Chapter 22
Why Some Come Back and What They Bring
Tom Sawyer was working under his pickup truck in his garage in upstate New York one spring afternoon in 1978 when the jack failed and the chassis crushed his chest. He could not breathe. He could not move. Within moments, by his own report and the report of those who came to help him, he was gone — pinned beneath several thousand pounds of steel, lungs collapsed, the light in his eyes already going out.1
What happened next is a story he would tell for the rest of his life. He found himself, he said, in a place of overwhelming light and love. He met a being who knew him — not just facts about him, but him — with a clarity and acceptance unlike anything he had ever known. He was shown his life in a way he had no language for. And then, at some point in this experience, he became aware that he could not stay. He had children at home. There was something he was supposed to do. Whether he was told he had to return, or whether he understood it without being told, he could not later say. But he understood. And in an instant, he was back — coughing, gasping, shocked into a body that hurt everywhere.
Tom Sawyer was, by every account of those who knew him before and after, a different man. The auto mechanic who had cared mostly about engines and Friday-night ball games became someone preoccupied with what love was and what people were for. He spoke at conferences. He wrote. He spent the rest of his life, until his death in 2007, telling a story he could never quite tell to his own satisfaction. Something had happened to him. And then, just as importantly — and just as mysteriously — he had been sent back.
Every near-death experience we possess is the report of someone who came back. That sentence sounds obvious, but if you sit with it for a moment, you'll notice that it organizes the entire field. We have no NDEs from those who fully died. The dead, so far, are not in the habit of granting interviews. What we have is the testimony of people who were on the threshold — who took some number of steps across — and who, for reasons they themselves usually cannot fully explain, were sent or pulled back into bodies that resumed working.
This is what statisticians call a selection bias. It is not a flaw in the data. It is a feature of the data. And it is itself instructive. It means that the empirical evidence I have been laying out across this book — the veridical perceptions, the encounters with deceased loved ones, the life reviews, the meetings with the Being of Light — is evidence about the threshold of death. Not evidence about the long course of postmortem life. Not evidence that settles the eschatology of heaven and hell. Evidence about that first stretch of the journey: the part where, sometimes, people are sent back to tell us about it.2
This chapter is about that sending-back. It is about why some come back, what the returning looks like from inside the experience, and what NDErs bring with them when they wake up in a hospital bed and realize the world looks different now — sometimes for the rest of their lives. It is also about what the return does and does not show.
Almost every full NDE includes some form of boundary — some point at which the experiencer realizes (or is told) that going further is not allowed. The form varies. Sometimes it is a literal feature in the landscape: a river one is not to cross, a fence, a doorway, a point on a path. Sometimes it is a question: Are you ready? Sometimes it is a directive: It is not your time. Sometimes it is a choice put to the experiencer: Do you want to return?3
What is striking, across the dissertation's case database, is that this element appears in cases where the experiencer had no prior expectation of it. Children describe it. Patients from non-Western cultures describe it. People who had read no NDE literature before their cardiac arrest describe it. Whatever it is, it is not a Western literary convention — it shows up too widely for that.4
Most NDErs do not want to come back. This is one of the harder things to convey to readers who have not encountered the literature, because it sounds wrong. You would think that someone with children, with a spouse, with a life, would naturally want to return. They don't. Or they do, but only after a struggle that often involves the being of light persuading them that they need to.
The reason, as nearly as the reports allow us to see it, is that the experience of being there — in the light, in the love, in the presence — is so overwhelmingly good that the body and earthly life look, by comparison, dim and far away. Coming back feels like leaving home, not arriving at it.5
When NDErs are told (or shown) why they must return, the reasons cluster into a few patterns. Children at home who need raising. Work that has not been finished. People who need them — sometimes named specifically. Occasionally a sense of purpose that the experiencer cannot fully articulate but understands clearly in the moment.
Whether these reasons are objectively the cause of the return, or whether they are the experiencer's interpretation of it, is a question the data cannot fully settle. What is clear is that the reasons given are not generally medical. NDErs rarely report being told they came back because the resuscitation worked. They report being told they came back because something, or someone, was waiting for them on this side.
From the case files. A woman who had a cardiac arrest in her early thirties — documented in the dissertation's qualitative dataset — reported the moment of decision this way (paraphrased from her own words): she was standing at what she called "the place where you don't go further," and she understood she had two small children at home, and the choice was put to her gently, without pressure. She said yes to coming back, and she said yes the way you say yes to something you are not eager about but cannot refuse. The next thing she remembered was the ICU.6
The return to the body is almost universally described as sudden. Many NDErs use the word snap: they snapped back, they were snapped in. Others describe it as falling, as being pulled, as being suddenly heavy. There is often pain — the body that has been in cardiac arrest, or has been crushed, or has been bleeding out, is a body that hurts. There is often confusion. Sometimes there is anger that the experiencer was made to come back at all. Almost always there is a sharp, jarring re-entry into a much smaller, much more limited mode of consciousness.7
The first hours and days after the experience are typically disorienting. NDErs report difficulty speaking, difficulty matching their pre-arrest memories to the people around them, sometimes a profound grief at being back. Spouses and children are sometimes met with a strange withholding — not because the NDEr loves them less but because the NDEr is trying to find their way back into a body, a life, a self that no longer fits the way it did. Some never fully readjust. Some re-enter their old lives with a permanent sense that they are visitors here.8
This is where the data become especially interesting, and where the empirical literature is, in my judgment, strongest. Because what NDErs report — sometimes thirty and forty years later — is that they were durably changed.
Kenneth Ring's Life at Death (1980) and especially Heading Toward Omega (1984) were the first systematic studies of NDE aftereffects. Ring documented a stable pattern: decreased fear of death, increased compassion, decreased materialism, reordered priorities, sometimes a vocational shift toward helping professions, often a deepened interior spiritual life.9 Cherie Sutherland's Australian study, Transformed by the Light (1992), found the same cluster in a different cultural context.10 P. M. H. Atwater, herself an NDEr and a researcher of NDEs, has spent forty years cataloging aftereffects in extraordinary detail.11
The most evidentially serious of these studies, in the medical-research literature, is Pim van Lommel's eight-year longitudinal follow-up published as part of the Dutch prospective cardiac-arrest study in The Lancet. Van Lommel and his collaborators were able to compare cardiac arrest survivors who had reported NDEs against cardiac arrest survivors who had not — controlling, in other words, for the trauma of cardiac arrest itself. Eight years out, the NDE group still showed statistically significant differences from the non-NDE group across a cluster of life-orientation measures: greater appreciation of ordinary things, increased empathy for others, decreased fear of death, increased belief in an afterlife, increased acceptance of others.12 The non-NDE cardiac arrest group did not show these patterns. The trauma alone did not produce the change. The NDE did.
The durability is the point. Pharmacological aftereffects — from the most intense psychedelic, anesthetic, or anoxic experiences medicine has cataloged — typically peak within weeks of the experience and have substantially decayed by twelve months. NDE aftereffects do not decay this way. They persist for decades. This single fact is one of the strongest empirical reasons to think NDEs are not pharmacologically equivalent to anything else medicine knows about. Whatever they are, they leave a mark drugs do not leave.13
The standard physicalist responses to NDE aftereffects fall into a few patterns, and it is worth taking each at its strongest before answering. The first is the traumatic-life-event account: any near-death medical crisis is itself transformative, and the NDE is incidental. People who almost die change. We don't need NDEs to explain the change.
This is a serious objection, and it would have weight if NDErs and non-NDE cardiac arrest survivors showed similar transformative profiles. They do not. Van Lommel's eight-year follow-up is precisely the study that controls for the trauma. Cardiac arrest by itself does not produce the durable cluster of changes. The NDE within the cardiac arrest does. The trauma is real, but the trauma alone does not explain the data.
The second physicalist response is the placebo-belief account: NDErs come to believe they have had a profound spiritual experience, and the belief itself is what produces the change. The change is real, but its cause is the meaning the experiencer assigns to the event, not the event itself.
This is harder to refute directly — one cannot easily separate experience from interpretation in a single subject — but the cumulative pattern weighs against it. Belief-driven changes typically track the cultural-religious framework of the believer. NDE-driven changes do not. They track the NDE phenomenology rather than prior belief: a militantly atheist NDEr and a devout Pentecostal NDEr both end up with decreased fear of death and increased compassion, even though their interpretations of what happened to them diverge sharply.14 The change-cluster is not what we would expect from belief alone; it is what we would expect from a real, structurally similar experience that different belief-systems then interpret in different ways.
The third response is the drug-aftereffect account — the suggestion that whatever neurochemistry produces NDEs (DMT, ketamine-like agents, anoxic peculiarities) also produces durable change. This is the response addressed in the callout above. It runs aground on the fact that the actual pharmacology of comparable agents does not produce comparable durability. The aftereffects of even the most powerful psychedelic experiences fade. The aftereffects of NDEs do not. Whatever NDEs are, they are not chemistry behaving like other chemistry.
It is worth being precise about what the return phase shows and what it leaves open. What it does show: the threshold experience is real, the experiencer brings back changes that are durable and statistically significant, and consciousness during the threshold — whatever its metaphysical character — produced changes that show up in the experiencer's life decades later. A merely subjective experience could not do that. Or rather: a merely subjective experience could not do that and look like every other NDEr's experience. The cross-experiencer consistency is the additional weight.
What the return phase does not show: the full nature of postmortem existence, the precise shape of the eschatological future, or comprehensive answers to the great questions about heaven and hell. Every NDEr returned. Their experiences span the first minutes — perhaps the first hour — of postmortem consciousness. Beyond that, the data go silent, because the dead have not been giving interviews.
This is a methodological limit I take seriously. The dissertation that underlies this book made a specific empirical claim — that veridical NDEs support substance dualism and the conscious intermediate state — and that claim is what the data carry. The further theological questions (Is the intermediate state long? What does final judgment look like? What happens to the unrepentant?) cannot be answered from NDE data alone. They are answered, if they are answered, from Scripture and from the broader theological tradition. NDE evidence converges with Scripture on the threshold; it does not replace Scripture for what lies beyond.15
A connected question: do those who do not return have a similar threshold experience? The dissertation's data cannot directly answer this. But the deathbed-vision literature engaged in Chapter 3 and the Peak in Darien literature engaged in Chapter 13 strongly suggests that they do. People who are dying and will not return often report similar phenomenology to those who do return: deceased loved ones meeting them, light, peace, a sense of arrival. The NDE phenomenon, then, is plausibly evidence not just about NDErs but about every dying person — the dying who do not return are simply the ones who can no longer file the report.16
I want to take a moment with the medical-physiological side, because it is easy to over-spiritualize the return. From the body's standpoint, what happens is more or less straightforward: a cardiac arrest is reversed by CPR or defibrillation; circulation resumes; brain perfusion resumes; the body returns to function. The medical explanation for the return is, in most cases, the medical explanation for any successful resuscitation. It does not require the supernatural to account for it.
What the medical explanation does not account for is the experiencer's report that they were sent or chose. That is content over and above the medical event. The historic Christian tradition has long held space for this kind of return — in the Lazarus narrative (John 11), in the resuscitations Elijah and Elisha performed, in the stories of saints who returned from the dead in the hagiographical tradition.17 Christ's resurrection is the paradigmatic return, though it is unique in that He returned not to a resuscitated mortal body but to a glorified one. NDE returns are resuscitations; the Resurrection is the firstfruits of something else entirely.18
The evidential consequence of returns is straightforward: without them, the threshold of death would be entirely inaccessible to empirical observation. The fact that some come back — and bring with them coherent reports, durable transformation, and (in some cases) verifiable knowledge they could not have obtained through the body — is what makes any of this empirically discussable at all. The returns are the door that has been opened. They do not show us the whole house. They show us the entryway.
NDErs are surprisingly common. The estimates from the prospective cardiac-arrest studies place NDE incidence at roughly 4–15% of cardiac arrest survivors who can be interviewed.19 Across the United States alone, that means many millions of living people have had some form of NDE. They are in our congregations. They are in our hospital chaplaincies. They are sitting in pews and walking in funeral processions and serving on church boards.
And most of them, in my pastoral experience and in the consistent finding of the literature, have never told their pastor. Sometimes because they fear being thought crazy. Sometimes because they tried once and were dismissed. Sometimes because they don't know how to put what happened to them into words their tradition would accept.
For pastors and chaplains. If you minister to a congregation of any size, you almost certainly have NDErs in your community. Most have not told you. The simplest pastoral intervention — preaching once on the conscious intermediate state, mentioning that you are aware of the NDE literature, signaling openness to listening — will often bring people forward who have been carrying this story for decades. They do not need you to validate every detail of what they experienced. They need to know they will not be mocked, dismissed, or pathologized for telling you. Listening is most of the work.
For the church, NDE testimony is best held in the same way the church has always held the testimony of remarkable Christians: with reverent attention, with theological discernment, and with Scripture as the final authority. NDEs are not revelation in the strict sense. They are experience — and like all experience, they require theological interpretation. Chapter 30 develops the discernment framework. Here it is enough to say that NDErs in the congregation are not heretics, are not deceived, and are not (in most cases) trying to overturn anything. They are people who saw something, came back, and are still trying to make sense of it. The church can help.
For the dying themselves, the return literature is — perhaps surprisingly — a source of hope. Not because every dying person will have an NDE. Most will not. But because the threshold experience appears to be real, and structurally similar across thousands of cases, and characterized by light, love, and the meeting of deceased loved ones rather than by terror. The reassurance for the dying Christian is not that they need to have an NDE to die well; it is that the threshold they are approaching has been visited, by enough people, for the church to speak with some confidence about what is on the other side of it. What pastors say at the bedside — Chapter 33 develops the bedside ministry — can now be said with deeper resources than the tradition alone provided.
The return is the bridge between the NDE phenomenon and ordinary Christian life. Tom Sawyer crawled out from under his truck a different man, and lived twenty-nine more years as that different man, and died in 2007. George Ritchie returned from his army-hospital pneumonia in 1943 and spent the rest of his career as a psychiatrist and Christian witness.20 Howard Storm returned from his Paris hospital and became a pastor.21 The list runs long.
None of them died on the day of their NDE. They died later, like everyone does. But they brought with them something that — on every measurable index we have — lasted. They were quieter about money. They were less afraid. They loved more openly. They were, by the testimony of those around them, more like Christ than they had been before. Not all the way, not perfectly — but more.
That is what the data show, and that is what the church should weigh. The NDErs who came back are not authorities on the next life. Scripture is the authority. But the NDErs are witnesses, in the older legal sense of the word: people who saw something and were marked by it, and whose lives are evidence that what they saw was not a dream. The conscious soul they came back with — the same soul we will turn to in the next chapter as we move from the empirical case to the doctrinal one — is a soul that the body did not generate, that the threshold did not extinguish, and that the return did not erase. The body picked up where it had left off. The soul, the better part of them, never left them at all.
↑ 1. Tom Sawyer's accident and subsequent NDE are documented in Sidney Saylor Farr, What Tom Sawyer Learned from Dying (Charlottesville, VA: Hampton Roads, 1993), and discussed at length in Kenneth Ring, Heading Toward Omega: In Search of the Meaning of the Near-Death Experience (New York: Quill, 1984), and Kenneth Ring and Evelyn Elsaesser Valarino, Lessons from the Light: What We Can Learn from the Near-Death Experience (New York: Insight Books, 1998). The author's dissertation, Near-Death Experiences as Evidence for Substance Dualism within the Conditional Immortality Debate (Trinity College of the Bible and Trinity Theological Seminary, 2025), Ch. 4, classifies the Sawyer case among the qualitatively rich return cases. Sawyer continued to speak publicly about his NDE until his death in 2007.
↑ 2. The methodological limit of NDE evidence to the threshold of death (rather than the full course of postmortem existence) is developed in the dissertation Ch. 5 and held throughout this book; see also Chapter 24 on what NDE evidence can and cannot tell us about the full intermediate state.
↑ 3. The boundary element is one of Raymond Moody's original fifteen elements; see Life After Life: The Investigation of a Phenomenon—Survival of Bodily Death (Atlanta: Mockingbird, 1975); and is one of Greyson's transcendental components; see Bruce Greyson, "The Near-Death Experience Scale: Construction, Reliability, and Validity," Journal of Nervous and Mental Disease 171, no. 6 (1983): 369–75.
↑ 4. Cross-cultural and pediatric data on the boundary element are summarized in the dissertation, Ch. 4, and in Chapter 9; see also Allan Kellehear, Experiences Near Death: Beyond Medicine and Religion (New York: Oxford University Press, 1996); Melvin Morse and Paul Perry, Closer to the Light: Learning from the Near-Death Experiences of Children (New York: Villard, 1990).
↑ 5. See the consolidated treatment of reluctance-to-return reports in Bruce Greyson, After: A Doctor Explores What Near-Death Experiences Reveal about Life and Beyond (New York: St. Martin's Essentials, 2021), and the dissertation Ch. 4 sub-analysis of return-phase emotional content.
↑ 6. The case is paraphrased from a qualitative-source case in the dissertation's database; specific identifying details are omitted. The pattern of "gentle choice" return reports is documented across hundreds of cases in the dataset; see dissertation Ch. 4.
↑ 7. Re-entry phenomenology is summarized in P. M. H. Atwater, The Big Book of Near-Death Experiences: The Ultimate Guide to What Happens When We Die (Charlottesville, VA: Hampton Roads, 2007), and in Greyson, After.
↑ 8. Integration difficulties are discussed at length in Atwater, The Big Book of Near-Death Experiences, and in Cherie Sutherland, Transformed by the Light: Life after Near-Death Experiences (Sydney: Bantam, 1992); see also Nancy Evans Bush, The Buddha in Hell and Other Alarms: Distressing Near-Death Experiences in Perspective (Cleveland, TN: Parson's Porch, 2016) on the additional integration difficulties faced by experiencers of distressing NDEs.
↑ 9. Kenneth Ring, Life at Death: A Scientific Investigation of the Near-Death Experience (New York: Coward, McCann & Geoghegan, 1980); Ring, Heading Toward Omega. Ring's "Life Changes Inventory" remains a foundational instrument for measuring NDE aftereffects.
↑ 10. Sutherland, Transformed by the Light. Sutherland's Australian sample independently replicated the core aftereffect cluster Ring had documented in North America.
↑ 11. P. M. H. Atwater, Coming Back to Life: The After-Effects of the Near-Death Experience (New York: Dodd, Mead, 1988); Atwater, The Big Book of Near-Death Experiences.
↑ 12. Pim van Lommel, Ruud van Wees, Vincent Meyers, and Ingrid Elfferich, "Near-Death Experience in Survivors of Cardiac Arrest: A Prospective Study in the Netherlands," The Lancet 358, no. 9298 (2001): 2039–45; van Lommel, Consciousness Beyond Life: The Science of the Near-Death Experience (New York: HarperOne, 2010), where the eight-year follow-up data are developed at length and the comparison between the NDE and non-NDE cardiac-arrest cohorts is presented.
↑ 13. The contrast between NDE aftereffects and pharmacological aftereffects is developed in Chapter 16; see also Charlotte Martial, Vanessa Charland-Verville, et al., "Neurochemical Models of Near-Death Experiences: A Large-Scale Study Based on the Semantic Similarity of Written Reports," Consciousness and Cognition 69 (2019): 52–69, on the phenomenological dissimilarity of NDE and DMT/ketamine reports.
↑ 14. The cross-belief consistency of NDE aftereffects is documented in Greyson, After, and is engaged in the dissertation Ch. 4 sub-analysis on prior-belief variables.
↑ 15. See John W. Cooper, Body, Soul, and Life Everlasting: Biblical Anthropology and the Monism-Dualism Debate, rev. ed. (Grand Rapids: Eerdmans, 2000), Ch. 9, on the proper theological role of empirical evidence in eschatological questions; the dissertation Ch. 5 develops the same point at greater length.
↑ 16. See William Barrett, Death-Bed Visions: The Psychical Experiences of the Dying (London: Methuen, 1926); Bruce Greyson, "Seeing Dead People Not Known to Have Died: 'Peak in Darien' Experiences," Anthropology and Humanism 35, no. 2 (2010): 159–71; Christopher Kerr with Carine Mardorossian, Death Is but a Dream: Finding Hope and Meaning at Life's End (New York: Avery, 2020).
↑ 17. John 11:38–44 (Lazarus); 1 Kings 17:17–24 (Elijah and the widow's son); 2 Kings 4:32–37 (Elisha and the Shunammite's son); 2 Kings 13:21 (the man revived by contact with Elisha's bones). The hagiographical resuscitation tradition is surveyed in Carolyn Walker Bynum, The Resurrection of the Body in Western Christianity, 200–1336 (New York: Columbia University Press, 1995).
↑ 18. 1 Corinthians 15:20–23 on Christ as the firstfruits of resurrection. The careful distinction between NDE return (resuscitation of mortal life) and resurrection proper is developed throughout the historic Christian tradition; see N. T. Wright, The Resurrection of the Son of God (Minneapolis: Fortress, 2003), Part I.
↑ 19. The 4–15% range is the consensus figure from the major prospective cardiac-arrest studies; see van Lommel et al., "Near-Death Experience in Survivors of Cardiac Arrest" (18% in the Dutch sample); Sam Parnia et al., "AWARE—AWAreness during REsuscitation," Resuscitation 85, no. 12 (2014): 1799–1805; Parnia et al., "AWAreness during REsuscitation—II: A Multi-Center Study of Consciousness and Awareness in Cardiac Arrest," Resuscitation 191 (2023): 109903; Penny Sartori, The Near-Death Experiences of Hospitalized Intensive Care Patients: A Five-Year Clinical Study (Lewiston, NY: Edwin Mellen, 2008).
↑ 20. George G. Ritchie with Elizabeth Sherrill, Return from Tomorrow (Old Tappan, NJ: Chosen Books, 1978); Ritchie, My Life After Dying: Becoming Alive Again (Norfolk, VA: Hampton Roads, 1991). Ritchie's case was the original case Raymond Moody encountered as a graduate student and which set Moody on the path to Life After Life.
↑ 21. Howard Storm, My Descent into Death: A Second Chance at Life (New York: Doubleday, 2005). Storm's case is engaged in Chapter 28 in connection with distressing NDEs and the experience of redemption from a hellish trajectory.