Anthony ‘TJ’ Hoover was 36-years-old when doctors pronounced him dead. What followed was a nightmare beyond the realm of any horror movie.
Following an overdose in his car, the keen hiker had suffered a massive heart attack. He spent five days on life support in the emergency room at the Baptist Health hospital in Richmond, Kentucky, before medics requested permission to switch off his ventilator.
‘We were told TJ had no reflexes, no responses, no brain activity,’ his sister Donna Rhorer said. ‘We made the decision as a family to remove him from life support because he was brain dead.’
TJ carried an organ donor card. As in many US hospitals, the custom at Baptist Health was for staff and family members to stand in a silent line along the corridors when the body was taken by trolley to the operating theatre. This mark of respect, prior to the removal of organs for transplant into other patients, is known as the ‘honour walk’.
But as her brother’s body was wheeled past her, Donna saw his eyes open. A doctor insisted this was a normal reflex for a corpse, and not a sign of life.
In the theatre, as the surgeon was about to make the first incision, TJ began to writhe, pulling his knees up to his chest. Nurse Natasha Miller, whose job was to place the harvested organs into cold storage, could not believe what she was seeing: ‘He was moving, thrashing around on the bed. And then when we went over there, you could see he had tears coming down. He was crying visibly.’
Miller’s colleague, Nyckoletta Martin, was so horrified by the incident in October 2021 that she resigned. ‘That’s everybody’s worst nightmare, right?’ she said. ‘Being alive during surgery and knowing that someone is going to cut you open and take your body parts out?.’
TJ survived, though with brain damage – and, his sister Donna said, a terrible sense of guilt. He believed he ought to have died, so that his own organs could help to save other lives.
Anthony ‘TJ’ Hoover was pronounced dead after five days on life support – and woke up on the operating table as his organs were about to be harvested
Investigators argue this could be proof that life somehow survives when the body dies – and that bursts of increased chemical and electrical signals in parts of the brain are generated as the soul departs
His chilling story has caused a stir after it was highlighted in the latest issue of the American magazine Popular Mechanics. But it is just one in a growing database of medical histories that suggests ‘brain dead’ patients removed from life support may in fact experience a surge of renewed physical and mental energy.
In extreme cases, this could mean they literally come back to life. And the horrific implication is that others might be left conscious but helpless, knowing the doctors are oblivious as they lie dying.
But other investigators argue this could be positive proof that life somehow survives when the body dies – and that bursts of increased chemical and electrical signals in parts of the brain are generated as the soul departs.
A paper published in a prestigious US medical journal, Proceedings of the National Academy of Sciences [PNAS], cites four cases where frantic brain activity was detected after the withdrawal of ventilator support.
Intrigued by the accounts of patients who reported near-death experiences [NDEs] following cardiac arrest, neurology professor Jimo Borjigin from the University of Michigan first undertook experiments on rats. She discovered that, after an animal’s heart stopped, its brain – starved of oxygen – experienced a flood of neurotransmitter chemicals including serotonin and dopamine.
With a team of researchers, Professor Borjigin delved into the detailed medical records of four patients who died in the neurointensive care unit [Neuro-ICU] at the university. Three suffered death by cardiac seizure, one by brain haemorrhage, and they were all undergoing electroencephalogram [EEG] brain monitoring when they died.
Patient One was a 24-year-old woman with two children. During both pregnancies, she experienced fainting fits and seizures, and was diagnosed with a condition known as Long QT syndrome, an inherited condition that causes an irregular heartbeat.
Just four weeks into her third pregnancy in 2014, she collapsed at home. Her mother called the emergency services but by the time paramedics arrived, her heart had been still for 10 minutes. In the emergency room at University of Michigan, it took three attempts with a defibrillator to shock her heart into beating again.
Placed on a ventilator with a pacemaker, she lay in a coma in NCU for three days. Her family was told that her brain was badly swollen and she would not recover. There was ‘no evidence of voluntary behaviour or any overt consciousness,’ Prof Borjigin said.
But when the family took the agonising decision to remove life support, and Patient One’s breathing tube was removed, the EEG monitors lit up.
In 2014, when Patient One’s breathing tube was removed, brain wave activity was especially high in her temporal lobes, where memory and emotion are processed
Dr Ajmal Zemmar says that ‘through generating oscillations involved in memory retrieval, the brain may be playing a last recall of important life events just before we die’
In technical terms, according to the paper in PNAS, the young mother ‘exhibited a rapid and marked surge of cross-frequency coupling of gamma waves with slower oscillations, and increased interhemispheric function’.
Notably, the researchers said, this ‘directed connectivity’ occurred within the posterior cortical ‘hot zone’, a region of the brain thought ‘to be critical for conscious processing. This gamma activity was stimulated by global hypoxia [oxygen starvation] and surged further as cardiac conditions deteriorated’ – with the pacemaker switched off 12 minutes after the breathing tube was extracted from her throat.
Analysis of the gamma wave activity showed it was especially high in the temporal lobes, where memory and emotion are processed, and in the prefrontal cortex, which is crucial in the expression of personality.
But the whole brain was affected, Prof Borjigin found: ‘The near-death surge of cortical coherence was global, and clearly detectable over all frequency bands, at distinct near-death stages and across the dying brain.’
The waves were synchronised, in patterns typical of a state of heightened awareness and intense memories. The surges came three times, the longest lasting for more than five minutes and another for about four minutes.
The professor believes it is highly likely Patient One was encountering what many people report after surviving near-death experiences – including visions of loved ones who have previously died, and a vivid review of memories from birth, sometimes described as ‘your life flashing before you’.
Other common accounts report a feeling of deep serenity, a tunnel of light, and a sensation of being surrounded by indescribable beauty.
Whatever the objective reality of these experiences, they cannot be explained by the usual catch-alls of evolutionary theory and inherited genetics – because it is vanishingly rare, even with today’s medical advances, for people to survive death and then go on to have children.
But descriptions of NDEs are nothing new. The oldest known account was discovered in medical records published in Paris 285 years ago, in 1740. Military doctor Pierre-Jean du Monchaux studied the phenomenon, in a book titled Anecdotes of Medicine, and cited the story of a successful Parisian apothecary or chemist, Monsieur LC, who suffered a ‘malign fever’ while in Italy and later recovered.
After lapsing into unconsciousness, ‘He reported that after having lost all external sensations, he saw such a pure and extreme light that he thought he was in the Kingdom of the Blessed [Heaven],’ wrote Monchaux. ‘He affirmed that never in all his life had he had a nicer moment.’
Li Xiufeng lay for six days in an open casket, as is traditional in her culture. A few hours before her funeral was due to be held, Xiufeng struggled upright, climbed out and went to her kitchen
In 1986, Czech biologist Miroslav Holub concluded that blood cells live on much longer than the body that created them, and asked whether a fragment of the soul persists in those cells
University of Arizona psychology professor and anaesthesia doctor Stuart Hameroff believes the phenomenon could be evidence of ‘the soul leaving the body’ after death.
‘Consciousness is actually, probably, a very low energy process in the brain,’ he says, explaining that anaesthesiologists regularly use EEGs to monitor brain activity in dead patients before their organs are removed for transplant.
In about half of cases, he says, gamma wave synchrony is detected after death, indicating that consciousness is, ‘the last thing to go’.
The Czech biologist and poet Miroslav Holub wrote, in a 1986 essay for the journal Science, of how he found a dead muskrat in his swimming pool and spent a week studying its blood cells (you had to make your own entertainment in Czechoslovakia in the 1980s).
He concluded that blood cells live on much longer than the body that created them, and asked whether a fragment of the soul persists in those cells.
In a 2022 study published by the journal Frontiers In Aging Neuroscience, scientists at the University of Tartu in Estonia described using EEG to monitor seizures in an 87-year-old patient. While under observation, the man suffered a serious heart attack.
He had previously signed a ‘Do Not Resuscitate’ form, requesting that he be allowed to die without invasive procedures to prolong his life. After consultation with his family, the doctors let him slip away. During the next 15 minutes, his brain activity was continuously monitored.
‘Just before and after the heart stopped working,’ said Dr Ajmal Zemmar, ‘we saw changes in a specific band of neural oscillations [ie, brain waves], so-called gamma oscillations, but also in others such as delta, theta, alpha, and beta oscillations.
‘Through generating oscillations involved in memory retrieval, the brain may be playing a last recall of important life events just before we die, similar to the ones reported in near-death experiences. These findings challenge our understanding of when exactly life ends and generate important subsequent questions, such as those related to the timing of organ donation.’
He added that the phenomenon could give comfort to grieving relatives: ‘As a neurosurgeon, I deal with loss at times. It is indescribably difficult to deliver the news of death to distraught family members.
‘Something we may learn from this research is that although our loved ones have their eyes closed and are ready to leave us, their brains may be replaying some of the nicest moments they experienced in their lives.’
But they might also be acutely aware of what is happening around them. Stories are common after NDEs of patients reporting out-of-body experiences, where they seemed to be floating outside their own skin, looking at themselves from one side or from above.
According to a study published in the journal Resuscitation in 2014, 40 per cent of patients who were revived after cardiac arrest said they were aware of what was happening while they were, in fact, clinically dead.
One of the most famous cases is related by Kimberley Clark Sharp, who was a social worker at Harborview Medical Center in Seattle, Washington, in the 1980s when a woman named Maria suffered a cardiac arrest and ‘flatlined’ – that is, her heart stopped.
Staff were able to revive her, but later that day Maria became agitated. She was desperate to tell someone what she had experienced. Sharp listened, as Maria explained that she had floated up to the ceiling and watched the doctors working on her lifeless body, before she drifted right out of the building.
On a third storey window ledge, she claimed, she had seen a man’s blue trainer, scuffed on one side, with the loose lace under the heel. To pacify the woman, Sharp went to check – and discovered the shoe was there, exactly as Maria described it.
Other stories are much more disturbing. In Poland, 91-year-old Janina Kolkiewicz woke up in a mortuary body bag. Horrified staff unzipped it after they saw movement. She had been in cold storage for 11 hours, after her family doctor Wieslawa Czyz declared her dead.
‘I’m stunned, I don’t understand what happened. Her heart had stopped beating, she was no longer breathing,’ Dr Czyz said. ‘I was sure she was dead.’
Janina’s family gave her hot soup and pancakes to warm her up. In China, a woman aged 95 suffered a similar experience – and woke up just as hungry. Li Xiufeng, of Guangxi province, suffered a fall and was pronounced dead by her neighbours. She lay for six days in an open casket, as is traditional in her culture.
A few hours before her funeral was due to be held, Xiufeng struggled upright, climbed out and went to her kitchen. ‘I slept for a long time. After waking up, I felt so hungry, and wanted to cook something to eat,’ she said.
Professor Borjigin fears some patients will inevitably have been buried or cremated alive. ‘Maybe we should have a camera inside a coffin,’ she suggests – though that raises the question of who would monitor the corpse. Few people want to watch their loved ones decomposing.
Dr Zemmar believes the safest solution could be to assume that the absence of a heartbeat and breathing is not complete proof of death. We should also monitor the brains of every patient who dies.
‘When are we dead?’ he asks. ‘When the heart stops beating, the brain keeps going. That plays a big role for questions such as, when do you go ahead with organ donation? This is a very interesting question for me. We may have tapped the door open now to start a discussion.’