Psience Quest

Full Version: Pam Reynolds' NDE--the "clicks": Continuous or discontinuous?
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"If the clicks weren't continuous, that leaves open the possibility that external sounds weren't blocked from Reynolds' ears or drowned out by the "clicks"

The purpose of the loud clicking sounds is mainly to monitor the integrity of the brain stem, not to prevent the patient hearing anything. Under adequate anaesthesia, consciousness is removed (apparently) but in a minute amount of patients  (estimates vary) around 0.1%, they do wake up. Burst suppression however, completely  removes that possibility (apparently) because the massive (Spetzler said) amounts of drugs administered flatten the brain waves.  

" (Despite claims to the contrary, even from Gerald Woerlee himself, I have been unable to exclude the possibility that anesthetic awareness occurs in "burst suppression" "

Gerry Woerlee told me (via email) that anaesthetic awareness is impossible under burst suppression but it is also simply a fact. 

I recently responded to a post by Keith Augustine on 'Ask the Atheist' which I came across simply by chance. Someone named Gary wrote a lengthy post about this subject claiming burst suppression basically doesn't mean a thing and if that's all we had to 'prove' that Reynolds couldn't hear, then it was worthless (summary)

Gary says:June 29, 2019 at 10:08 am

I have no knowledge of the Pam Reynolds case but I am familiar with the phenomenon of burst suppression (BSP). Two claims made about this are wrong:
(i) It is not characterised by mostly flat brainwaves
(ii) It does not necessarily preclude processing of sensory information
BSP is a highly variable EEG pattern found in controlled anaesthesia and also brain pathology characterised by alternate periods of high amplitude electrical activity (burst waves) and depressed (though not necessarily completely flat) waves.

…… If the evidence presented in the Pam Reynolds case evidence relies primarily on the claimed impossibility of auditory information being processed during BSP and/or deep anaesthesia then that evidence is either not particularly strong and/or is misleading."

This post (from Gary) is simply wrong. I responded more or less straight away with this below, but the owner of the blog won't publish it. It's been sitting awaiting moderation since June 29th.

"tim" says:June 29, 2019 at 11:10 am

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Gary,

I’m not sure why you’ve decided to enter the debate with that rather odd ‘composition’ above, but I’m afraid it’s mostly incorrect. What I’m stating here is not my opinion; it’s an accepted medical fact. I’m a layperson, I don’t claim expertise. I listen very carefully to what the medical experts themselves know or profess to know.

Burst suppression flattens brainwaves. That’s simply a fact. The ratio of burst to suppression, varies according to the dosage of barbiturates (then). See here in the paragraph below.

Therapy (barbiturate, propofol, or halogenated anesthetic) is titrated to an electroencephalographic (cEEG) endpoint. Complete pharmacologic suppression results in a flat-line EEG. Typically, a 1:10 burst to suppression ratio is chosen as an arbitrary endpoint, but this is neither evidence based nor a universal practice. In other words, a 10 second screen of EEG would have 1 second of burst activity and 9 seconds of flat-line EEG. Optimal dosing is unknown and there is no evidence base to guide therapy (6).

https://www.openanesthesia.org/burst_suppression/

I don’t know if you are familiar with some of the arguments around this case? Dr Gerry Woerlee, who is a very accomplished anaesthesiologist (it has to be said) has ‘weighed in’ on the case many times. He is a hard-line sceptic and believes that Pam had anaesthesia awareness (which explained her observations) even though the surgeons themselves have repeatedly denied this.

Leaving that aside, I can tell you categorically that Dr Woerlee also accepts burst suppression eliminates any possibility of consciousness. He confirmed that for me via email. Woerlee actually asserts that burst suppression was achieved later in the operation, just before standstill, to be clear.

However, Dr Spetzler and his colleagues sought burst suppression early because they had found that it offered better “protection” (barbiturate protection) for the brain cells while they are starved of oxygen and glucose, during the time when there was no blood flow into the brain (standstill). Indeed no blood in the brain at all.

Pam Reynolds clearly heard a conversation (and somehow remembered it) at the same time that she observed the bone saw that was being used to take the roof of her eye socket off. At that time she was under burst suppression, which is, as I said, a pattern of mostly flat brainwaves which eliminates any possibility of consciousness (apparently).
That’s why the case is so fascinating and that’s why it remains unexplained. Best regards
As far as I know, the monitoring was constant as they have to be sure the patient is under burst suppression all the time. 

She never heard the clicks during her NDE, in neither of the two parts composing it. It's really weird that she recalled and registered pretty clearly voices and music, but not a single mention of the clicks, not even some "background noise". Sum this up with how remote is the possibility of having AW under burst suppression, and the case becomes really strong.
Raf999 Wrote:As far as I know, the monitoring was constant as they have to be sure the pèatient is under burst suppression all the time. 

She never heard the clicks during her NDE, in neither of the two parts composing it. It's really weird that she recalled and registered pretty clearly voices and music, but not a single mention of the clicks, not even some "background noise". Sum this up with how remote is the possibility of having AW under burst suppression, and the case becomes really strong.

She was monitored all the way through the operation. No anaesthesia awareness was detected, Raf, the surgeons who conducted the operation have told us this.

Burst suppression eliminates that possibility anyway. If anaesthesia awareness had occurred, the surgeons wouldn't have been as perplexed as they were by her report. In other words, some of the mystery would have been removed. Furthermore, she would have been terrified, lying there helpless and awake, having the roof of her eye socket sawn open and her groin cut open at both sides.  

The case is absolutely solid and always was. However, dishonest/conniving pseudo sceptics and ideological debunkers have manged to plant misinformation all over the web about it. Keith Augustine specialises in it.

It's up to everyone who is interested in the facts to accept them as they are. Materialists never will.  It doesn't "prove" life after death, of course, but Pam Reynolds was dead by every medical criteria (during standstill) and her NDE continued without a break. People can draw their own conclusions.
(2019-07-22, 04:17 PM)tim Wrote: [ -> ]She was monitored all the way through the operation. No anaesthesia awareness was detected, Raf, the surgeons who conducted the operation have told us this.

Burst suppression eliminates that possibility anyway. If anaesthesia awareness had occurred, the surgeons wouldn't have been as perplexed as they were by her report. In other words, some of the mystery would have been removed. Furthermore, she would have been terrified, lying there helpless and awake, having the roof of her eye socket sawn open and her groin cut open at both sides.  

The case is absolutely solid and always was. However, dishonest/conniving pseudo sceptics and ideological debunkers have manged to plant misinformation all over the web about it. Keith Augustine specialises in it.

It's up to everyone who is interested in the facts to accept them as they are. Materialists never will.  It doesn't "prove" life after death, of course, but Pam Reynolds was dead by every medical criteria (during standstill) and her NDE continued without a break. People can draw their own conclusions.
Yes, the idea that AW could end up into some sort of "heavenly" experience is also a bit misleading. Most accounts of AW have in them terror, panic, difficulty breathing, or even tremendous pain if you are really unlucky. There has been people emerging from that experience with their minds forever scarred, suffering from severe PTSD. A few even commited suicide after that event. At the very least, the experience is either neutral or just slightly distressing. I've never read about pleasurable AW experiences.

Gerry says that opiates made her experience us blissfull, but honestly i don't think it makes for a convincing answer. Also, if she wasn't under burst suppression, how were opiates in circle inside her body and in a dose so massive to let them feel so at peace while literally getting her skull cracked open like a coconut? I mean, that procedure is horrible and messy. Also, I don't get how opiates made her able to "filter" the intense noise in her ears, maybe they can help tolerate the noise, make it a bir more pleasant, but they don't suddenly turn you into daredevil.
ParapsychResearcher Wrote:Hello tim,

Thanks for your response.

To clarify, I didn't intend to suggest that the purpose of the "clicks" was to block out sound--I know that the clicks as such were used to monitor brain activity. But I have read many arguments to the effect that one consequence of the "clicks"--in addition to the gauze, tape, glue, etc. (I left that unclear in my OP, sorry)--would have been the prevention of Reynolds from hearing external sounds, which has been taken as one reason to think that "anesthesia awareness," even if it occurred, wouldn't have allowed her to hear conversations, or at least hear them clearly.

I'm familiar with the arguments about "burst suppression," etc., but didn't want this thread to deal with that matter, except perhaps incidentally. I believe it has been established at this point that Reynolds was in "burst suppression" before her skull was opened, despite Woerlee's statements to the contrary. Also, as noted in my OP, I know that Woerlee himself concedes that BP wouldn't allow anesthetic awareness. It's just that I haven't seen it clearly and empirically established in academic publications that BP excludes this possibility. It is entirely possible that this is due only to my insufficient knowledge of the relevant literature. One thing that does seem clear from that literature is that the EEG monitoring that occurs in surgeries does not give full insight into brain activity under general anesthesia, which can apparently vary between patients in ways that surgical EEG monitoring often fails to detect.

But to return to my key question: Why did the Mayses claim in 2008 that Reynolds was only exposed to the clicks "about 25 times," whereas Karl A. Greene indicates that the clicks were played continuously for the full duration of Reynolds' procedure? The apparent contradiction between those claims is what really mystifies me.

It's just that I haven't seen it clearly and empirically established in academic publications that BP excludes this possibility.

Hi, did you look at the link above where it explains burst suppression ? Without brain waves it is supposed to be impossible to form consciousness/thoughts.

I don't know why Robert and Suzanne Mays said that (25 times). I don't know what they mean to be honest. I don't like name dropping (here I have to) but Robert Mays contacted me several years ago about the Reynolds case and I told him all I knew. Chris Carter also contacted me about the 27 degree new fact (which I discovered). Whilst doing that he reminded me that Stuart Hammeroff had said (about the Reynolds case) that the lack of burst suppression was worrying.

I told Chris Carter that it wasn't the case because she was under burst suppression; the surgeons said so and it's also in his published paper. Stuart Hameroff had apparently simply assumed that Woerlee was presenting the facts as they were, without needing to go to the definitive source (Spetzler and Greene) to check. 

So you can easily extrapolate from Hameroff's comments that burst suppression is the gold standard.
(2019-07-22, 11:56 PM)ParapsychResearcher Wrote: [ -> ]To make my view at this point as clear as possible: I do think, based on what I currently know, that it's very likely that Reynolds did experience an OBE with truly anomalous veridical perceptions.
If you will only go so far as "likely" rather than "certain", may I ask which other explanations do you consider as alternatives? When I say "explanation" I don't mean vague hand-waving, but a specific, detailed explanation which accounts for all of the details.
ParapsychResearcher Wrote:Hello tim,

What I mean to say is that I haven't seen a study that provides empirical data--which I could inspect myself--that are sufficiently strong to establish the impossibility of anesthesia awareness in "burst suppression." 

With respect to Reynolds' being monitored for anesthesia awareness, it unfortunately seems that the EEG monitoring used in surgical settings isn't reliable enough to exclude the possibility of anesthesia awareness with full confidence: https://ekja.org/journal/view.php?doi=10...4.66.5.339 https://link.springer.com/article/10.100...014-0061-x.

Okay but that's not the point here. Burst suppression is the deepest level of anaesthesia possible without killing the patient (apparently) and it excludes anaesthesia awareness. That's one of the reasons why they do it.  Also (lack of) brain waves are not the only monitor. 

Electrophysiological Monitoring
With this technique, intraoperative monitoring includes recording the spontaneous electroencephalographic (EEG) activity, somatosensory evoked potentials (SSEP's), and brain-stem auditory evoked potentials (BAEP's). The suppression of EEG activity by barbiturates is used to titrate an effective dose for cerebral protection. 1The preservation of SSEP's is used to confirm the integrity of sensory conduction.

The two test modalities (SSEP monitoring <end evoked potential recording) complement each other. The EEG recording is a sensitive index of generalized cortical activity and a precise measure of a cerebroprotective barbiturate dose.~9 The SSEP is a more specific response of intact sensory pathway conduction that persists despite barbiturate-induced EEG burst suppression. Spontaneous EEG activity is lost when body temperature is below 2SOC and cerebral blood flow is 21' to 30 cc/100 gm/min. The SSEP's persist to hypothermic levels as low as 18° to 20T and flows of 10 to 15 ~;:/ 100 gm/min. Together they can be monitored to achieve optimum doses of barbiturates and min:::-:2 ! retraction of neural structures before hypothermic 2X[size=7]rest. [/size]

Just for anyone interested, this is the clear statement from Spetzler's paper about burst suppression being sought early. Spetzler pioneered this operation in the States. Other more recent practitioners seek burst suppression later (apparently) 
    
[size=4]Our experience with profound hypothermia and circulatory arrest indicates that prearrest, precooling administration of barbiturates (thiopental) in quantities sufficient to maintain burst suppression of EEG activity has not been deleterious and probably has improved cerebral protection.
http://ether.stanford.edu/library/neuroa...reated.pdf POSTED BELOW [/size]


You don't have to accept the statements above but you ought to of course. Materialists don't; they just persist with their own versions that never happened. That's how important the issue seems to be to to them.

Lastly, there was a second veridical set of observations when she was being rewarmed. Hearing the music, seeing her body jump etc. Debunkers have to get rid of those, too but they can't.
Just for anyone interested, this is the clear statement from Spetzler's paper about burst suppression being sought early. Spetzler pioneered this operation in the States. Other more recent practitioners 
    
"Our experience with profound hypothermia and circulatory arrest indicates that prearrest, precooling administration of barbiturates (thiopental) in quantities sufficient to maintain burst suppression of EEG activity has not been deleterious and probably has improved cerebral protection. "
This is a partially accurate report (which I'm sure most will have seen before so apologies) an excerpt from "Beyond human limits".

From 2.10 to 2.33 Spetzler explains the sequence of events. Patient put to sleep (actually on an ice bed to cool her down)
and then given a drug that has the power to get rid of all your brainwaves.

Unfortunately, they then move it on to much further in the operation and eventually standstill...and then they bring Pam on to narrate the initial part of her experience (the sight of the bone saw and hearing the conversation) as though it had occurred during standstill which it hadn't.

It occurred when Spetzler was taking off her eye socket and the cardiac surgeon Camilla Mican was trying to hook her up to the by-pass machine to completely cool her down. But it' still remarkable because she had no brainwaves at that time as Spetzler states.

@7.45  

"Without any brainwave activity, it is inconceivable to me that the brain can receive, internalise and maintain a memory...."
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