The author, Sanjay Gupta, is a practicing neurosurgeon & associate chief of neurosurgery at Grady Memorial Hospital & assistant professor at Emory University Hospital in Atlanta. He is a columnist for Time Magazine & chief medical correspondent at CNN.
This was a really interesting book & I was very intrigued by all the various stories, some that really stuck out are below:
Cardiologist Dr. Gordon Ewy at the Sarver Heart Center in Tucson had been doing CPR experiments for more than 20 years. The focus was to try to understand the role that artificial breathing plays in an emergency resuscitation. For more than a decade he has argued that breathing was nearly irrelevant. Ewy began noticing that the survival rates for people getting chest compressions alone weren’t only as good as people getting full AHA-approved CPR, they were better. Almost by accident, the public health campaign had stumbled onto a medical discovery.
To understand Ewy’s theory about CPR, you have to know about the 3 phase model of cardiac arrest.
The 3 phases are electrical, circulatory, & metabolic.
The first lasts approx 4 minutes, during which time the heart still pulsates with its own electrical energy.
The circulatory phase lasts approx 4 minutes after cardiac arrest until the 10 minute mark. Whatever oxygen was present in the blood has been consumed, and without oxygen, the heart can no longer generate electrical energy. The absence of oxygen also triggers dangerous chemical reactions throughout the body, as cells turn to sources of stored energy. At a certain point-about 10 minutes after cardiac arrest- the cascade of cell-killing chemical reactions reaches a crescendo.
This marks the third step toward death, the metabolic phase. It’s during this time that cell death begins in earnest.
The model helps explain why some interventions work. During the electrical phase, defibrillation is highly effective, but after that; not so much. That’s because defibrillation doesn’t restore electricity to the heart; it just resets the rhythm. For it to work, the heart needs to have enough energy present to resume beating once given the chance.
In traditional CPR, artificial breaths are supposed to add oxygen to the blood & chest compressions are meant to circulate that oxygen. We can see that when breathing ceases, for several minutes there is still a good amount of oxygen sitting in the bloodstream. The human body stores far more oxygen than we are generally aware of, & that oxygen lingers for some time after we’ve actually stopped breathing. Therein lies an important lesson that turns conventional CPR on its head; maybe, just maybe those artificial breaths aren’t necessary.
According to the American Hearth Association, for every minutes that goes by without someone attempting CPR or defibrillation, the odds of survival decrease 7-10 percent.
* Without any oxygen at all the deadly chemical reactions couldn’t take place. Given a high dose of carbon monoxide, each insect froze in place, but it wasn’t dead. It was like hitting the pause button on the remote. Each insect could survive 24 hours, then resume it’s normal business as soon as the carbon monoxide in the enclosure was replaced by oxygen.
*Not every Near Death Experience is the same, but Moody has noticed several common features of consistent characteristics in the stories people told about what happened when they died. . The first signal is DEATH, a usually loud, unpleasant noise.
A man is dying and, as he reaches the point of greatest physical distress, he hears himself pronounced dead by his doctor. He begins to hear an uncomfortable noise, a loud ringing or buzzing, and at the same time feels himself moving very rapidly through a long, dark tunnel. After this, he suddenly finds himself outside of his own physical body, but still in the immediate physical environment, and he sees his own body from a distance, as though he is a spectator. He watches the resuscitation attempt from this unusual vantage point and is in a state of emotional upheaval.
Soon other things happen. Others come to meet and to help him. He glimpses the spirits of relatives and friends who have already died, and a warm, loving spirit of a kind he has encountered before- a being of light- appears before him. This being asks him a question, nonverbally, to make him evaluate his life and helps him along by showing him a panoramic, instantaneous playback of the major events of his life. He finds himself approaching some kind of barrier or border, apparently representing the limit between earthly life and the next life.
The notion of a soul as separate from the body is as ancient as humankind.
Nowhere in our lives is there as transparent an interface between spirituality and science as there is with near-death experience.
During REM sleep the body is paralyzed- a condition known as atonia.
After a near death experience, people don’t fear death. They know there’s an afterlife, and they think it’s wonderful.
In 2006, Schiff examined the brain of an Arkansas man who had woken up after nearly two decades in a coma. Terry Wallis was 19 years old with a 5 month old daughter, when his pickup truck veered off the side of a steep hill. Along with causing severe brain damage, the accident life him completely paralyzed. Nineteen years later, a nursing home aide, making conversation, asked who was coming to visit that day. The aide’s jaw dropped as Wallis answered, “Mom”. Within months, he was speaking frequently and had even regained the ability to make new memories. His family allowed Schiff to peer inside Wallis’ brain, using PET scans and diffusion tensor imaging. He found that Wallis had grown new brain connections, working around the severe damage he suffered in the crash. That’s pretty surprising to many people; until recently most doctors were taught in medical school that brain cells, once dead, do not regenerate.
You’ve got a choice; dig in your heels, wrap yourself around hope, or crawl into a corner and die. There’s nothing in between.
Since the 1970’s, it’s been standard care to treat cardiac arrest by giving a shot epinephrine (adrenaline) along with any CPR and defibrillation. But doctors in Norway just finished a study that lasted 5 years, with more than a thousand patients, comparing the survival rates of patients who received epinephrine during their cardiac arrest with patients who did not. There were no difference in survival. The standard treatment didn’t help at all.
When we challenge conventional wisdom, we may find that treatments we’ve taken for granted- like traditional CPR- aren’t terribly effective, and we may find newer approaches that work better.