At first it seemed like nothing more than the worst headache she’d ever had.
So Karla Pérez—22 years old, the mother of three-year-old Genesis, and five months pregnant—went into her mother’s room to lie down, hoping it would pass. But the pain got worse, and as she vomited off the side of the bed, she told her younger brother to call 911.
It was not quite midnight on Sunday, February 8, 2015. The ambulance raced Pérez from her home in Waterloo, Nebraska, to Methodist Women’s Hospital in Omaha. She began to lose consciousness in the emergency room, and doctors put a tube down her throat to keep oxygen flowing to her fetus. They ordered a CT scan, and there it was: a massive brain bleed creating severe pressure in her skull.
She had suffered a stroke, but amazingly her fetus was doing fine, the heartbeat strong and steady as if nothing were wrong. Neurologists did another CT scan at about two in the morning, and their worst fears were confirmed: Pérez’s brain had become so swollen that the whole brain stem had pushed out through a small opening at the base of her skull.
“When they saw that,” says Tifany Somer-Shely, the obstetrician who’d cared for Pérez through her pregnancy with Genesis and with this baby too, “they knew for sure that it wasn’t going to end well.”
Pérez had landed at the ragged border between life and death, with a brain that had ceased functioning and would never recover—in other words, it was dead—and a body that could be sustained mechanically, in this case for one reason only: to nurture her 22-week-old fetus until he was big enough to manage on his own.
This borderland is becoming increasingly populated, as scientists explore how our existence is not a toggle—“on” for alive, “off” for dead—but a dimmer switch that can move through various shades between white and black. In the gray zone, death isn’t necessarily permanent, life can be hard to define, and some people cross over that great divide and return—sometimes describing in precise detail what they saw on the other side.
Death is “a process, not a moment,” writes critical-care physician Sam Parnia in his book Erasing Death. It’s a whole-body stroke, in which the heart stops beating but the organs don’t die immediately. In fact, he writes, they might hang on intact for quite a while, which means that “for a significant period of time after death, death is in fact fully reversible.”
How can death, the very essence of forever, be reversible? What is the nature of consciousness during that transition through the gray zone? A growing number of scientists are wrestling with such vexing questions.
In Seattle biologist Mark Roth experiments with putting animals into a chemically induced suspended animation, mixing up solutions to lower heartbeat and metabolism to near-hibernation levels. His goal is to make human patients who are having heart attacks “a little bit immortal” until they can get past the medical crisis that brought them to the brink of death.
In Baltimore and Pittsburgh trauma teams led by surgeon Sam Tisherman are conducting clinical trials in which gunshot and stabbing victims have their body temperature lowered in order to slow bleeding long enough for surgeons to close up their wounds. The medical teams are using supercooling to do what Roth wants to do with chemicals—kill their patients, temporarily, in order to save their lives.
In Arizona cryonics experts maintain more than 130 dead clients in a frozen state that’s another kind of limbo. Their hope is that sometime in the distant future, maybe centuries from now, these clients will be thawed and revived, technology having advanced to the point where they can be cured of whatever killed them.
In India neuroscientist Richard Davidson studies Buddhist monks in a state called thukdam, in which biological signs of life have ceased yet the body appears fresh and intact for a week or more. Davidson’s goal is to see if he can detect any brain activity in these monks, hoping to learn what, if anything, happens to the mind after circulation stops.
And in New York, Parnia spreads the gospel of sustained resuscitation. He says CPR works better than people realize and that under proper conditions—when the body temperature is lowered, chest compression is regulated for depth and tempo, and oxygen is reintroduced slowly to avoid injuring tissue—some patients can be brought back from the dead after hours without a heartbeat, often with no long-term consequences.
Now he’s investigating one of the most mysterious aspects of crossing over: why so many people in cardiac arrest report out-of-body or near-death experiences, and what those sensations might reveal about the nature of this limbo zone and about death itself.
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