What happens when we die: Is there a ‘third state’ beyond life and death?

Dr Christof Koch, a neuroscientist at the Allen Institute in Seattle, a leading brain research centre, knows a great deal about near-death experiences (NDEs) – where people report having mystical encounters after they were declared clinically dead, but then were successfully revived.

Dr Koch has spent 35 years studying consciousness: he is eminent in his field, the author of more than 350 scientific papers and many books.

But he knows NDEs intimately because, four years ago, he experienced one himself during a health emergency in the early days of COVID.

“It was utterly remarkable”’ he recalls.

“I saw a singularity of overwhelming brightness and felt terror and ecstasy.

“Nothing else – no body, no Christof, no self, no identity whatsoever. But also no world and no passage of time. Nothing except for the icy light,” he said recently.

“Nothing was left but a non-self… it [this ‘nonself’ he’d become] didn’t want anything, expect anything, think anything, remember anything, dread anything. But it [the non-self] experiences... It saw a cold, white light of unbearable intensity, unable to conceive of looking away, as there was no ‘away from’.”

There was “no smell, no pleasure, no pain”, just “a timeless universe convulsed to a blazing, icy light”.

Dr Koch, 67, says this experience has marked him for life – not least because he says he no longer has any fear of death (which is ‘not uncommon in people who have undergone an NDE’).

It has also made him a unique figure in an emerging new era of research into dying and death.

Death remains one of life’s greatest mysteries. But new scientific investigations into the bizarre medical phenomena that can arise when we approach death, and even afterwards, may start to unravel it (or make it even more mysterious, as we shall see).

This could help researchers develop new ways to cure debilitating illnesses such as cardiovascular disease and cystic fibrosis – and improve vastly resuscitation techniques and the care of the dying – within just five to ten years, according to some experts.

The latest discovery in this field of death science reveals something that sounds quite spooky, but which may soon offer revolutionary lifesaving cures: our own human cells can grow into microscopic new creatures after we die.

It’s not quite the afterlife as we might have imagined it, but nonetheless it is a discovery with extraordinary implications.

Scientists are also focusing on an astonishing phenomenon called “terminal lucidity” – where terminally ill patients who have long been unconscious suddenly rally into life and communicate happily with staff and visitors, shortly before dying.

And then there is the better known, but just as mysterious, near-death experience.

Such phenomena have traditionally been dismissed by doctors and scientists as just unaccountably weird, or simply invented or imagined.

Now leading experts are starting to take them very seriously.

All these strange phenomena raise the question whether the apparently solid boundaries between life and death are far more porous than modern science currently holds.

Renewed debate about what happens to us when we die has been sparked by a recent report by a group of eminent biologists in the US.

They argue that, as well as “alive’ and ‘dead”, there actually exists another condition called the “third state,” – which “lies beyond the traditional boundaries of life and death”.

The “third state” is a term coined by Peter Noble, a professor of microbiology at the University of Alabama at Birmingham in the US, and one of the authors of the report (published in the Physiology Journal).

As he explained to Good Health, in this state after we are clinically dead, our bodies’ individual cells can survive and reform themselves into new, multicell life forms that can replicate themselves – effectively breeding new life after death – and may even be able to repair other human tissues.

He says this intriguing ability of cells to survive Lazarus-like from dead creatures was first demonstrated three years ago by Michael Levin, a professor of biology at Tufts University in the US.

“He found that skin cells extracted from deceased frog tissue were able to adapt to the new conditions of a Petri dish, spontaneously reorganising themselves into multicellular organisms that could even replicate themselves,” explains Professor Noble.

“Not only that, these new creatures [called ‘xenobots’], could do much more than simply be skin cells – they used their cilia [small, hair like structures] to move through their surroundings, whereas in a living frog, cilia are typically used to move mucus around the creature’s slimy skin.”

If that were not astonishing enough, Professor Noble says that Professor Levin’s latest research, published in January in the journal Advanced Science, suggests that cells taken from a human windpipe also reorganised themselves into multicellular creatures, called “anthrobots”.

And when these anthrobots were placed in a Petri dish with damaged nerve tissue, they attempted to repair the nerves.

How could individual cells reinvent themselves from their previous existence in a living body?

One theory is that complex animals (and, ultimately, humans) evolved as single-celled creatures joined together to cooperate to create multicellular creatures.

This involved them giving up their autonomy to serve narrow roles within the multi-celled creature (rather like a multi-skilled craftsperson getting a job doing only one thing on a factory production line).

In reverse fashion, Professor Noble believes that when a multi-celled creature dies, their cells can revert to their previous individualistic states with all their old abilities, such as the frog cells’ swimming, and then reform in new ways that might enable them to survive their host’s death.

“We should not be surprised that human cells can do the same thing as ones from frogs,” he says.

“Who knows what can be created? Until now, we’ve never looked.”

Beyond showing that our cells are more resilient and resourceful than previously imagined, “these discoveries offer prospects for remarkable new treatments”, says Professor Noble.

He predicts that soon specially evolved medical anthrobots could be made from living patients’ own tissue and injected back into their bodies to perform specific tasks.

These could include repairing damaged spinal cords, clearing plaques in arteries and removing excess mucus from the airways of cystic fibrosis patients.

The anthrobots may also deliver medication, such as chemother apy, precisely where needed.

Such advances may come sooner rather than later: “I think we are five to ten years away from clinical applications,” says Professor Noble.

The fact that cells may survive clinical death may help not only create revolutionary therapies, but could also explain near death experiences.

NDEs are triggered by major events such as a heart attack, shock or suffocation.

Studies generally suggest that more than one in ten hospital patients who recover from being clinically dead through cardiac arrest recall having an NDE.

These experiences usually share much in common, such as becom ing painfree, seeing a bright light at the end of a tunnel, meeting deceased relations, or seeing one’s life flash in front of one’s eyes.

Not all NDEs are comforting.

In a 2019 study published in the journal Memory, 17 of the 123 patients who reported an NDE recounted seeing demons, visiting Hell or falling into terrifying voids.

Charlotte Martial, a neuroscientist at the University of Liège in Belgium, who co-authored the study, is now trying to verify patients’ claims about their out-of-body experiences during NDEs.

Around eight in ten people who’ve had an NDE report leaving their body, sometimes stating facts about their environment that they seemingly should not know.

To test this, Dr Martial has decorated a resuscitation room at Liege University Hospital with unexpected objects and images, some of which are hidden in places that could be viewed only from the vantage point of someone near the ceiling – she is then asking patients who report NDEs if they’d noticed anything unexpected in the room.

But what actually causes NDEs?

Professor Noble’s group cites a recent study of 11 cardiac arrest patients from the UK and US who reported having near-death experiences while their brains appeared clinically dead (i.e. where the electrical activity had flatlined).

However, as the journal Resuscitation reported, when the patients finally began to revive through doctors’ resuscitation efforts, their brains’ cells had survived so well – even after up to an hour without oxygen – that they experienced sudden spikes of the sort of activity normally associated with higher mental function, such as thinking and imagining.

The patients had also had typical NDEs.

One, for example, recalled, “I thought I heard my grandma [who had died] saying, ‘You need to go back’ “

Dr Sam Parnia, an associate professor of medicine at New York University who led this study, says that it shows these patients were experiencing “lucid consciousness” even though they seemed clinically dead, and that brain cells can survive and even continue to function during extended periods without oxygen.

A major implication, he says, is that “a lot of physicians are taught that after, say, three-to-five minutes of oxygen deprivation, the brain dies. Our study showed this is not true.”

He adds: “It showed that the brain may not be functioning, which is why they flatline. But if you’re able to resuscitate them appropriately, you can restore activity up to an hour later.”

Conventional medicine is writing off these patients prematurely, he argues.

“Nobody has tried to find treatments or new ways to restart the heart or prevent brain injury. They think it’s futile.

“Our work opens the window to developing cocktails of drugs that could be given to patients who have technically gone through death to bring them back to life again.”

But why do patients whose brains are clinically dead report mystical NDEs?

Dr Parnia’s theory is that when the dying brain flatlines, the normal “brakes” come off our brain cells’ control systems this disinhibition may then open access to “new dimensions of reality, including lucid recall of stored memories from early childhood to death”.

But other leading investigators disagree.

Dr Koch, whose own NDE inspired his new book, Then I Am Myself The World: What Consciousness Is And How To Expand It, argues that this research doesn’t show patients were having NDEs while their brains were flatlined.

He says: “They could have had these memories come to them later, before they fully returned to consciousness. The patients wouldn’t be able to know when the NDEs had happened.”

Instead Dr Koch (who said “I hope I will never again have to undergo [another such experience] as it is utterly terrifying”) suggests that these experiences may occur as dying brains effectively have the bounds of their egos fall away, along with their sense of space and time.

In this way people undergoing an NDE experience what he calls “mind at large”, a form of consciousness that may pervade the entire universe.

While this may sound mystical or religious, Dr Koch believes that consciousness is a physical quality of the universe, just like magnetism, gravity or any of the forces proposed by quantum physics.

“Therefore all this may be explained scientifically one day,” he says. “But not yet. Nothing in the current laws of physics, chemistry or biology explains consciousness. Yet here we are, seeing, hearing, feeling.”

More mysterious still, perhaps, is another death-related anomaly that scientists are beginning to take seriously, called terminal lucidity.

Over the past 250 years, physicians have recorded cases of terminally ill and long unconscious patients suddenly rallying into life, communicating with medics and family, but then dying shortly afterwards.

Commonly, these patients are the least likely to rally – those who’ve suffered prolonged, irreversible brain decline as a result of meningitis, dementia, stroke or brain tumours, for instance.

Terminal lucidity incidents may also be very common.

In a survey of nursing-home caregivers, 79 per cent reported they’d witnessed patients who’d been in deep comas suddenly rouse and coherently say their goodbyes before dying, reported the journal Archives of Gerontology and Geriatrics in 2010.

Some experts have suggested this might, oddly, reflect cultural values deeply ingrained over a lifetime that it’s polite to say “goodbye”.

But if terminal lucidity were culturally ingrained, it wouldn’t happen in very young children.

Yet earlier this year, case reports from two paediatric hospitals showed that terminal lucidity can occur in children as young as two, reported the Journal of Nervous and Mental Disease.

One three-year-old girl was in end-of-life care for an autoimmune disease: one evening after a fortnight’s unresponsiveness she began talking with her parents, which they and the nurse described as “like a miracle”.

She talked to all of the important people in her life, spoke of her impending death, and reassured loved ones of the need not to be concerned about her.

She also seemed to be communicating with people who were not visible to others.

After several hours, she asked to “go to bed” and she returned to her comatose state.

After 48 hours, she died in her parents’ arms.

“Children so young would not be expected to have the cultural conditioning or developmental capacity to understand the concepts of death and dying, nor be aware of the emotional impact of their impending death upon their parents,” researchers said.

Chris Roe, a professor of psychology at the University of Northampton and one of the report’s co-authors, told Good Health that terminal lucidity has clear parallels with NDEs.

“But there is an extra layer – it involves people whose conditions are usually regarded as irreversibly deteriorated,” he says.

“It is very difficult to imagine how they could suddenly and briefly get better.

“People often think that they are miracle recoveries but they typically are not. Instead, they are the precursor to death.”

Such experiences can be a double-edged sword for loved ones, adds Professor Roe.

“With dying children it can be especially heart-rending,” he says.

“But, conversely, if you have a child who dies with grace and serenity, it can be a considerable comfort.

“After the initial shock of witnessing what they’ve seen, parents are usually extremely glad about what happened.”

Beyond examining the emotional experiences, Professor Roe says that scientists have a duty to understand terminal lucidity and its biological implications.

“We need to study a lot more cases to verify this as a medical condition and explore what underlies it,” he says.

“We are very open to the idea that we can explain it biologically or neurologically. Nevertheless its explanation may lay beyond the realms of current science.”

He adds: “We believe that terminal lucidity is not rare – many nurses tell us they have seen such things often, though they won’t discuss it with medical colleagues for fear of being dismissed as silly.”

Professor Noble adds: “I’ve lost count of the number of times that people have reacted by calling this work ‘Frankenstein science”. But I don’t mind, because it sparks public interest in what’s being done here to explore something mysterious – something that could prove vitally important to our lives.”