“Coming Back from the Dead” Is No Longer Science Fiction
Last year, there were widespread reports of a 53-year-old Frenchman who had suffered a cardiac arrest and "died," but was then resuscitated back to life 18 hours after his heart had stopped.
The once black-and-white line between life and death is now blurrier than ever.
This was thought to have been possible in part because his body had progressively cooled down naturally after his heart had stopped, through exposure to the outside cold. The medical team who revived him were reported as being "stupefied" that they had been able to bring him back to life, in particular since he had not even suffered brain damage.
Interestingly, this man represents one of a growing number of extraordinary cases in which people who would otherwise be declared dead have now been revived. It is a testament to the incredible impact of resuscitation science -- a science that is providing opportunities to literally reverse death, and in doing so, shedding light on the age-old question of what happens when we die.
Death: Past and Present
Throughout history, the boundary between life and death was marked by the moment a person's heart stopped, breathing ceased, and brain function shut down. A person became motionless, lifeless, and was deemed irreversibly dead. This is because once the heart stops beating, blood flow stops and oxygen is cut off from all the body's organs, including the brain. Consequently, within seconds, breathing stops and brain activity comes to a halt. Since the cessation of the heart literally occurs in a "moment," the philosophical notion of a specific point in time of "irreversible" death still pervades society today. The law, for example, relies on "time of death," which corresponds to when the heart stops beating.
The advent of cardiopulmonary resuscitation (CPR) in the 1960s was revolutionary, demonstrating that the heart could potentially be restarted after it had stopped, and what had been a clear black-and-white line was shown to be potentially reversible in some people. What was once called death—the ultimate end point— was now widely called cardiac arrest, and became a starting point.
From then on, it was only if somebody had requested not to be resuscitated or when CPR was deemed to have failed that people would be declared dead by "cardiopulmonary criteria." Biologically, cardiac arrest and death by cardiopulmonary criteria are the same process, albeit marked at different points in time depending on when a declaration of death is made.
The apparent irreversibility of death as we know it may not necessarily reflect true irretrievable cellular damage inside the body.
Clearly, contrary to many people's perceptions, cardiac arrest is not a heart attack; it is the final step in death irrespective of cause, whether it be a stroke, a heart attack, a car accident, an overwhelming infection or cancer. This is how roughly 95 percent of the population are declared dead.
The only exception is the small proportion of people who may have suffered catastrophic brain injuries, but whose hearts can be artificially kept beating for a period of time on life-support machines. These people can be legally declared dead based on brain death criteria before their hearts have stopped. This is because the brain can die either from oxygen starvation after cardiac arrest or from massive trauma and internal bleeding. Either way, the brain dies hours or possibly longer after these injuries have taken place and not just minutes.
A Profound Realization
What has become increasingly clear is that the apparent irreversibility of death as we know it may not necessarily reflect true irretrievable cellular damage inside the body. This is consistent with a mounting understanding: it is only after a person actually dies that the cells in the body start to undergo their own process of death. Intriguingly, this process is something that can now be manipulated through medical intervention. Being cold is one of the factors that slows down the rate of cellular decay. The 53-year-old Frenchman's case and the other recent cases of resuscitation after prolonged periods of time illustrate this new understanding.
Last week's earth-shattering announcement by neuroscientist Dr. Nenad Sestan and his team out of Yale, published in the prestigious scientific journal Nature, provides further evidence that a time gap exists between actual death and cellular death in cadavers. In this seminal study, these researchers were able to restore partial function in pig brains four hours after their heads were severed from their bodies. These results follow from the pioneering work in 2001 of geneticist Fred Gage and colleagues from the Salk Institute, also published in Nature, which demonstrated the possibility of growing human brain cells in the laboratory by taking brain biopsies from cadavers in the mortuary up to 21 hours post-mortem.
The once black-and-white line between life and death is now blurrier than ever. Some people may argue this means these humans and pigs weren't truly "dead." However, that is like saying the people who were guillotined during the French Revolution were also not dead. Clearly, that is not the case. They were all dead. The problem is not death; it's our reliance on an outdated philosophical, rather than biological, notion of death.
Death can no longer be considered an absolute moment but rather a process that can be reversed even many hours after it has taken place.
But the distinction between irreversibility from a medical perspective and biological irreversibility may not matter much from a pragmatic perspective today. If medical interventions do not exist at any given time or place, then of course death cannot be reversed.
However, it is crucial to distinguish between biologically and medically: When "irreversible" loss of function arises due to inadequate treatment, then a person could be potentially brought back in the future when an alternative therapy becomes available, or even today if he or she dies in a location where novel treatments can slow down the rate of cell death. However, when true irreversible loss of function arises from a biological perspective, then no treatment will ever be able to reverse the process, whether today, tomorrow, or in a hundred years.
Probing the "Grey Zone"
Today, thanks to modern resuscitation science, death can no longer be considered an absolute moment but rather a process that can be reversed even many hours after it has taken place. How many hours? We don't really know.
One of the wider implications of our medical advances is that we can now study what happens to the human mind and consciousness after people enter the "grey zone," which marks the time after the heart stops, but before irreversible and irretrievable cell damage occurs, and people are then brought back to life. Millions have been successfully revived and many have reported experiencing a unique, universal, and transformative mental state.
Were they "dead"? Yes, according to all the criteria we have ever used. But they were able to be brought back before their "dead" bodies had reached the point of permanent, irreversible cellular damage. This reflects the period of death for all of us. So rather than a "near-death experience," I prefer a new terminology to describe these cases -- "an actual-death experience." These survivors' unique experiences are providing eyewitness testimonies of what we will all be likely to experience when we die.
Such an experience reportedly includes seeing a warm light, the presence of a compassionate perfect individual, deceased relatives, a review of their lives, a judgment of their actions and intentions as they pertain to their humanity, and in some cases a sensation of seeing doctors and nurses working to resuscitate them.
Are these experiences compatible with hallucinations or illusions? No -- in part, because these people have described real, verifiable events, which, by definition are not hallucinations, and in part, because their experiences are not compatible with confused and delirious memories that characterize oxygen deprivation.
The challenge for us scientifically is understanding how this is possible at a time when all our science tells us the brain shuts down.
For instance, it is hard to classify a structured meaningful review of one's life and one's humanity as hallucinatory or illusory. Instead, these experiences represent a new understanding of the overall human experience of death. As an intensive care unit physician for more than 10 years, I have seen numerous cases where these reports have been corroborated by my colleagues. In short, these survivors have been known to come back with reports of full consciousness, with lucid, well-structured thought processes and memory formation.
The challenge for us scientifically is understanding how this is possible at a time when all our science tells us the brain shuts down. The fact that these experiences occur is a paradox and suggests the undiscovered entity we call the "self," "consciousness," or "psyche" – the thing that makes us who we are - may not become annihilated at the point of so-called death.
At New York University, the State University of New York, and across 20 hospitals in the U.S. and Europe, we have brought together a new multi-disciplinary team of experts across many specialties, including neurology, cardiology, and intensive care. Together, we hope to improve cardiac arrest prevention and treatment, as well as to address the impact of new scientific discoveries on our understanding of what happens at death.
One of our first studies, Awareness during Resuscitation (AWARE), published in the medical journal Resuscitation in 2014, confirmed that some cardiac arrest patients report a perception of awareness without recall; others report detailed memories and experiences; and a few report full auditory and visual awareness and consciousness of their experience, from a time when brain function would be expected to have ceased.
While you probably have some opinion or belief about this based upon your own philosophical, religious, or cultural background, you may not realize that exploring what happens when we die is now a subject that science is beginning to investigate.
There is no question more intriguing to humankind. And for the first time in our history, we may finally uncover some real answers.
“Siri, Read My Mind”: A New Device Lets Users Think Commands
Sometime in the near future, we won't need to type on a smartphone or computer to silently communicate our thoughts to others.
"We're moving as fast as possible to get the technology right, to get the ethics right, to get everything right."
In fact, the devices themselves will quietly understand our intentions and express them to other people. We won't even need to move our mouths.
That "sometime in the near future" is now.
At the recent TED Conference, MIT student and TED Fellow Arnav Kapur was onstage with a colleague doing the first live public demo of his new technology. He was showing how you can communicate with a computer using signals from your brain. The usually cool, erudite audience seemed a little uncomfortable.
"If you look at the history of computing, we've always treated computers as external devices that compute and act on our behalf," Kapur said. "What I want to do is I want to weave computing, AI and Internet as part of us."
His colleague started up a device called AlterEgo. Thin like a sticker, AlterEgo picks up signals in the mouth cavity. It recognizes the intended speech and processes it through the built-in AI. The device then gives feedback to the user directly through bone conduction: It vibrates your inner ear drum and gives you a response meshing with your normal hearing.
Onstage, the assistant quietly thought of a question: "What is the weather in Vancouver?" Seconds later, AlterEgo told him in his ear. "It's 50 degrees and rainy here in Vancouver," the assistant announced.
AlterEgo essentially gives you a built-in Siri.
"We don't have a deadline [to go to market], but we're moving as fast as possible to get the technology right, to get the ethics right, to get everything right," Kapur told me after the talk. "We're developing it both as a general purpose computer interface and [in specific instances] like on the clinical side or even in people's homes."
Nearly-telepathic communication actually makes sense now. About ten years ago, the Apple iPhone replaced the ubiquitous cell phone keyboard with a blank touchscreen. A few years later, Google Glass put computer screens into a simple lens. More recently, Amazon Alexa and Microsoft Cortana have dropped the screen and gone straight for voice control. Now those voices are getting closer to our minds and may even become indistinguishable in the future.
"We knew the voice market was growing, like with getting map locations, and audio is the next frontier of user interfaces," says Dr. Rupal Patel, Founder and CEO of VocalID. The startup literally gives voices to the voiceless, particularly people unable to speak because of illness or other circumstances.
"We start with [our database of] human voices, then train our deep learning technology to learn the pattern of speech… We mix voices together from our voice bank, so it's not just Damon's voice, but three or five voices. They are different enough to blend it into a voice that does not exist today – kind of like a face morph."
The VocalID customer then has a voice as unique as he or she is, mixed together like a Sauvignon blend. It is a surrogate voice for those of us who cannot speak, just as much as AlterEgo is a surrogate companion for our brains.
"I'm very skeptical keyboards or voice-based communication will be replaced any time soon."
Voice equality will become increasingly important as Siri, Alexa and voice-based interfaces become the dominant communication method.
It may feel odd to view your voice as a privilege, but as the world becomes more voice-activated, there will be a wider gap between the speakers and the voiceless. Picture going shopping without access to the Internet or trying to eat healthily when your neighborhood is a food desert. And suffering from vocal difficulties is more common than you might think. In fact, according to government statistics, around 7.5 million people in the U.S. have trouble using their voices.
While voice communication appears to be here to stay, at least for now, a more radical shift to mind-controlled communication is not necessarily inevitable. Tech futurist Wagner James Au, for one, is dubious.
"I'm very skeptical keyboards or voice-based communication will be replaced any time soon. Generation Z has grown up with smartphones and games like Fortnite, so I don't see them quickly switching to a new form factor. It's still unclear if even head-mounted AR/VR displays will see mass adoption, and mind-reading devices are a far greater physical imposition on the user."
How adopters use the newest brain impulse-reading, voice-altering technology is a much more complicated discussion. This spring, a video showed U.S. House Speaker Nancy Pelosi stammering and slurring her words at a press conference. The problem is that it didn't really happen: the video was manufactured and heavily altered from the original source material.
So-called deepfake videos use computer algorithms to capture the visual and vocal cues of an individual, and then the creator can manipulate it to say whatever it wants. Deepfakes have already created false narratives in the political and media systems – and these are only videos. Newer tech is making the barrier between tech and our brains, if not our entire identity, even thinner.
"Last year," says Patel of VocalID, "we did penetration testing with our voices on banks that use voice control – and our generation 4 system is even tricky for you and me to identify the difference (between real and fake). As a forward-thinking company, we want to prevent risk early on by watermarking voices, creating a detector of false voices, and so on." She adds, "The line will become more blurred over time."
Onstage at TED, Kapur reassured the audience about who would be in the driver's seat. "This is why we designed the system to deliberately record from the peripheral nervous system, which is why the control in all situations resides with the user."
And, like many creators, he quickly shifted back to the possibilities. "What could the implications of something like this be? Imagine perfectly memorizing things, where you perfectly record information that you silently speak, and then hear them later when you want to, internally searching for information, crunching numbers at speeds computers do, silently texting other people."
"The potential," he concluded, "could be far-reaching."
There's no shortage of fake news going around the internet these days, but how do we become more aware as consumers of what's real and what's not?
"We are hoping to create what you might call a general 'vaccine' against fake news, rather than trying to counter each specific conspiracy or falsehood."
Researchers at the University of Cambridge may have answered just that by developing an online game designed to expose and educate participants to the tactics used by those spreading false information.
"We wanted to see if we could preemptively debunk, or 'pre-bunk', fake news by exposing people to a weak dose of the methods used to create and spread disinformation, so they have a better understanding of how they might be deceived," Dr Sander van der Linden, Director of the Cambridge Social Decision-Making Lab, said in a statement.
"This is a version of what psychologists call 'inoculation theory', with our game working like a psychological vaccination."
In February 2018, van der Linden and his coauthor, Jon Roozenbeek, helped launch the browser game, "Bad News," where players take on the role of "Disinformation and Fake News Tycoon."
They can manipulate news and social media within the game by several different methods, including deploying twitter-bots, photo-shopping evidence, creating fake accounts, and inciting conspiracy theories with the goal of attracting followers and maintaining a "credibility score" for persuasiveness.
In order to gauge the game's effectiveness, players were asked to rate the reliability of a number of real and fake news headlines and tweets both before and after playing. The data from 15,000 players was evaluated, with the results published June 25 in the journal Palgrave Communications.
The results concluded that "the perceived reliability of fake news before playing the game had reduced by an average of 21% after completing it. Yet the game made no difference to how users ranked real news."
Just 15 minutes of playing the game can have a moderate effect on people, which could play a major role on a larger scale.
Additionally, participants who "registered as most susceptible to fake news headlines at the outset benefited most from the 'inoculation,'" according to the study.
Just 15 minutes of playing the game can have a moderate effect on people, which could play a major role on a larger scale when it comes to "building a societal resistance to fake news," according to Dr. van der Linden.
"Research suggests that fake news spreads faster and deeper than the truth, so combating disinformation after-the-fact can be like fighting a losing battle," he said.
"We are hoping to create what you might call a general 'vaccine' against fake news, rather than trying to counter each specific conspiracy or falsehood," Roozenbeek added.
Van der Linden and Roozenbeek's work is an early example of the potential methods to protect people against deception by training them to be more attuned to the methods used to distribute fake news.
"I hope that the positive results give further credence to the new science of prebunking rather than only thinking about traditional debunking. On a larger level, I also hope the game and results inspire a new kind of behavioral science research where we actively engage with people and apply insights from psychological science in the public interest," van der Linden told leapsmag.
"I like the idea that the end result of a scientific theory is a real-world partnership and practical tool that organizations and people can use to guard themselves against online manipulation techniques in a novel and hopefully fun and engaging manner."
Ready to be "inoculated" against fake news? Then play the game for yourself.