Authors: Eben Alexander III M.D.
As my loving family and caregivers gathered around my bed, still dumbstruck by the inexplicable transition, I had a peaceful, joyous smile.
“All is well,” I said, radiating that blissful message as much as speaking the words. I looked at each of them, deeply, acknowledging the divine miracle of our very existence.
“Don’t worry . . . all is well,” I repeated, to assuage any doubt. Phyllis told me later that it was as if I were imparting a crucial message from the beyond, that the world is as it should be, that we have nothing to fear. She said she often recalls that moment when she is vexed by some earthly concern—to find comfort in knowing that we are never alone.
As I took stock of the entourage, I seemed to be returning to my earthly existence.
“What,” I asked those who were assembled, “are you doing here?”
To which Phyllis replied, “What are
you
doing here?”
B
ond had envisioned his same old dad would wake up, take a look around, and just need a little catching up on what had happened before resuming my role as the father he’d always known.
He soon discovered, however, that it wasn’t going to be quite that easy. Dr. Wade cautioned Bond about two things: First, he shouldn’t count on my remembering anything I was saying as I emerged from the coma. He explained that the process of memory takes enormous brain power, and that my brain wasn’t sufficiently recovered to be performing at that sophisticated level. Second, he shouldn’t worry much about what I said during these early days, because a lot of it was going to sound pretty crazy.
He proved right on both counts.
That first morning back, Bond proudly showed me the drawing he and Eben IV had made of my white blood cells attacking the
E. coli
bacteria.
“Wow, wonderful,” I said.
Bond glowed with pride and excitement.
Then I continued: “What are the conditions like outside? What does the computer readout say? You need to move, I’m getting ready to jump!”
Bond’s face fell. Needless to say, this was not the full return he had been hoping for.
I was having wild delusions, reliving some of the most exciting times of my life, in the most vivid fashion.
In my mind, I was on jump run, ready to skydive out of a DC3 three miles above the earth . . . going to be the last man out, my favorite position. It was the maximal flying of my body.
Bursting into brilliant sunshine outside the airplane door, I immediately assumed a head dive with my arms tucked behind me (in my mind), feeling the familiar buffeting as I fell beneath the prop blast, watching from upside down as the belly of the enormous silvery plane started to shoot skyward, its huge propellers whirling in slow motion, earth and clouds below mirrored on its underbelly. I was musing over the odd sight of flaps and wheels down (as if landing) while still miles above the ground (all to slow down and minimize wind shock to the exiting jumpers).
I tucked my arms in extra tight in a head-down dive to accelerate briskly to over 220 miles per hour, nothing more than my speckled blue helmet and shoulders against thin upper air to resist the tug of the huge planet below, moving more than the length of a football field every second, the wind roaring by furiously at thrice hurricane speed, louder than anything—ever.
Passing between the tops of two enormous puffy white clouds, I rocketed into the clear chasm between them, green earth and sparkling deep blue sea far below, in my wild, thrilling rush down to join my friends, just barely visible, in the colorful snowflake formation, growing larger every second as other jumpers joined in, far, far below . . .
I was flipping back and forth between being present there in the ICU and being out of my mind in the adrenaline-soaked delusions of a gorgeous skydive.
I was between nutty—and getting it.
For two days I blabbered about skydiving, airplanes, and the Internet to all who would listen. As my physical brain gradually
recovered its bearings, I entered a strange and exhausting paranoid universe. I became obsessed with an ugly background of “Internet messages” that would show up whenever I closed my eyes, and that sometimes appeared on the ceiling when they were open. When I shut my eyes I heard grinding, monotonous, anti-melodious chanting sounds that usually went away when I opened them again. I kept putting my finger in the air, pointing just like ET, trying to guide the Internet ticker flowing past me, in Russian, Chinese.
In short, I was a little crazy.
It was all a little like the Realm of the Earthworm’s-Eye View, only more nightmarish, because what I heard and saw was laced with the trappings of my human past (I recognized my family members, even when, as in Holley’s case, I didn’t remember their names).
But at the same time it completely lacked the astonishing clarity and vibrant richness—the ultra-reality—of the Gateway and the Core. I was most definitely back in my brain.
Despite that initial moment of seemingly full lucidity when my eyes first opened, I soon once again had no memory of my human life before coma. My only memory was of where I had just been: the rough, ugly Realm of the Earthworm’s-Eye View, the idyllic Gateway, and the awesome heavenly Core. My mind—my real self—was squeezing its way back into the all too tight and limiting suit of physical existence, with its spatiotemporal bounds, its linear thought, and its limitation to verbal communication. Things that up until a week ago I’d thought were the only mode of existence around, but which now showed themselves as extraordinarily cumbersome limitations.
Physical life is characterized by defensiveness, whereas spiritual life is just the opposite. This is the only explanation I could
come up with to explain why my reentry had such a strong paranoid aspect to it. For a stretch of time I became convinced that Holley (whose name I still didn’t know but whom I somehow recognized as my wife) and my physicians were trying to kill me. I had further dreams and fantasies about flight and skydiving—some of them extremely long and involved. In the longest, most intense, and almost ridiculously detailed of these, I found myself in a South Florida cancer clinic featuring outdoor escalators where I was pursued by Holley, two South Florida police officers, and a pair of Asian ninja photographers on cable pulleys.
I was in fact going through something called “ICU psychosis.” It’s normal, even expected, for patients whose brains are coming back online after being inactive for a long period. I’d seen it many a time, but never from the inside. And from the inside it was very, very different indeed.
The most interesting thing about this session of nightmares and paranoid fantasies, in retrospect, is that all of it was indeed that: a fantasy. Portions of it—in particular the extended South Florida ninja nightmare—were extremely intense, and even outright terrifying while happening. But in retrospect—indeed, almost immediately after this period ended—it all became clearly recognizable as what it was: something cooked up by my very beleaguered brain as it was trying to recover its bearings. Some of the dreams I had during this period were stunningly and frighteningly vivid. But in the end they served only to underline how very, very dissimilar my dream state had been compared with the ultra-reality deep in coma.
As for the rockets, airplanes, and skydiving themes that I imagined so consistently, they were, I later realized, quite accurate from a symbolic point of view. Because the fact was that
I
was
making a dangerous reentry from a place far away, to the abandoned but now once again functional space station of my brain. One could hardly ask for a better earthly analogy for what happened to me during my week out of body than a rocket launch.
B
ond wasn’t the only one having difficulty accepting the decidedly kooky person I was during those first days back. The day after I recovered consciousness—Monday—Phyllis called Eben IV on his computer using Skype.
“Eben, here’s your dad,” she said, turning the video camera toward me.
“Hi, Dad! How’s it going?” he said cheerfully.
For a minute I just grinned and stared at the computer screen. When I finally spoke, Eben was crushed. I was painfully slow in my speech, and the words themselves made little sense. Eben later told me, “You sounded like a zombie—like someone on a bad acid trip.” Unfortunately, he had not been forewarned about the possibility of an ICU psychosis.
Gradually my paranoia abated, and my thinking and conversation became more lucid. Two days after my awakening, I was transferred to the Neuroscience Step-down Unit. The nurses there gave Phyllis and Betsy cots so that they could sleep next to me. I trusted no one but the two of them—they made me feel safe, tethered to my new reality.
The only problem was that I didn’t sleep. I kept them up all night, going on about the Internet, space stations, Russian double agents, and all manner of related nonsense. Phyllis tried to convince the nurses that I had a cough, hoping a little cough syrup would bring on an hour or so of uninterrupted sleep. I was like a newborn who did not adhere to a sleep schedule.
In my quieter moments, Phyllis and Betsy helped pull me slowly back to earth. They recalled all kinds of stories from our childhood, and though by and large I listened as if I were hearing them for the first time, I was fascinated all the same. The more they talked, the more something important began to glimmer inside me—the realization that I had, in fact, been there for these events myself.
Very quickly, both sisters told me later, the brother they had known became visible again, through the thick fog of paranoid chatter.
“It was amazing,” Betsy later told me. “You were just coming out of coma, you weren’t at all fully aware of where you were or what was going on, you talked about all kinds of crazy stuff half the time, and yet your sense of humor was just fine. It was obviously
you
. You were back!”
“One of the first things you did was crack a joke about feeding yourself,” Phyllis later confided. “We were prepared to have fed you spoonful by spoonful for as long as it took. But you’d have none of it. You were determined to get that orange Jell-O into your mouth on your own.”
As the temporarily stunned engines of my brain kicked back in ever further, I would watch myself say or do things and marvel: where did
that
come from? Early on, a Lynchburg friend named Jackie came by to visit. Holley and I had known Jackie and her husband, Ron, well, having bought our house from them. Without my willing them to do so, my deeply ingrained southern social graces kicked in. Seeing Jackie, I immediately asked, “How’s Ron?”
After a few more days, I started having occasional genuinely lucid conversations with my visitors, and again it was fascinating to see how much of these connections were automatic and
did not require much effort on my part. Like a jet on autopilot, my brain somehow negotiated these increasingly familiar landscapes of human experience. I was getting a firsthand demonstration of a truth that I’d known very well as a neurosurgeon: the brain is a truly marvelous mechanism.
Of course, the unspoken question on everybody’s mind (including mine in my more lucid moments) was: How well would I get? Was I really returning in full, or had the
E. coli
done at least some of the damage all the doctors had been sure it would do? This daily waiting tore at everyone, especially Holley, who feared that all of a sudden the miraculous progress would stop, and she would be left with only a portion of the “me” she had known.
Yet day by day, ever more of that “me” returned. Language. Memories. Recognition. A certain mischievous streak I’ve always been known for returned as well. And while they were pleased to see my sense of humor back, my two sisters weren’t always thrilled with how I chose to use it. Monday afternoon, Phyllis touched my forehead and I recoiled.
“Ouch,” I screamed. “That hurts!”
Then, after enjoying everybody’s horrified expressions, I said, “Just kidding.”
Everyone was surprised by the speed of my recovery—except for me. I—as of yet—had no real clue how close to death I had actually been. As, one by one, friends and family headed back to their lives, I wished them well and remained blissfully ignorant of the tragedy that had been so narrowly averted. I was so ebullient that one of the neurologists who evaluated me for rehab placement insisted that I was “too euphoric,” and that I was probably suffering from brain damage. This doctor, like me, was a regular bow-tie wearer, and I returned the favor of his diagnosis
by telling my sisters, after he had left, that he was “strangely flat of affect for a bow-tie aficionado.”
Even then, I knew something that more and more of the people around me would come to accept as well. Doctors’ views or no doctors’ views, I wasn’t sick, or brain-damaged. I was completely well.
In fact—though at this point only I knew this—I was completely and truly “well” for the first time in my entire life.
“T
ruly well”—even if I did still have some work to do as far as the hardware side of things went. A few days after moving to outpatient rehab, I called Eben IV at school. He mentioned that he was working on a paper in one of his neuroscience courses. I volunteered to help but soon regretted doing so. It was much harder for me to focus on the subject than I had expected, and terminology I thought I had fully back suddenly refused to come to my mind. I realized with a shock just how far I still had to go.