Chapter 7

A Brief History of NDE Research

Moody, Sabom, Ring, Long — fifty years of taking the dying seriously

In the autumn of 1965, a young philosophy student at the University of Virginia sat in a classroom and heard his professor tell a story he could not forget.

The professor was Dr. George Ritchie, a psychiatrist on the medical faculty. Twenty-two years earlier, in December 1943, Ritchie had been a soldier in basic training at Camp Barkeley, Texas. He came down with double pneumonia. His fever climbed past 106. His body shut down. The military doctor pronounced him dead and ordered his body covered with a sheet. Nine minutes later, an attendant noticed his hand twitch. The doctor came back, gave him an injection of adrenaline straight into the heart, and worked on him until he came around.¹

But Ritchie said he had not been gone. He said he had stood up out of his body, looked down at it, and traveled — through walls, across the country, into a presence of light he was sure was Christ. He had seen things. He had been changed. He came back unable to forget what he had seen, and unable to live the same way again.

The young philosophy student in that classroom was Raymond Moody. He listened. He could not get the story out of his head. He started asking around. Quietly, almost embarrassed at first, he asked patients and friends and friends-of-friends if they had ever heard of anything like that. They had. Many of them had. By the time Moody finished his Ph.D. in philosophy and went to medical school at the Medical College of Georgia, he had collected dozens of accounts. The patterns were uncanny.

In November 1975, Moody published a small paperback called Life After Life. He coined a phrase for what these patients had described. He called it the near-death experience.²

The book sold thirteen million copies. The field of NDE research was born.

What I want to do in this chapter is walk you through how the field grew up. Not because the history is the argument — the argument comes in the chapters that follow — but because you cannot evaluate the evidence without knowing where it came from and who has worked on it.

If you have ever heard a pastor wave NDEs away as "just popular spirituality," I get it. The field has a reputation for paperback books with bright covers and breathless titles. Some of that reputation is earned. There is a real cottage industry of dubious heaven-tourism literature, and Christian readers are right to be cautious. But the reputation hides a different reality. Over the past fifty years, NDE research has slowly, sometimes painfully, grown into a real scientific field. Its papers appear in The Lancet, in Resuscitation, in Lancet Psychiatry, in Frontiers in Psychology. Its researchers include cardiologists at major teaching hospitals, university psychiatrists, ICU nurses with doctorates, and critical-care physicians running multi-center clinical trials.

You can disagree with their conclusions. Many serious scientists do. But you cannot honestly say there is no field there. There is. And if you want to think clearly about what happens to a person at the border of death, you have to know who has been there before you and what they found.

So let me introduce you to them.

The Founders

Moody's Life After Life did three things at once. It named the phenomenon. It identified a pattern of common elements — separation from the body, a tunnel of darkness, a being of light, a life review, a border that could not be crossed, a return to the body. And it framed all of this in language ordinary people could understand. Moody was a philosopher by training, and he wrote with a philosopher's caution. He did not say, "This proves there is an afterlife." He said something much more careful: something is going on here, the patterns are striking, and we should look at it.³

Most of his fellow doctors did not want to. The book was reviewed in the popular press but mostly ignored in academic medicine. Moody followed it up with Reflections on Life After Life in 1977 and The Light Beyond in 1988. He became a household name. His influence ran far ahead of his discipline's willingness to follow.

If Moody was the herald, the next figure was the skeptic.

Michael Sabom was a young cardiologist in Atlanta in the late 1970s. He was, by his own admission, a doubter. He picked up Life After Life expecting to find it foolish. Instead, he found it puzzling. The patterns Moody described matched stories he had begun to hear from his own patients — patients who had been brought back from cardiac arrest. So Sabom did something brave. He ran a study.

He took two groups of patients. The first group consisted of NDErs — people who had had a cardiac arrest, a resuscitation, and a memory of consciousness during the event. The second was a control group of medically experienced cardiac patients who had never had an NDE. He asked both groups to describe what a resuscitation looks like.

The results were striking. The non-NDE control patients, when asked to imagine the procedure, made standard, predictable mistakes — the kind of errors anyone gets from television medical dramas. The NDErs got the medical details right. Several of them described their own resuscitations with such accuracy that Sabom, the cardiologist, could not explain how they had known what they knew.⁴

Sabom published his findings in Recollections of Death in 1982. It was the first systematic medical NDE research with a controlled methodology. Years later, in 1998, he wrote Light and Death, a more personal book that walked carefully through the famous case of Pam Reynolds (we will meet her in Chapter 12) and laid out his own conversion to evangelical Christianity. He had set out to debunk the field and ended up persuaded.

Kenneth Ring was a third early voice. An academic psychologist at the University of Connecticut, Ring was neither a philosopher like Moody nor a clinician like Sabom but a working researcher with a statistician's eye. Life at Death, published in 1980, brought careful methodology to the field for the first time. Ring developed a measurement tool he called the Weighted Core Experience Index. He gathered cases systematically. He ran the numbers.

Then, in 1981, Ring helped found IANDS — the International Association for Near-Death Studies. IANDS still exists. It maintains a peer-reviewed academic journal, the Journal of Near-Death Studies. It hosts conferences. It supports research. From 1981 forward, NDE study had a professional society.⁵

Ring's later book, Mindsight (1999), co-authored with Sharon Cooper, became one of the most important works in the field. It documented the cases of more than two dozen blind people, some of them blind from birth, who reported visual perception during their NDEs. We will spend a whole chapter on those cases in Chapter 11. They may be the strongest single piece of evidence for substance dualism the field has produced.

Into the Mainstream

Bruce Greyson, a psychiatrist at the University of Virginia (the same institution that had given a young Raymond Moody his first NDE encounter through George Ritchie), brought a different kind of rigor. In 1983, Greyson published the Greyson NDE Scale.⁶ It is a sixteen-question instrument that measures whether a given experience qualifies as a near-death experience and how richly developed it is. The scale is now standard. Almost every academic NDE paper uses it. Greyson's career-summary book, After, came out in 2021. He served for many years as editor of the Journal of Near-Death Studies. He has personally interviewed thousands of NDErs. He still does. He has been called the dean of academic NDE research, and the title is fair.

The decisive moment for the field's scientific legitimacy came in December 2001. The Dutch cardiologist Pim van Lommel — along with three colleagues — published a prospective study of NDEs in cardiac arrest survivors in The Lancet, one of the most respected medical journals in the world.⁷ It was the first time NDE research had appeared in a top-tier mainstream medical publication. The study followed 344 cardiac arrest patients across ten Dutch hospitals. It found that 18 percent reported some form of NDE. It documented several cases that could not be easily explained by oxygen deprivation, medication, or psychological factors. Van Lommel's later book, Consciousness Beyond Life (2010), summarized the case for what he called nonlocal consciousness. After 2001, NDE research could no longer be dismissed as fringe.

Sam Parnia is the most ambitious clinical NDE researcher of his generation. A British-American critical-care physician now at NYU Langone Health, he launched the AWARE study (AWAreness during REsuscitation) in 2008. The first phase ran through 2014. The second phase, AWARE II, ran from 2014 through 2022. Parnia's project is unprecedented in scope: dozens of hospitals in multiple countries, prospective enrollment, real-time monitoring of cardiac arrests, EEG documentation, and an attempt to objectively test the claim that consciousness persists during cardiac arrest.

Parnia's books — What Happens When We Die (2006), Erasing Death (2013), and Lucid Dying (2024) — have made his work available to the public. He prefers the term actual death experience to near-death experience because, he argues, his patients are not "near" death; they are by every clinical standard dead, and then resuscitated. His 2023 paper in Resuscitation documenting bursts of high-frequency EEG activity in cardiac arrest patients was a major scientific event.⁸ We will return to his work in detail in Chapter 12.

Jeffrey Long is a radiation oncologist who founded NDERF — the Near Death Experience Research Foundation — in 1998. NDERF is a website and a database. Anyone who has had an NDE can submit their account using a structured questionnaire designed to capture phenomenology in standard categories. Over five thousand people have done so. The NDERF database is the largest single collection of NDE accounts in the world.⁹ My own dissertation drew on it heavily. Of the 5,278 cases I analyzed, 4,446 came from NDERF and from the older IANDS archive. Long's Evidence of the Afterlife (2010) and God and the Afterlife (2016) summarize the database's findings for general readers.

Eben Alexander is a neurosurgeon. In 2008, he came down with a rare and devastating form of bacterial meningitis. His cortex shut down. He went into a deep coma for seven days. While his brain showed no higher function on imaging, he reports that he had a profoundly detailed NDE. His 2012 book Proof of Heaven sold millions of copies. His case is medically interesting and theologically complicated. The dissertation engages it carefully — his interpretation drifts toward a vaguely New Age framework that orthodox Christians cannot endorse — but his medical documentation is real.¹⁰

Penny Sartori is a Welsh ICU nurse who completed a five-year prospective study of cardiac patients for her doctoral research. The Near-Death Experiences of Hospitalized Intensive Care Patients (2008) is one of the most careful clinical NDE studies ever published. Her case files include patients who reported accurate visual content during cardiac arrest — content her control patients, asked to imagine resuscitations, could not match.¹¹

Other figures matter as well. Janice Holden's editorial work at the Journal of Near-Death Studies has shaped the field's standards for years. Mario Beauregard's neuroscientific publications brought NDE research into closer dialogue with the philosophy of mind. J. Steve Miller, an evangelical writer, produced one of the first careful Christian apologetic engagements with the data.¹² The field is not the work of one person. It is a tradition, with elders, with peer review, and with structured debate.

What the Skeptics Say

The history I have just walked through is the field's own story of itself. The story looks different through skeptical eyes.

The earliest dismissals were not really scientific. They were dispositional. NDEs were "popular spirituality." They were "wishful thinking." They were the kind of thing a serious physician did not waste his time on. That dismissal worked, more or less, until van Lommel's Lancet paper made it untenable.

Once the field had peer-reviewed standing, the skeptical response had to become more sophisticated. Three streams of skeptical research emerged.

The first is the dying-brain hypothesis. Susan Blackmore's Dying to Live (1993) is the most influential statement of this view.¹³ Anoxia — oxygen starvation — produces visual phenomena that resemble NDEs. The tunnel is the visual cortex misfiring. The light is the disinhibition of activity in the visual centers. The peace and euphoria are endorphins, the body's natural opiates. We will examine this hypothesis carefully in Chapter 15. For now, the relevant point is methodological. The hypothesis is real, the researchers are serious, and the cumulative case has to address it. It does. We will see how.

The second stream is the temporo-parietal junction hypothesis. The Swiss neurologist Olaf Blanke published a series of papers in the early 2000s showing that direct electrical stimulation of a region of the brain called the right temporo-parietal junction can produce a sensation of being out of one's body. Blanke's findings are real and important. They explain some illusory out-of-body sensations in waking subjects. They do not explain veridical perception during clinical death — for reasons we will explore in Chapter 17.

The third stream is the surge-of-activity stream. Kevin Nelson at the University of Kentucky has argued that NDEs are episodes in which REM sleep mechanisms intrude into waking consciousness. Jimo Borjigin and her colleagues at the University of Michigan have published striking studies showing brief surges of high-frequency electrical activity in the dying brains of rats, and more recently in dying human cardiac arrest patients. Whether these surges are sufficient to support the kind of detailed conscious experience NDErs report is the central question of Chapter 15.

These are not the only skeptical responses, but they are the major ones. Each has produced peer-reviewed papers. Each has its proponents and its critics. None has been able to explain the full range of veridical NDE evidence. But none should be dismissed without careful engagement, and the chapters ahead will give them that engagement.

Christian skeptics have offered their own responses. Some argue NDEs are demonic deception. Others argue they are best read as God-given visions, different in kind from what secular researchers describe. We will treat these readings carefully in Chapter 30. For now I will only say this: the demonic-deception response is wholly inadequate to the data, and the kinder Christian readings deserve a more careful engagement than they have generally received.

Fifty Years In

What has fifty years of NDE research established? And what has it not?

I want to be careful here, because both sides of that question matter.

The field has established several things solidly. NDEs are widespread. The best estimates from prospective studies suggest that ten to twenty percent of cardiac arrest survivors report some NDE phenomenology — that is, between one in ten and one in five.¹⁴ Across the millions of cardiac arrest events worldwide each year, this means many millions of people are quietly carrying NDE memories.

The field has established that the core phenomenology of NDEs is consistent. Across cultures, across decades, across age groups, the same pattern shows up. Out-of-body. Tunnel. Light. Life review. Border. Return. Differences exist, especially in how the experience is interpreted, but the core sequence does not vary much. Chapter 9 looks at this in detail.

The field has established that veridical perception during clinical death does occur. Hundreds of cases — my dissertation found 1,114 of them — record persons who, while their bodies were down and (often) their EEGs were flat, perceived events at a distance and reported them accurately when they came back. The cases vary in documentary strength. The strongest are extremely strong. We will look at them in Chapters 10 through 13.

The field has established that the standard physicalist explanations cannot account for the full range of veridical content. Anoxic hallucinations are real, but they do not produce verifiable accurate distant observation. REM intrusion is real, but it does not produce coherent narrative perception during cardiac arrest. The Borjigin surges are real, but the timing and the duration do not match the rich, sustained experiences NDErs describe. The cumulative weight of these failures is the subject of Chapter 17.

But there are things the field has not established, and honesty requires saying so.

It has not produced a definitive causal-explanatory account of how the soul perceives during clinical death — that is to say, how the immaterial perceives the physical world. The field documents that it does. It does not yet explain how. Whether such an explanation is even possible at the level of natural science is itself an open question.

It has not established that all NDEs are theologically reliable. Some NDErs report content that contradicts Christian teaching — universalist confidence without atonement, occasional reincarnation language, syncretic religious framing. Christian discernment is required. Not every NDE account is on the same evidential footing, and not every NDEr's interpretation of their own experience is correct.

It has not settled the eschatological question. The conditional-immortality versus universal-reconciliation versus eternal-conscious-torment debate is not solved by the NDE evidence. The evidence supports substance dualism and the conscious intermediate state. It does not, by itself, decide what happens at the final judgment. That work belongs to Scripture and to the broader theological conversation.

In short: the field is real, it has produced solid findings, and it has limits. A serious reader should respect both.

Why This Matters

So why does this history matter for a book about Christian dying?

It matters because the church has spent most of its two thousand years answering questions about death on theological grounds alone. That was not a failure of the church. There was no other ground available. The dying were dying. The dead were dead. Whatever happened in between was inferred from Scripture, from the witness of the dying themselves, and from the long pastoral memory of the church.

Now, for the first time, there is something more. Not a replacement for theology. Not a substitute for Scripture. But a body of evidence that bears directly on the questions the church has always been asking.

When a hospice chaplain stands at the bedside of a dying woman who suddenly looks past her chaplain, smiles, and says, "He's here" — she is not making it up. The chaplain has heard such reports for as long as chaplains have existed. What is new is that we now have fifty years of careful research suggesting that what the dying see is real, not a side effect of a dying brain.

When a pastor preaches a funeral and tells the congregation that the deceased is "now with the Lord" — he is repeating what Christians have always said. What is new is that we have reasons, not just from Scripture but from observation, to think that the dead are not nowhere.

The history of NDE research is, in this sense, a gift to the dying church. It does not change the gospel. It does not replace the resurrection. It does not settle the great theological debates. But it gives the pastor, the chaplain, and the dying person something they have not had before: a community of careful, credentialed researchers who have taken seriously what the dying say, who have tested it against control groups and medical records and EEG strips, and who have found that the dying are not lying.

The next two chapters develop the methodological tools we need to evaluate this evidence carefully. Chapter 8 defines what "veridical" actually means and lays out the scoring framework my own dissertation used. Chapter 9 walks through the cross-cultural pattern. Then the case files begin. The dying have been speaking for fifty years. It is time to listen.