Parapsychology Journalism: The People, The Theory, The Science, The Skeptics
Terminal Lucidity is the term used when dying people, who have previously been unresponsive or minimally responsive, suddenly gain clarity of mind for a few hours, often talking coherently with loved ones before passing away a short time later. This has been known to occur even when the patient’s speech center has been destroyed and some have gained mobility where they previously had none. It’s a remarkable, and very minimally studied area of medicine. Anecdotes are plentiful though, as can be seen on this nurse’s forum. (here.)
The reason that it hasn’t been studied much is that it doesn’t fit any current underlying theory of medicine, which is viewed in strictly materialistic fashion. The most basic problem is that there is no biological need for people to suddenly regain lucidity within hours of dying. Even if there is a material explanation for why this can take place, there is no reason why it should. A biological system at the end of life is in decline and it doesn’t make sense for one part of that system to have a sudden positive change that creates lucidity, but then goes away a short time later.
Even more troublesome for a materialist explanation is that terminal lucidity only makes sense in the context of personal meaning. The one thing that all cases of terminal lucidity have in common is that they are full of personal meaning. The dying get closure with their relatives; they have one last moment to say their final goodbyes before they are gone.
So here we have a physical event whose only purpose is to have meaning. Meaning however, is of the mind and a brain is completely physical. This means that something, which cannot be the brain, is making a decision, (which requires a mind) to temporarily change a biological decline process (which we assume is strictly material) in order to experience something meaningful. (which is a domain belonging exclusively to the mind.) It’s impossible to get away from the conclusion that terminal lucidity is a situation where the mind, perhaps at a deep subconscious level, is in complete control of the body. This flies in the face of materialist theories of biology.
There has been some research into terminal lucidity, mainly because understanding it might help people who are suffering from dementia for any number of reasons such as whether we can trigger it before people are on the brink of death. Mostly, though, people have just looked at case studies. The most significant of these is Terminal lucidity: A review and a case collection which I will be drawing upon for this article:
At present, we have identified 83 cases of terminal lucidity mentioned in the literature of the last 250 years and have collected comparable unpublished contemporary accounts. The published cases were reported by 55 different authors, mostly by professionals working in the medical setting. Of the cases that contained a description of the course of the illness, 22 patients were female and 32 were male. In addition to those particular case references and descriptions, we identified 18 general claims of physicians or caregivers who stated that they had witnessed terminal lucidity in mental disorders but gave no details of their observations.
They surveyed case reports from the 19th century, but these were problematic in that diagnoses were not advanced and included mental diseases such as “mania” and “melancholia.” More importantly for a study of terminal lucidity is when a diagnosis is dementia, it’s important to know what kind of dementia. And some of the diagnoses occurred outside of a medical setting, making them less than reliable. Nevertheless, there were some interesting findings:
In a case published in 1822, a boy at the age of 6 had fallen on a nail that penetrated his forehead. He slowly developed increasing headaches and mental disturbances. At the age of 17, he was in constant pain, extremely melancholic, and starting to lose his memory. He fantasized, blinked continuously, and looked for hours at particular objects. When he additionally started to throw up frequently, he was admitted to a hospital. He was not able to sit or get out of bed. He remained in the hospital in this state for 18 days. On the morning of the 19th day, he suddenly left his bed and appeared very bright, claiming he was free of all pain and feelings of sickness. He intended to leave the hospital the next day. A quarter of an hour after the attending physician left him, he fell unconscious and died within a few minutes. The front part of his brain contained two pus-filled tissue bags the size of a hen’s egg (Pfeufer, 1822).
There have also been examinations of recent cases where the patient received excellent diagnostics prior to death, leaving little doubt that terminal lucidity is a very strange phenomena:
Haig (2007) reported the case of a young man dying of lung cancer that had spread to his brain. Toward the end of his life, a brain scan showed little brain tissue left, the metastasized tumors having not simply pushed aside normal brain tissue but actually destroyed and replaced it. In the days before his death, he lost all ability to speak or move. According to a nurse and his wife, however, an hour before he died, he woke up and said good-bye to his family, speaking with them for about five minutes before losing consciousness again and dying.
This review was also divided into different medical conditions, which demonstrated that terminal lucidity is not confined to particular health problems. They found examples of terminal lucidity in stroke victims, (Noyes, 1952), (Osis, 1961; Osis and Haraldsson, 1977), (Daumer, 1865); they found it in Alzheimer’s patients,(Nahm and Greyson, 2009), (Brayne et al., 2008), (Osis, 1961), and in meningitis, (Osis and Haraldsson 1977).
There have also been cases of terminal lucidity in patients with severe mental disorders. Schizophrenia, (Turetskaia and Romanenko, 1975), (Osis, 1961) and possible affective disorders, although these cases were from the 19th century. (Butzke, 1840), (Jacobi, 1837), (Bergmann, 1829),. Although Terminal lucidity was well known in the 19th century among physicians, investigations into this phenomena virtually stopped in the 20th century, with the earliest study occurring in the 1970’s. (Interestingly enough, this coincides with the rise and fall and rise of the popularity of parapsychology in general. Popular support seems to be necessary for scientists to investigate unusual topics.)
The authors of this review produced conclusions which I have edited into highlights: I can add nothing to this.
. . . Some of the cases presented, particularly those involving destruction of brain tissue caused by tumors, strokes, or Alzheimer’s disease, pose difficulties for currently prevailing explanatory models of brain physiology and mental functioning.
At present, we think that it is not possible to formulate definitive mechanisms for terminal lucidity. Indeed, terminal lucidity in differing mental disorders might result from different processes, depending on the etiology of the diseases. For example, cachexia in chronically ill patients might conceivably cause shrinking of brain tissue, relieving the pressure exerted by space-occupying intracra- nial lesions and permitting fleeting return of some brain function.
. . .We hope that drawing attention to this phenomenon may stimulate research into the psychopathology and neuropathology involved in near-death states. Studying terminal lucidity could help elucidate the factors governing the peculiar relationship between mind and brain, particularly as the brain deteriorates (Fenwick et al., 2010); and it could facilitate the development of new therapies.
. . .Research into terminal lucidity might lead to better understanding of the processes involved in memory and cognition. The unexpected return of mental faculties raises questions about cognitive processing at the end of life, especially in diseases that involve the degeneration of the brain regions usually responsible for complex cognition, and may suggest new neuroscientific models for memory and cognition in terminal illnesses. In addition, increased awareness of unusual end-of-life experiences on the part of physicians, caregivers, and bereaved family members could help them prepare for witnessing such phenomena, and thus better cope with them.