetorically (p. 147). "Here ... a more worldly explanation is not only likely but obvious. Pam's near-death experience occurred before her brain was put in suspended animation. There is no reason to believe she met her grandmother or had any other part of the experience when her EEG was flat" (p. 147). Reynolds simply (albeit horrifically) regained consciousness as surgery was in progress, apparently overheard a conversation between the doctors, and married that with sensory information she gathered once she was wheeled into the operating room. There are, in fact, no documented cases of near-death experiences occurring specifically during a period when brain activity is nonexistent. Even in the case of Reynolds, brain-centric explanations suffice.

What, then, of out-of-body experiences? If one's consciousness seems to be floating separately from the flesh, does this not mean that mind is distinct from matter, lending support to a kind of dualism? On the contrary, like alien and extra limbs, the sensation of consciousness wrenched from the body seems to be mere brain trickery—perhaps even replicable trickery at that. Nelson describes a patient suffering from right-temporal-lobe seizures who had electrical current applied to her brain by Olaf Blanke and his colleagues in Switzerland. Stimulation to her temporoparietal region was found to produce a kind of out-of-body experience. As Nelson writes: "The research team turned off the current and she immediately returned to her body. When the current was turned back on, she instantly felt 'lightness' and 'floated' six feet or more above her body. Current on and she immediately left her body; current off, she returned" (p. 141).

The Spiritual Doorway in the Brain totals more than 300 pages with notes and references, presenting a multi-pronged, deeply neurologically driven interpretation of near-death experiences. The level of detail that it provides is immensely beyond this review's scope. Nevertheless, one of the author's most important theories is based on REM intrusion, where the dreamlike, fantastical imagery that we are acquainted with in REM (rapid eye movement) sleep intrudes into waking consciousness. Could near-death experiences be correlated directly to REM intrusion, with the intensity, memorability, and personal meaning amplified by the exceptional life-threatening circumstances? Fascinatingly, the author makes a link that seems statistically significant.

Nelson and his team assembled 55 research subjects, all of whom had experienced a near-death event, and analyzed possible REM intrusions, comparing their results to an equivalent control group. Nelson describes the findings:

We asked the subjects about their lifetime sleep experiences, using exactly the same questions for everyone. Specifically, we wanted to know about the borderland between wakefulness and sleep. We asked if during this transition they had ever experienced visions, sounds, or paralysis, in other words REM consciousness.

What we found was that the brain switch linking waking and REM consciousness was different in people who have had a near-death experience. Instead of passing directly between the REM state and wakefulness, the brain switch in those people was two-and-one-half times more likely to blend the two states. Across the board, people who'd had near-death experiences had more REM intrusion—be it REM's dreamlike visual imagery, auditory hallucinations, or paralysis. It was fifty-fifty if the person first experienced near-death or REM intrusion. (pp. 200, 202)

Nelson's theories are fully fleshed out in his book, but the upshot for skeptics with a bent toward metaphysical naturalism is that unusual brain activity seems sufficient to explain near-death experiences. Although readers are certainly entitled to tack a supernatural explanation on to the phenomenon, no otherworldly appeals seem necessary, and no persuasive evidence points toward Cartesian dualism or veritable brushes with a world beyond. Although Nelson carefully avoids cheerleading for naturalism, preferring instead to simply stick with the science, he might concede a bit too much. Reflecting on the insignificance of humankind, our planet, and even our galaxy in the unimaginably vast and ancient cosmos, as well as the explicability of near-death experiences, he writes: "Do these cold, hard clinical facts suck the divine nectar from our spiritual lives? My answer is an [emphatic] NO! We are poised on the threshold of a new era that holds tremendous promise for a new level of spiritual exploration" (pp. 258-259).

It occurs to me that this "new level of spiritual exploration" should be rooted in the recognition that, however powerful, persuasive, and transformative extraordinary experiences might be, their genesis does matter. Many intense feelings of wonder, oneness, and revelation can be brought on by doses of hallucinogenic drugs, such as LSD and psilocybin mushrooms. Nelson makes repeated reference to William James, to whom he attributes the following quote: "By their fruits ye shall know them, not by their roots." In other words, however spiritual experiences might originate, their "fruits" are what matter.

But if revelations of spiritual or cosmic truth are delivered by means of mind-altering drugs, seizures, a blood-starved brain in the throes of crisis, or the application of electrical currents in a researcher's lab, surely the "roots" become relevant. Here, Carl Sagan's The Demon Haunted World: Science as a Candle in the Dark (1996) is instructive, albeit in the service of a different subject. Sagan writes:

Occasionally, I get a letter from someone who is in "contact" with extraterrestrials. I am invited to "ask them anything." And so over the years I've prepared a little list of questions. The extraterrestrials are very advanced, remember. So I ask things like, "Please provide a short proof of Fermat's Last Theorem." Or the Goldbach Conjecture. (p. 100)

When considering the extraordinary nature of supernatural and otherworldly claims, it might be wise to judge their truth value—and indeed their importance—only commensurately with the evidence that something truly different is occurring. Man is ill advised to wed himself to a hypnotic and compelling dream, however reluctant he might be to slip from its bewitching grasp.

Copyright ©2011 Dan Ferrisi. The electronic version is copyright ©2011 by Internet Infidels, Inc. with the written permission of Dan Ferrisi. All rights reserved.

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