Chapter 7
Part II: The Evidence — When the Dying See What They Shouldn’t
Every field of study has its watershed moment — that one piece of evidence so well-documented and so carefully observed that it forces everyone, even the skeptics, to take a harder look. In Egyptology, that moment came with the Rosetta Stone. In the study of near-death experiences, it came in 1991, in an operating room at Barrow Neurological Institute in Phoenix, Arizona, when a 35-year-old woman named Pam Reynolds was deliberately brought as close to death as modern medicine knows how to do — and then brought back. What she reported afterward changed the entire NDE debate.
I want to be careful here. No single case can settle a question this big all by itself. But the Pam Reynolds case is so unusual, so well-controlled, and so well-documented that it deserves its own chapter. It is the closest thing NDE research has to a laboratory experiment. The medical conditions during her experience are known down to the minute. Her brain activity was monitored continuously by three independent measures. The surgical procedures were recorded. The conversations were logged. And what she reported lined up with details she could not have known by ordinary means. As we explored in Chapter 6, veridical NDEs — experiences in which patients accurately report verifiable information from outside their bodies — have already shifted the debate from speculation to evidence. Pam Reynolds is the case in which that shift becomes hardest to ignore.1
To understand why this case matters, we have to understand what was being done to Pam’s body. She had been diagnosed with a giant basilar artery aneurysm — a weakened, ballooning section of the large artery at the base of her brain. If it ruptured, she would die instantly. Because of its size and dangerous location, the only realistic surgical option was a procedure called hypothermic cardiac arrest, nicknamed “standstill” by the doctors who perform it. The neurosurgeon was Dr. Robert Spetzler, then director of Barrow Neurological Institute and one of the world’s leading vascular neurosurgeons.2
Here is what “standstill” required. First, Pam was placed under deep general anesthesia. Her eyes were lubricated and taped shut. Small molded speakers were inserted into both ears. These speakers emitted 100-decibel clicks at about 11 clicks per second — louder than a jackhammer at close range — and they completely filled and blocked the ear canals. The clicks were not for music. They were a medical test, designed to measure brainstem activity by way of brainstem auditory evoked potentials (BAEPs) — small electrical responses in the brain triggered by sound. As long as the brainstem can hear and respond, those tiny spikes show up on a monitor. When they flatten, brainstem function has stopped.3
Then the team cooled her body. Her warm blood was pumped out through tubes into a heart-lung machine, chilled, and circulated back. Her core temperature fell to 60°F (about 15.5°C) — colder than a refrigerator. As the cold reached her heart, she went into ventricular fibrillation; potassium chloride stopped the heart completely. Her electroencephalogram (EEG), which records electrical activity in the cerebral cortex, went flat. The brainstem clicks no longer produced any response. Then the surgical team took the most extraordinary step: they tilted the operating table, turned off the bypass machine, and drained the blood from her body. Sabom describes it bluntly — “the blood was drained from Pam’s body like oil from a car.”4 By every clinical measure medicine uses to determine death, Pam Reynolds was, in those moments, dead. As Dr. Spetzler himself put it on national television: “There is no brain activity, no blood going through the brain. Nothing, nothing, nothing.”5
For NDE research, the standstill operation creates a uniquely controlled situation. Most cardiac arrests happen unexpectedly in hospitals or homes, where brain monitoring is limited. In Pam’s case, three different measures were running simultaneously: a flat EEG (no cortical activity), absent brainstem evoked potentials (no brainstem activity), and confirmed absence of blood flow to the brain. There was no oxygen, no metabolism, no measurable signal of any kind. This is the medical equivalent of turning off the lights and locking the door. And yet — something happened.
Pam’s account, recorded by Sabom in extensive interviews and cross-checked against surgical records, unfolds in three connected scenes.6
Pam reported being “pulled” out of the top of her head by the sound of a tone — a natural D, she said. She found herself, in her words, “metaphorically sitting on Dr. Spetzler’s shoulder,” looking down at the surgical field. The vision, she said, was sharper and clearer than ordinary sight. She noticed details that startled her. She noticed how her head had been shaved (only part of it, not all). She noticed a tool the surgeon was using that looked, to her, like an electric toothbrush:
The saw thing that I hated the sound of looked like an electric toothbrush and it had a dent in it, a groove at the top where the saw appeared to go into the handle, but it didn’t. … And the saw had interchangeable blades, too, but these blades were in what looked like a socket wrench case.7
The instrument she was describing was the Midas Rex pneumatic craniotome — a high-speed bone saw spinning at roughly 73,000 rpm, used to cut through her skull. Sabom, by his own admission, did not know what that tool looked like at the time of the interview. He filed the tape and only later contacted the Midas Rex company in Fort Worth, Texas, asking for photographs. When the manual arrived, Sabom said he was “shocked with the accuracy of Pam’s description.” The saw really did look like an electric toothbrush. The interchangeable blades were stored in something that really did resemble a socket wrench case.8
While the surgical team was opening her skull, a female cardiac surgeon, Dr. Murray, was attempting to access blood vessels in Pam’s right groin to connect her to the heart-lung machine. Pam reported hearing a comment — a female voice — saying something about her veins and arteries being too small. She thought, “I should have told her about that.” The surgical record confirmed it. Dr. Murray had dictated in her report that the right femoral artery was “quite small,” only about 4 mm wide, too small for the cannula they wanted to use, requiring them to switch to the left side. Spetzler’s own report noted that this conversation happened “simultaneous with the opening of the craniotomy” — that is, at exactly the moment the bone saw was being used.9
Two things should hit us about this. First, Pam’s ears were sealed with the 100-decibel click speakers. Ordinary hearing was not just unlikely — it was being actively blocked at extreme volume. Second, the timing locked her observation to a moment when the craniotomy was underway and standstill preparations were being made. She was not piecing together stray sounds from before or after surgery. She was reporting a specific exchange that occurred at a specific moment that the medical record verifies.
Sometime during the standstill itself, Pam’s experience changed. She felt a pulling sensation — “like going up in an elevator real fast,” “like the Wizard of Oz being taken up in a tornado vortex.” She traveled down what felt like a dark shaft toward a pinpoint of light that grew bigger and brighter. She heard her grandmother calling — not, she said, with her ears, but with a clearer kind of hearing. She entered a brilliant light, met deceased relatives (her grandmother, an uncle, her great-great-aunt, her grandfather), and was told she could not go further or she would not be able to return. Her uncle eventually led her back. Re-entering her body, she said, felt like “jumping into a pool of ice water.”10
On Greyson’s widely used NDE Scale, Pam scored a 27 — the highest in Sabom’s entire Atlanta Study. The average for an NDE on this scale is about 15. Her experience was not a faint flicker; it was, by the standard measurement tool of the field, the deepest NDE on record at the time.11
Now let’s be fair. Skeptics have been working on this case for thirty years, and they have proposed several alternative explanations. We need to take each one seriously. But here is what makes Pam Reynolds so unusual: the standard skeptical accounts of NDEs each require something in particular — some leftover oxygen, some residual brain activity, some moment of unnoticed awareness — and Pam’s case is precisely the one where those somethings have been controlled away.
Could this just be a vivid hallucination produced by a dying brain? It is the standard fallback. But hallucinations don’t produce verifiable, accurate descriptions of unfamiliar surgical instruments. They don’t time themselves to specific surgical conversations. A randomly firing brain might generate a sensation of light or motion, but it cannot generate the specific shape of a Midas Rex bone saw a patient has never seen. The shape of that saw, in that case, was not in Pam’s memory bank. It had to come from somewhere else. As Sabom notes, after carefully considering this option, the accuracy of Pam’s description “lends support to the claim that the experience truly occurred apart from the body.”12
Some researchers argue that NDEs are caused by anoxia — the brain’s last gasp as oxygen runs out. But Pam’s brain was not merely oxygen-deprived. The blood was physically drained from her head. There was no oxygen, no glucose, no circulating fluid of any kind. You cannot get a brain more deprived than that. If anoxia were producing NDEs, you would expect this state to produce nothing — or random noise — not a coherent, sequential, verified experience.
This is probably the most popular skeptical move today. The idea is that even when an EEG looks flat, deeper brain regions might still be active and producing experience. But Pam’s case was monitored precisely with that worry in mind. The 100-decibel click speakers and the brainstem auditory evoked potentials were specifically designed to detect brainstem activity. They detected none. Spetzler — the surgeon, not the NDE researcher — flatly said: “Nothing, nothing, nothing.” If physicalism requires brain activity to explain consciousness, Pam Reynolds is the falsifying case. There was no measurable activity to explain anything.13
“Anesthesia awareness” is a real phenomenon in which patients regain partial awareness during surgery while paralyzed and unable to move. Could Pam’s experience be a case of that? Three things rule it out. First, she was under deep general anesthesia from the very beginning — well before the standstill — with EEG patterns confirming the depth of sedation. Second, during the standstill itself there was zero brain function — not light anesthesia, not residual awareness, but complete neurological silence. Third, anesthesia awareness involves accidental wakefulness during normal anesthesia, not vivid spiritual experience during medically induced flatline.
The most sophisticated skeptical objection is the timing argument. Maybe, the skeptic suggests, Pam’s observations occurred before the standstill (when she was anesthetized but her brain was still running) or after (during rewarming and recovery). On this view, her brain might have processed sounds and details at those points and assembled them into a story afterward. This is a fair worry and deserves careful response.
Several pieces of evidence weigh against it. First, Pam herself reported that her experience began with the sound of the bone saw — that is, with the craniotomy. She didn’t describe anything earlier. Second, Spetzler’s own surgical record confirms that the femoral conversation occurred “simultaneous with the opening of the craniotomy” — meaning at exactly the moment Pam said her out-of-body experience began. Third, the 100-decibel ear speakers were running throughout the procedure — including before the standstill — making ordinary auditory pickup extremely unlikely. Fourth, the tunnel and the light experience took place during the time her brain was confirmed flatline. Could every single one of these alignments be coincidence? Possibly. But the coincidences keep stacking up in the same direction, and at some point a long string of friendly coincidences becomes its own kind of evidence.14
I want to be honest about one thing. Sabom himself notes a small puzzle in Pam’s description: she said the bone saw had a “groove at the top where the saw appeared to go into the handle,” but the actual groove on the Midas Rex is at the other end. So her description was not perfect. Sabom suggests a couple of explanations — she may not have seen the tip clearly from her vantage point, or her memory may have shifted slightly in retelling. Skeptics will seize on that. But if we’re being honest, a description that is mostly right with one small detail off is closer to genuine perception than to invention. Inventions tend to be either fully wrong or eerily perfect; perceptions tend to be mostly right with edges that blur.15
Step back for a moment. If Pam Reynolds had a coherent, sequential, partly verifiable experience while her brain was confirmed flatline by three independent measures, then consciousness can function — at least sometimes — in the absence of measurable brain activity. That sentence, if true, is enormous. Physicalism, the view that the mind just is the brain, claims that no brain means no mind. The case in front of us seems to put a counterexample on the table.
The philosopher and biblical scholar John Cooper, writing well before some of the strongest NDE evidence had been compiled, was cautious about overstating what such cases prove. He argued that NDEs do not on their own demonstrate the soul’s ability to survive and function indefinitely apart from the body. But he also concluded — carefully, in his usual measured way — that the evidence “certainly does not conflict with a dualistic anthropology,” and that NDE evidence “tends to support dualism and requires more than a standard physiological account of consciousness.”16 That is an understated way of saying something powerful: the data point in dualism’s direction.
For the Christian theologian, this matters. If consciousness can persist when the brain has stopped, then the biblical witness to a conscious intermediate state — Jesus saying to the thief, “Today you will be with me in paradise” (Luke 23:43); Paul preferring to be “away from the body and at home with the Lord” (2 Cor. 5:8); the souls under the altar crying out in Revelation 6:9–11 — fits comfortably with the empirical evidence. We will explore these passages in depth in Chapter 20. The point here is simply that NDEs, and Pam Reynolds in particular, do not embarrass biblical anthropology. They support it.
If the human soul is the bearer of consciousness, capable of perceiving and thinking when the brain is silent, this is also exactly the kind of soul we would expect Christ to have assumed in his incarnation. As I argue in my companion volume The Word Made Flesh, a soul that can remain conscious during the body’s death is precisely the soul that descended to the dead during the triduum mortis — the three days between Christ’s death and resurrection. As Wilkinson notes in his Chalcedonian anthropology, Christ’s human soul is genuinely a human soul of the same kind we possess.17 The empirical evidence from Pam Reynolds and the Christological logic of the incarnation are pointing in the same direction.
I want to end on a note of honesty. Pam Reynolds is not a magic bullet. Skeptics have offered objections, and some have been thoughtful. The case is not perfectly clean — no human case ever is. But here is the situation, as I see it: every common naturalistic explanation requires something the case has ruled out. Hallucinations don’t produce accurate descriptions of unfamiliar surgical tools. Anoxia can’t generate coherent experience without any blood. Residual brain activity wasn’t there. Anesthesia awareness was excluded by the depth of sedation and the flatline. The “before or after” move requires us to believe a series of unrelated coincidences explains every alignment between her report and the medical record. At some point, the simplest explanation is that Pam Reynolds was conscious when her brain was not — and the simplest theory consistent with that is substance dualism, the view that there is more to the human person than the body alone.18
That is why this case earns its chapter. It does not stand alone — Chapter 8 will introduce another category of evidence, the visual experiences of the congenitally blind, that is at least as devastating to physicalism. But Pam Reynolds is the case that most clearly meets the skeptic on the skeptic’s own terms: in a hospital, with monitors, under medical supervision, with a paper trail. And on those terms, she did something the brain alone cannot account for.
1 For a full presentation of the Pam Reynolds case, see Michael Sabom, Light and Death: One Doctor’s Fascinating Account of Near-Death Experiences (Grand Rapids, MI: Zondervan, 1998), chap. 3, “Death: Defining the Final Frontier,” and chap. 10, “The Near-Death Experience: A Medical Perspective,” esp. the section “Pam’s Near-Death Experience.” Sabom’s account remains the most thorough first-person research treatment of the case. ↩
2 Sabom, Light and Death, chap. 3, “Death: Defining the Final Frontier.” For Spetzler’s position and the significance of the standstill technique, see also Robert F. Spetzler et al., “Aneurysms of the Basilar Artery Treated with Circulatory Arrest, Hypothermia, and Barbiturate Cerebral Protection,” Journal of Neurosurgery 68, no. 6 (1988): 868–79. ↩
3 Sabom, Light and Death, chap. 3, “Death: Defining the Final Frontier.” On brainstem auditory evoked potentials as a measure of brainstem function, see also John C. Stevens, “Auditory Brainstem Responses,” in Aminoff’s Electrodiagnosis in Clinical Neurology, 6th ed., ed. Michael J. Aminoff (Edinburgh: Saunders, 2012), 503–24. ↩
4 Sabom, Light and Death, chap. 3, “Death: Defining the Final Frontier,” section “Into the Valley of the Shadow of Death.” ↩
5 Quoted in Sabom, Light and Death, chap. 3, “Death: Defining the Final Frontier.” Spetzler made the comment in an interview with CBS’s 48 Hours. ↩
6 Sabom, Light and Death, chap. 3, “Death: Defining the Final Frontier,” and chap. 10, section “Pam’s Near-Death Experience.” ↩
7 Pam Reynolds, interview transcript reproduced in Sabom, Light and Death, chap. 3, “Death: Defining the Final Frontier,” and chap. 10, section “Pam’s Near-Death Experience.” ↩
8 Sabom, Light and Death, chap. 10, section “Pam’s Near-Death Experience.” Sabom obtained the Midas Rex student manual from the manufacturer in March 1996, more than a year after first interviewing Pam in November 1994. ↩
9 Sabom, Light and Death, chap. 10, section “Pam’s Near-Death Experience.” Sabom quotes directly from both Dr. Murray’s and Dr. Spetzler’s operative reports. ↩
10 Sabom, Light and Death, chap. 3, “Death: Defining the Final Frontier,” section “Into the Valley of the Shadow of Death.” ↩
11 Sabom, Light and Death, chap. 3, “Death: Defining the Final Frontier.” On the Greyson NDE Scale, see Bruce Greyson, “The Near-Death Experience Scale: Construction, Reliability, and Validity,” Journal of Nervous and Mental Disease 171, no. 6 (1983): 369–75. ↩
12 Sabom, Light and Death, chap. 10, section “Nailing Jell-O to the Wall.” ↩
13 Sabom, Light and Death, chap. 10, section “Pam’s Near-Death Experience.” For broader treatment of the failure of residual-brain-activity hypotheses, see also Pim van Lommel, Consciousness Beyond Life: The Science of the Near-Death Experience (New York: HarperOne, 2010), chap. 9. ↩
14 Sabom, Light and Death, chap. 10, section “Pam’s Near-Death Experience.” For a Christian appraisal of the cumulative case for veridical NDEs, see also J. Steve Miller, Is Christianity Compatible with Deathbed and Near-Death Experiences? The Surprising Presence of Jesus, Scarcity of Anti-Christian Elements, and Compatibility with Historic Christian Teachings (Acworth, GA: Wisdom Creek Press, 2023), chap. 1, “Why Take NDEs Seriously?” ↩
15 Sabom, Light and Death, chap. 10, section “Pam’s Near-Death Experience.” ↩
16 John W. Cooper, Body, Soul, and Life Everlasting: Biblical Anthropology and the Monism-Dualism Debate (Grand Rapids, MI: Eerdmans, 2000), 214. See also Cooper’s broader appraisal of NDE evidence at 213–215. ↩
17 Michael A. Wilkinson, Crowned with Glory and Honor: A Chalcedonian Anthropology, Studies in Historical and Systematic Theology (Bellingham, WA: Lexham Academic, 2024), 45. On the Christological grounding of human-soul anthropology, see also Joshua R. Farris, An Introduction to Theological Anthropology: Humans, Both Creaturely and Divine (Grand Rapids, MI: Baker Academic, 2020), 145. ↩
18 John Burke, Imagine Heaven: Near-Death Experiences, God’s Promises, and the Exhilarating Future That Awaits You (Grand Rapids, MI: Baker Books, 2015), chap. 2, “Skeptical Doctors and the Afterlife,” for a parallel pastoral assessment of the cumulative force of veridical evidence. ↩
Burke, John. Imagine Heaven: Near-Death Experiences, God’s Promises, and the Exhilarating Future That Awaits You. Grand Rapids, MI: Baker Books, 2015.
Cooper, John W. Body, Soul, and Life Everlasting: Biblical Anthropology and the Monism-Dualism Debate. Grand Rapids, MI: Eerdmans, 2000.
Farris, Joshua R. An Introduction to Theological Anthropology: Humans, Both Creaturely and Divine. Grand Rapids, MI: Baker Academic, 2020.
Greyson, Bruce. “The Near-Death Experience Scale: Construction, Reliability, and Validity.” Journal of Nervous and Mental Disease 171, no. 6 (1983): 369–75.
Miller, J. Steve. Is Christianity Compatible with Deathbed and Near-Death Experiences? The Surprising Presence of Jesus, Scarcity of Anti-Christian Elements, and Compatibility with Historic Christian Teachings. Acworth, GA: Wisdom Creek Press, 2023.
Sabom, Michael. Light and Death: One Doctor’s Fascinating Account of Near-Death Experiences. Grand Rapids, MI: Zondervan, 1998.
Spetzler, Robert F., Mark N. Hadley, Daniele Rigamonti, L. Philip Carter, Patrick P. Raudzens, Stephen J. Shedd, and Eugene Wilkinson. “Aneurysms of the Basilar Artery Treated with Circulatory Arrest, Hypothermia, and Barbiturate Cerebral Protection.” Journal of Neurosurgery 68, no. 6 (1988): 868–79.
Stevens, John C. “Auditory Brainstem Responses.” In Aminoff’s Electrodiagnosis in Clinical Neurology, 6th ed., edited by Michael J. Aminoff, 503–24. Edinburgh: Saunders, 2012.
van Lommel, Pim. Consciousness Beyond Life: The Science of the Near-Death Experience. New York: HarperOne, 2010.
Wilkinson, Michael A. Crowned with Glory and Honor: A Chalcedonian Anthropology. Studies in Historical and Systematic Theology. Bellingham, WA: Lexham Academic, 2024.