We’ve seen it in the movies, and it’s a generally understood by the wider non-medical community (that is, normal people like us), that a body’s time of death is called when a heartbeat can’t be detected.
After all, the concept of “flatlining” is the basis for one of the most important (ahem) movies ever made: Flatliners (1990), which is about a group of students playing with death.
The movie is just another one of the many things we have to be grateful for from 90s hearthrob, Keifer Sutherland…
Anyway, you get the point.
A palliative care nurse shares top five regrets of the dying. Post continues.
Fast forward almost 30 years from that medical milestone (yes, we’re ignoring the 2017 ‘reboot’ of the film) and we encounter a team of researchers at New York University, who believe that when a heart stops beating, it may not be the end of the (grey) matter (excuse the pun).
The group of scientists have discovered that the brain can function after the heart stops beating, by examining what happened with patients who died and were brought back to life. The study, looking at cases in Europe and the United States where a cardiac arrest occurred, is the largest study of its kind, according to Dr. Sam Parnia, director of critical care and resuscitation research at NYU Langone School of Medicine in New York City.
Speaking to website LiveScience, the doctor explained that, “in the vast majority of terminal cases, physicians medically define death based on when the heart no longer beats.”
But his researchers have found that even though the brain starts to die immediately after the heart stops pumping, people can remain partially conscious. Dr Parnia’s team have discovered that patients who have been ‘brought back’ can describe details of some of the things that were happening around them when they were technically dead – which of course, indicates some form of ongoing brain function. And, crucially, their accounts have been verified by the medical staff with them.
“They’ll describe watching doctors and nurses working; they’ll describe having awareness of full conversations, of visual things that were going on, that would otherwise not be known to them,” Dr. Parnia said.
Meaning that a patient can potentially understand they are ‘dead’, and are being saved.
So, how does this happen? It’s all about looking at death as a “trajectory”, Dr Parnia explained. Put basically, death is a process of cells slowing down and dying – it’s not an instant end to all electrical activity.
“The brain’s cerebral cortex — the so-called ‘thinking part’ of the brain — slows down instantly, and flatlines, meaning that no brainwaves are visible on an electric monitor, within two to 20 seconds. This initiates a chain reaction of cellular processes that eventually result in the death of brain cells, but that can take hours after the heart has stopped,” Dr Parnia said.
And when CPR is performed successfully – meaning when the heart starts pumping again – “you’ll gradually get the brain functioning again.” Which is why patients can sometimes ‘come back’ without any long-term brain function impairment, and clarity about what happened to them.
If this all sounds a little too 90s thriller-film-ish to you, there’s a less morbid aspect to all of this. Dr Parnia said that patients who experience this transitional state often have a new appreciation for life afterwards.
“They become more altruistic, more engaged with helping others. They find a new meaning to life having had an encounter with death.”
Well, that’s comforting.