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Eventually Dr. Sabom conducted an exhaustive investigation of Pam’s story. He obtained her records, including a timeline of the surgery and transcripts. He confirmed the conversation about her small veins, the description of the Midas Rex bone saw and its case. He confirmed the defibrillation, the number of doctors and nurses, even their position around the operating table.

I asked Pam’s neurosurgeon, Robert Spetzler, how he explains Pam’s perceptions.

“From a scientific perspective, I have absolutely no explanation about how it could have happened,” he replied.

What about the drugs, or neurotransmitters, creating hallucinations?

“Those are suspect, but not in this setting,” Spetzler said. “You can have patients who become hypoxic”—who have too little oxygen in the blood; in that situation, patients may experience hallucinations—“where you see yourself transported up into maybe a corner of the ceiling and you’re looking down on things. But in virtually every one of those settings, you have a warm body which is missing something— either not enough oxygen, or it’s metabolically missing something—or it is feverish. So that you can imagine all sorts of neurons firing in an unorganized fashion and it would give you an explanation.

“Here you have the opposite,” Spetzler continued. “Here you have the neurons in a depth of a sleepy state, of a suspended animation, that makes it very hard to think that it’s from active neural transmission.”

“So in your opinion,” I said, “what does Pam’s case say about consciousness, and whether it can be separate from the brain?”

“It comes down to the metaphysical,” the neurosurgeon reflected. “It comes down to the soul. It comes down to whether you’re religious and believe in these things. I think it is the ultimate arrogance for anyone, whether they’re a scientist, or anyone else, to say that something can’t be. I accept Pamela’s account, although I have no explanation of how it could have happened.”

Hallucinations and the Last Gasp of a Dying Brain

Gerald Woerlee believes he can explain it.

“It’s a total load of rubbish,” he said with a laugh.

The Australian anesthesiologist and author of Mortal Minds6 is one of the feistier debunkers of near-death experiences. When I reached him by phone,Woerlee told me the mind simply cannot perform when the brain is disabled. Pam Reynolds’s case, he said, crumbles under scrutiny.

First, he said, Pam awakened from the anesthesia when the surgeon began drilling her skull. Hence the “natural D.” In other words, she was conscious right up to the moment that her heart fully stopped, and during this semiconscious period, she underwent her out-of-body experience. She “floated” out of her body, he explained, when the bone saw vibrated her muscle spindles. These are the movement sensors associated with your muscles. You may have learned about these sensors when you were a child if you ever pressed your arms against a doorframe, stepped away, and felt your arms floating upward. Woerlee theorized that when the bone saw vibrated, the muscle spindles contracted and suddenly Pam felt herself moving upward until she was perched above the operating table.

Alternatively,Woerlee offered, oxygen deprivation could be the culprit : When Pam’s brain was gasping for oxygen, it began suffering from “hypoxic convulsions,” or epileptic activity, an electrical storm in the brain. Woerlee contended this stimulated the part of the brain that located Pam in space, and suddenly, her brain told her she was not on the operating table but up near the ceiling, looking down.

Many neurologists embraced the epileptic-seizure explanation, and indeed there appears to be a link between temporal lobe epilepsy and out-of-body experiences.7 Neurologists in Switzerland have even located a spot in the brain that sparks out-of-body experiences—and it is, of course, in the temporal lobe.8 British skeptic Susan Blackmore argues that the brain creates models of reality based on sensory impressions, and