What Did My Dad Think and Feel in the Moments of His Death?

Source: Photo courtesy Pavel Danilyuk

There are two types of death: cardiac and circulatory. Death is either when blood circulation or brain function irreversibly ceases. Both will happen; it's a matter of which occurs first.

Brain death is less common and occurs after the brain has been so badly damaged that it swells, cutting off blood flow, and permanently stops, for example, following a head injury or a stroke.

Circulatory death, where the heart comes to a standstill, is far more common.

In a sudden cardiac arrest, it can take a minute—or even two—for brain cells to die when they have no blood flow. This means, on some level, the brain remains active after a circulatory death. There is scientific evidence that the brain becomes unusually active, even after cardiac death. ¹

My father died of sudden cardiac arrest, and even after 35 years, I am plagued by the question: What did he think of in the minutes surrounding his death? He left me when I was just 11, divorced my mother, immediately remarried, and adopted his second wife’s daughter. I was tossed out. Discarded. We had a lot of unfinished business.

Decades later, when I was in the hospital for a severe septic infection, I thought about my possible death as well as my father’s. Sepsis—a whole-body, blood inflammation—has a mortality rate estimated between 25 and 50 percent. Sepsis is the leading cause of death in hospitalized patients. It claims 220,000 American lives each year and is also the most expensive disease to treat in the hospital, costing approximately $17 billion each year. ²

My septicemia was caused by an onslaught of hyper-CVAD chemotherapy for mantle cell lymphoma. My white blood cell counts were so low that my body could no longer fight infection—even from my intestinal tract. The sequelae of this was a rare growth of escherichia coli that invaded my bloodstream. ³

In my hospital room, I begged for blankets to stop the teeth-chattering chills. My husband, Dan, pulled them around me, but still, I shook. Then, burning up, I threw them off and begged for ice. The room was sweltering, or, no, maybe it was freezing. Dan lay in a recliner. The night was endless and an agony. Before dawn, I sat up and watched my husband sleep.

The last time I saw my father, he lay in a mortuary and slept as well—the long, dreamless sleep from which no one wakes. He’d died two evenings before of a heart attack. At just sixty. So suddenly, he never got to say I love you, or goodbye, or thank you to anyone. Through these last tormented hours, at least I’d been able to tell my husband I loved him.

The July evening my dad died, he’d come home from his engineering firm and, after dinner, as he’d done so many times before, watered his backyard garden. His second wife found him. Perhaps she’d heard a strange sound or just noticed him gone. Maybe the hose was still running. I never asked. These were intimate details, and I didn’t think she would want me probing into the private moments surrounding my father’s death. The paramedics failed to resuscitate him.

Was his death painful or so quick he didn’t notice? Did he call someone’s name? Who did he think of? Was it me? My mother? What was the last thing he felt? Remorse? Fear? Nothing? Peace?

Putting my hands to my throbbing temples, I sensed a frequency, a tone. What was I hearing? Was death a sound? Did it just slip in and separate the life from the body? I feared that death might be that simple, that quick, that incontestable. Did my father hear this tone in his garden the evening he died?

My hands swept over the humid sheet. The feel of dampness, warmth, and soft cotton, calmed me. My husband’s steady breathing calmed me. Even pain calmed me. I was still here, in my body. But in my feverish dream state, I couldn’t leave the questions alone: Did my father sense his death? Will I sense mine? Does death have the same shape, sound, and smell for everyone?

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Did his failures, weaknesses, his inability to express love haunt him at the moment of his death? And what will be my burden? My regret? Who or what will I think of in the instant of my death? How will I feel in that moment when we all legendarily see our lives pass before our eyes?

Studies of the brain indicate answers to those questions. Research confirms that our entire metabolic system is run by the brain; it directs everything. This is why sometimes, just before death, a person can snap into a moment of clarity where they say something that can be very profound. Mark Boughey, director of palliative medicine at Melbourne's St Vincent's Hospital, says, "It's just the natural physiology. The brain is trying to keep functioning." ¹

Other research points to evidence that the sharpening of the senses some people report also seems to match what we know about the brain’s response to dying. Jimo Borjigin, a neuroscientist at the University of Michigan, first became intrigued by this subject when she noticed something strange in the brains of animals. Just before the animals died, neurochemicals in the brain suddenly surged. Although scientists had known that brain neurons continued to fire after a person died, this was different. The neurons were secreting new chemicals, and in large amounts.

“A lot of cardiac-arrest survivors describe that during their unconscious period, they have this amazing experience in their brain,” Borjigin said. “They see lights and then they describe the experience as ‘realer than real.’” She realized that the sudden release of neurochemicals might help to explain this phenomenon.

Borjigin and her research team tried an experiment. They anesthetized eight rats then stopped their hearts. “Suddenly, all the different regions of the brain became synchronized,” she said. The rats’ brains showed higher power in different frequency waves and also what is known as coherence—the electrical activity from different parts of the brain working together.

“If you’re focusing attention, doing something, trying to figure out a word or trying to remember a face—when you’re doing a high-level cognitive activity, these features go up,” Borjigin said. “These are well-used parameters in studying human consciousness in awake humans. So, we thought, if you’re alert or aroused, similar parameters should also go up in the dying brain. That was the case.” ⁴

Another study, published in Frontiers in Human Neuroscience, suggests that when the following experiences occur varies from person to person:

• A hyper-aware mental state, or very clear consciousness. This may be in a waking or dream state.
• An out-of-body experience, usually in the form of you hovering above your deathbed. Possibly caused by your brain’s temporoparietal junction (TPJ) being damaged from a lack of oxygen.
• Your life flashing before your eyes. Many people see significant moments in their life playback for them.
• A reunion with lost loved ones—sometimes even with ancestors you never met in life. Lack of oxygen to the brain can cause hallucinations.
• An overwhelming sense of peace and rest, possibly triggered by a rush of endorphins.
• A bright white light at the end of a tunnel. The bright light can be due to our visual system being flooded with carbon dioxide, causing significant sensitivity to light.

According to near-death survivors, these experiences make death acceptable, even welcoming. “We may never know for certain what’s beyond death if anything at all, but you can at least rest easy knowing your brain will try to make it as comfortable as possible.” ⁵

Well before these scientific studies and breakthroughs, Leo Tolstoy wrote The Death of Ivan Ilych. In his final moments, "’some force’ strikes Ivan in the chest and side, and he is brought into the presence of a bright light. His hand falls onto his nearby son's head, and Ivan pities his son. He no longer hates his daughter or wife but rather feels pity for them and hopes his death will release them. In so doing, his terror of death leaves him, and as Tolstoy suggests, death itself disappears.” ⁶

During these moments of enhanced consciousness, did my father see his life and think he might have done something different/better? I will never know (well, probably not). And, despite our unfinished business, I hope his last moments were a solace. Comfort is what I want for him as it is what I wish for myself. Science knows: The coherence of the brain is our friend.