Introduction

Raymond Moody (1975), as a philosophy and, later, medical student, became fascinated by stories of people who had been resuscitated after being declared clinically dead. Starting with the Greeks, he collected 100 case studies and noticed that despite coming from individuals of different backgrounds and beliefs, many of the stories shared common elements. He found that people would often describe things such as:

• a feeling of being out of their body

• traveling through a dark tunnel

• encountering a bright light or a “being of light”

• reviewing their life in a rapid, panoramic fashion

• meeting deceased relatives or other spiritual beings

• a feeling of profound peace and love.

He described this collection of phenomena, which occurred to individuals who were close to death but returned to life, in his groundbreaking book Life After Life. The book is written in a clear, nontechnical style, making it suitable for general audiences, which has to the sale of 13 million copies.

Moody’s book brought the subject into the public consciousness, making near-death experience (NDE) a widely recognized term. Moody came from a skeptical, nonreligious family (Mace 2013). After fifty years of research, he has concluded that NDEs are real and like visits to another dimension of reality.

Interestingly, philosopher-theologian Paul Tillich (1959) has also written about interpenetrating dimensions, the horizontal and the vertical. The horizontal is the dimension of relations between finite material objects. The vertical is transcendent-spiritual. NDEs illuminate the spiritual dimension. It is unencumbered by organizational failings and historical atrocities performed in the name of religion. Spirituality involves ultimate concern, that which is of the greatest importance to us. It gives meaning, purpose, and guidance for living. Religion includes believing, behaving morally, and belonging to a community. Unlike illusions, NDEs are structured and lucid but often ineffable, like trying to write a novel with only half an alphabet. Music and art can help. NDEs nevertheless result in long-term behavioral changes, including life-changing spiritual transformations.

Dr. Alexander’s Near-Death Experience

Dr. Eben Alexander (2012), author of the best-selling book Proof of Heaven: A Neurosurgeon’s Journey to the Afterlife, had an NDE that transformed his life. Before this, he thought he understood what happened to the brain when people are near death and had always believed there are good scientific explanations for the out-of-body journeys described by those who narrowly escaped death. However, after seven days in a coma, during which his brain showed a complete absence of neural activity in all but the primitive portions, he experienced something so profound that it gave him a reason to believe in consciousness after death. This included meeting his deceased sister, whom he never knew he had. He was able to verify her existence later.

Alexander (2012, 9–10) believes:

There is no scientific explanation for the fact that while my body lay in coma, my mind—my conscious, inner self—was alive and well. While the neurons of my cortex were stunned to complete inactivity by the bacteria that had attacked them, my brain-free consciousness journeyed to another, larger dimension of the universe: a dimension I’d never dreamed existed and which the old, pre-coma me would have been more than happy to explain was a simple impossibility.

But that dimension—in rough outline, the same one described by countless subjects of near-death experiences and other mystical states—is there. It exists, and what I saw and learned there has placed me quite literally in a new world: a world where we are much more than our brains and bodies, and where death is not the end of consciousness but rather a chapter in a vast, and incalculably positive, journey.

When Alexander was on Oprah Winfrey’s show in 2012, she asked him if he had seen God. Alexander answered that God is neither a “he” nor a “she” but infinitely powerful, all knowing, infinite love, transcending time and space, symbolized by a brilliant orb of light and expressed by the sound “ohm.” God does not have a face. Alexander’s transcendent experiences were difficult for him to express in words. He said it was like trying to write a novel with only half the alphabet.

Alexander’s NDE transformed him from a Christmas and Easter churchgoer to a deeply committed Christian. In the conclusion of his book, he states that his NDE was like a jouney to a larger dimension of the universe.

Can Science Explain Near-Death Experiences?

Neurologist Dr. Oliver Sacks (2012), who considered himself to be a nonmilitant atheist who did not believe in an afterlife, chose the title “Seeing God in the Third Millennium” for his article offering a naturalistic, scientific explanation of Alexander’s NDE.

For Sacks, a hallucination occurs when an individual sees something that others cannot see. A hallucinatory journey to the bright light and beyond, a full-blown NDE, can occur in twenty or thirty seconds, even though it seems to last much longer. Subjectively, during such a crisis, the very concept of time may seem variable or meaningless. Sacks believes the one most plausible hypothesis in Alexander’s case then is that his NDE occurred not during his coma but as he was surfacing from the coma and his cortex was returning to full function. Sacks (2012) finds it curious that Alexander does not allow this obvious and natural explanation but instead insists on a supernatural one: “Hallucinations, whether revelatory or banal, are not of supernatural origin; they are part of the normal range of human consciousness and experience. This is not to say that they cannot play a part in the spiritual life or have great meaning for an individual. Yet while it is understandable that one might attribute value, ground beliefs, or construct narratives from them, hallucinations cannot provide evidence for the existence of any metaphysical beings or places. They provide evidence only of the brain’s power to create them.” For Sacks, Alexander’s NDE was not proof of heaven.

Near-Death Experience Awakens Classical Piano for Dr. Tony Cicoria

The lasting, life-transforming effects of NDEs may be hard to explain as neurophysiological artifacts. No neurophysiological finding can explain the full range of near-death phenomena. As words are inadequate to express the transcendent beauty of NDEs, perhaps music can help.

Tony Cicoria, then 42, was a well-regarded orthopedic surgeon in a small city in upstate New York. One afternoon in 1994, he noticed a few storm clouds in the distance; it looked like rain. He left a family gathering to go to a pay phone outside to make a quick call to his mother (this was before the age of cell phones). There was a little bit of rain, thunder in the distance. The following is a transcription from Cicordia’s “Getting Comfortable with Near-Death Experiences: My Near-Death Experience A Telephone Call from God” and his YouTube video (Every Soul Knows – Film Series 2025).

My mother didn’t answer. The phone was a foot away from where I was standing when I got struck. I remember a flash of light coming out of the phone. It hit me in the face. Next thing I remember, I was flying backwards like a rag doll.

Then I was flying forwards. Bewildered. I looked around. I saw my own body on the ground. I said to myself, “Oh shit, I’m dead.” I saw people converging on the body. I saw a woman—she had been waiting to use the phone right behind me—position herself over my body, give it CPR . . . I floated up the stairs—my consciousness came with me. I saw my kids, had the realization that they would be okay. Then I was enveloped in a bluish-white river of light energy . . . an enormous feeling of wellbeing and peace. The highest and lowest points of my life raced by me. I had the perception of accelerating, being drawn up . . . There was speed and direction. Then, as I was saying to myself, “This is the most glorious feeling I have ever had”—slam! I was back.

Cicoria knew that he was back in his own body because he felt pain—pain from the burns on his face and on his left foot where the electrical charge had entered and exited—and he realized that only bodies have pain. He wanted to go back. He wanted to tell the woman to stop giving him CPR, to let him go. But it was too late—he was firmly back among the living. After a minute or two, when he could speak, he said, “It’s okay, I’m a doctor!” The woman, who turned out to be an intensive care unit nurse, replied, “A few minutes ago, you weren’t.”

Cicoria consulted a neurologist—he was feeling sluggish (most unusual for him) and having some difficulties with his memory. He found himself forgetting the names of people he knew well. He had a thorough neurological exam, an EEG, and an MRI. Again, nothing seemed amiss.

A couple of weeks later, when his energy returned, Cicoria went back to work. There were still some lingering memory problems—he occasionally forgot the names of rare diseases or surgical procedures—but his surgical skills were unimpaired. In another two weeks, his memory problems disappeared, and that, he thought, was the end of the matter.

What happened then filled Cicoria with amazement. Life had returned to normal, seemingly, when he suddenly, over two or three days, had an insatiable desire to listen to classical piano music. This was completely out of keeping with anything in his past. He had had a few piano lessons as a boy, he said, “but no real interest.” He did not have a piano in his house. What music he did listen to tended to be rock and roll. During a dream, he heard a musical tune. He tried to suppress it but could not.

Cicoria acquired a piano. In trying to teach himself to play the tune in his head, he realized he needed to take piano lessons.

In 2007, under the direction of Polly van der Linde, who runs an international piano camp for adults and children in Old Bennington, Vermont, Tony gave recitals at the Sonata Adult Piano Camp. He played piano compositions by Chopin, Brahms, and an earlier version of his own composition, “Lightning Sonata.”

January 29, 2008, marked an important milestone in Cicoria’s musical career. He publicly debuted at the Goodrich Theater in Oneonta, New York, presented by the Catskill Conservatory in association with the State University of New York at Oneonta. The performance was assisted by a grant from the NYS Council on the Arts. This performance was recorded live by Granada Media UK, BBC One, and German National Television.

Cicoria was encouraged to have an interview with famous neurologist Dr. Oliver Sacks (2007), author of Musicophilia: Tales of Music and the Brain. Sacks suspected that Cicoria’s brain might be very different from what it had been before he was hit by lightning, or in the days immediately following, when neurological tests showed nothing amiss. Could Sacks now, years later, define the neurological basis of Cicoria’s love of music? Many new and far subtler tests of brain function had been developed since Cicoria had his injury. Cicoria agreed during his interview with Sacks that it would be interesting to investigate this further, but after a moment, Cicoria reconsidered and said that perhaps it was best to let things be. His was a lucky strike, and the music, however it had come, was a blessing, a grace—not to be questioned.

Cicoria’s NDE convinced him that our continuousness continues after death. One might conclude that his need for deeper spirituality was actualized as his obsessive need for the transforming effects of music. Music has always been an essential part in religious worship. Cicoria now believes in reincarnation and that we are placed here on Earth to become more spiritual. If we do not become spiritual enough in our first life on Earth, we will be reincarnated to try again.

Spiritually Transforming Art

For those who have experienced NDEs, they are ineffable, difficult to describe and explain. Perhaps art can help.

Theologian Paul Tillich (1955) experienced a transforming divine presence when seeing the painting of Botticelli’s Madonna with Singing Angels. He described his “One Moment of Beauty” as follows:

Divine revelation comes to few, but understanding of it came to me one moment years ago. I looked, for the first time, at beauty revealed by a man who had been dead more than 400 years. As the son of a Protestant minister in eastern Germany in the days before World War I, I had grown up in the belief that visual beauty is unimportant.

Strangely, I first found the existence of beauty in the trenches of World War I. At 28, I became a chaplain in the German army and served for five ugly years until the war ended. To take my mind off the mud, blood and death of the Western Front, I thumbed through the picture magazines at the field bookstores. In some of them I found reproductions of the great and moving paintings of the ages. At rest camps and in the lulls in the bitter battles, especially at Verdun, I huddled in dugouts studying this “new world” by candle and lantern light. But at the end of the war, I still had never seen the original paintings in all their glory.

Going to Berlin, I hurried to the Kaiser Friederich Museum. There on the wall was a picture that had comforted me in battle: Madonna with Singing Angels, painted by Sandro Botticelli in the fifteenth century. Gazing up at it, I felt a state approaching ecstasy. In the beauty of the painting there was Beauty itself. It shone through the colors of the paint, as the light of day shines through the stained-glass windows of a medieval church. As I stood there, bathed in the beauty its painter had envisioned so long ago, something of the divine source of all things came through to me. I turned away shaken.

That moment has affected my whole life, giving me the keys for the interpretation of human existence, brought vital joy and spiritual truth. I compare it with what is usually called revelation in the language of religion. I know that no artistic experience can match the moments in which prophets were grasped in the power of the Divine Presence, but I believe there is an analogy between revelation and what I felt. In both cases, the experience goes beyond the way we encounter reality in our daily lives. It opens up depths experienced in no other way. I know now that the picture is not the greatest. I have seen greater since then. But that moment of ecstasy has never been repeated. (Tillich 1955)

Without this transforming spiritual experience, Tillich might have suffered what is now called PTSD, Post Traumatic Stress Disorder. Tillich (1963) describes such transformations eloquently in is sermon “Spiritual Presence”: “Spiritual Presence is the transforming power within us but not of us, qualifying us for service in a new state of things. The Spirit can transform our moods of aggression and depression into stability and serenity. Spiritual experience is a reality for everyone, as actual as the experience of being loved and or the breathing of air. The Spirit is God present in communities and personalities, grasping them, inspiring them, and transforming them.”

Decades of Near-Death Experience Research

Let us now examine the decades of NDE research on thousands of patients who have survived cardiac arrest, as summarized in Dr. Pim van Lommel’s (2010) book Consciousness Beyond life: The Science of the Near-Death Experience; Dr. Bruce Greyson’s (2021) book After: A Doctor Explores What Near-Death Experiences Reveal About Life and Beyond, (2021); Dr. Jeffrey Long’s and Marjorie Woollacott’s (2024) paper “Long-term, Transformational Effects of Near-Death Experiences”; and Jonathan Kopel’s and Mark Webb’s (2022) paper “Near-Death Experiences and Religious Experience: An Exploration of Spirituality in Medicine.”

Cardiologist van Lommel designed a research study to investigate NDEs under the controlled environment of a cluster of hospitals with a medically trained staff in the Netherlands. For more than twenty years, van Lommel systematically studied NDEs in a wide variety of hospital patients who had survived a cardiac arrest.

He and his fellow researchers published their study on NDEs in the renowned medical journal The Lancet (2001). The article caused an international sensation, as it was the first scientifically rigorous study of this phenomenon. In this work, he gives a prospective analysis of 509 successful resuscitations of 344 Dutch patients who suffered a cardiac arrest. Of those, 18% had a NDE. In other studies, the percentage varies for adult cardiac arrest victims who recall a NDE. Melvin Morse (1996) found 85% among children.

Van Lommel came to the conclusion that the near-death phenomenon is an authentic experience that cannot be attributed to imagination, psychosis, or oxygen deprivation. He further reveals that after such a profound experience, most patients’ personalities undergo a permanent change. In van Lommel’s opinion, current views on the relationship between the brain and consciousness held by most physicians, philosophers, and psychologists are too narrow for a proper understanding of the phenomenon. Van Lommel shows that our consciousness does not always coincide with brain functions and that, remarkably and significantly, consciousness can even be experienced separate from the body, showing the continuity of human consciousness after the traditionally defined death of our body.

Interestingly, across all times and in many cultures, people have been convinced that the essence of man, usually known as the soul, lives on after the death of the body. So, an NDE seems to be a personal re-discovery of wisdom and insight that is ages and ages old but nowadays seem to be forgotten. In the past, these experiences were often known under different names, such as visions or mystical, religious, or enlightenment experiences, and in antiquity they were referred to as journeys to the underworld. Nowadays, we would classify most of these cases as near-death experiences. (Van Lommel 2022)

Greyson’s book, After: A Doctor Explores What Near-Death Experiences Reveal about Life and Beyond, chronicles his four decades of scientific research into NDEs. Greyson is Professor Emeritus of Psychiatry and Neurobehavioral Sciences at the University of Virginia School of Medicine. In 1981, he was a cofounder and president of the International Association of Near-Death Studies. It provides research, information, and education about NDEs, supports those who have had them, and organizes periodic North American conferences.

As a physician with a scientific and skeptical background, Greyson initially dismissed NDEs as a quirk of the brain. However, after encountering a patient whose NDE contained details that were medically impossible for her to have known, he began a professional and personal journey to understand the phenomenon.

Greyson combines personal anecdotes from his career with extensive scientific research to present a new perspective on the relationship between the brain and consciousness. Rather than arguing for a specific religious or spiritual belief, Greyson uses the evidence from NDEs to challenge the traditional view that consciousness is solely a product of brain activity. He suggests that the brain might instead act as a filter or receiver for consciousness, which could be a fundamental part of reality not limited to our physical bodies.

Key themes and takeaways from the book include:

• NDEs are common and transformative. Greyson highlights that NDEs are not rare, and the individuals who experience them often report lasting and profound life changes, such as a reduced fear of death, a greater sense of purpose, and increased compassion.

• The paradox of consciousness. NDEs often occur when the brain is severely compromised, such as during cardiac arrest. Yet people describe heightened awareness and clear thinking during these times, which challenges the assumption that the mind cannot function independently of a fully operational brain.

• A new understanding of the mind–brain relationship. The book proposes that the evidence from NDEs supports an alternative theory where consciousness is not generated by the brain but may exist independently of it. Greyson explores this idea, prompting readers to reconsider what it means to be human and what the nature of consciousness truly is.

In essence, Greyson’s book is a compelling and thought-provoking exploration of NDEs that seeks to bridge the gap between science and spirituality. It invites readers to open their minds to the possibility that death may not be an ending but a transition, and that our understanding of consciousness may need to expand to account for these experiences.

Long is a radiation oncologist and founder of the Near-Death Experience Research Foundation, whose website, NDERF.org, has validated 5,400 NDEs. He observes that 10–20% of people who are revived from life-threatening situations have an NDE. About 5% of the United States population have had them, according to a Gallup poll. They can happen to anyone: children, adults, clergy, religious, atheists, physicians, and scientists.

Long and Marjorie Woollacott (2024) authored “Long-term, Transformational Effects of Near-Death Experiences.” Here is the abstract of their study:

We compared 834 NDE responses with those of 42 individuals who had faced life-threatening situations (LTE) without experiencing NDEs. Our central finding reveals a significant transformation in values and spiritual attitudes among participants following their NDEs, as compared to individuals who were faced with life-threatening situations without an NDE. Key transformations include an enhanced belief in divinity and the afterlife, a decreased fear of death, and increased levels of compassion. Participants also reported a stronger belief in the meaningfulness of life and a profound shift in life priorities and values, emphasizing the increased importance of their spiritual or religious lives.

Long has also compared NDEs in our Western culture with those in the East. He has observed that the NDE experiences and symbolisms are similar. This is consonant with the universal unconscious and inherited archetypes of Carl Jung, the renowned Swiss psychiatrist, who had a profound NDE during a heart attack in 1944. His out-of-body experience reinforced his belief in the continuity of consciousness after death and the connection between the psyche and universal consciousness. It also influenced his psychological theories and personal philosophy.

Kopel and Webb (2022, 11–12) conclude their paper “Near-Death Experiences and Religious Experience: An Exploration of Spirituality in Medicine” as follows:

NDEs touch upon the common religious experiences of human beings regardless of any previous religious or philosophical leaning. In general, viewing NDEs from a point of view informed by both science and religion may constitute a paradigm change in medical treatment, combining scientific research and belief with patient disease experiences with a new understanding of spiritual and medical relationships.

Since the Enlightenment, reductionism has been an important component of the development of science and Western civilization. The practice of abstracting and reducing parts of the universe to their essential components has greatly enhanced the knowledge of the physical and chemical laws in all realities. However, the medical paradigm of the 20th century undermined the human being’s holistic character. In this regard, the human person is seen not as a mechanical process defined exclusively by physical rules but as an interconnected totality. With the new medical paradigm, the complex social and environmental connections that influence human health and illness were more understood. New facts or interpretations can, just like with any perspective of philosophy or science, challenge or expand the current ideas, yet old paradigms are inflexible to take these changes.

Kopel’s and Webb’s holistic viewpoint is like Sister Callista Roy’s (2009) nursing philosophy, which views each person as a biopsychosocial adaptive system interacting with their changing environment. Spiritual transformations help individuals adapt to health challenges and achieve integrity, wholeness, and a good quality of life by managing stimuli across four adaptive modes: physiological, self-concept, role function, and interdependence.

Conclusions

NDEs are multifaceted phenomena that often extend beyond phenomenological curiosity into life-changing spiritual transformations. Scientific investigation into these changes seeks to expand our understanding of consciousness, spirituality, and the human response to life-threatening events.

Through the stories of Alexander and Cicoria, this article has shown how NDEs are transformational for those who have them. van Lommel, Greyson, Long, and others have investigated thousands of NDEs. Those who have had NDEs show enhanced belief in divinity and the afterlife, a decreased fear of death, and increased levels of compassion. NDE experiencers also have a stronger belief in the meaningfulness of life and a profound shift in life priorities and values, emphasizing the increased importance of their spiritual and religious lives.

NDEs studies are advancing our understanding of who we humans truly are, created by the evolutionary process from cosmic stardust in the “image of God.”

Created from dust of stars afar,

We gaze in wonder at light from where galaxies are.

Why are we, cosmic created creatures, curious to see what happens in heaven? NDEs give new insights and visions of an afterlife so that all may “[k]now fully, even as I (we) have been fully known” (1 Corinthians 13:12).

Acknowledgment

I am indebted to Barbara Bachner, who has attended meetings of the International Association for New Death Studies, for her helpful comments and suggestions. She is a Methodist minister’s kid, like me.

Competing Interests

The author declares that they have no competing interests.