The Parnia AWARE study – Take 2

October 12, 2014 § Leave a comment

Though I posted about this on Friday, I have to return to this Parnia AWARE study for one more post, because I read a post on it yesterday from a certain Steven Novella MD, which would have been hilarious, had the attitude not been actually dangerous.

This is about Dr Novella from his own website:

“Dr. Novella is an academic clinical neurologist at Yale University School of Medicine. He is the president and co-founder of the New England Skeptical Society. He is the host and producer of the popular weekly science podcast, The Skeptics’ Guide to the Universe. He is also a senior fellow and Director of Science-Based Medicine at the James Randi Educational Foundation (JREF), a fellow of the Committee for Skeptical Inquiry (CSI) and a founding fellow of the Institute for Science in Medicine.”

I think you can see a pattern forming here.

Anyway, the gist of Dr Novella’s post is this: “I and most scientist [sic] favor the more mundane and likely explanation that memories of NDEs are formed at other times, when the brain is functioning, for example during the long recovery process.”

He then goes on to quote the paragraph from the AWARE study which says that 78% of cardiac arrest happened in rooms with no hidden images. He then says:

“Well that’s disappointing. However, apparently there were no cases of cardiac arrest patients who were able to see, remember, and report the hidden images.”

Err, yeah. Because he leaves out the part which explains that the only two cases of patients reporting remembering their own resuscitations happened in rooms without any hidden images.

*sigh*

Disinformation, much?

But that’s not why I’m writing this. I covered the issue of disinformation in my previous post on the subject. I’m writing this because I want to address Dr Novella’s favoured explanation for NDEs, which is that the brain confabulates the memories of the experience from other bits and pieces of data and memories collected at other times.

First of all, Dr Novella mistakenly appears to think that the issue is necessarily one of proving the existence of non-materialist phenomena. (Heaven forbid that anyone should attempt such a stupid thing, or challenge Dr Novella’s deeply held philosophical convictions!) But of course it’s not. Parnia never claimed it was, the study doesn’t claim it is, in fact, it doesn’t even remotely hint that it might be. But of course if you haven’t read it and rely instead on Dr Novella’s blog for information, you’d be forgiven for thinking that that’s what it was trying to prove. Here’s what he says about it:

“Failing to obtain any actual evidence that NDEs represent non-corporeal cognition, Parnia apparently decided to fall back on the old, let’s just report what people say and present that as if it were actual objective evidence.”

Who the hell said anything about non-corporeal cognition? The study doesn’t. The study is intended to examine whether there’s consciousness where current medical methods are unable to detect any.

Again, disinformation, much? But it’s not actually disinformation; at least not consciously. This is actually what Dr Novella thinks the study is about. Because to him it’s inconceivable that medicine might actually still have something to learn on the subject. Unlike, I must point out Dr Nicholas Schiff, of Weil Cornell Medical College:

“Dr. Nicholas Schiff directs an integrative translational research program with a primary focus on understanding the process of recovery of consciousness following brain injuries. This research program links basic systems and clinical neuroscience with the goal of developing novel neurophysiologic and neuroimaging diagnostics applied to human subjects and therapeutic strategies. Dr. Schiff and his research group have contributed several landmark advances, including the first demonstrations of brain structural alterations occurring in the setting of very late recovery from severe brain injury.

More recently, Dr. Schiff and his colleagues have taken insights into the neurophysiological mechanisms of arousal regulation and of deep brain electrical stimulation techniques to demonstrate evidence that long-lasting, severe cognitive disability may be influenced by electrical stimulation of the human central thalamus. Dr. Schiff received the 2007 Research Award for Innovation in Neuroscience from the Society for Neuroscience for this research. This work provides an important foundation for developing further understanding of both the mechanisms of recovery of consciousness and basic mechanisms underlying consciousness in the human brain.”

Do you want to hear what Dr Schiff has to say on the subject of detecting consciousness? Go to minute 6:50 here:

(Whilst you’re at it, you may as well listen to the whole discussion, which is fascinating.)

Now, if you’ve listened to that, you’ll know why I said Dr Novella’s attitude is actually dangerous.

It is also dangerous because he is entirely ignoring and flippantly dismissing patients’ reporting of their own condition. He is doing this based on his own prejudices and preconceptions, and what some machines say. These machines, of course, are designed to detect signals based on our current understanding of things, our prejudices and preconceptions. Presumably he is aware, and if not, he should be, of the fact that all NDE-rs report that their memories of their NDEs are more vibrant, sharper, clearer than any other memory they have in their lives, and that these memories do not fade over time. This means that the patients report that these memories are qualitatively different to their other memories.

If you want ,you can hear Dr Mary Neal describing how her own NDE memory is completely qualitatively different to all other experiences in her life, and how it doesn’t fade, and the details of it don’t change, unlike even the memory of the day her son was killed – take a moment to think about that, especially if you have children; her recollections of that day’s details might change, but that of her NDE do not – then go here, to minute: 53:16.

Dr Novella’s post made me angry, because I have had my own reports of my condition flippantly dismissed and ignored by doctors, based on their own preconceptions and the readings on a machine, and their attitude might well have led to my death. In 2012, I got a very bad case of the flu. What kind of virus it was, I don’t know, but it was pretty bad. I got bronchitis and sinusitis, it affected my liver and my spleen – thankfully not permanently – but it also left me with permanent asthma. The first time my husband took me to the hospital, there was blood streaming from my nose (from the inflammation), I was coughing uncontrollably, and I couldn’t breathe. That was the reason he took me to the hospital. I couldn’t breathe. It was at the Marburg University Hospital in Germany, a distinguished institution. A friend drove us there. I managed to tell the receptionist at the A&E, between gasps and coughing bouts, and while woozily swaying on my feet, that I have trouble breathing. An hour and a half later, a harassed looking doctor finally got round to seeing me. He stuck the little reader on my finger which measures pulse and oxygen intake. (He did not check blood gases). By that time, of course, my most violent attack had somehow abated. He saw an oxygen intake of around 86%, and said, “You’re fine.”

I said, “No, I’m not fine. I can’t breathe. “

“No no,” he said, “you’re imagining it.”

NO,” I said, “I am not imagining it. I’m slightly better now, because an hour and a half has gone past, but I have still trouble breathing.”

“No, no,” he said, “you’re just having a panic attack.”

Since the silly woman was being offhandedly dismissed because she was just having a panic attack, apparently, and just imagined she wasn’t able to breathe when in fact she was, my husband and our (male) friend decided it was time to intervene, and both told the doctor in the strongest possible terms that “No, actually, she can’t breathe!

After which, he grudgingly, and with the air of one who was being greatly put upon, decided, sighing, to admit me. Which is lucky, because he might have just sent me home to die of another, uncontrolled asthma attack.

You probably think that was the end of that, and that I was duly diagnosed and prescribed the appropriate medication. Actually, no. For two months, with me coughing constantly and having uncontrollable asthma attacks every second day (sometimes every day), no doctor was able to diagnose asthma in Germany. Because no one happened to do a lung function test at the precise moment when I was having an attack, and the rest of the time, I did very good lung function tests. There was a reason for that. I had had classical singing training for years and I knew how to breathe through the diaphragm and how to belt out all the air I’d stored in to the very last drop. Of course, they didn’t know this, and they never asked. After two months, I said, fuck this, got on a plane, and went to Greece, where our national health service is fucked, but we have excellent doctors. My brother is a psychologist at a hospital and I just decided I’d go private. I got diagnosed practically the moment I walked through the door. Do you know why? Because they didn’t have any machine readings to go on and no preconceptions and personal biases. They just heard me coughing. It’s a very distinctive cough, the asthma cough, which I can now also recognise anywhere. Also, the specialist that now treats me told me, one day, just before giving me one: “Lung function tests don’t mean much. You can have full-blown asthma and still do brilliant lung function tests.”

Presumably the doctors in Germany didn’t believe in this heretical mythology. Because I wasn’t the only one with this experience in the University town of Marburg. I have a friend there, who also has asthma, and one day she ended up at the same hospital with an asthma attack that wasn’t responding to her inhaler. She told the doctor in the A&E: “I have asthma”.

“No, you don’t,” he said.

“Yes, I do,” she said.

“No, no,” said the doctor. “If you had asthma you wouldn’t have been able to breathe out like you do.”

“WTF?” she said. WTF? – I said, when she told me about this. When I have my attacks, just like her, I have trouble breathing in, not out! Luckily for my friend, her sister is also a doctor, and so she was able to prescribe her the medication she needed. Her sister believed her, apparently.

The reason I’ve told you this long story was to highlight how even with something as, theoretically, straightforward as asthma and an asthma attack, preconception, prejudices and machine readings can lead to – in hindsight – ludicrous diagnoses. Let alone with something as complex and as poorly understood as the brain and human consciousness.

But presumably Dr Novella thinks it’s all sorted already, and there’s nothing new we can learn on the subject. So he’ll dismiss patients’ reports of their experiences as imaginary, fanciful, and completely irrelevant, simply because the reports don’t fit in with his preconceived notions of how the world should work. The arrogance is colossal and preposterous. And it is attitudes like this that lead, not only to deaths, but, even worse, to years of suffering.

For the record, this is how Dr Novella presents this interpretation of the AWARE study results:

“What is a little surprising to me is that Parnia could only come up with one case with a memory that can be presented as matching events during cardiac arrest. This does not make that one case ‘verified’, it makes it highly selected and filtered from a larger set of data.”

I personally don’t see why this is surprising. If it happened to everybody we wouldn’t be needing new studies to examine it. We’d probably know much more about the phenomenon already.

It is also not highly selected and filtered from a larger set of data. This actually borders on libel, since there was no selection and no filtering of the data. ALL data was reported and taken into consideration in the statistic analysis. There were only 140 people who survived their cardiac arrest and consented to be interviewed. Of these, 101 completed the second stage of interviews. The rest could not because of fatigue. Of these 101, 85 reported no perception or awareness of memories. That means 55 people reported remembering something from the time they were unconscious. 46 described memories incompatible with NDEs, and 9 described memories compatible with NDEs, all according to the Greyson scale. Finally, 2 reported auditory and visual recollections of events during their cardiac arrest.

Everything one of these two reported was later confirmed and corroborated with his medical records and medical staff, and verified as having actually happened. Hence it was ‘verified’. The reason the other person’s recollection cannot be reported as ‘verified’, is because he was too ill to undergo a third, in-depth interview.

All this means that 2 in 100 people, that is 2% reported remembering actual events from their cardiac arrest. In one of these cases the reports were also verified. A 1% verified awareness during cardiac arrest is not a negligible number. It is not negligible at all. It is 1 in 100 people. And it doesn’t matter whether Dr Novella would like to dismiss it as just “what people say”, something which is not, he persists, verified, even though it was verified. It happened just as the patient said it happened. Dr Novella presumably would like to put this down to coincidence. But just because he’d feel more comfortable doing so, it doesn’t mean it should be. It doesn’t mean that the experiences reported by patients should ever be so cavalierly and flippantly dismissed – even more so if the truth of even one of them has been verified by a documented study – merely because they clash with a doctor’s prejudices and some machine readings.

 

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