Discussion

ONLY APPROXIMATELY FIVE PERCENT OF individuals who suffer a massive coronary occlusion survive through artificial resuscitation procedures. The authors review some of the literature describing these survivors and report that more than one-third experience a new-found and enduring sudden understanding or insight. The experience often is one of being outside of oneself, observing the frantic scene "below, " of light, of vivid review of one's life, and is an ineffable experience of being taken up and held by a gigantic being. The authors have, in addition, interviewed nineteen such individuals, a few of whom have an enduring new-found self-curiosity. To my knowledge, the authors report, for the first time, an instance in which a recovered individual then has sought psychoanalytic treatment. He sought treatment for perhaps the optimal reason: to continue and deepen an experience of intense quest for knowledge, specifically self-knowledge, out of a newly-discovered sense that his pre-cardiac-arrest personality had been encumbered by neurotic illness. This insight, more usually the hard-won result of an effective psychoanalytic treatment, was the motivating factor in seeking analysis. In addition, the authors feel that this patient first grasped the nature of psychoanalytic method during the brush with death.

The literature on death and dying is vast, and yet is remarkable in the relative paucity of attention given to the near-death experience