Terminal Lucidity

#1
Hi, I'm new so please be gentle....;)

Ian Wardell and I were just discussing this phenomenon -- terminal lucidity -- in the 'introduce yourself' thread, and I thought it worthy of further discussion than we could obviously give it there.

This is one of those unexplained phenomena that could have a physical cause but also may point to chinks in the armor of physicalist explanations for consciousness. Folks near death will occasionally 'rally' and become conscious briefly or show some sign of improved abilities shortly before death. I've seen the phenomenon myself. It is not common by any stretch of the imagination -- most folks in comas never regain consciousness before death.

I would need do a little more digging to see which types of patients show this change since I haven't seen it in years (my practice is now entirely outpatient based, thank goodness) and can't recall particulars the few times I have witnessed it. Perhaps Linda (whom I'm very happy to see is in this forum) could chime in with examples of her own.

I can generate at least one theory how this is possible on a physicalist account but would be very happy to hear from others what you think.


If any are interested, here is a paper outlining several cases: http://www.medicine.virginia.edu/cl...ily-kelly-pdfs/OTH25terminal lucidity-AGG.pdf
 
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#3
Welcome Phil.

There is another. This might be of interest too. I am sure I read a study from Japan but can't seem to find it easily.

http://spiritualscientific.com/yahoo_site_admin/assets/docs/Lucidity_at_Death_Nahm_M.9131520.pdf

It is an interesting phenomenon.

Thank you for the link. I agree, it is a very interesting phenomenon. One that medicine cannot explain at this time, though we may offer possibilities.


Two observations on the two papers -- (1) there really isn't terribly good documentation (or we are not made privy to it), which hinders accurate modeling, and (2) at least half and probably more appear to have died from increased intracranial pressure and brain herniation -- which may be an important clue to the process(es) involved.

For the patients with dementia (in the first paper) I would postulate an entirely different type of explanation, but all is necessarily conjecture. We are not provided good accounts of the cause of death of those patients from what I recall. They may all have died of septic shock; a release of catecholamines could account for improvements, but also release of acetylcholine and improvement of forebrain depression would certainly work (that is the mechanism for most of the existing Alzheimer's treatments).

For the cases with some details in the second paper, chronic meningitis appears to be a common theme -- also mentioned in the first paper.

This points toward one of the problems we encounter when discussing consciousness from a neurological perspective. Consciousness is not one thing; there are at least three different processes involved. In fact, when physicians discuss consciousness we discuss three different 'levels' -- arousal, awareness, and the contents of consciousness. It is certainly possible that all three 'levels' come into play in different ways with different types of patients.
 
#4
I don't have much to add, since I don't recall particulars at the moment. I have lots of stories of people with variable lucidity. But I get the feeling "terminal lucidity" isn't supposed to be variable lucidity which happens to be pre-terminal. And when someone sees/talks to something which isn't there, I (perhaps foolishly) am probably more likely to regard that as delirium or psychosis, than visions of the afterlife. ;)

I'll think on it, and see what I remember.

Linda
 
#9
I don't have much to add, since I don't recall particulars at the moment. I have lots of stories of people with variable lucidity. But I get the feeling "terminal lucidity" isn't supposed to be variable lucidity which happens to be pre-terminal. And when someone sees/talks to something which isn't there, I (perhaps foolishly) am probably more likely to regard that as delirium or psychosis, than visions of the afterlife. ;)

I'll think on it, and see what I remember.

Linda

I've been racking my brain for details in the one case I was involved in; I was not a direct eyewitness. From what I recall, and memory being what it is take this with a large grain of salt, the family of a young man with a GBM reported a significant improvement in his mental state a few hours before he died.

Actually I think most of the cases reported are exaggerated improvements in variable lucidity. All seem to involve delirium that considerably improves soon before death -- which, of course, raises the possibility that we focus on it as important because it immediately precedes death and there may simply be no more to it than variations in awareness that define delirium. Or, the mechanism causing death produces a change in the delirium.

Given the paucity of reported data I'm not sure I would make too much of it.

It does raise a few interesting issues, though, when it comes to various dualistic views. If one views the brain as a filter through which the mind functions, there should be no difference between mind as brain and mind expressing itself through brain (though mind is a separate entity); and if mind is completely separate from brain, why does this phenomenon occur so rarely?

I've never seen anything like it in folks in coma. It should be independent of injury mechanism if brain and mind are separate 'entities'; so, why does it never occur with hypoxia-ischemia?

So, Ian, the more I think about this the more I would stay away from it. We can't explain it precisely, and it would be extremely difficult to study the phenomenon; but it looks to me like evidence that could easily be used against you.
 
#10
Yeah, I was also struck by the suggestion that this phenomena be studied for use in anomalous consciousness research. I'm at a bit of a loss as to how this would be done, given it's highly sporadic and unpredictable nature. At best, a prospective cohort study could be undertaken to document whether or not it is different from exaggerated improvements in variable lucidity in the first place (i.e. is this actually a real phenomenon?).

Linda
 
#11
Yeah, I was also struck by the suggestion that this phenomena be studied for use in anomalous consciousness research. I'm at a bit of a loss as to how this would be done, given it's highly sporadic and unpredictable nature.
Do you get what anomalous means?
 
#12
Actually I think most of the cases reported are exaggerated improvements in variable lucidity. All seem to involve delirium that considerably improves soon before death -- which, of course, raises the possibility that we focus on it as important because it immediately precedes death and there may simply be no more to it than variations in awareness that define delirium. Or, the mechanism causing death produces a change in the delirium.
You might want to check out Peter Fenwick. I watched a video a ways back with him talking on Terminal Lucidity. Dementia/alzheimers was only one of many conditions mentioned. I seem to recall one case where somebody was paralyzed getting up out of bed shortly before death. So, there is probably more breadth to the phenemenon than just conditions involving cognitive decline.
 
#13
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#16
It can't happen! I refuse! The only way to verify is by having a death room where we have people die and study it in a lab.
Worse than that, there is no way to know from my post that what I am referring to was an anecdote, or something backed up by "evidence". I don't even remember, myself! It was just a friendly post providing suggestions to help somebody find additional, related material to a topic they were interested in.
 
#17
Worse than that, there is no way to know from my post that what I am referring to was an anecdote, or something backed up by "evidence". I don't even remember, myself! It was just a friendly post providing suggestions to help somebody find additional, related material to a topic they were interested in.
So it's your anecdote... about a possible anecdote?
 
#18
Do you get what anomalous means?
I was referring to the article by Nahm suggesting that these experiences could be used to look at explanations other than brain physiological processes (what I referred to as "anomalous"). I'm not sure what you're getting at.

Linda
 
#19
It can't happen! I refuse! The only way to verify is by having a death room where we have people die and study it in a lab.
This is the problem isn't it? If we concentrate on areas that are impossible to study scientifically (NDEs, terminal lucidity, deathbed visions etc) we can very easily claim dissatisfaction with any scientific explanations (because they are impossible to study scientifically, remember). To claim that all such events demonstrate "Psi" does appear, at least, lazy logic. LoneShaman uses similar "gap" arguments against Ethan in other threads and Ethan deals with them accordingly.


Let's try this another way round. What conclusions do you think we can draw from "terminal lucidity"?
 
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#20
This is the problem isn't it? If we concentrate on areas that are impossible to study scientifically (NDEs, terminal lucidity, deathbed visions etc) we can very easily claim dissatisfaction with any scientific explanations (because they are impossible to study scientifically, remember). To claim that all such events demonstrate "Psi" does appear, at least, lazy logic. Loneshaman uses similar "gap" arguments against Ethan in other threads and Ethan deals with them accordingly.


Let's try this another way round. What conclusions do you think we can draw from "terminal lucidity"?
Hm. Good question. Maybe we can infer that apparent loss of memory caused by dementia etc is sometime more a problem with the recall mechanism than a loss of memory? Just a thought.
 
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