Does the Mind Survive Death?
A response to Matthew Sabatine's "The Common Caveat" on near death experiences
Whether or not they know it, most people are substance dualists. I base this on polling data like a recent Angus Reid survey that found 60% of Canadians believe in life after death. And, in the United States, over 80% believe that “people have a soul or spirit in addition to their physical body.”
Among psychologists, neuroscientists, philosophers of mind and others who study the mind/body question as their profession, the situation is quite different. There, the idea that the mind is a non-physical entity that can exist independently of the body remains a decidedly minority position. That is not to say, however, that there are not those who disagree with this consensus. Some have argued that the occurrence of what are known as near-death experiences (NDE’s) provides scientific evidence that the mind can, in effect, separate itself from the body and continue to function when the brain is not operating, possibly even after death. 1
I have been discussing a particularly well-known instance of an NDE with one of my online friends, Matthew Sabatine. Matthew operates a blog and a You Tube channel called The Common Caveat where he discusses, in his words, “the intricate relationship between science, Christianity, and the multifaceted nature of human experience.” When I first “met” Matthew, maybe 3-4 years ago, he was an atheist, but since then he has converted back to Christianity. (More details of his personal history are described in an interview he did for the C. S. Lewis Institute.)
The Story of Maria and the Running Shoe
The case Matthew and I have been discussing is one of the best-known and most commonly cited examples of what is called a veridical NDE, in which the person reports witnessing details, whose accuracy can be confirmed, that, supposedly, they could not have witnessed if consciousness was localized to a functioning brain. The case was reported by Kimberly Clark Sharp, a social worker who is a strong proponent of the idea that NDE’s demonstrate the existence of a soul that survives after death. I am basing the following summary of the case on an account provided in the 2003 edition of Sharp’s book After the Light: What I Discovered on the Other Side of Life That Can Change You (Authors Choice Press).
Maria was a middle-aged Hispanic woman who, in April of 1977, had a serious heart attack while visiting friends in Seattle, WA, and was admitted to the cardiac care unit of Harborview Medical Center, where Sharp was then working. Sharp was assigned to provide Maria assistance with locating family, arranging payment of her medical costs, and other issues.
On the fourth day of her admission, Maria suffered a cardiac arrest. Fortunately, the medical team was able to respond immediately and resuscitate her. Shortly after Maria had regained consciousness and was breathing, Sharp was urgently summoned to her bedside. She found Maria in an agitated state, “eyes wild, arms flailing and speaking Spanish excitedly.” After Sharp calmed her down, Maria told her that, during the cardiac arrest, she had the experience of hovering in a corner of the ceiling of the room, watching the medical team working to revive her. She described who had been in the room and what they were doing during the code, including details such as the paper coiling out of the electrocardiogram machine and falling to the floor. She said she then instantly found herself floating in the air outside the window of her hospital room, looking down at the entrance to the emergency department. Again, she was able to describe details such as the shape of the driveway, that the doors opened inward and that the vehicles moved in one direction only. She was then distracted by an object she saw above her on a ledge of the third storey of the building. She floated up to take a closer look and found it was a running shoe. Sharp repeats a detailed description Maria gave of this object: “It was a dark blue tennis shoe, well-worn, scuffed on the left side where the little toe would go. The shoelace was caught under the heel.” Maria then implored Clark to find and retrieve this shoe, so Maria would have concrete evidence that her experience had really happened.
By Sharp’s account, this was no trivial task. She describes walking around the entire hospital looking up at the window ledges with no luck. So, she returned to the hospital and went through each patient’s room, one by one, until finally she found the shoe sitting on a ledge on the side of the building opposite Maria’s room. Even then, she writes that she had to press her face against the windowpane in order to see it. (One wonders how she explained this strange behavior to the occupants of the rooms she was entering). As her gaze fell on the shoe, she describes her intense emotional response: “(My) knees nearly gave out from under me. I leaned toward the window for support, my forehead still pressed against the pane. My breath fogged the glass as I slowly whispered, ‘This…happened…to…me.’” She then had a flashback to her own NDE, experienced years before. As she opened the window and took the shoe, she describes feeling a sense of validation, and also a decision forming that she would seek out and talk with other people who had experienced NDE’s. “I wanted them to know that they weren’t alone, and that what they had experienced was real.”
Skeptical Inquirer responds
When Matthew mentioned this anecdote on Facebook last year, I was already familiar with it. I was also aware of a 1996 article by Hayden Ebbern, Sean Mulligan and Barry L. Beyerstein published in Skeptical Inquirer2 investigating Sharp’s story. By the time that article was published, the story of Maria and the shoe had gained notoriety as being among the NDE’s that most convincingly defied a physicalist explanation. When I shared the Skeptical Inquirer article with Matthew, he decided to discuss it in a You Tube video, and asked if I would respond, to which I agreed. Matthew’s video will be found below, but before we get to that here are some general comments on how NDE’s can be understood and accounted for from a physicalist perspective and a summary of what I see as the salient points of the Skeptical Inquirer article.
If we just consider non-veridical NDE’s, there is little disagreement that these occur. That is to say, there is no reason to believe people are making up stories about things they did not actually experience. And they are not that uncommon: Between 9% and 18% of people who suffer a cardiac arrest will report having an NDE.3 The disagreement, rather, is over the degree to which these subjective experiences require explanations that cannot be provided by normal physical, biological, neurological and psychological processes.
Several features of NDE’s are shared with out of body experiences (OBE’s), in particular the experience Maria reported of feeling as if she had left her body and was observing it from above (The term for this experience is “autoscopy”). Such OBE’s can result from various physical causes, including traumatic brain injury4, epilepsy,5 inner ear disease,6 and the use of psychoactive drugs.7 They can also follow psychological trauma8. Additionally, OBE’s have been reliably produced under experimental conditions thru the use of drugs9, brain stimulation1011 and stimulation of the vestibular system.12 To be clear, it would be a mistake to conclude that these correlations definitively prove that these phenomena have a purely physical basis. However, they do contradict the claim that these experiences cannot have a physical explanation and therefore, by default, demand non-physical explanations. One reasonable hypothesis is that these features of NDE’s result from a combination of factors such as hypoxia, the administration of drugs, and psychological trauma that occur during a cardiac arrest and subsequent resuscitation, and that these factors produce alterations in brain functioning similar to what occurs in OBE’s.
For this reason, proponents of the existence of a non-physical soul place great emphasis on veridical NDE’s such as Maria’s where, it is argued, the person reports perceiving things they could only have perceived through paranormal means. However, the strength of such an argument strongly depends on the accuracy of the (invariably) anecdotal evidence that supports it. This was what Ebbern and Mulligan, then students at British Columbia’s Simon Fraser University, attempted to assess through their investigation. They travelled to Seattle to interview Sharp and also attended a number of support groups Sharp ran for people who had experienced NDE’s In addition, they visited the hospital where the incident took place. (By then, the Maria’s whereabouts were unknown, and it was concluded that she was likely deceased.)
Probably their most striking finding was that Sharp’s account how difficult it would have been to visualize the shoe was highly questionable. Ebbern and Mulligan had Sharp return to the hospital and point out where she believed she had found the shoe. They then placed a shoe of their own on the ledge at this location and “were astonished at the ease with which they could see and identify the shoe” (p.32). It could easily be seen from many points at ground level around the building, as confirmed by photographs included in the article. Moreover, contrary to Sharp’s claim that she could only see the shoe from inside the building with great difficulty, the authors found it would have been easily visible from multiple points inside a patient’s room, including by a patient while lying in bed. That the shoe was easily visible was further demonstrated by the fact that, when the authors returned to the hospital a week later, someone had removed it from the window ledge. (Sharp responds to this point by claiming she had only guessed at the shoe’s location when pressed by Ebbern and Mulligan. But if her memory of this detail is really so poor, then it calls into question the other details she claims to have recalled with complete fidelity.)
Based on their investigation, the authors suggest an alternative explanation to Sharp’s of Maria’s experience: The memories Maria reported of witnessing the medical team’s actions and equipment during her arrest were possibly the result of her incorporating bits of knowledge she already had or had obtained during the time she was in hospital into “the hallucinatory world that is often formed by a sensory-deprived and oxygen-starved brain.” Sharp herself, in fact, initially considered this possibility (though she mislabels the phenomenon as “confabulation”) before quickly dismissing it. Similarly, though it is unlikely that Maria saw the shoe herself, it is possible she was aware of its existence through comments by staff who had seen it and were talking in Maria’s presence about an object in such an unusual place. This piece of knowledge would, then, also have been incorporated into her memory of her hallucinatory experience.
The authors also raise questions about the reliability of Sharp’s own account of events. Did Maria really report aspects of the shoe and the hospital in such exacting detail? Or has the story been altered and embellished over time as Sharp has told and re-told the story? One highly pertinent detail was undeniably misremembered: It had been claimed that the only way someone could have seen the shoe is if they were positioned in a building a few miles away called Smith Tower, and even then only by looking through binoculars. The authors provide photographic evidence that this was not the case. The shoe could, in fact, be easily seen from multiple points within the hospital and on its grounds. What other details of the story, that cannot be verified, were similarly embellished?
Matthew Sabatine’s response
Below is Matthew’s discussion of the Ebbern et al paper. I encourage the reader to watch it in its entirety, but I will be summarizing its key points.
Matthew’s video relies heavily on Kimberly Clark Sharp’s own response to the Skeptical Inquiry article.13 Her article was published in 2007 as a response to another paper that cited the Ebbern article. I recall first reading Sharp’s paper a number of years ago and being surprised by its peevish and unscholarly tone. Much of the paper consists of ad hominem attacks against Ebbern and Mulligan, referring to them demeaningly as “boys” and “lads” and making unfounded accusations that they had trespassed on hospital property and put the health of vulnerable patients at risk. But, more importantly, Sharp fails to refute any of the article’s substantive points and often does not even seem to understand what those criticisms are. Unfortunately, in relying on this article, Matthew repeats many of her errors. I will go through his main points sequentially.
1) The claim that Sharp and others “embellished” parts of the story is not supported by any direct evidence.
Both Sharp and Sabatine misunderstand what Ebbern et al mean by “embellishment” and seem to think it implies Sharp and others have deliberately and knowingly fabricated parts of the story. However, that is not the case. Rather, when a story is repeatedly told and re-told by multiple people, it is often the case that details are unintentionally added, omitted and distorted. This will be familiar to anyone who has played the game “Telephone.” The authors of the Skeptical Inquirer mention that the story of Maria’s shoe had become something of a legend among members of Sharp’s NDE support group, which they described as having a “revival meeting atmosphere”. One highly important detail was undeniably embellished: The claim that the shoe could only have been seen through binoculars from Smith tower, unless one’s spirit was levitating outside the third storey window. Ebbern and Muligan were able to easily see their shoe without doing either.
2) Ebbern and Mulligan failed to take into consideration new construction at the hospital in 1994 could have affected Sharp’s ability to see the shoe from the ground when she first tried to find it.
It is difficult to see how this weakens Ebbern et al’s argument. They are not denying that Sharp may not have been able to see the shoe from the particular vantage point she used back in 1977. The point is that many others could have seen it from other locations, as Ebbern and Mulligan confirmed. In fact, Sharp, herself, concedes she likely would have been able to see the shoe if she had moved to another vantage point further from the building, but she simply did not think of doing so at the time. Moreover, Ebbern and Mulligan also demonstrated that the shoe could be seen from various locations inside the hospital. The new construction only involved an addition at what once was a parking lot and patient recreation area. While it is true the construction prevented the investigators from viewing the ledge from the exact location Sharp was standing when she was unable to see to shoe, this does not change the fact that the shoe would have been visible from other locations on the ground level, and the construction certainly would have had no effect on the visibility of the shoe from inside the building.
3) It is unlikely that Maria would have paid attention to a mundane item like the shoe when was in an anxious state while being transported to hospital after a heart attack.
This is reasonable, but also beside the point. The issue is not just whether Maria, herself, saw the shoe, but whether anyone else could have.
It also raises a point that I find curious and unconvincing in Sharp’s account: Imagine you are in the situation that Sharp describes Maria as being. You, in effect, have just died and now find yourself floating above your own lifeless body, watching as the medical team tries to revive you. You then find you have the ability to transport yourself at will through the air to any location, merely by thinking. What are you going to do? Will the first item on your list be: Memorize every single minute detail of an old, abandoned running shoe? I doubt it, which makes me wonder about the accuracy of Sharp’s account of Maria’s initial description of her NDE. We will return to this point.
4) Ebbern et al’s appeal to cryptomnesia14 as an explanation for how she was able to report the details of the shoe is not plausible. Controlled studies of the phenomenon generally involve people recalling and claiming as their own items generated by another person in close temporal proximity.
I am actually in partial agreement with Matthew here, and don’t believe cryptomnesia (which usually refers to inadvertent plagiarism) is the most germane concept to the present discussion. In my opinion, more pertinent research will be found in studies demonstrating the malleabiity of memory over time. One finding that has been replicated is that subjects commonly endorse having seen videos of newsworthy events, such as a plane crash or the car accident that killed Princess Diana, when no such video actually exists. They will even claim to recall specific aspects of these non-existent videos, such as the angle at which a plane struck a building.15 Interestingly, some research has found these false memories to be more likely to occur in people described as “fantasy prone” (though other studies have failed to find such a correlation16). Among other characteristics, such people are more likely to report having experienced OBE’s .
In Matthew’s video, he neglects to mention that Maria had been in hospital for three days prior to her cardiac arrest. That was more than sufficient time to become familiar with the procedures and equipment used in a cardiac care unit. This would be in addition to information she may have already had from previous experience, media depictions, etc. It is also plausible that she could have overheard conversations mentioning the unusually positioned shoe on the window ledge. This is how she could have become aware of its existence without actually seeing it herself.
5) Sharp denies that she has changed a single detail of the story in all the time she has been telling it, so the accusations of inaccuracies and embellishments are unfounded.
Sharp, herself, responds to the suggestion that the story may have changed over time by insisting she had “told anyone who would listen about the shoe” for years prior to the first publication of the story. The problem is the first written account of the story did not appear until 1984, seven years after the event occurred. Far from proving the accuracy of that account, this raises the question of how one can be assured that the events she recounts unfolded exactly as she writes. Rather than bolstering her argument, the fact she had been telling and re-telling her story for seven years before it was committed to writing actually makes it less likely that the written account is accurate. Research demonstrates that, each time a memory is reactivated, it is subject to distortion. Details may be omitted, added or altered, and information gained after the event can be incorporated. This is particularly the case for narrative memories, as is the case here.17 An analogy is to a block of ice kept in a freezer. Each time it is removed and examined, it will melt slightly, and the more often it is taken out the less it will resemble its initial shape. Whereas a block of ice that is just kept in the freezer will retain its shape much more closely.
This casts reasonable doubt on Sharp’s account of the startlingly accurate description she claims Maria had provided of the running shoe. Did Maria really spontaneously divulge all these details before Sharp had retrieved the shoe from the window ledge? Or was this description, in fact, provided after Sharp had found the shoe? And were these details elicited through leading questions and other hints that Sharp unintentionally provided? Recall that, according to her own account, by the time Sharp returned to Maria’s bedside she was already convinced Maria’s mind had left her body when she was near-dead and that she (Sharp) had herself also had a similar experience years earlier. Sharp also says, at that moment, she had already decided that her life’s work would be to convince others that their NDE’s represented genuine experiences and were not illusions.
I have to say, this is one part of Sharp’s account that, for me, simply does not pass the smell test. Why would Maria have provided such an exhaustively detailed description of the shoe? It’s not as if Sharp was likely to find dozens of blue running shoes on the window ledge, and Maria wanted to make sure she retrieved the correct one. And, even if we assume Maria’s mind had left her body and she then saw the shoe, how likely is it that she would have recalled all these details? There is an extensive body of psychological research showing, not only that recall of witnessed events is often unreliable, but that this can be significantly affected by the questions asked to elicit these memories.18
To be clear, I am not accusing Sharp of intentionally misleading her readers or of deliberately manipulating Maria. On the contrary, it would have been inappropriate for her to question or challenge Maria’s story. Sharp was not conducting a scientific study but was providing support and assistance to an anxious and vulnerable patient. Nonetheless, the fact that she could not scrutinize Maria’s story with the highest degree of scientific rigor seriously undermines that story’s value as scientific evidence.
So, what did happen to Maria?
With all that considered, what follows is an explanation for Maria’s story that I believe is not only plausible, but which also does not require an appeal to paranormal or supernatural factors. It is also consistent with current psychological and neuroscientific knowledge and with a physicalist understanding of the mind. (It does not much differ from the one suggested in the Skeptical Inquirer article.)
When Maria suffered her cardiac arrest, she experienced a dissociative episode that resulted in the sensation of perceiving the world from a location outside of her body. This likely occurred in the moments just before she lost consciousness and/or immediately following her resuscitation and was the result of hypoxic insult to her brain. Afterwards, she was convinced she had actually left her body and, in recalling and reconstructing the experience, incorporated bits of knowledge that she had acquired during her time in hospital, as well as things that she could have reasonably surmised from previous experience or common knowledge. Among the things she incorporated into this “memory” was the running shoe on the window ledge, of which she was aware through remarks others had made during her admission.
When Sharp found the shoe, she was convinced, not only that Maria’s mind had left her body, but that the same thing had happened to her during her own near-death experience years before. Moreover, she believed this provided solid, concrete evidence for the existence of a non-material soul that survives after the death of the physical body. With this conviction, and in her own excited state, she may have then unintentionally elicited responses from Maria that seemed to confirm that Maria had seen the shoe during her NDE. Sharp may then have misremembered these responses as being given prior to her recovering the shoe. Over the ensuing years that Sharp repeatedly recounted this story it is possible that she inadvertently changed it to include further details that, while making it more impressive and convincing as an argument for life after death, made it less accurate as an account of what had actually happened.
As Ebbern et al state in their article, the story of Maria and the shoe is regularly cited as one of the most persuasive pieces of evidence for non-local consciousness, yet it does not appear to stand up to strong scrutiny. There are inevitable difficulties that arise when one relies on anecdotal evidence of this sort to support a hypothesis, and for that reason efforts have been made to study NDE’s under more rigorously controlled conditions. To date there have been at least five studies that have involved placing visual targets in areas where an NDE is most likely to occur, such as the resuscitation suite of a hospital emergency department. These targets have been placed in locations that would not be visible to someone at ground level but could be seen if someone was floating in the air near the ceiling (as experiencers of NDE’s often claim to have done). In none of these studies has a single incident of a veridical NDE been documented.19 Given rarity of these phenomena, this finding is perhaps not totally surprising. However, it is also exactly what would be predicted if physicalism is correct, if the mind exists only as a consequence of physical brain functions, and if it ceases to exist once the brain ceases to function. Taken as a whole, anecdotes of veridical near-death experiences, of which the story of Maria and the shoe is exemplary, provide insufficient reason to reject these conclusions.
Van Lommel P. (2013). Nonlocal Consciousness. A concept based on scientific research on near-death experiences during cardiac arrest. Journal of Consciousness Studies, 20, 7-48.
Ebbern H, Mulligan S, Beyerstein B. (1996). Maria’s near-death experience: Waiting for the other shoe to drop. Skeptical Inquirer, July/August, 27-33.
Greyson B. (1998). The incidence of near-death experiences. Medicine and Psychiatry, 1, 92–99.
Blanke O, Landis, T, Spinelli, L, Seeck, M. (2004). Out‐of‐body experience and autoscopy of neurological origin, Brain, Volume 127, Issue 2, 243–258.
Greyson B, Fountain NB, Derr LL, Broshek DK. (2014). Out-of-body experiences associated with seizures. Front Hum Neurosci. Feb 13;8:65.
Lopez C, Elzière M. (2018). Out-of-body experience in vestibular disorders - A prospective study of 210 patients with dizziness. Cortex. Jul;104:193-206.
Wilkins LK, Girard TA, Cheyne JA. (2011). Ketamine as a primary predictor of out-of-body experiences associated with multiple substance use. Conscious Cogn. 2011 Sep;20(3):943-50.
Nicholson AA, Densmore M, Frewen PA, Théberge J, Neufeld RW, McKinnon MC, Lanius RA. (2015). The Dissociative Subtype of Posttraumatic Stress Disorder: Unique Resting-State Functional Connectivity of Basolateral and Centromedial Amygdala Complexes. Neuropsychopharmacology. Sep;40(10):2317-26.
Vlisides PE, Bel-Bahar T, Nelson A, Chilton K, Smith E, Janke E, Tarnal V, Picton P, Harris RE, Mashour GA. (2018). Subanaesthetic ketamine and altered states of consciousness in humans. Br J Anaesth. Jul;121(1):249-259.
De Ridder D, Van Laere K, Dupont P, Menovsky T, Van de Heyning P. (2007). Visualizing out-of-body experience in the brain. N Engl J Med. Nov 1;357(18):1829-33.
Lyu D, Stieger JR, Xin C, Ma E, Lusk Z, Aparicio MK, Werbaneth K, Perry CM, Deisseroth K, Buch V, Parvizi J. (2023). Causal evidence for the processing of bodily self in the anterior precuneus. Neuron. 2023 Aug 16;111(16):2502-2512.
Wu HP, Nakul E, Betka S, Lance F, Herbelin B, Blanke O. (2023). Out-of-body illusion induced by visual-vestibular stimulation. iScience. Nov 22;27(1):108547.
Sharp, K. (2007). The other shoe drops: Commentary on “Does paranormal perception occur in near-death experiences?” Journal of Near-Death Studies, 25:4, 245-250.
Brown, AS, Murphy, DR. (1989). Cryptomnesia: Delineating inadvertent plagiarism. Journal of Experimental Psychology: Learning, Memory, and Cognition, 15(3), 432–442.
Wilson, K, French, C. (2006). The relationship between susceptibility to false memories, dissociativity, and paranormal belief and experience. Personality and Individual Differences. 41. 1493-1502.
Sjödén B, Granhag PA, Ost J, Roos Af Hjelmsäter E. (2009). Is the truth in the details? Extended narratives help distinguishing false "memories" from false "reports". Scand J Psychol. Jun;50(3):203-10.
Scully ID, Napper LE, Hupbach A. (2017). Does reactivation trigger episodic memory change? A meta-analysis. Neurobiol Learn Mem. Jul;142(Pt A):99-107.
Loftus EF. (2005). Planting misinformation in the human mind: a 30-year investigation of the malleability of memory. Learn Mem. Jul-Aug;12(4):361-6.
Augustine, K. (2007). Does paranormal perception occur in near-death experiences? Journal of Near-Death Studies, 25(4), 203–236.