Locked-In and Out of Luck

By Kenneth Ring, Ph.D.

You’re a healthy man in your early thirties and a soccer enthusiast. One evening, while your wife is out, you are engrossed in watching an exciting match on your TV. But, all of a sudden, you don’t seem to be watching it anymore. There’s a good reason for that, but you don’t know it yet. Meanwhile, your wife, a nurse, returns to find you slumped over on the couch, slipping in and out of consciousness in a highly confused state. She is naturally very concerned and sees that your skin has turned a bluish-purple color, a sign that you are cyanotic, owing to prolonged oxygen deprivation. She calls for an ambulance to take you to the hospital. 

In the hospital, you are still in an alarming condition and are put into a coma. Yet, instead of becoming entirely unconscious, you become perfectly clear and alert although you cannot move your body. Worse, you can’t seem to communicate to your doctors. You feel that you are "locked-in" to your body, its involuntary prisoner. You become very frightened and think, "Will I be like this for the rest of my life?"

All this reads like an episode from a medical horror story of the sort that Edgar Allan Poe wrote, but it’s not a case of ghoulish fiction. In fact, it’s a brief summary of an actual case of an Israeli guy named Gil Avni. In this blog you will learn a lot more about Avni and what he experienced while in this dreadful locked-in state, but first I need to provide some background information in order that you have a proper context for what follows. 

The Back Story

Some years ago, I became aware of the work of a German researcher named Michael Nahm, who was investigating a phenomenon of which I had never heard, which he had labeled terminal lucidity. It referred to something that was astonishingly paradoxical that occurred to some people on the verge of death. These individuals had usually been profoundly demented, often suffering from Alzheimer’s or other severe forms of end-stage dementia, and in many cases had been mute for years. Yet, by a seeming miracle, they suddenly "woke up," and were able to carry on lucid conversations, inquiring about health of various family members, etc., as if they had never been away. And, then, typically, some hours later or the next day, they died.  

I was tremendously excited to learn about this phenomenon. It made me wish I could still be active in doing research, so that I could do my own studies of terminal lucidity (TL). But since I couldn’t, I wrote to Nahm, and as a result, we had a very warm and cordial series of e-mail exchanges for the next year or so, and I eventually made contact with other TL researchers and wrote about TL in my blogs.

I had only sporadic contact with Nahm until just recently when he wrote to me about his latest research, which dealt with the case of Gil Avni, and attached the draft of an article he and some colleagues he had written about this kind of locked-in experience. [The paper will be published in the upcoming issues of Journal of Scientific Exploration, so stay tuned for it!] In this blog, I will be drawing extensively on the draft of this paper, with Dr. Nahm’s kind permission. 

Interestingly enough, the three principal authors of this paper were Nahm and two other researchers I knew very well. One was my dear friend and longtime colleague, Pim van Lommel, a Dutch cardiologist, and one of the world’s most renowned NDE researchers. The other, to my happy and delighted surprise, was a nurse named Madelaine Lawrence whom I had first met fifty years ago (!) when she had taken a graduate course in transpersonal psychology with me. We eventually published some research together (PDF) and stayed in touch for a few years before each of us went our separate ways. But over the years, Madelaine became one of the world’s leading authorities in the study of states of awareness in comatose patients. So I was really glad to learn about her career and look forward to making contact with her again after all these years!

Now, with this as background, let me return to the case of Gil Avni and begin to tell you his remarkable story.

Being Comatose

But before getting into Avni’s experience, we need a brief preface about what it’s like to be comatose, as Avni was for forty-four hours. We know from the research of Madelaine Lawrence and others that between 25% and 40% of comatose patients are able to hear and understand what had been said in their environment during the time of their supposed unconsciousness. Another study found that only 27% of patients had no awareness at all while comatose.

In a recent book devoted to the experiences of patients who recovered from medically induced comas like the one into which Avni was put, it was found that for some, it can be quite frightening. Nahm et al provide a brief summary of some of these cases.

For example, the patients may have experienced being cruelly tortured for prolonged periods of time or may have spent years from a subjective perspective in seemingly other realms of existence – even if the coma itself lasted only days or weeks. These bewildering experiences frequently appear perfectly real or even "more real than real" to those who report them.

Being Avni

Because of space limitations, I will be forced to give only a very brief description of Avni’s experience. It will include more about what led to his becoming comatose and what he experienced during the forty-four hours of his ordeal. For this purpose, I will draw on and slightly edit the abstract that Nahm et al provide:

Gil Avni was diagnosed with a cerebral edema and suffered severe anoxic brain damage that had already affected his brain stem. He was put in an induced coma to minimize the brain’s oxygen consumption. Still, he was expected to die within hours. However, the patient recovered unexpectedly. It turned out he had been fully conscious throughout the 44 hours he was in this coma. [My emphasis.] As a result, he was able to describe in detail every occurrence and conversation that had been held at his bedside throughout this time. This locked-in experience had an utterly traumatic impact on the patient, as I (KR) will note later.

Eventually, his doctors decided it was time to bring him out of his coma. This took some time, but when he woke up completely, to the surprise of everybody, all his critical symptoms, including his pulse and blood pressure, rapidly returned to normal. As Nahm et al write:

In order to facilitate communication with him (he was still weak and intubated), the nurse handed him a letter board as well as sheets of paper and a pen. One of the first things Avni communicated was: "I was in full consciousness since Thursday evening. I heard everything they said, word for word."

It was later determined that every conversation Avni reported was confirmed as being completely accurate according to the testimony of the individuals whom Avni claimed to overhear while comatose. 

As the authors continue:

  

On Sunday morning, the endotracheal tube and other medical devices were removed. Soon after, Avni left the hospital on his own account. To this day, none of the physicians and ICU nurses involved in Avni’s case has a medical explanation for his sudden and dramatic life-threatening breakdown – much less for his prompt recovery to full health. Only the aspiration pneumonia improved comparably slowly. It took three months until Avni’s lungs were healthy again.

But while Avni ultimately recovered physically, psychologically, it was another story. For some time afterward, he would wake up screaming. Indeed, his PTSD was understandably very severe before it finally began to subside. 

At this point, I need to interrupt this narrative to tell you that if you get Amazon Prime, you can watch an extremely compelling documentary about Avni where you see him, his wife, and the various medical personnel who attended him during his ordeal.  It lasts an hour and twenty-two minutes, and it is emotionally very powerful.  It also shows you what happened to Avni afterward.  It’s called 44 Hours, and I highly recommend it. View the film's trailer on YouTube.

But I am now going to tell you about some remarkable things that were not mentioned in the documentary, but only in the article Nahm sent to me. As you will see, there was much more to Avni’s experience than I have told you, and what it was, was even more extraordinary.

For this concluding portion of Avni’s story, it would be best for me simply quote directly from one section of the article by Nahm et al. It begins by informing us that one of the doctors taped Avni’s eyes shut to prevent damage to his corneas. However, that did not prevent him from seeing, as you will now learn. It turns out that while comatose and apparently close to death, Avni also had an extensive NDE. Here’s how Nahm et al describe this aspect of Avni’s experience:

From then on, he followed the events that occurred during the next two days chiefly via his sense of hearing from this in-the-body perspective, although he also experienced occasional OBEs again during which he seemed to perceive his environment visually.

Typically, Avni entered the OBE-state in particularly distressing and emotionally intense situations. This happened for example when the visitors came to say their goodbyes. In this situation, he was able to perceive them visually and memorized the clothes they wore. He even saw his sister, who had to wait in a corridor of the hospital in about 30 to 40m in distance to his room. She was not allowed to visit Avni at his bedside because she was pregnant and he was treated with nitric oxide, a substance that may cause harm to developing fetuses. Still, Avni saw her (crying) and followed the conversations she led, e.g. with her husband, and was later able to describe her clothing. In discussions with Avni, his sister and other visitors, members of the team producing the documentary were able to corroborate that he had described the events that occurred accurately and gave correct descriptions of their clothes.

Other elements that link his case to NDEs include the perception of an attractive bright whitish light. He perceived it in the OBE state in the distance when he was initially transported through the hospital corridors into the room where he was to be put into the coma. But Avni did not want to get closer to this light. Moreover, he felt the distinct presence of a spiritual entity throughout the entire time he was in the coma. When he was in the OBE state, he could even perceive it as a shadow-like figure inside his room. 

Apparently, this entity was already present when he arrived in the hospital room and stayed with him until the decision was made to wake him up from the coma. Throughout that time, it encouraged Avni to stay alert and awake, and not to give up hope for recovery. According to Avni, who regards this entity as a kind of guardian angel, it approached him and touched him with a finger after the decision to wake him up was made. This touch felt like a tremendous jolt of electricity-like energy, and the being informed him that it was now time to leave him because its duty was fulfilled.  

So, Avni was never alone throughout this soul-crushing ordeal. He was comforted by this Presence, which he understandably came to regard as his guardian angel. It was this Presence who instructed him as to what to do and who gave Avni hope that he would recover. As indeed he did, against all expectation and to the astonishment of everyone involved in his case.

And now you know why.