Review of Proof of Heaven: A Neurosurgeon’s Journey into the Afterlife by Eben Alexander, M.D.

If I had to pick just one first-person account of a near-death experience (NDE) for a scientifically minded friend to read, then Eben Alexander’s 2012 book Proof of Heaven would be my choice.

An NDE occurs when the subject nearly dies, or dies and is resuscitated, and is usually described by the subject as an experience of the afterlife or of a transcendental reality beyond the ordinary physical world. There is a rather large literature on the subject, not just by those who have had an NDE, but by scientists who have studied the phenomenon. Books such as 90 Minutes in Heaven by Don Piper (with Cecil Murphey) and Heaven is for Real by Todd Burpo and Lynn Vincent have sold millions of copies. I have not read Heaven is for Real, but I found 90 Minutes in Heaven to be a very interesting and credible account of an NDE. It contains many elements that are common in NDEs, including an experience of entering Heaven and meeting deceased family members (though interestingly, despite being a Christian minister, Piper specifically says that he did not meet Jesus).

The main reason I would choose Proof of Heaven over 90 Minutes in Heaven for someone who is scientifically minded is that the author, Eben Alexander, is a neurosurgeon, and hence is able to understand the medical details of his own case in a way that most people cannot. Moreover, Alexander was not particularly religious prior to his NDE and his attitude towards the NDEs of others was that of a typical skeptical materialist.

Wonderful stuff, no question. But all of it, in my opinion, was pure fantasy. What caused the otherworldly types of experiences that such people so often report? I didn’t claim to know, but I did know that they were brain-based. All of consciousness is. If you don’t have a working brain, you can’t be conscious.

This is because the brain is the machine that produces consciousness in the first place. When the machine breaks down, consciousness stops. As vastly complicated and mysterious as the actual mechanics of brain processes are, in essence the matter is as simple as that. Pull the plug and the TV goes dead. The show is over, no matter how much you might have been enjoying it.

Alexander’s medical crisis was caused by an extremely rare infection known as E. coli meningitis, which almost never occurs in adults in the absence of head trauma or neurosurgery. He was in a coma for seven days. “During that time, my entire neocortex—the outer surface of the brain, the part that makes us human—was shut down. Inoperative. In essence, absent.” By the end of the seven days, everyone had all but given up hope that he would survive. Then, without warning, as his son Bond and a family friend Sylvia were watching him, he recovered. “My eyes opened.”

Sylvia shrieked. She would later tell me that the next biggest shock, almost as shocking as my eyes opening, was the way they immediately began to look around. Up, down, here, there… They reminded her not of an adult emerging from a seven-day coma, but of an infant—someone newly born to the world, looking around at it, taking it in for the first time.

Astonishingly for someone in his condition, Alexander made a full recovery. For him personally, however, the medical facts of his recovery were just a sidebar to what he considered to be the main story, namely his NDE. Alexander writes that some decades ago, cardiac arrest was thought to indicate death or near-death, but that today it is recognized that it is brain activity that really matters. During the week that he was in a coma, his brain was inactive.

The more primitive parts of my brain—the housekeeping parts—functioned for all or most of my time in coma. But when it came to the part of my brain that every single brain scientist will tell you is responsible for the human side of me: well, that part was gone. I could see it on the scans, in the lab numbers, on my neurological exams—in all the data from my very closely recorded week in hospital. I quickly began to realize that mine was a technically near-impeccable near-death experience, perhaps one of the most convincing such cases in modern history. What really mattered about my case was not what happened to me personally, but the sheer, flat-out impossibility of arguing, from a medical standpoint, that it was all fantasy.

Alexander emphasizes that the standout characteristic of his NDE was that it was real, even though his neocortex was not functioning. “That part of my brain was down, and out.”

And yet despite all of this, I had been alive, and aware, truly aware, in a universe characterized above all by love, consciousness, and reality. (There was that word again.) There was, for me, simply no arguing this fact. I knew it so completely that I ached. What I’d experienced was more real than the house I sat in, more real than the logs burning in the fireplace.

What exactly was the content of this reality? Alexander describes various “locations” in the universe that he experienced—the Earthworm’s-Eye View, the Gateway, the Core—and a beautiful female companion that accompanied him, whom he refers to as the Girl on the Butterfly Wing. “Each time I reached the Core, I went deeper than before, and was taught more, in the wordless, more-than-verbal way that all things are communicated in the worlds above this one.” What was he taught?

It came in three parts, and to take one more shot at putting it into words (because of course it was initially delivered wordlessly), it would run something like this: You are loved and cherished. You have nothing to fear. There is nothing you can do wrong.

This message is the reason Alexander wrote his book, and it is what he sees as his mission in life now.

It is my belief that we are now facing a crucial time in our existence. We need to recover more of that larger knowledge while living here on earth, while our brains (including its left-side analytical parts) are fully functioning. Science—the science to which I’ve devoted so much of my life—doesn’t contradict what I learned up there. But far, far too many people believe it does, because certain members of the scientific community, who are pledged to the materialist worldview, have insisted again and again that science and spirituality cannot coexist.

They are mistaken. Making this ancient but ultimately basic fact more widely known is why I have written this book, and it renders all the other aspects of my story—the mystery of how I contracted my illness, of how I managed to be conscious in another dimension for the week of my coma, and how I somehow recovered so completely—entirely secondary.

The unconditional love and acceptance that I experienced on my journey is the single most important discovery I have ever made, or will ever make, and as hard as I know it’s going to be to unpack the other lessons I learned while there, I also know in my heart that sharing this very basic message—one so simple that most children readily accept it—is the most important task I have.

Alexander writes well and his account is gripping and persuasive. He talks passionately about many deeply personal issues, including his professional successes and failures, the ups and downs of searching for his birth family (he was adopted as a baby), his love of skydiving, and of course his “conversion” from skeptic to believer. He ties together all these elements (even the skydiving) into a single compelling story.

What makes the book of particular interest to someone who is scientifically minded but who has not thought about NDEs before is Alexander’s insistence that there is no neuroscientific hypothesis that could adequately account for his NDE. In Appendix B, he lists several such hypotheses and dismisses them all. Here is an abbreviated version of his list.

1. A primitive brainstem program to ease terminal pain and suffering.

2. The distorted recall of memories from deeper parts of the limbic system (for example, the lateral amygdala).

3. Endogenous glutamate blockade with excitotoxicity, mimicking the hallucinatory anesthetic, ketamine.

4. N,N-dimethyltryptamine (DMT) “dump” (from the pineal, or elsewhere in the brain).

5. Isolated preservation of cortical regions.

6. Networks of inhibitory neurons might have been predominantly affected, allowing for unusually high levels of activity among the excitatory neuronal networks to generate the apparent “ultra-reality” of the NDE.

7. The thalamus, basal ganglia, and brainstem might have contributed.

8. A “reboot phenomenon”—a random dump of bizarre disjointed memories due to old memories in the damaged neocortex, which might occur on restarting the cortex into consciousness after a prolonged system-wide failure.

9. Unusual memory generation through an archaic visual pathway through the midbrain.

Clearly Alexander has given a lot of thought to his own case and has not arrived at his conclusions lightly.

Having said all that, I should emphasize that I do not agree with all of Alexander’s conclusions, and that another reason that I think his book is a good one to read is that it brings into sharp focus many of the controversies surrounding NDEs.

Some of Alexander’s critics are rather superficial in my opinion. Not long after Proof of Heaven came out, Luke Dittrich wrote a scathing article in Esquire magazine, describing various malpractice suits that had been brought against Alexander, and drawing attention to apparent factual errors in the book. Dittrich also insinuated that Alexander may have fabricated his NDE story in order to get rich quick. I have no doubt that the facts cited in Dittrich’s article are accurate, but I do not draw the conclusions that Dittrich seems to want us to draw. Everyone lies and makes mistakes sometimes, and Dittrich seems to be exploiting the fact that most of his readers do not fully appreciate how unreliable human memory is. The main question for me is whether Alexander has invented his NDE account out of whole cloth. There is reason to be cautious, especially since the notorious case of The Boy Who Came Back from Heaven, which was later forcefully disavowed by one of the authors (ironically named Alex Malarkey) as a fabrication, despite its original billing as “a true story.” However, having read Proof of Heaven, I find it implausible that Alexander’s account is fictional. I am prepared to accept his story largely at face value, with the tacit understanding that some details may have been somewhat embellished or misremembered.

A more serious criticism is that Alexander has been too quick to dismiss his list of proposed explanations in Appendix B. Oliver Sacks, the late neurologist and writer, seemed to favor some version of #8. In a 2012 Atlantic article entitled “Seeing God in the third millennium,” Sacks wrote:

Alexander insists that his journey, which subjectively lasted for days, could not have occurred except while he was deep in coma. But we know from the experience of Tony Cicoria and many others, that a hallucinatory journey to the bright light and beyond, a full-blown NDE, can occur in 20 or 30 seconds, even though it seems to last much longer. Subjectively, during such a crisis, the very concept of time may seem variable or meaningless. The one most plausible hypothesis in Dr. Alexander’s case, then, is that his NDE occurred not during his coma, but as he was surfacing from the coma and his cortex was returning to full function. It is curious that he does not allow this obvious and natural explanation, but instead insists on a supernatural one.

To deny the possibility of any natural explanation for an NDE, as Dr. Alexander does, is more than unscientific—it is antiscientific. It precludes the scientific investigation of such states.

I believe that Sacks is right to point out that the NDE could have taken place entirely when Alexander’s neocortex was coming back to life. After all, Alexander himself emphasizes that he went to “a place where there’s no sense of time as we experience it in the ordinary world,” so he really has no basis for insisting that his NDE took place when his neocortex was “down and out.”

At the same time, I believe that both Alexander and Sacks are making the same fallacious assumption, namely that the identification of some kind of physical process that correlates with an NDE amounts to a complete explanation of the NDE, and in particular implies that all the entities and places experienced during the NDE are not real. I do not want to launch on an extended discussion here of this point, which in my view plagues much of the philosophical literature on consciousness; suffice it to say that even if there were some kind of “scientific explanation” of Alexander’s experience, such as a complete log of his brain state over time and a detailed account of which brain events corresponded to each of the experiences reported in his book, it would not in any way demonstrate that (for example) there was no Girl on the Butterfly Wing. To be sure, there was no Girl on the Butterfly Wing in our familiar physical world at any time during Alexander’s NDE, but everyone already agrees with that, and it does not mean that she is not real. Whether the present physical universe comprises all that is real is precisely what is in question. Antony Flew’s parable of a satellite phone, which I mentioned in my review of There Is a God, is suggestive here.

Conversely, even if somehow there did not exist any kind of “scientific explanation” of Alexander’s NDE, that would not necessarily imply all the conclusions that Alexander, either explicitly or implicitly, seems to want to draw from his experience—e.g., that what he was taught was true, that there is an afterlife in the sense that most people understand the term “afterlife,” and so on. Here is a portion of what Alexander says about his encounter with God.

My situation was, strangely enough, something akin to that of a fetus in a womb. The fetus floats in the womb with the silent partner of the placenta, which nourishes it and mediates its relationship to the everywhere present yet at the same time invisible mother. In this case, the “mother” was God, the Creator, the Source who is responsible for making the universe and all in it. This Being was so close that there seemed to be no distance at all between God and myself. Yet at the same time, I could sense the infinite vastness of the Creator, could see how completely minuscule I was by comparison. I will occasionally use Om as the pronoun for God because I originally used that name in my writings after my coma. …

Through the Orb, Om told me that there is not one universe but many—in fact, more than I could conceive—but that love lay at the center of them all. Evil was present in all the other universes as well, but only in the tiniest trace amounts. Evil was necessary because without it free will was impossible, and without free will there could be no growth—no forward movement, no chance for us to become what God longed for us to be. Horrible and all-powerful as evil sometimes seemed to be in a world like ours, in the larger picture love was overwhelmingly dominant, and it would ultimately be triumphant.

Much of this sounds plausible to me, but I am not sure that I find it any more compelling just because it comes from someone who had an NDE, and whether the NDE has a “scientific explanation” strikes me as irrelevant. Even from Alexander’s own point of view, why does it really matter whether there is a scientific explanation of his NDE? Of course, the conviction that there was no scientific explanation played a role in his own “spiritual awakening,” but his current standpoint is that science and spirituality are not in conflict, and the existence of a scientific explanation would presumably not shake his conviction that what he experienced was real, so why work so hard to deny that his NDE has a scientific explanation? The concluding words of the book make me wonder if it is a sense of self-importance (which he claims, unconvincingly, not to have) that drives his insistence on this point.

So here I am. I’m still a scientist, I’m still a doctor, and as such I have two essential duties: to honor truth and to help heal. That means telling my story. A story that as time passes I feel certain happened for a reason. Not because I’m anyone special. It’s just that with me, two events occurred in unison and concurrence, and together they break the back of the last efforts of reductive science to tell the world that the material realm is all that exists, and that consciousness, or spirit—yours and mine—is not the great and central mystery of the universe.

I’m living proof.

Let me mention that there is one other thing that I keep an eye out for when reading NDE accounts, which is whether the subject reports knowledge of events in this world (as opposed to some other, spiritual world) that it seems they could not have known. It turns out that there is not much of this sort of thing in Alexander’s account. Somewhat unusually for an NDE, Alexander for the most part does not report seeing his operating room from a bird’s-eye perspective, nor does he report meeting anyone familiar (such as deceased relatives). The main exception is that just before “re-entry,” Alexander reported being aware of six people, five of whom were present in the hospital at the time of his awakening—his wife Holley, her sister Peggy, their friend Sylvia, his son Bond, and the physician Scott Wade. Other people who had been at the hospital during the week but not the day when he came out of the coma were not there. The sixth person is, from my point of view, the most interesting—Susan Reintjes, who was not physically present but who was an “intuitive.” Sylvia had earlier telephoned Susan and asked her to try to make psychic contact with Alexander while he was still in a coma, and Susan had complied. That Alexander reported this set of six people is somewhat interesting, but hardly earth-shattering, even if we assume that on this point, his memory was entirely accurate. Susan was, after all, someone that Alexander already knew. The one other incident in Alexander’s account worth noting in this regard is that he identified the Girl on the Butterfly Wing as his deceased birth sister Betsy, whom he had never met. However, he made this identification only much later, after seeing a photo of Betsy, and even then he did not make the identification instantly.

Towards the end of the book, Alexander—unfortunately, from my point of view—dives rather uncritically into a mass of what one might loosely call “New Age” thinking, often contradicting himself. For example, he says that “There is nothing about the physics of the material world (quarks, electrons, photons, atoms, etc.), and specifically the intricate structure of the brain, that gives the slightest clue as to the mechanism of consciousness.” Less than two pages later, he writes:

At the heart of the enigma of quantum mechanics lies the falsehood of our notion of locality in space and time. The rest of the universe—that is, the vast majority of it—isn’t actually distant from us in space. Yes, physical space seems real, but it is limited as well. The entire length and height of the physical universe is as nothing to the spiritual realm from which it has risen—the realm of consciousness (which some might refer to as “the life force”).

So does quantum mechanics give us a hint of what consciousness is about, or not? Also, the way he speaks of quantum mechanics makes me wonder whether he really understands it. I think that Alexander would be wise to stick to what he does know, and be cautious about buying into exciting-sounding ideas that bear some superficial resemblance to what he learned from his own NDE.

Despite all these caveats, I still think that Proof of Heaven is well worth reading. There is no doubt that a growing number of people are having NDEs, and I believe that all thinking people, believers or not, should educate themselves about the subject and come to some assessment of the implications. Alexander’s book is an excellent place to start.

Posted June 2018

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