Category: Consciousness

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The Day Ram Dass Died

— He taught me to be more curious, present, and self-loving. His final lesson was more surprising.

By Christopher Fiorello

I woke up every thirty minutes the night before Ram Dass died. Stretching my perception through the big divider that separated his study—where I lay on a narrow couch—from his bedroom, I’d count the seconds between the short, ragged breaths churning through his sleep-apnea machine.

Four years later, I still have no idea why I was chosen to watch over him that night. I was at the bottom of the caregiver pecking order when it came to things directly related to Ram Dass’s body. I lacked the size and strength to transfer him from bed to wheelchair, or wheelchair to recliner, on my own; was too much of a novice to help organize his schedule or coördinate with his doctors; and was too unfamiliar to offer intellectual comfort in the rare moments that he wanted to talk. I’d met him ten months earlier, had his voice in my head for just three years. There were people in the house, on Maui, who had known him for more than three decades.

Before arriving, I had no formal medical training, but I had done three weeks of volunteering at a hospice facility in anticipation of coming to the island. Most of it involved moving Kleenex and changing the amount of light in empty rooms. Several times I sat with the dying. It was overwhelming to look at their closed eyes, feeling the heaviness in the room, the sense of something happening or about to happen. I scanned their faces for signs of pain, of fear or bliss, of transcendence. Through the palliative haze of opioids, they were impossible to read. No one was thrashing in pain; no one was smiling, either.

But it somehow buoyed me, being so close to death. The heaviness seemed critically important to my spiritual growth. I imagined myself giving peace to the dying through my presence, and in the process conquering my own fear of leaving life behind.

During my time with Ram Dass, I flitted constantly between self-righteousness and self-pity, one day indulging in grandiose fantasies that I was the heir to his legacy, charged with scattering his ashes, and the next imagining that everyone in the house hated me. The caregivers called it the classroom or the fire—a site of purifying work, a pathway to enlightenment.

My own work, purifying or otherwise, consisted mostly of handling various chores needed to keep a six-bedroom cliffside home with a pool, guesthouse, and two-acre yard going. For the bits that mattered—the scrubbing and the laundry and the cooking—there was a team of cleaners and a rotating cast of chefs. I ended up doing a lot of the rest: separating recycling, washing dishes, and replacing cat-scratched screens. There were three other caregivers in the house, and I was given a modest salary, plus my own room, meals, and shared access to a truck. I was an employee, but most days the house felt like a family, for better or worse.

Still, this was only the second time I’d been asked to spend the night in the study. It was generally perceived as an act of intense devotion: accepting a horrible night’s sleep, on a couch that reeked of cat pee, while facing the prospect of Ram Dass dying on your watch. I hated it, but I was there to care for the guy however it was decided that he needed care.

Most of the deciding was done by a woman affectionately dubbed Dassi Ma, a seventysomething lapsed-Catholic firecracker from Philadelphia. Dassi Ma was Ram Dass’s primary caretaker, and, though she no longer did the more strenuous physical tasks, she was still in command of what he got and when, often more so than Ram Dass himself. He was eighty-eight, and his health had been steadily deteriorating owing to a host of issues, including chronic infections. When I moved to Maui to be near him, in February, 2019, he had almost died the night I arrived. He bounced back, to everyone’s surprise but his own. “It wasn’t time,” I remember him saying in his stoic way, neither relieved nor disappointed. Now he had another spreading infection, and what appeared to be a cracked rib from being transferred to and from his wheelchair.

Ram Dass’s life is the subject of multiple documentaries, an autobiography, and a docuseries in development starring “High Maintenance” ’s Ben Sinclair. He was born Richard Alpert in 1931 to a wealthy Boston family. His pedigree was sterling: a Stanford psychology Ph.D., tenure track at Harvard, visiting professorship at Berkeley. In 1963, after five years at Harvard—much of it spent studying psychedelics with his fellow-psychologist Timothy Leary—he was fired for giving psilocybin mushrooms to an undergraduate.

He bopped around for a few years, often taking obscene amounts of mind-altering substances with Leary at the Hudson Valley estate of his friend Peggy Hitchcock. In 1967, like so many other Westerners of the time, he travelled to India in pursuit of exotic answers to life’s biggest questions. He’d grown disenchanted with the psychedelic world, which had come to seem rotely defined by highs and comedowns. In India, he met a Californian hippie named Kermit Riggs and followed him to a village called Kainchi, in the Himalayan foothills, to meet Riggs’s guru.

The guru was an old, squat man named Neem Karoli Baba. Before long, an enthralled Alpert was reborn as Ram Dass, or roughly “servant of God.” He returned to America later that year, arriving at the airport dressed in white robes and with a long, scraggly beard, and began his career as a spiritual teacher. Most of what he talked about, from 1967 to his death, were the experiences he had with Neem Karoli Baba, whom he called Maharaj-ji (“great king”), and the spiritual beliefs that emerged from those experiences.

One of his main ports of call became death and dying. In 1981, he co-founded the Dying Center, in Santa Fe, an organization that described itself as “the first place specifically created to support and guide its residents to a conscious death.” The center sought, in effect, dying people who wanted to use their death to become spiritually enlightened, and staff members who wanted to use other people’s deaths to achieve the same. Even before the Dying Center took shape, Ram Dass was lecturing on the spirituality of death, its place in the natural order, and the starkly contrasting way that he believed it was perceived in the East. His teachings were rooted in a specific vision of metaphysical reality, as informed by his guru and by the Bhagavad Gita, a sacred Hindu text. Roughly, he believed in nondualism, that there existed an unchanging and absolute entity—the Hindu Brahman, which Ram Dass more frequently called God, the divine, or oneness—from which all material reality came. Included in that reality were souls (something like the Hindu atman), which by their nature were caught in the illusion of their separateness from God, repeating a cycle of birth, suffering, death, and reincarnation until they remembered their true nature as part of the oneness—that is, until they became enlightened.

Death could be a crucial moment for remembering this nonduality, as it was when the “veil of separateness” was thinnest. In his 1971 book, “Be Here Now,” which has sold more than two million copies worldwide, Ram Dass summarizes his views: “You are eternal . . . There is no fear of death because / there is no death / it’s just a transformation / an illusion.”

He often spoke to crowds afraid of dying, repeating that he had “no fear of death.” He sat with people on their deathbeds and talked routinely about the power of “leaving the body,” his efforts to “quiet himself” so that the dying could see where they were in the reincarnation process and do what they could to escape it. His stories were sometimes graphic—people dying prematurely, or dying in tremendous pain—but always tinged with a lightness and humor.

Perhaps Ram Dass’s most memorable remarks about death came not from his own mind but from a woman named Pat Rodegast, who claimed she had channelled a spirit named Emmanuel from 1969 to her death, in 2012. Rodegast was working as a secretary, raising children, and practicing Transcendental Meditation when she began to see a light, which evolved into what she called telepathic auditory guidance. Some of that guidance was captured in three books published in the eighties and nineties, two of which came with forewords from Ram Dass. According to Ram Dass, when he asked Emmanuel what to tell people about death, Emmanuel replied that it was “absolutely safe,” “like taking off a tight shoe.”

I first encountered the voice of Ram Dass in 2016. I was twenty-seven and living in New York, in a Chinatown building that rattled every time an empty box truck drove down First Avenue. Each morning, I tumbled down five flights of sticky stairs and placed one of his talks deep into my ears, letting his distinct blend of scientific erudition and spiritual mysticism carry me across town.

He had a habit of segueing from psychological concepts, like attachment theory and childhood trauma, to cryptic ones, like Emmanuel’s messages and the astral plane, pausing briefly to ask listeners if they could really, truly “hear this.” He seemed to build on the insights of others who had revolutionized end-of-life care in America—thinkers such as the psychiatrist Elisabeth Kübler-Ross—but also spoke in the New Age argot of Alan Watts. I gobbled it all up, feeling my spiritual life deepen exponentially by the day. His lectures made me more prosocial, more anti-capitalist, more curious, and decidedly more self-loving.

This was my second rodeo with spirituality; growing up, a rigid strain of Protestantism had been foisted on me like a chore. In Kansas City, Missouri, I was enveloped by an atmosphere of creationism, tent revivals, and anti-abortion screeds. I still recall standing on a busy street as a six-year-old and holding a sign that read “Before I Formed You in the Womb I Knew You—God.”

The teachings of Ram Dass were nothing like that. They were straight out of the hippie movement, and seemed to license a more liberal, self-directed search for meaning. As the grind and filth of Manhattan wore me down, Ram Dass’s voice became a salve, a way to “wake up to the illusion of our separateness.” I turned to his work again and again—to ease my loneliness when, walking down the street, droves of people moved around me like I was a light post, or to arrogantly tell my ex-girlfriend that we would always be “together,” even though I’d already dumped her.

After a couple of years, I learned that I could actually meet Ram Dass, for free, by signing up for one of his “Heart-to-Hearts”—a one-on-one, hour-long Skype call he offered as a sort of public service. When my time came, and the man appeared onscreen, I was stunned into silence. I had thought of him as a spry, ethereal figure who existed only in decades-old recordings. This Ram Dass was very old and lived with fairly advanced aphasia, a side effect of a major stroke he’d had in 1997. His speech was slow—in our full hour, he said roughly sixty words—but not at all ponderous. I thought it gave him a mystical quality.

There was no format to the session; Ram Dass just smiled his winning smile and listened. At one point, after I’d nervously overshared, he told me, “You take yourself pretty seriously.” That struck me as profound, at least at the time, but what endured was more feeling than words. It seemed he had arrived at a place from which he could find genuine love for strangers like me. It didn’t strike me as brand positioning, or as a form of ego; I didn’t think he loved me in the sense that he wanted to be close, or even that he cared whether we got to know each other. I just believed he saw me as another soul, and that, in his view, made me worthy of kindness.

By then, I was walking around New York, trying desperately to feel connected to anything. I wanted what Ram Dass had. So I left the city, intending, among other things, to get him to show me how to have it.

The friend I’d discovered Ram Dass with had already moved to Neem Karoli Baba’s temple, in Taos, New Mexico. I visited him for a fortnight of cooking group meals, wandering through the snowy high desert, and hobnobbing with Maharaj-ji zealots, including one white teen-ager who insisted that he was the reincarnation of Krishna, one of Hinduism’s most revered avatars. Like the young Krishna of lore, he would steal away to the temple pantry to eat pure butter until caught.

Some of this evoked my childhood church, where kids compared how quickly they could transition into speaking in tongues, or flexed the depth of their personal relationship with Jesus while leading a collective prayer. But this was my first encounter with Neem Karoli Baba devotees; I figured followers would be a bit more mellow the farther I got from his temple. Toward the end of my stay, I met a longtime friend of Ram Dass. He saw that I was eager to do volunteer work—known as seva, Sanskrit for “service”—so, when he learned of my intent to find Ram Dass on Maui, he offered to put in a good word to Dassi Ma.

That recommendation made the seemingly impossible possible. People of all ages came to the island to be near Ram Dass. Some found their way into the group texts for arranging kirtan—living-room chanting sessions at Ram Dass’s house—or beach excursions. A few found opportunities to be useful around the house, or made friends with one of the live-in caregivers, enabling them to drop by every week or so. But to be offered to help care for Ram Dass, for pay, as a virtual nobody, was exceptionally rare.

Upon arriving at the house, I found it shot through with the same quasi-religious fervor I had seen at the temple. I was quickly intercepted by another caregiver and taken to a lean-to, in a nearby pasture, so that I could silently meditate with prayer beads. It was incredibly humid, and I got annihilated by mosquitoes. I returned to the house to find a living room packed with people chanting—mostly the Hanuman Chalisa, a devotional hymn that features verses like “With the lustre of your vast sway, you are propitiated all over the universe.” A collective effervescence filled the room, and I joined along, staring at hundreds of statuettes of religious figures while fighting back the sense that I was in church.

After more than an hour of chanting, we milled about, greeting one another over chai and snacks. Attendees swapped stories of Maharaj-ji’s miracles, told me that my presence must be part of his plan, sat smiling at Ram Dass’s feet, their hands over their hearts. During my year on Maui, Ram Dass’s foundation led retreats at a local resort, where hundreds of people would gather for spiritual talks and chanting. Inevitably, someone at these events would look at me with confusion or pity when I told them my name was Christopher. “He hasn’t given you a name yet?” the person would ask. Ram Dass often bestowed a Hindu name on people: Lakshman, Govinda, Hari, Devi. I was fine with Christopher.

But there were other moments, informal and fleeting, when I witnessed the mixture of play and profundity that first drew me to Ram Dass. One autumn morning, two other caregivers and I were helping him get through his daily routine—brushing teeth and hair, putting on clothes and hearing aids, making the bed—when I turned on Doja Cat’s “Go to Town,” a song I later learned was about cunnilingus. I cranked the volume, and the four of us started dancing with illicit glee. One caregiver jumped on the bed, another swung from the divider between the bedroom and the study, and Ram Dass waved his one mobile hand with bright eyes and a rascally smile.

Another day, I was alone with Ram Dass, helping him pick out a shirt. Though I spent nearly all my time in the house, I could count the hours we had been alone together on two hands, and most of them had involved food and drink, or foot massages, ostensibly to relieve the pain that he felt from diabetic neuropathy. On this day, the house was recovering from Ram Dass having been denied psilocybin owing to his health. I felt sorrow for him; the drug was, after all, the beginning of his spiritual journey more than five decades prior. I asked him if the house ever felt like a prison. A full minute of silence passed, with me standing over him in his walk-in closet. Eventually, he tapped his temple and said, “This is the prison.”

When morning broke on December 22, 2019, and Ram Dass was still alive, I allowed myself a moment of relief. Dassi Ma came up, looking short on sleep, and took his vitals. They were horrible. We snapped into action, trying to comfort Ram Dass until one of his doctors arrived.

The infection had pooled fluid in his lungs, which made every breath a burden. Wet, rattling half-breaths were punctuated by coughs of bloody mucus. He looked wrecked, but still managed a weak smile when his Chinese-medicine doctor told a joke at his bedside.

At some point, Dassi Ma and the doctor began talking in the study; other caregivers were on an oxygen-tank-and-essentials supply run. I was on one side of Ram Dass’s bed; on the other was his longtime co-author Rameshwar Das, a friend since Kainchi. Then Ram Dass started choking.

It wasn’t that different from any of the other horrible breaths he’d taken that morning, except that he just couldn’t breathe it. When he realized this, he turned to me with a look that haunts me even now: light eyes wide as quarters, mouth open, lips a bit rounded. I immediately panicked, calling for Dassi Ma and trying to get his adjustable bed as upright as possible so that he could clear his throat. Then, when that didn’t seem upright enough, I frantically tried to lug his torso up so that his head could hang over his waist; perhaps he could vomit his throat clear.

Thirty seconds had passed since he first lost his breath. Somewhere from near his feet, the doctor snapped at me: “You have to calm down!” It jolted me into an awareness that Ram Dass was dying, right there. Perhaps it did the same for Dassi Ma, because she sprang for the study, returned with a large framed photo of Neem Karoli Baba, and commanded him to focus. “Ram Dass! Maharaj-ji! Maharaj-ji!” she said, placing the photo at the foot of the bed. She told him that she loved him, that he could go. I told him that I loved him. And then Ram Dass stopped trying to breathe.

I was the only person to leave the room. Stumbling into the study, I picked up my phone, hands quivering, and sent word to the other caregivers: “RD’s dying imminently. Like within the next couple of minutes.”

The wind was screaming outside. On Maui’s North Shore, it wasn’t unusual for it to reach thirty, forty knots, rattling the windows and throwing palm fronds across the lawn. That day, it had blown from early in the morning, under a tightly woven blanket of gray clouds. Sitting in the study, I watched it bend the trees, felt the violence of it, indiscriminate.

Ram Dass believed that fear kept us from recognizing our interconnection to all things. “Change generates fear; fear generates contraction; contraction generates prejudice, bigotry, and ultimately violence,” he said. In his teachings, he often placed fear and love on opposing sides of the human experience. Fear was the by-product of the ego; love was the by-product of the soul that remained pure, in the moment, especially at the time of death. “When we are fully present,” Ram Dass wrote, “there is no anticipatory fear or anxiety because we are just here and now, not in the future.”

And yet this binary is precisely what made watching him die so disorienting. I’ve no idea what Ram Dass felt in those final moments, what he could see or hear. I don’t even really know if that was fear I saw in his eyes, though it certainly looked like it. Perhaps it was surprise or another sensation entirely, the rush of emptiness before a huge plunge into something tremendous.

Whatever it was, its existence seemed largely absent from his teachings. There were times when he acknowledged the pain and coarse brutality of death. In his book “Still Here” (2000), he writes:

Dying is often not easy. the stoppage of circulation and starving of the heart muscle. the inadequate transport of oxygen to tissues, the failure of organs. Where can we hope to stand in our own consciousness during such traumatic conditions, in order to die with clarity and grace?

Yet the emphasis he placed, over decades of lectures, on the importance of grace during death made so little space for terror—for how fear could coexist with presence, and even with love. In the minutes after his passing, the chasm between how he died and how I thought he was supposed to die reminded me of the betrayal I’d felt when, at sixteen, I flouted my mother’s and pastor’s admonitions and stopped asking God for protection, only to discover that a similar slew of terrible and wonderful things still happened to me.

In the house, too, marching through three days of death rituals before Ram Dass’s body was removed, I felt my spirituality slip its moorings. Late on the second night, his body lay on ice in his study—a rite he’d specifically requested, hoping that it would help those around him transcend their fear. I sat on the floor and peered up at his face through candlelight, his skin whitish blue and gaunt, his mouth slightly agape. I waited for grace, for him to speak reassuringly from some other plane of reality. Instead, I was taken back to our final moments together, where fear sutured me to each passing second. Not fear of the past or some uncertain future, but fear of the vast, strange intensity of what is.

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The new science of death

— ‘There’s something happening in the brain that makes no sense’

New research into the dying brain suggests the line between life and death may be less distinct than previously thought

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Patient One was 24 years old and pregnant with her third child when she was taken off life support. It was 2014. A couple of years earlier, she had been diagnosed with a disorder that caused an irregular heartbeat, and during her two previous pregnancies she had suffered seizures and faintings. Four weeks into her third pregnancy, she collapsed on the floor of her home. Her mother, who was with her, called 911. By the time an ambulance arrived, Patient One had been unconscious for more than 10 minutes. Paramedics found that her heart had stopped.

After being driven to a hospital where she couldn’t be treated, Patient One was taken to the emergency department at the University of Michigan. There, medical staff had to shock her chest three times with a defibrillator before they could restart her heart. She was placed on an external ventilator and pacemaker, and transferred to the neurointensive care unit, where doctors monitored her brain activity. She was unresponsive to external stimuli, and had a massive swelling in her brain. After she lay in a deep coma for three days, her family decided it was best to take her off life support. It was at that point – after her oxygen was turned off and nurses pulled the breathing tube from her throat – that Patient One became one of the most intriguing scientific subjects in recent history.

For several years, Jimo Borjigin, a professor of neurology at the University of Michigan, had been troubled by the question of what happens to us when we die. She had read about the near-death experiences of certain cardiac-arrest survivors who had undergone extraordinary psychic journeys before being resuscitated. Sometimes, these people reported travelling outside of their bodies towards overwhelming sources of light where they were greeted by dead relatives. Others spoke of coming to a new understanding of their lives, or encountering beings of profound goodness. Borjigin didn’t believe the content of those stories was true – she didn’t think the souls of dying people actually travelled to an afterworld – but she suspected something very real was happening in those patients’ brains. In her own laboratory, she had discovered that rats undergo a dramatic storm of many neurotransmitters, including serotonin and dopamine, after their hearts stop and their brains lose oxygen. She wondered if humans’ near-death experiences might spring from a similar phenomenon, and if it was occurring even in people who couldn’t be revived.

Dying seemed like such an important area of research – we all do it, after all – that Borjigin assumed other scientists had already developed a thorough understanding of what happens to the brain in the process of death. But when she looked at the scientific literature, she found little enlightenment. “To die is such an essential part of life,” she told me recently. “But we knew almost nothing about the dying brain.” So she decided to go back and figure out what had happened inside the brains of people who died at the University of Michigan neurointensive care unit. Among them was Patient One.

At the time Borjigin began her research into Patient One, the scientific understanding of death had reached an impasse. Since the 1960s, advances in resuscitation had helped to revive thousands of people who might otherwise have died. About 10% or 20% of those people brought with them stories of near-death experiences in which they felt their souls or selves departing from their bodies. A handful of those patients even claimed to witness, from above, doctors’ attempts to resuscitate them. According to several international surveys and studies, one in 10 people claims to have had a near-death experience involving cardiac arrest, or a similar experience in circumstances where they may have come close to death. That’s roughly 800 million souls worldwide who may have dipped a toe in the afterlife.

As remarkable as these near-death experiences sounded, they were consistent enough that some scientists began to believe there was truth to them: maybe people really did have minds or souls that existed separately from their living bodies. In the 1970s, a small network of cardiologists, psychiatrists, medical sociologists and social psychologists in North America and Europe began investigating whether near-death experiences proved that dying is not the end of being, and that consciousness can exist independently of the brain. The field of near-death studies was born.

Over the next 30 years, researchers collected thousands of case reports of people who had had near-death experiences. Meanwhile, new technologies and techniques were helping doctors revive more and more people who, in earlier periods of history, would have almost certainly been permanently deceased. “We are now at the point where we have both the tools and the means to scientifically answer the age-old question: What happens when we die?” wrote Sam Parnia, an accomplished resuscitation specialist and one of the world’s leading experts on near-death experiences, in 2006. Parnia himself was devising an international study to test whether patients could have conscious awareness even after they were found clinically dead.

But by 2015, experiments such as Parnia’s had yielded ambiguous results, and the field of near-death studies was not much closer to understanding death than it had been when it was founded four decades earlier. That’s when Borjigin, together with several colleagues, took the first close look at the record of electrical activity in the brain of Patient One after she was taken off life support. What they discovered – in results reported for the first time last year – was almost entirely unexpected, and has the potential to rewrite our understanding of death.

“I believe what we found is only the tip of a vast iceberg,” Borjigin told me. “What’s still beneath the surface is a full account of how dying actually takes place. Because there’s something happening in there, in the brain, that makes no sense.”

For all that science has learned about the workings of life, death remains among the most intractable of mysteries. “At times I have been tempted to believe that the creator has eternally intended this department of nature to remain baffling, to prompt our curiosities and hopes and suspicions all in equal measure,” the philosopher William James wrote in 1909.

The first time that the question Borjigin began asking in 2015 was posed – about what happens to the brain during death – was a quarter of a millennium earlier. Around 1740, a French military physician reviewed the case of a famous apothecary who, after a “malign fever” and several blood-lettings, fell unconscious and thought he had travelled to the Kingdom of the Blessed. The physician speculated that the apothecary’s experience had been caused by a surge of blood to the brain. But between that early report and the mid-20th century, scientific interest in near-death experiences remained sporadic.

In 1892, the Swiss climber and geologist Albert Heim collected the first systematic accounts of near-death experiences from 30 fellow climbers who had suffered near-fatal falls. In many cases, the climbers underwent a sudden review of their entire past, heard beautiful music, and “fell in a superbly blue heaven containing roseate cloudlets”, Heim wrote. “Then consciousness was painlessly extinguished, usually at the moment of impact.” There were a few more attempts to do research in the early 20th century, but little progress was made in understanding near-death experiences scientifically. Then, in 1975, an American medical student named Raymond Moody published a book called Life After Life.

Sunbeams behind clouds in vivid sunset sky reflecting in ocean water

In his book, Moody distilled the reports of 150 people who had had intense, life-altering experiences in the moments surrounding a cardiac arrest. Although the reports varied, he found that they often shared one or more common features or themes. The narrative arc of the most detailed of those reports – departing the body and travelling through a long tunnel, having an out-of-body experience, encountering spirits and a being of light, one’s whole life flashing before one’s eyes, and returning to the body from some outer limit – became so canonical that the art critic Robert Hughes could refer to it years later as “the familiar kitsch of near-death experience”. Moody’s book became an international bestseller.

In 1976, the New York Times reported on the burgeoning scientific interest in “life after death” and the “emerging field of thanatology”. The following year, Moody and several fellow thanatologists founded an organisation that became the International Association for Near-Death Studies. In 1981, they printed the inaugural issue of Vital Signs, a magazine for the general reader that was largely devoted to stories of near-death experiences. The following year they began producing the field’s first peer-reviewed journal, which became the Journal of Near-Death Studies. The field was growing, and taking on the trappings of scientific respectability. Reviewing its rise in 1988, the British Journal of Psychiatry captured the field’s animating spirit: “A grand hope has been expressed that, through NDE research, new insights can be gained into the ageless mystery of human mortality and its ultimate significance, and that, for the first time, empirical perspectives on the nature of death may be achieved.”

But near-death studies was already splitting into several schools of belief, whose tensions continue to this day. One influential camp was made up of spiritualists, some of them evangelical Christians, who were convinced that near-death experiences were genuine sojourns in the land of the dead and divine. As researchers, the spiritualists’ aim was to collect as many reports of near-death experience as possible, and to proselytise society about the reality of life after death. Moody was their most important spokesman; he eventually claimed to have had multiple past lives and built a “psychomanteum” in rural Alabama where people could attempt to summon the spirits of the dead by gazing into a dimly lit mirror.

The second, and largest, faction of near-death researchers were the parapsychologists, those interested in phenomena that seemed to undermine the scientific orthodoxy that the mind could not exist independently of the brain. These researchers, who were by and large trained scientists following well established research methods, tended to believe that near-death experiences offered evidence that consciousness could persist after the death of the individual. Many of them were physicians and psychiatrists who had been deeply affected after hearing the near-death stories of patients they had treated in the ICU. Their aim was to find ways to test their theories of consciousness empirically, and to turn near-death studies into a legitimate scientific endeavour.

Finally, there emerged the smallest contingent of near-death researchers, who could be labelled the physicalists. These were scientists, many of whom studied the brain, who were committed to a strictly biological account of near-death experiences. Like dreams, the physicalists argued, near-death experiences might reveal psychological truths, but they did so through hallucinatory fictions that emerged from the workings of the body and the brain. (Indeed, many of the states reported by near-death experiencers can apparently be achieved by taking a hero’s dose of ketamine.) Their basic premise was: no functioning brain means no consciousness, and certainly no life after death. Their task, which Borjigin took up in 2015, was to discover what was happening during near-death experiences on a fundamentally physical level.

Slowly, the spiritualists left the field of research for the loftier domains of Christian talk radio, and the parapsychologists and physicalists started bringing near-death studies closer to the scientific mainstream. Between 1975, when Moody published Life After Life, and 1984, only 17 articles in the PubMed database of scientific publications mentioned near-death experiences. In the following decade, there were 62. In the most recent 10-year span, there were 221. Those articles have appeared everywhere from the Canadian Urological Association Journal to the esteemed pages of The Lancet.

Today, there is a widespread sense throughout the community of near-death researchers that we are on the verge of great discoveries. Charlotte Martial, a neuroscientist at the University of Liège in Belgium who has done some of the best physicalist work on near-death experiences, hopes we will soon develop a new understanding of the relationship between the internal experience of consciousness and its outward manifestations, for example in coma patients. “We really are in a crucial moment where we have to disentangle consciousness from responsiveness, and maybe question every state that we consider unconscious,” she told me. Parnia, the resuscitation specialist, who studies the physical processes of dying but is also sympathetic to a parapsychological theory of consciousness, has a radically different take on what we are poised to find out. “I think in 50 or 100 years time we will have discovered the entity that is consciousness,” he told me. “It will be taken for granted that it wasn’t produced by the brain, and it doesn’t die when you die.”

If the field of near-death studies is at the threshold of new discoveries about consciousness and death, it is in large part because of a revolution in our ability to resuscitate people who have suffered cardiac arrest. Lance Becker has been a leader in resuscitation science for more than 30 years. As a young doctor attempting to revive people through CPR in the mid-1980s, senior physicians would often step in to declare patients dead. “At a certain point, they would just say, ‘OK, that’s enough. Let’s stop. This is unsuccessful. Time of death: 1.37pm,’” he recalled recently. “And that would be the last thing. And one of the things running through my head as a young doctor was, ‘Well, what really happened at 1.37?’”

In a medical setting, “clinical death” is said to occur at the moment the heart stops pumping blood, and the pulse stops. This is widely known as cardiac arrest. (It is different from a heart attack, in which there is a blockage in a heart that’s still pumping.) Loss of oxygen to the brain and other organs generally follows within seconds or minutes, although the complete cessation of activity in the heart and brain – which is often called “flatlining” or, in the case of the latter, “brain death” – may not occur for many minutes or even hours.

For almost all people at all times in history, cardiac arrest was basically the end of the line. That began to change in 1960, when the combination of mouth-to-mouth ventilation, chest compressions and external defibrillation known as cardiopulmonary resuscitation, or CPR, was formalised. Shortly thereafter, a massive campaign was launched to educate clinicians and the public on CPR’s basic techniques, and soon people were being revived in previously unthinkable, if still modest, numbers.

As more and more people were resuscitated, scientists learned that, even in its acute final stages, death is not a point, but a process. After cardiac arrest, blood and oxygen stop circulating through the body, cells begin to break down, and normal electrical activity in the brain gets disrupted. But the organs don’t fail irreversibly right away, and the brain doesn’t necessarily cease functioning altogether. There is often still the possibility of a return to life. In some cases, cell death can be stopped or significantly slowed, the heart can be restarted, and brain function can be restored. In other words, the process of death can be reversed.

It is no longer unheard of for people to be revived even six hours after being declared clinically dead. In 2011, Japanese doctors reported the case of a young woman who was found in a forest one morning after an overdose stopped her heart the previous night; using advanced technology to circulate blood and oxygen through her body, the doctors were able to revive her more than six hours later, and she was able to walk out of the hospital after three weeks of care. In 2019, a British woman named Audrey Schoeman who was caught in a snowstorm spent six hours in cardiac arrest before doctors brought her back to life with no evident brain damage.

“I don’t think there’s ever been a more exciting time for the field,” Becker told me. “We’re discovering new drugs, we’re discovering new devices, and we’re discovering new things about the brain.”

The brain – that’s the tricky part. In January 2021, as the Covid-19 pandemic was surging toward what would become its deadliest week on record, Netflix released a documentary series called Surviving Death. In the first episode, some of near-death studies’ most prominent parapsychologists presented the core of their arguments for why they believe near-death experiences show that consciousness exists independently of the brain. “When the heart stops, within 20 seconds or so, you get flatlining, which means no brain activity,” Bruce Greyson, an emeritus professor of psychiatry at the University of Virginia and one of the founding members of the International Association for Near-Death Studies, says in the documentary. “And yet,” he goes on to claim, “people have near-death experiences when they’ve been (quote) ‘flatlined’ for longer than that.”

That is a key tenet of the parapsychologists’ arguments: if there is consciousness without brain activity, then consciousness must dwell somewhere beyond the brain. Some of the parapsychologists speculate that it is a “non-local” force that pervades the universe, like electromagnetism. This force is received by the brain, but is not generated by it, the way a television receives a broadcast.

In order for this argument to hold, something else has to be true: near-death experiences have to happen during death, after the brain shuts down. To prove this, parapsychologists point to a number of rare but astounding cases known as “veridical” near-death experiences, in which patients seem to report details from the operating room that they might have known only if they had conscious awareness during the time that they were clinically dead. Dozens of such reports exist. One of the most famous is about a woman who apparently travelled so far outside her body that she was able to spot a shoe on a window ledge in another part of the hospital where she went into cardiac arrest; the shoe was later reportedly found by a nurse.

an antique illustration of an 'out of body experience'

At the very least, Parnia and his colleagues have written, such phenomena are “inexplicable through current neuroscientific models”. Unfortunately for the parapsychologists, however, none of the reports of post-death awareness holds up to strict scientific scrutiny. “There are many claims of this kind, but in my long decades of research into out-of-body and near-death experiences I never met any convincing evidence that this is true,” Sue Blackmore, a well-known researcher into parapsychology who had her own near-death experience as a young woman in 1970, has written.

The case of the shoe, Blackmore pointed out, relied solely on the report of the nurse who claimed to have found it. That’s far from the standard of proof the scientific community would require to accept a result as radical as that consciousness can travel beyond the body and exist after death. In other cases, there’s not enough evidence to prove that the experiences reported by cardiac arrest survivors happened when their brains were shut down, as opposed to in the period before or after they supposedly “flatlined”. “So far, there is no sufficiently rigorous, convincing empirical evidence that people can observe their surroundings during a near-death experience,” Charlotte Martial, the University of Liège neuroscientist, told me.

The parapsychologists tend to push back by arguing that even if each of the cases of veridical near-death experiences leaves room for scientific doubt, surely the accumulation of dozens of these reports must count for something. But that argument can be turned on its head: if there are so many genuine instances of consciousness surviving death, then why should it have so far proven impossible to catch one empirically?

Perhaps the story to be written about near-death experiences is not that they prove consciousness is radically different from what we thought it was. Instead, it is that the process of dying is far stranger than scientists ever suspected. The spiritualists and parapsychologists are right to insist that something deeply weird is happening to people when they die, but they are wrong to assume it is happening in the next life rather than this one. At least, that is the implication of what Jimo Borjigin found when she investigated the case of Patient One.

In the moments after Patient One was taken off oxygen, there was a surge of activity in her dying brain. Areas that had been nearly silent while she was on life support suddenly thrummed with high-frequency electrical signals called gamma waves. In particular, the parts of the brain that scientists consider a “hot zone” for consciousness became dramatically alive. In one section, the signals remained detectable for more than six minutes. In another, they were 11 to 12 times higher than they had been before Patient One’s ventilator was removed.

“As she died, Patient One’s brain was functioning in a kind of hyperdrive,” Borjigin told me. For about two minutes after her oxygen was cut off, there was an intense synchronisation of her brain waves, a state associated with many cognitive functions, including heightened attention and memory. The synchronisation dampened for about 18 seconds, then intensified again for more than four minutes. It faded for a minute, then came back for a third time.

In those same periods of dying, different parts of Patient One’s brain were suddenly in close communication with each other. The most intense connections started immediately after her oxygen stopped, and lasted for nearly four minutes. There was another burst of connectivity more than five minutes and 20 seconds after she was taken off life support. In particular, areas of her brain associated with processing conscious experience – areas that are active when we move through the waking world, and when we have vivid dreams – were communicating with those involved in memory formation. So were parts of the brain associated with empathy. Even as she slipped irrevocably deeper into death, something that looked astonishingly like life was taking place over several minutes in Patient One’s brain.

The shadows of anonymous people are seen on a wall

Those glimmers and flashes of something like life contradict the expectations of almost everyone working in the field of resuscitation science and near-death studies. The predominant belief – expressed by Greyson, the psychiatrist and co-founder of the International Association of Near Death Studies, in the Netflix series Surviving Death – was that as soon as oxygen stops going to the brain, neurological activity falls precipitously. Although a few earlier instances of brain waves had been reported in dying human brains, nothing as detailed and complex as what occurred in Patient One had ever been detected.

Given the levels of activity and connectivity in particular regions of her dying brain, Borjigin believes it’s likely that Patient One had a profound near-death experience with many of its major features: out-of-body sensations, visions of light, feelings of joy or serenity, and moral re-evaluations of one’s life. Of course, Patient One did not recover, so no one can prove that the extraordinary happenings in her dying brain had experiential counterparts. Greyson and one of the other grandees of near-death studies, a Dutch cardiologist named Pim van Lommel, have asserted that Patient One’s brain activity can shed no light on near-death experiences because her heart hadn’t fully flatlined, but that is a self-defeating argument: there is no rigorous empirical evidence that near-death experiences occur in people whose hearts have completely stopped.

At the very least, Patient One’s brain activity – and the activity in the dying brain of another patient Borjigin studied, a 77-year-old woman known as Patient Three – seems to close the door on the argument that the brain always and nearly immediately ceases to function in a coherent manner in the moments after clinical death. “The brain, contrary to everybody’s belief, is actually super active during cardiac arrest,” Borjigin said. Death may be far more alive than we ever thought possible.

Borjigin believes that understanding the dying brain is one of the “holy grails” of neuroscience. “The brain is so resilient, the heart is so resilient, that it takes years of abuse to kill them,” she pointed out. “Why then, without oxygen, can a perfectly healthy person die within 30 minutes, irreversibly?” Although most people would take that result for granted, Borjigin thinks that, on a physical level, it actually makes little sense.

Borjigin hopes that understanding the neurophysiology of death can help us to reverse it. She already has brain activity data from dozens of deceased patients that she is waiting to analyse. But because of the paranormal stigma associated with near-death studies, she says, few research agencies want to grant her funding. “Consciousness is almost a dirty word amongst funders,” she added. “Hardcore scientists think research into it should belong to maybe theology, philosophy, but not in hardcore science. Other people ask, ‘What’s the use? The patients are gonna die anyway, so why study that process? There’s nothing you can do about it.’”

Evidence is already emerging that even total brain death may someday be reversible. In 2019, scientists at Yale University harvested the brains of pigs that had been decapitated in a commercial slaughterhouse four hours earlier. Then they perfused the brains for six hours with a special cocktail of drugs and synthetic blood. Astoundingly, some of the cells in the brains began to show metabolic activity again, and some of the synapses even began firing. The pigs’ brain scans didn’t show the widespread electrical activity that we typically associate with sentience or consciousness. But the fact that there was any activity at all suggests the frontiers of life may one day extend much, much farther into the realms of death than most scientists currently imagine.

Other serious avenues of research into near-death experience are ongoing. Martial and her colleagues at the University of Liège are working on many issues relating to near-death experiences. One is whether people with a history of trauma, or with more creative minds, tend to have such experiences at higher rates than the general population. Another is on the evolutionary biology of near-death experiences. Why, evolutionarily speaking, should we have such experiences at all? Martial and her colleagues speculate that it may be a form of the phenomenon known as thanatosis, in which creatures throughout the animal kingdom feign death to escape mortal dangers. Other researchers have proposed that the surge of electrical activity in the moments after cardiac arrest is just the final seizure of a dying brain, or have hypothesised that it’s a last-ditch attempt by the brain to restart itself, like jump-starting the engine on a car.

Meanwhile, in parts of the culture where enthusiasm is reserved not for scientific discovery in this world, but for absolution or benediction in the next, the spiritualists, along with sundry other kooks and grifters, are busily peddling their tales of the afterlife. Forget the proverbial tunnel of light: in America in particular, a pipeline of money has been discovered from death’s door, through Christian media, to the New York Times bestseller list and thence to the fawning, gullible armchairs of the nation’s daytime talk shows. First stop, paradise; next stop, Dr Oz.

But there is something that binds many of these people – the physicalists, the parapsychologists, the spiritualists – together. It is the hope that by transcending the current limits of science and of our bodies, we will achieve not a deeper understanding of death, but a longer and more profound experience of life. That, perhaps, is the real attraction of the near-death experience: it shows us what is possible not in the next world, but in this one.

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What Dying Feels Like

— Palliative Care Doctor

Although a dying person tends to spend more and more time asleep or unconscious, there may be a surge of brain activity just before death

By Denyse O’Leary

Wednesday was Ash Wednesday in the Western Catholic tradition. It marks the beginning of Lent, a season of reflection and repentance. A common custom is that, during the service, the priest traces the sign of the cross in ashes on the penitent’s forehead, saying “You are dust and you will return to dust” (Gen 3:19). It’s one of many customs worldwide that offer a sobering reflection on the inevitability of death for all of us — unless, of course, we are transhumanists who genuinely believe that technology can grant us immortality.

What does dying actually feel like?

Most human beings have always believed that the essence of a human being survives the death of the body though the outcome is envisioned in a variety of ways. But, assuming that pain and distress are controlled, what does dying actually feel like? Can science tell us anything about that?

Caregiver supporting sick woman with cancer dying in the hospital

At BBC Science Focus, palliative care doctor Kathryn Mannix offers a few thoughts from long experience, including:

A dying person spends progressively less time awake. What looks like sleep, though, gradually becomes something else: dipping into unconsciousness for increasing periods. On waking, people report having slept peacefully, with no sense of having been unconscious…
As dying progresses the heart beats less strongly, blood pressure falls, skin cools down and nails become dusky. Internal organs function less as blood pressure drops. There may be periods of restlessness or moments of confusion, or just gradually deepening unconsciousness…
Breathing moves from deep to shallow and from fast to slow in repeating cycles; eventually breathing slows and becomes very shallow; there are pauses; and, finally, breathing ceases. A few minutes later, the heart will stop beating as it runs out of oxygen.
Kathryn Mannix, “What does dying feel like? A doctor explains what we know” BBC Science Focus, February 10, 2024

Surge of brain activity just before death

We are also learning that, contrary to what we might have expected, the brain does not necessarily just die down quietly. Researchers have recorded a surge of activity just before death:

To that end, the brain activity of four people who passed away in hospitals while being monitored by an EEG (electrogram) device was studied.
“The data generated, even though it’s only four patients, is massive, so we were able to only report a fraction of the features that it’s actually showing on the data,” Prof. Borjigin said.
At the time of death, brain activity was detected in the TPJ region of the brain — named because it’s the junction between the temporal, parietal and occipital lobes in the back of the brain.
Dan Gray, “Study finds evidence of increased brain activity in people right before they die,” Medical News Today, May 5, 2023. The paper is open access.

There may be a correlation between the surge of activity and near-death experiences, though that wouldn’t account for the NDEs of people who showed no neurological activity.

In any event, cells deprived of oxygen are doomed. But that does not mean that all of the body’s cells cease to function immediately when a person dies:

The brain and nerve cells require a constant supply of oxygen and will die within a few minutes, once you stop breathing. The next to go will be the heart, followed by the liver, then the kidneys and pancreas, which can last for about an hour. Skin, tendons, heart valves and corneas will still be alive after a day. White blood cells, which are more independent, can keep going for almost three days.
Luis Villazon, “When we die, does our whole body die at the same time? ”BBC Science Focus, nd.

So when a medic declares a person dead, that means that the death process is past the point of no return, not that every cell in the body is dead.

Terminal lucidity — getting in the last word

There are many stories through the ages of people near death suddenly waking up and saying something lucid. Researchers who study the phenomenon call it terminal lucidity. At Psychology Today in 2018, nurse educator Marilyn Mendoza noted regarding research to date::

So far, the response rate to the questionnaire he distributed has been limited. While the results are in no way definitive, out of the 227 dementia patients tracked, approximately 10 percent exhibited terminal lucidity. From his literature review, Nahm has reported that approximately 84 percent of people who experience terminal lucidity will die within a week, with 42 percent dying the same day.
Marilyn Mendoza, “Why Some People Rally for One Last Goodbye Before Death,” Psychology Today, October 10, 2018

As to why it happens, she offers,

There is as yet no logical scientific answer to this medical mystery. There is just not enough information to postulate a definitive mechanism for terminal lucidity. The fact that it occurs in people with different diseases suggests that there may be different processes occurring. Some speculate that this could be a spiritual experience or divine gift. It certainly is a gift for family members attending the death to have one last opportunity to be with their loved one and to say their last goodbyes. Both family members and caregivers who have been witness to this state that they feel changed by the experience.
Mendoza, “One Last Goodbye”

One interesting trend is this: Fifty years ago, slick media commentators expected to report that research into death and dying would explod all those myths about a soul or the hereafter or the human mind. But the opposite has happened. Topics like terminal lucidity and near-death experiences are conventionally researched now. And it’s just as clear now as it was fifty years ago that life is a journey and death is not, itself, the destination; rather, it’s a gateway to one.

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Terror Management Theory

— How Humans Cope With the Awareness of Their Own Death

By Cynthia Vinney, PhD

Terror Management Theory (TMT) suggests that human beings are uniquely capable of recognizing their own deaths and therefore they must manage the existential anxiety and fear that comes with knowing their time on Earth is limited.

The theory was developed by psychological researchers Jeff Greenberg, Sheldon Solomon, and Tom Pyszczynski, who published the first TMT article in 1986.1 They based TMT on the writings of Ernest Becker, who spoke of the need to protect against the universality of the terror of death.

In this article, we’ll review key concepts of TMT, look at empirical evidence in support of TMT, explore real-life examples of TMT, and discuss how it is used across different fields.

Key Concepts and Principles of Terror Management Theory

Terror Management Theory explains that people protect themselves against mortality salience, or awareness of one’s own death, based on whether their fears are conscious or unconscious.

If they’re conscious, people combat them through proximal defenses by eliminating the threat from their conscious awareness. If they’re unconscious, distal defenses, such as a sense of meaning, like cultural worldviews, or value, like self-esteem, diminish unconscious concerns about death.2

Cultural worldviews and self-esteem are key concepts of TMT. They are both central to protection against mortality salience. David Tzall, PsyD, a licensed psychologist in New York, notes, “TMT suggests that individuals gravitate towards and defend their cultural worldviews more strongly when confronted with thoughts of mortality.”

Through cultural worldviews, people can achieve literal or symbolic immortality. Literal immortality, the idea that we will continue to exist after our death, is usually the domain of religious cultural worldviews. Symbolic immortality is the idea that something greater than oneself continues to exist after their death, such as families, monuments, books, paintings, or anything else that continues to exist after they’re gone.

TMT suggests that individuals gravitate towards and defend their cultural worldviews more strongly when confronted with thoughts of mortality.

Self-esteem plays a significant role in TMT too. “When faced with the awareness of death,” Tzall says, “people often engage in activities or behaviors that boost their self-esteem as a way to manage the anxiety associated with mortality.” In so doing, they provide the sense that they are a valuable participant  in a meaningful universe.3

These have led to two important hypotheses in TMT. First, the mortality salience hypothesis says we have negative reactions to individuals from a different group, called “outgroupers,” who present a threat to our group, and have positive reactions to those who represent our cultural values, referred to as “ingroupers.” Second, the anxiety-buffer hypothesis says strengthening our anxiety-buffer by, for example, boosting self-esteem, should reduce the individual’s anxiety about death.4

Review of Empirical Evidence Supporting Terror Management Theory

There are over 500 studies conducted in countries around the world supporting TMT. For example, one study found that raising self-esteem reduces anxiety in response to images of death.5 Similarly, increasing self-esteem reduces the effects of mortality salience on the defense of one’s worldview. When the researchers provided positive personality feedback instead of neutral feedback, their preference for a US-based author was equivalent to that of the control group, whereas participants who received neutral feedback far exceeded the control group in preference for the author.6

Another study found that worldview threats increase accessibility of death thoughts. When Canadians were exposed to a website that either derogated Canadian values or Australian values, they had far more thoughts about death when they encountered the anti-Canadian information.7

Real-Life Examples Illustrating the Application of Terror Management Theory

There are many ways that terror management theory can be applied to real life. Tzall provides some examples, such as “religion where religious beliefs and practices offer explanations for life’s meaning, purpose, and what happens after death. People will turn to religion to alleviate existential anxiety and find solace in the idea of an afterlife.”

Believing in religion may provide a chance at literal immortality, but beyond that, it can provide a cultural worldview that brings meaning and purpose to life and can alleviate mortality salience.

Likewise, Tzall gives the example of belonging to a nation that “provides a sense of identity and belonging, which can help individuals feel connected to something enduring. People may strive to achieve success, create meaningful relationships, or contribute to society in ways that leave a lasting impact.” There are all sorts of ways that people can find meaning and achieve symbolic immortality, including being part of a nation that will go on after their death.

In addition to feeling like a part of the nation, people will want to put their own stamp on the nation whether through success in industry, meaningful relationships that have a lasting impact, or other options like volunteering, having a family, or writing a book.

Implications of Terror Management Theory across Different Fields

Different fields can use TMT in different ways. For example, the most obvious may be the field of therapy and counseling. As Tzall explains, “TMT sheds light on how individuals’ psychological well-being, self-esteem, and behavior are influenced by thoughts of mortality.” Tzall continues, this “can help therapists understand existential anxiety and develop strategies to address it.”

The theory can similarly be used in marketing and advertising, but the emphasis is different. “TMT can inform advertising strategies that tap into consumers’ desires for symbolic immortality,” Tzall says. In this conception, marketers and advertisers advertise goods or services in a way that communicates their desire for symbolic immortality can be met.

Similarly, political science “can help explain the polarization of political ideologies,” explains Tzall, “and the ways in which leaders appeal to their followers’ existential concerns to gain support.” Through cultural worldviews that appreciate others like them but reject others that are not like them, leaders can exploit their followers and even lead them to rise up against others that do not agree with them, in wars, conflicts, or events like January 6th, where a small group of like-minded citizens stormed Congress.

Significance of Terror Management Theory in Understanding Human Behavior and Beliefs

Though some studies about TMT have failed to be replicated, Terror Management Theory has continued to resonate with many people. And researchers still use it to describe various events.

For example, a group of researchers used TMT to detail the COVID-19 pandemic during its height, explaining that regardless of how deadly the virus is, the risk of dying was highly salient.8 As a result, in response to the pandemic, people responded to the constant fear of death in both proximal and distal ways.

In proximal ways: drinking and eating in excess to arguing that the virus isn’t nearly as lethal as health experts claim. And in distal ways: affirming an individual’s cultural worldview to maximizing one’s self-esteem, in line with the TMT literature. As threats that remind us of our own deaths continue and expand, TMT will continue to be a leading source of understanding human behavior and beliefs.

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Death Is a Part of Life

— A mindfulness of death practice inspired by the Buddha’s teachings in the Maranasati Sutta

By Nikki Mirghafori

The Buddha taught mindfulness of death teachings in many different discourses. Today we will discuss the Maranasati Sutta (Anguttara Nikaya 6.19). Maranasati means death awareness—marana (death) and sati (awareness or mindfulness). At the beginning of the Maranasati Sutta, the Buddha is said to address the monks, or practitioners (we’re all practitioners), thus:

When mindfulness of death is developed and cultivated, it’s beneficial. It culminates in the deathless, and ends with the deathless—but how does one develop mindfulness of death?

I’d like to go over these benefits before talking about the specific instructions he gave the monks.

The Benefits of Practicing Mindfulness of Death

Many of us in the West might be afraid of death—we don’t want to think about it, we don’t want to talk about it—and yet, bringing death into our awareness has many benefits—benefits for ourselves and our loved ones, benefits in how we live, and benefits for how we die. This practice prepares us to have a sense of peace, not being scared and fearful, when the moment of death arises.

The moment of death is said to be a liberating moment. So doing this practice is supreme training for that important moment of transitioning. However, this practice isn’t just for the potential of liberation. It impacts the way we live and how we show up for ourselves and others—loved ones, people we don’t know, and people we have challenges with.

Living according to our values is one of the many benefits of this practice. When we know that our time in this body and in this life is finite—when we fully embrace finitude—we don’t waste time. When the scarcity of our time comes into the forefront of our consciousness, we tend not to do the unskillful actions that cause harm. When we “greet and hold death as an advisor on our shoulder all the time,” as Carlos Castaneda said, the way we live our life changes.

We live with more freedom, peace, ease, love, and care because we know there is nothing to hang on to. We are a traveler on this earth. This body is not mine. It’s for rent. This life is for rent.

When we realize this, we live differently, we live more freely. We let go of our clinging, our sense of attachment to me, me, me, mine, mine, mine. It shifts our perspective. We can live with more freedom, generosity, kindness, and forgiveness. There is nothing to take with us. There’s nothing to hang on to. So this practice is liberating, just as the Buddha says, and it has the deathless as its fruit.

What does the deathless mean?

The deathless refers to nibbana (nirvana). The deathless is another translation for nibbana, freedom, liberation, awakening. So mindfulness of death practice is a liberating practice. It leads to freedom in the way we live and in the moment that we die—the ultimate letting go.

Summarizing the Sutta

So with that as the preamble, let’s continue with the Maranasati Sutta.

So then, as I read, the Buddha asked the monks:

Do you develop mindfulness of death? How do you develop mindfulness of death, knowing how important it is?

One monk raises their hand and says:

Oh, yes, I develop mindfulness of death. If I’d only live for another day and night, I’d focus on the Buddha’s instructions and I could really achieve a lot. That’s how I develop mindfulness of death.

And then another monk raises their hand and says:

Me too, me too! I practice mindfulness of death. If I’d only live for a day, then I’d focus on Buddha’s instructions.

Another one raises their hand and says:

Me too, me too! I practice as if I’d only live as long as it takes to eat a meal of alms food.

And then the fourth one raises their hand and says:

Oh, Buddha, Buddha, I practice, thinking if I lived only as long as it takes to chew and swallow four or five morsels of food.

A fifth one raises their hand and says:

Actually, the way I practice is, if only I lived as long as it takes to chew and swallow one morsel of food.

And then the last one, the sixth one in the story, raises their hand and says:

Buddha, the way I practice is, I might live only long enough to breathe out, after breathing in, or breathe in, after breathing out. That’s how I practice mindfulness of death.

And then the Buddha says:

Okay practitioners, those of you who said, “I think I’m going to live another day or night and I have time,” or said, “I may live another day,” or said, “I may live to eat another meal,” or said, “I may live to eat three or four morsels of food,” all of you are living heedlessly. All of you are living heedlessly.

Those of you who are practicing while thinking, “I might only live long enough to chew this bite of food,” or “I might only live long enough to eat this bite of food,” or “I might only live long enough for the duration of this in-breath or the duration of this out-breath, that I might die after this in-breath or after this out-breath”—you are practicing heedfully.

So as practitioners, how do we heedfully practice the instructions of the Buddha? The invitation is not to think, Oh I’ll have time, I have another year, or another month, or another week.

Heedlessly was considered thinking I have another day, another few bites of food. The Buddha is inviting us to consider that we could die in this moment, at the end of this in-breath or this out-breath, at the end of this bite of food, right here, right now. The Buddha is inviting us to bring death intimately into each breath.

The Practice of Mindfulness of Death

So with this, I would like to lead a guided meditation for us to practice with these instructions. I would like to invite you to close your eyes, if that’s comfortable for you. To feel yourself sitting or lying down, whatever posture is comfortable for you. Feel yourself having a sense of integrity, a sense of uprightness, letting the body be relaxed while rooted to this earth, to your sit bones, to your feet. Feeling your hands and yet the sense of uprightness, dignity.

Let us begin by bringing our awareness, our attention, into this body. This long fathom body, breathing in this moment. Feeling the breath where it’s comfortable for you, or in your abdomen, sensing the life force moving through.

This body is alive in this moment and breathing. Let’s connect with the sense of aliveness in this body. Breathing, pulsating, this amazing piece of nature. Through this in-breath, through this out-breath.

After we connect with the living, pulsating, alive nature of this body, let us connect to the fact that this body too shall die. This body is nature. It’s not a mistake. It’s not an aberration. It’s not a problem. Death is a part of life. Everything that is born also dies, and this body too.

Letting the awareness connect with the in-breath, with the out-breath. Settling, calming, and appreciating that death is so close. It’s always close. I might only live as long as it takes to breathe in, that’s all. Or I might live as long as it takes to breathe out after breathing in.

Death is so close and intimate. Can we bring it close and intimate, like a friend who advises us, on how to live, how to practice, how to be in this moment attending to the Buddha’s teachings on love, compassion, letting go, and generosity.

What if I only have the length of this in-breath to live? The length of this out-breath to live? Can we open our hearts to relax and embrace this liberating truth of impermanence?

For some of us, this practice can bring up a sense of agitation. It’s okay. You’re not doing it wrong. If agitation arises, let yourself relax with the out-breath. Connect with the sensations in the body in a spacious way, making space for the agitation or the fear that may have arisen. It’s not a mistake. As we allow ourselves to make space and be with what is difficult, arising in this moment. As expand our capacity for peace. To be with what is challenging, we extend our capacity and we cultivate fearlessness, another synonym for nibbana.

So as you do this practice on your own, bring in this contemplation: Death is so close, I might only live as long as it takes to breathe this in-breath or out-breath.

At the end of this morsel of food, how do you want to live? How do you want to show up? How do you want to cultivate your heart and mind in this short flash that is our life?

Remember that this practice of mindfulness of mortality is a liberating practice. It ends in the deathless. In nibbana, in freedom, awakening.

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People Experience ‘New Dimensions of Reality’ When Dying

— Groundbreaking Study Reports

Scientists recorded the brain waves of people in cardiac arrest to understand what happens to consciousness when we die.

by Becky Ferreira

Scientists have witnessed brain patterns in dying patients that may correlate to commonly reported “near-death” experiences (NDEs) such as lucid visions, out-of-body sensations, a review of one’s own life, and other “dimensions of reality,” reports a new study. The results offer the first comprehensive evidence that patient recollections and brain waves point to universal elements of NDEs.

During an expansive multi-year study led by Sam Parnia, an intensive care doctor and an associate professor in the department of medicine at NYU Langone Health, researchers observed 567 patients in 25 hospitals around the world as they underwent cardiopulmonary resuscitation (CPR) after suffering cardiac arrest, most of which were fatal.

Electroencephalogram (EEG) brain signals captured from dozens of the patients revealed that episodes of heightened consciousness occurred up to an hour after cardiac arrest. Though most of the patients in the study were sadly not resuscitated by CPR, 53 patients were brought back to life. Of the survivors, 11 patients reported a sense of awareness during CPR and six reported a near-death experience.

Parnia and his colleagues suggest that the transition from life to death can trigger a state of disinhibition in the brain that “appears to facilitate lucid understanding of new dimensions of reality—including people’s deeper consciousness—all memories, thoughts, intentions and actions towards others from a moral and ethical perspective,” a finding with profound implications for CPR research, end-of-life care, and consciousness, among other fields, according to a new study published in Resuscitation.

Patients who survive cardiac arrest “have consistently reported that even though from the perspective of doctors like myself—who try to revive them when they appear to be in a coma and totally unresponsive, teetering between life and death—from their own inner perspective, they find that they’re fully conscious,” Parnia said in a call with Motherboard. “They have an inner experience and their consciousness is not only there but it’s heightened to a level that they’ve never experienced before. Their thoughts become sharper than usual, and clearer than usual.”

“Importantly, this experience also involves a purposeful, meaningful reevaluation of their entire life,” he continued. “Not just random moments, but the entirety of their life. It’s been a mystery, and it’s not one or two anecdotes. There have been a number of studies that have suggested maybe up to 10 percent of the adult population is living with one of these experiences, which if you do the math probably works out to 400 or 500 million people in the world.”

Given the sheer ubiquity and common themes of these NDEs, Parnia and his colleagues set out to search for specific brain waves in dying people that might be linked to the experiences that are so often reported by survivors of close calls with death. Between 2017 and 2020, the team studied hundreds of comatose patients who were undergoing CPR at hospitals in the United Kingdom and the United States. Getting EEG readings in such an intense environment is understandably challenging, and researchers had to record brain activity in the brief breaks between chest compressions. But they succeeded in capturing transient biomarkers of lucid consciousness in several patients long after initial cardiac arrest.

“One of the things that was unique about this project is that this was the first time ever where scientists had put together a method to examine for signs of lucidity and consciousness in people as they’re being revived by looking for brain markers, or brain signatures of consciousness, using an EEG device as well as a brain oxygen monitor,” Parnia explained.

“Most doctors are taught and believe that the brain dies after about five or 10 minutes of oxygen deprivation,” Parnia said. “One of the key points that comes out of this study is that that is actually not true. Although the brain flatlines after the heart stops, and that happens within seconds, it doesn’t mean that it’s permanently damaged and [has] died. It’s just hibernating. What we were able to show is that actually, the brain can respond and restore function again, even after an hour later, which opens up a whole window of opportunity for doctors to start new treatments.”

Indeed, the study reports that “near-normal/physiological EEG activity (delta, theta, alpha, beta rhythms) consistent with consciousness and a possible resumption of a network-level of cognitive and neuronal activity emerged up to 35–60 minutes into CPR. This is the first report of biomarkers of consciousness during CA/CPR.”

These findings are in line with a wave of recent studies focused on the experiences of dying people, which includes reports of surges of brain activity during death, evidence of a gradual shift to death (as opposed to a sudden event), and common themes in near-death experiences.

Parnia and his colleagues also interviewed 28 survivors of cardiac arrest about their brushes with death. The team note that the vivid experiences that patients report on the border of life and death are highly distinct from dreams and hallucinations that might occur during the days or weeks of recovery from their cardiac arrest.

Indeed, people from all different backgrounds and cultures tend to report near-death experiences with similar elements, such as an out-of-body journey back to a comforting place like a childhood home, where the person’s life is reviewed in detail through a moral lens, followed by an intuition to return back to the body. The team suggested that these common experiences, which also include glimpses of new dimensions of reality, are triggered by the brain’s disinhibition during death, which enables episodes of heightened consciousness that are inaccessible to the living.

“When you looked at the recalled experience of death, and these were actually among a global population, the themes were all consistent,” Parnia said. “Our conclusion is that this is a real experience that emerges only with death. As we transition from life to death, somehow, this experience occurs.”

“We’re discovering essentially what happens to us all when we go through death; what happens to our consciousness,” he concluded. “Our plans are to do more comprehensive methods of analyzing what’s happening in the brain second-by-second, to essentially map out the neurophysiology of life and death in people as they go through it.”

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Does a Person Know When They Are Dying?

By Angela Morrow, RN

Family members and friends of a dying loved one may wonder if the person knows they are dying. They may worry that if their loved one doesn’t know death is near, telling them might dash any hope and even make them die sooner. Here’s how to recognize the signs that someone is close to dying and why it is ok to acknowledge it.

The Important Tasks of Dying

It is natural to want to shield the ones we love from pain and sorrow. Trying to protect a loved one from the truth about their condition may initially seem like a good idea, but in fact withholding that information can lead to resentment and disappointment.

When a person knows they are dying, they have the opportunity to do five important things:1

  1. Apologize for past mistakes
  2. Forgive others for their mistakes
  3. Thank those people who matter most
  4. Say “I love you” to those they love
  5. Say goodbye

Without the opportunity to do these valuable things, your loved one could die with unfinished business.

Hope at the End of Life

It may seem like a dying person can’t possibly feel hopeful, but dying people do retain an amazing capacity to hope. While they may have stopped hoping for a cure or for a long life, they may still hope to mend relationships with loved ones and to die peacefully.

Keeping the truth about dying from the one who is nearing death could rob them of the chance to reflect on their lives and fulfill their final wishes.

Signs That Death Is Near

As someone nears the end of life, they usually experience certain specific physical and mental changes, including:2

  • Fatigue or sleepiness
  • Refusing food and drink
  • Mental confusion or reduced alertness
  • Anxiety
  • Shortness of breath or slowed or abnormal breathing
  • Hands, arms, feet, and legs that are cool to the touch

At the very end, the eyes may look glassy and the person may breathe noisily, making a gurgling sound known as a “death rattle.”

Awareness May Linger

It isn’t clear how long a person who is dying retains awareness of what is going on around them, but research suggests that some degree of awareness may remain even after the person slips from unconsciousness.

A 2014 study looked at 2,060 patients from 15 hospitals in the United Kingdom, the United States, and Austria who had been given CPR after going into cardiac arrest (in which the heart stops completely). Of those who survived, 140 were surveyed about their near-death experiences. Thirty-nine percent reported feeling some kind of awareness before their heart was restarted, but did not have an explicit recall of events.3

Often, people will lapse into a coma before they die—a deep state of unconsciousness and unresponsiveness. People in a coma may still hear people talking even when they can no longer respond. Because of this, the Hospice Foundation of America suggests that caregivers, family, and physicians should behave as if the dying person is aware of what is going on and is able to hear and understand voices.2

A 2020 study that investigated hearing in palliative care patients who were close to death provides evidence that some people may still be able to hear while in an unresponsive state. Electroencephalography (EEG) was used to measure the dying brain’s response to sound. The findings suggest that telling a person you love them in their final moments may register with them.4

They Know They’re Dying

Dying is a natural process that the body has to work at. Just as a woman in labor knows a baby is coming, a dying person may instinctively know death is near. Even if your loved one doesn’t discuss their death, they most likely know it is coming.

In some cases, the person comes from a culture or a family in which death is simply not discussed. Furthermore, your loved one may sense that others feel uncomfortable recognizing the dying process so they don’t want to bring it up.

Death can then become the elephant in the room. Everyone knows it’s there but no one will acknowledge it. Family discussions may be awkward and superficial and never reach an intimate level. In this case, the important work of mending and completing relationships may not happen.

Talking About Dying

Talking about death is rarely easy. Many of us feel uncomfortable even saying the words “death” or “dying.” Talking about it with a loved one who has been diagnosed with a terminal illness can be especially awkward.5

First, remember that you are talking to someone who is still living, and that talking about memories and shared experiences honors the dying person’s life. Experiencing sadness with the loved one is appropriate; that’s part of life, too.

If necessary, a therapist or hospice social worker with experience in this area can make these conversations easier.

Frequently Asked Questions

What does dying feel like?

While we can observe another person’s death and perhaps imagine what it feels like for them, there is no way to know what it actually feels like to die.

What are the signs that death is near?

Someone who is very close to death will likely refuse food and water. Their breathing and heart rates will slow and/or be abnormal and their hands, arms, feet, or legs may be cool to the touch. They may also be agitated, anxious, and confused.

What should I say to someone who is dying?

There is no right or wrong thing to say to a dying person. You may want to share memories or make sure your loved one knows you love them. A therapist or hospice social worker can help make conversations about dying easier.

What are the five stages of death and dying?

According to one widely-accepted theory, originally conceived of by psychiatrist Elisabeth Kubler-Ross in 1969, the five stages of coping with realizing you are going to die are denial, anger, bargaining, depression, and acceptance.6

Some Final Thoughts

As uncomfortable as it can be to acknowledge openly that a person you love is dying, it’s important to realize that the person is most likely aware that they are dying, so you don’t have to struggle with “breaking the news.” In fact, dying people often appreciate being able to use the time they have left to tell people they love them and mend certain relationships if necessary.

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