B (63:06)
That whole point about leading up to your death and what your brain is doing before you die does actually lead me on to the last cognitive ghost that I wanted to talk to you about. This is something I found fascinating for such a long time because there is this well reported effect that when people are coming towards the end of their life, particularly if they're cancer patients in palliative care or whatever it might be, but where they're sort of cognizant awake and able to talk in the weeks and months leading up to their death, over and over again, patients will report that about a month out from dying, they will have a really, really vivid dream. And these dreams generally involve people who they know, who they've loved, who have already died standing with them. There are these key themes that appear. One is this idea of a welcoming committee. This is sort of the most common vision that people have where they're, you know, interacting with deceased loved ones, parents, spouses, old friends, whoever it might be, sometimes deceased pets too. They rarely dream of people who are still alive in this very vivid dream that they have. There's also another theme is the idea of a journey. So patients frequently dream that they're packing bags or they're waiting for a train, or they're looking for their passport, sort of preparing for a trip in some way. Another theme that comes up is that patients sometimes dream about past traumas or estranged relationships, but the dreams always end in this kind of sense of forgiveness or closure. And for decades and decades and decades, there's been reports of this, but the medical establishment were like, no, no, no, it's just morphine. It's just hallucinations, just sort of chaotic. Your brain is oxygen starved, something. You just don't worry about it. But the thing about this is that these are not rare edge cases, and they are very different from delirium. So delirium is very chaotic. It's fragmented. It's kind of scary. The patient's really anxious. They're terrified. But these, they're called end of life dreams and visions. They are super lucid, they're structured, they're almost universally comforting as well. So about 10 years ago, Dr. Christopher Kerr, who works at hospice and palliative care in Buffalo, he started collecting these stories, and he ended up quantifying the experience of 1,400 dying patients over the course of a decade. And he revealed that up to 88% of patients, right, almost everybody has at least one of these dreams before they die. And they typically start with a few weeks before death, and then they can increase in frequency and vividness right up as the patient gets closer and closer towards the end of their life. Now, in terms of, like, what is going on here, it's really hard to know. So the thing that we can say is you can put on EEGs to collect data from people who are in palliative care, and there are a couple of theories about why this might be happening. One thing that you do see from the EEGs is that in the final moments or final days and weeks, the brain doesn't just fade away. Instead, it actually experiences this surge of gamma waves. And gamma waves, they're the fastest frequency of brain waves, and they're what you get with intense concentration, essentially with memory retrieval. This is what we were seeing with the guy in the FMRI scann. They're also, with conscious awareness, your brain is sort of lighting up in this electrical storm, essentially, of deep concentration, rendering these, like, very immersive experiences for yourself that feel very different from other dreams. The theory about why this might happen, though, you know, other than just the evidence of what's going on in the brain, is that as your organs start failing, maybe your body is. Is stopping getting all the data in from the outside world. You know your eyes are failing, right? Your ears are Failing touch is failing. But your brain is like this prediction engine and it's trying to just fill in those gaps. Right. Sort of. It's trying to construct a version of reality. Another suggestion for this is that, you know, dying is obviously this incredibly traumatic physical event. I mean, the most traumatic physical event there is. And that maybe as your organs fail, your body is subjected to this really big levels of physiological stress. And so perhaps to protect the conscious mind from the catastrophic pain that's going on, maybe the brain is flooding itself with, with, you know, endogenous endorphins and sort of free analgesia and trace amounts of what effectively amounts psychedelics in a sense. You're sort of, you're chemically sedating yourself in order to not have to sit there with the physiological pain that's going on. But, you know, the true answer about why this happens is we just have no idea. We just have no idea. Which I think is very profoundly beautiful, actually, because I am completely open to more spiritual interpretations of this. I'm not closed. We've spoken about in this podcast before. I'm not closed off to deeper, more meaningful interpretations of this. But I also think that it really does demonstrate that the sort of, the most important moments of a person's life, as they transition from being alive to being dead. There is still so much that we don't understand. When you cannot ask a person, how did it feel to go through that? There is still so many unanswered questions.
