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.

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.

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.

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.