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In this episode, we delve into a fascinating yet often overlooked medical phenomenon—near-death experiences (NDEs)—with John C. Hagan III, an ophthalmologist and expert on the subject. Despite being reported by as many as one in five patients who survive critical medical events, NDEs remain absent from most medical curricula, leaving physicians unprepared to recognize and support patients through these transformative experiences. John discusses the key features of NDEs, their impact on patients and families, and why it’s crucial for health care professionals to ask, listen, validate, and educate.
John C. Hagan III is an ophthalmologist.
He discusses the KevinMD article, “What you need to know about near-death experiences.”
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Transcript
Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today, we welcome back John Hagan. He’s an ophthalmologist, and today’s KevinMD article is, “What You Need to Know About Near-Death Experiences.” John, welcome back to the show.
John C. Hagan III: Thank you, Kevin. Thanks for inviting me. I want to tell everyone today, especially the physicians, that what we’re going to be talking about today is a clinical syndrome.
This is relevant to your everyday practice. Although there is a preternatural, supernatural content to a near-death experience, what we will be keying in on is a medical syndrome that is extremely common. Some estimates say as many as 20 million people in the United States have had a near-death experience.
And how you should handle it makes a big difference. For your patient, this is the most real, most important thing that ever occurs in their life. And there are two types of near-death experiences. One is heavenly, where they go to a heavenly place and meet with a deity. They come back a changed and better person.
That person could probably survive your neglect, but at least 10 percent of near-death experiences are distressing, and they’re the antithesis of the heavenly experience. So from the get-go, the patient feels enmity and evil in the world. They go to a hellish place. They meet with an entity most people would call the devil, and they come back fearful. These are the people who need us the most.
So, let me tell you just a little bit about my credentials and why Kevin invited you to talk with me today. Like most physicians, I was not taught anything about near-death experiences. And I personally have not had a near-death experience, but I have had over 50 people describe their near-death experiences to me, including four physicians.
Of the physicians, three had a positive or a heavenly experience, but one of them had a hellish or damnation experience and sought some solace from me. So, I have a friend that I went to college with, and we both like to read, and he lives in the same general neighborhood. When we see one another, we usually ask what the other person is reading.
So, I was at a party, and he said, “John, you’re a doctor. What do you think about near-death experiences?” And I said, “What do you mean?” He said, “You know, people die or almost die, and they go to heaven, and they come back, and they’re a changed person. It’s really fascinating. What do you doctors think about that?”
And I said, “You know, hey, I’m pretty much clueless.” So, he said, “Why don’t you read my book?” The book was Evidence of the Afterlife by Dr. Jeffrey Long. Dr. Jeffrey Long is a radiation oncologist who runs the Near Death Research Foundation and has over 2,500 case reports. So, I read my friend’s book and thought, “Wow, this is fascinating.”
So, I read and read and read, and then at some point, it clicked: “Hey, this is something that doctors need to know about. This is a medical syndrome, and we should learn more.” One of the things that I do is, for the last 24 years, I’ve been the editor of Missouri State Medical Journal, Missouri Medicine.
That’s a 120-year-old, prize-winning, indexed, peer-reviewed journal with faculty from six medical schools on it. Since this had never been done before, and it still hasn’t, where a peer-reviewed medical journal runs a series of articles educating physicians on near-death experiences, I pitched the contributing editors, much as I’m pitching you today, and they said, “Yeah, we got it. It’s a syndrome. Go for it.”
And because this had never been done before, I started at the top and asked all the world’s experts, and they all said yes. So, we started the series in 2013 and ran it through 2015 to great acclaim. Shortly after the series closed, the University of Missouri Press contacted me and said, “Hey, can you turn this into a book?”
So, we contacted the authors, they updated it, and it came out in 2017. It’s called The Science of Near Death Experiences, and it remains, I believe, the only textbook for physicians.
So, let me describe, give you a case history of a near-death experience. And this is typical. It’s actually one of my neighbors. We had a neighborhood party, and he had read the newspaper about the book and asked if he could speak to me in private.
So, he’s a 52-year-old Italian male. He worked for the Federal Reserve, and he was at a local hospital, having abdominal surgery. When the surgeons encountered uncontrollable bleeding, he was in the black hole of anesthesia, and suddenly he came out of his body. He felt at peace; he felt love; he felt timeless. What he describes as his soul—this patient is a very devout Catholic—what he describes as his soul rose above the operating table to the ceiling. He looked down on this chaotic scene where the surgeons were trying to stem the bleeding, hollering for blood, and he realized at that point that his body was not himself, that it was sort of a carrier, and that his soul had exited, much the same way we get out of our car.
We understand the car; we were in the car, but that’s not us. And he ascended through a tunnel of light to a heavenly place. He describes it as wonderful. He met departed friends, most importantly, his mother. They had a joyful reunion. And it’s kind of funny. He said, “Dr. Hagan, this is the Catholic heaven. It’s really great.”
With his mother, he met with God. Parenthetically, when people have these experiences, they are seen in the context of their cultural and religious experience. So, Catholics, for instance, see a Christian God. They often see the Virgin Mary. Jewish people don’t see the Virgin Mary. Muslims, Buddhists—it’s cast in the colors of their religion, but it has a strong essential component.
So, he met with the deity in company with his mother. He had a life review. He realized all the good things he’d done and all the bad things he’d done. Love was the most important thing, and then God and his mother said, “It’s not your time. You have to go back.” He didn’t want to go back, but they said, “You need to go back.”
So, almost instantaneously, he woke up in pain and discomfort in the ICU unit. He spent seven or eight days in pain and discomfort. While he was there, he told the nurses and the doctors about this near-death experience. Typically, what they said was, “That didn’t happen. Your brain wasn’t getting enough oxygen.” He kept talking about it, and finally, one of his doctors said, “You know, you really shouldn’t tell people about this because they’re going to think you’re psychotic.”
So, he was deeply upset. Now, here’s the kicker. He went to Italy, where he had relatives. And in the course of his visit, he described the near-death experience to a physician over there.
The physician said, “Yeah, you had a near-death experience. They’re very common. Lots of people have them. Most people find them enlightening and life-changing. They reduce the fear of death.”
The patient was angry at his American physicians. Europeans are far, far ahead of us in terms of recognition and treatment. So much so that they’ve done prospective studies in Europe. Dr. Pim Van Lommel, who wrote one of the chapters in our book, has done this. They take a referral medical center, and for a given period, say two months, any patient that almost dies in the ICU, the emergency room, or a coordinated care unit and has to be resuscitated—after they recover, they send in someone who’s part of the study. They basically say, “When you almost died, did anything unusual happen to you that you’d like to talk about?”
That’s called systemic thoughtful inquiry. When you do that, 20 percent of the people who almost died reported a near-death experience, not with prompting, but with questioning. They stopped doing that, and they took a similar period of time, and they tabulated how many people self-reported. It was 2 percent.
It’s extremely common, and physicians need to know that.
Kevin Pho: When a patient comes to a physician expressing that they had a near-death experience, what are some ways that the physician can acknowledge it and address it?
John C. Hagan III: Yeah, in the hospital setting where a person almost died, ideally the physician would be proactive and say, “While you were almost dead, did anything happen to you that you’d like to talk about?” If they say no, go on and see the next patient. If they say yes, then there are five components: systematic inquiry, thoughtful listening, validation, education, and referral.
Kevin Pho: And when you say referral, where do we refer people to?
John C. Hagan III: This is not something that you would refer to your favorite specialist. The best way to serve these patients is to refer them to a number of support groups and organizations. The International Association for Near-Death Studies (IANDS), NDERF (Near-Death Experience Research Foundation), also bibliotherapy—there are a number of excellent books, many written by physicians, that can educate patients.
It’s also, Kevin, I think, important to educate the family because this person is different, and the family needs to know it. After this, the person may not be compatible with their spouse and family. There can be divorces, alienation, and, in the case of distressing experiences, even suicide.
Kevin Pho: So just to expound on that, you mentioned there is a subset of near-death experiences where they quote-unquote meet the devil, and it’s a distressing event. People who undergo this and it’s not appropriately addressed—it could lead to things like substance abuse and psychiatric crises, correct?
John C. Hagan III: Yeah, not only could it, but it does and has. These people spend the rest of their lives trying to deal with this. There are three coping mechanisms. One is, “Hey, I need to get right with God,” and these people often turn to very orthodox religions. The second is minimalization: “Hey, this didn’t really happen. My brain wasn’t getting enough oxygen.” And the third is, “I’m living a good life. Why did this happen to me?”
Kevin Pho: You mentioned earlier that near-death experiences obviously have a spiritual component. How can a physician address that diversity of religious backgrounds without imposing their own values? Tell me the type of approaches you would recommend.
John C. Hagan III: Well, that’s the beauty of this. We don’t need to. All we have to say is that many people have these experiences. In most cases, they’re uplifting. They reduce the fear of death. They substantiate their belief in a deity or God. And just go through those five steps that I talked about.
I hate to compare this to delirium tremens or psychosis, but when a patient tells you they’re seeing flying elephants or mice driving cars, you don’t have to buy into that. So even if your listeners are atheists and believe that when we die, there’s nothing else, you don’t need to comment on that. It’s not what we think, it’s what that person thinks.
Kevin Pho: Are there specific counseling services, if the physician isn’t comfortable talking about near-death experiences, that we can give the patient to provide support?
John C. Hagan III: In large metropolitan areas— for instance, I went to Los Angeles and gave a talk, and there was a support group there—but typically the answer is no. It has to be done on a national or international scale. There are not likely to be local resources.
Kevin Pho: So, I’m a primary care physician, and if I’m talking to a patient who brings up their near-death experience, other than what I’m learning today, I don’t have a lot of experience with that. Tell me what resources I can send that patient to.
John C. Hagan III: The first thing I would do—and this is not a plug because I have no financial interest in this—but if you want to learn more, I would suggest purchasing our textbook, The Science of Near Death Experiences, written for physicians by physicians. It completely outlines this. Again, the copyright is owned by the Missouri State Medical Association, and the proceeds go to medical education. It’s easy to get on the internet and to go to Dr. Long’s organization. That patient can be referred there. IANDS is the largest organization that can be referred to. Actually, at the University of Virginia, they have a department that studies these, but they study the part we’re not talking about today. We’re discussing a clinical entity. They study the supernatural, preternatural interface with reality.
Kevin Pho: You gave a case study earlier about a patient having a near-death experience under anesthesia. Are there clinical scenarios that lend themselves more to near-death experiences from your experience? Surgery, cardiac arrest, traumatic accidents?
John C. Hagan III: Yes, basically, Kevin, anytime you’re going to call a code. So, somebody has a cardiac arrest in their room or anyplace else. Somebody comes into the emergency room. It doesn’t have to be cardiogenic. It can be someone’s in an accident and almost bleeds to death like the case history I gave earlier. It can even be an overdose from fentanyl. Any situation where a person almost dies—accidental, therapeutic, whatever—it can occur.
Kevin Pho: And just to be clear, when you talk about near-death experiences, do you get pushback from the conventional medical societies saying there’s no scientific explanation for what’s going on? Tell me about the obstacles or pushback you may receive.
John C. Hagan III: Actually, Kevin, very little. In fact, I’ve given lectures from Illinois to California and Kansas City, where I live. I’ve spoken to all the major hospitals except for one. Another thing, Kevin, is when I give grand rounds at a hospital, in many instances, the nurses are invited, and I’m giving my talk, and they’re shaking their heads like you are because they know—they spend a lot more time with patients than we do. The people who come up and say, “Hey, Dr. Hagan, I’ve had these experiences,” are generally ICU, CCU, emergency room nurses. They’re very, very receptive. But to answer your question, no real pushback, but indifference, which I find frustrating.
Kevin Pho: We’re talking to John Hagan. He’s an ophthalmologist. Today’s KevinMD article is, “What You Need to Know About Near-Death Experiences.” John, as always, we’ll end with your take-home messages that you want to leave with the KevinMD audience.
John C. Hagan III: OK, we’re talking about a clinical syndrome. If you want to be the best doctor you can be, you need to know about them. If you have a patient who almost dies, you need to ask about them. If a patient spontaneously tells you they had a near-death experience, accept it, and refer them.
Kevin Pho: John, as always, thanks again for sharing your perspective and insight. Thanks again for coming back on the show.
John C. Hagan III: Thank you, Kevin.
