An elderly woman never speaks, no longer recognizes her loved ones when they come to visit, and shows no expression. By the looks of her, she is a human vegetable. And she's been this way for over a year. Her brain's cerebral cortex and hippocampus -- necessary for memory, thought, language, and normal consciousness -- are severely shrunk. Her brain bears little resemblance to a healthy one.
Yet something utterly astonishing is about to happen. As reported by both the nursing staff of her care unit and her family members: "Unexpectedly, she calls her daughter and thanks her for everything. She has a phone conversation with her grandchildren, exchanges kindness and warmth. She says farewell and shortly thereafter dies."
Similar cases have been scattered side notes in the medical literature, but recently a small body of researchers, such as Bruce Greyson, professor of psychiatry and neurobehavioral sciences at the University of Virginia, and Michael Nahm in Freiburg, Germany, have begun to take a careful look at the phenomenon and agreed to call it terminal lucidity, or TL. Professor Alexander Batthyany, who teaches cognitive science at the University of Vienna, is currently running a large-scale study on the phenomenon -- the first of its kind. He is sending out detailed questionnaires to caregivers of Alzheimer's victims, mostly nurses and medical doctors, and as the questionnaires trickle in, new mysteries arise as fast as older ones are clarified. The case cited above comes from Batthyany's database.
Almost all brain scientists have assumed up until now that a severely-damaged brain makes normal cognition impossible. But Batthyany's preliminary results, presented at the annual IANDS Congress in Newport, California, last month, suggests that normal cognition, or lucidity, does occur in spite of a severely-damaged brain -- not often, but in about 5-10 percent of Alzheimer's cases. And only when death is very near.
This has led him to wonder how terminal lucidity -- which he describes as "close to a miracle, given what we know about brain function and cognition" -- can occur. What is actually going on during those amazing moments? We know that there is no observable change in the brain -- the cerebral cortex doesn't suddenly grow billions of new neurons -- so what accounts for TL?
Conventional brain science has no explanation. It has long assumed that as the brain goes, so goes the mind; for the brain is what gives rise to the mind. The return of mental clarity and memory in a brain ravaged by Alzheimer's is not supposed to happen. Yet it does in some cases.
This has given rise to some unorthodox speculation. Could it be that the conventional wisdom is wrong? Is it possible that the mind's sudden and short-lived return to normalcy just before death is brought about, not by some inexplicable surge in brain functioning, but by the mind's distancing itself from the brain? What if the brain does not give rise to the mind, as commonly thought? What if the mind uses the brain as its organ? What if the mind of an Alzheimer's victim is like the sun in eclipse, and the moon obscuring the sun like the sick brain? Batthyany is far from claiming this, but he does wonder about it. Indeed, the analogy of eclipse is his.
To put it differently, it is possible that the conscious self -- the thinking, feeling being that we are -- is very much intact when we are stricken by Alzheimer's, but has been hampered from expressing itself in the normal way because of its involvement with a sick brain. In the early stages of the disease, Alzheimer's victims are often painfully aware that they can't formulate their thoughts; it's like trying to formulate a message on a computer when it has a virus. There is nothing wrong with you, the user of the computer, but your message comes out scrambled or incoherent because you're stuck with a faulty instrument. And if you can't get it fixed, you might give up trying to communicate altogether. But the onset of death alters the situation. You begin to peel away from the brain and suddenly find yourself able to remember, think, and communicate normally.
How this communication once free from the brain is accomplished is of course mysterious -- but no more so, Batthyany says, than communication through it. Batthyany's research is in its very early stages. He hopes that more questionnaires, thousands more, will bring more clarity and tip the scales in one direction of another.
Batthyany is aware of research on the near-death experience and deathbed visions. On the surface both suggest a view of the self that he is contemplating here -- that the conscious self is an autonomous agent working through a material brain. He is not ready, however, to claim that his research into terminal lucidity points to survival beyond death. But it may suggest a crucial distinction between the brain, which obviously dies, and the self -- the user of the brain -- which might not. At the moment his position, as told me via email, is that "more studies are needed, that our study is ongoing, and that it is far too early to draw any strong conclusions other than that TL does occur, even if only rarely, and that it is a solid mystery which needs to be studied in more detail."
In the meantime, cases of terminal lucidity continue to occur, and there are lessons to be learned for all of us. One of Batthyany's respondents confessed how she used to consider her advanced Alzheimer's patients as "human vegetables." A single instance of TL changed her outlook completely: "Had you seen what I saw, you could understand that dementia can affect the soul but not destroy it. I only wish I had known this earlier."
Professor Batthyany is always looking for more cases of TL. If you know of any, he asks that you feel free to contact him by email at firstname.lastname@example.org.