{"id":90127,"date":"2026-07-21T00:01:00","date_gmt":"2026-07-21T06:01:00","guid":{"rendered":"https:\/\/www.opinionpublica.tv\/portada\/?p=90127"},"modified":"2026-07-20T21:14:25","modified_gmt":"2026-07-21T03:14:25","slug":"why-do-some-dementia-patients-return-just-before-they-die","status":"publish","type":"post","link":"https:\/\/www.opinionpublica.tv\/portada\/why-do-some-dementia-patients-return-just-before-they-die\/","title":{"rendered":"Why do some dementia patients \u2018return\u2019 just before they die?"},"content":{"rendered":"\n
\"Why<\/figure>\n\n\n\n

In the spring of 2000, while completing his degree in psychology at the University of Vienna, Alexander Batthyany received an unusual call from his mother. She had just gotten off the phone with Batthyany\u2019s grandmother.<\/p>\n\n\n\n

\u201cI do not know what happened \u2014 but you should call,\u201d his mother told him. \u201cSomehow, she\u2019s back again.\u201d Batthyany was confused: His grandmother, who lived in a nursing home in Switzerland, had vascular dementia and, for the past year, had hardly been able to speak \u2014 let alone pick up the phone and initiate a conversation, as his mother claimed had just occurred.<\/p>\n\n\n\n

Doubting his mother\u2019s story, Batthyany nevertheless said he would call. He dialed his grandmother\u2019s number. When she answered, it was in the refined, elegant German he remembered her speaking in his childhood. In shock, he found himself wanting to shout: Oh, you can talk!<\/p>\n\n\n\n

His grandmother greeted him affectionately. She told him that for the past few months, she hadn\u2019t really been herself. She had been, she said, \u201cvery, very, very tired.\u201d<\/p>\n\n\n\n

At the sound of his grandmother\u2019s voice, memories came back to Batthyany, flashes of things they did together when he was a boy: hiking in the Alps, skiing trips in St. Moritz, a visit to the famed puppet theater of Geneva. His grandmother remembered it all. For 10 minutes, they reminisced in what Batthyany called \u201cthe most lovely conversation.\u201d Almost whispering, his grandmother told him, \u201cYou brought so much joy to our lives.\u201d This was his grandmother \u2014 gentle, caring, warm \u2014 the same as he knew her before she fell ill. But as the call ended, he sensed beneath the joy a painful finality \u2014 that this conversation would be their last. Several days later, his grandmother died.<\/p>\n\n\n\n

The conversation remained, in Batthyany\u2019s words, \u201can inexplicable personal experience,\u201d until one day in 2009 when he came across a paper in The Journal of Near-Death Studies, an academic outlet for discussion of death-related phenomena that have no ready scientific explanation. The article, written by a German biologist and parapsychologist named Michael Nahm, drew attention to reports of unexpected mental clarity in gravely ill people. Evidence of such events existed going back to antiquity, but the phenomenon had been largely forgotten since the 19th century.<\/p>\n\n\n\n

Nahm called it \u201cterminal lucidity.\u201d In his research, he had come across many remarkable instances, including the story of a 26-year-old woman, Anna Katharina Ehmer, who died in a German psychiatric hospital in 1922. Ehmer reportedly had never learned to speak, but according to the accounts of two witnesses, spent the final half-hour of her life in bed singing hymns. Similar seemingly impossible behavior, Nahm found, had been seen in people with dementia, tumors, neurological disorders, abscesses \u201cthe size of a hen\u2019s egg\u201d and many other forms of brain-ravaging illness.<\/p>\n\n\n\n

Batthyany realized immediately that Nahm was describing what occurred with his grandmother \u2014 and that he must not be the only one with such an experience. As a psychologist, he grew interested in the ways the events might affect those who witnessed them. He worked with colleagues to send out surveys, seeking cases from the modern era. Soon he had collected more than 60 reports, most of them relating to people living with dementia. In story after story, Batthyany\u2019s respondents described elderly people who suddenly reached for a loved one\u2019s hand; made amends for past wrongs; offered thanks; or simply seemed, through a shift in their eyes, to become present again.<\/p>\n\n\n\n

In 2014, Batthyany\u2019s initial findings were presented at the annual conference of the International Association for Near-Death Studies. An article that came out after the conference caught the attention of Basil Eldadah, a program officer at the National Institute on Aging, a division of the National Institutes of Health. Eldadah had a longstanding personal interest in the science of human consciousness, stretching back to his days as a medical resident; he followed the neuroscientific literature and kept up with research into poorly understood phenomena like near-death experiences. For Eldadah, terminal lucidity was particularly intriguing because it appeared in people with dementia \u2014 one of the populations he focused on in his work at the N.I.A.\u2019s geriatrics branch.<\/p>\n\n\n\n

Reading Batthyany\u2019s case reports, Eldadah thought about Alzheimer\u2019s disease and its relentless destruction of brain matter. The effects of that degeneration were said to be irreversible, and people with Alzheimer\u2019s were often spoken of as if they disappeared in lock step with the progression of the disease. But if it were true that mental clarity and memory could return in the latest stages of the disease, even just temporarily, Eldadah realized, \u201cit would call into question our models of what is actually going on in the brain.\u201d<\/p>\n\n\n\n

Eldadah secured funding for a two-day workshop where researchers could discuss what was known about the lucidity phenomenon and how best to study it. In June 2018, nine experts in nursing, geriatrics, neuroscience, psychology, patient care and linguistics assembled in a conference room at the N.I.A. office in Bethesda, Md. There was an air of uncertainty and excitement. At Eldadah\u2019s invitation, Batthyany flew in from Vienna to present his case collection. Eldadah also invited George Mashour, an anesthesiologist and neuroscientist at the University of Michigan, to present on the science of consciousness. Mashour and several other attendees shared that, like Batthyany, they had witnessed lucid episodes firsthand. But the more the researchers discussed the phenomenon, the more it confounded them. Mashour likened the brain in late-stage Alzheimer\u2019s to a pothole-ridden highway system on the verge of collapse, the biological traffic of mind and memory no longer able to flow. \u201cIf this were happening with actual highways,\u201d he told me, \u201cat no point would we say: \u2018Well, you know what? Just before this highway totally collapses, we\u2019re going to have a really smooth ride.\u2019 We\u2019d say, \u2018It\u2019s just going to get worse and worse until the whole damn thing crumbles.\u2019\u201d<\/p>\n\n\n\n

The challenge in trying to study the phenomenon was that the workshop attendees didn\u2019t know exactly what they were looking for: Because so little research existed, the lucid episodes\u2019 distinguishing characteristics, based solely on anecdote, were poorly defined. Batthyany\u2019s case reports indicated that many lucid episodes lasted just minutes and could be easy to miss. To document them, the group concluded that scientists would probably need to set up cameras, and the cameras would need to run more or less continuously. They thought it best not to limit the search to the days before death. Some proposed they think of the phenomenon as \u201cparadoxical lucidity,\u201d which would not only lessen the emphasis on death but also better reflect one of the main questions of interest: How could the mind resurface in a brain so terribly damaged by disease?<\/p>\n\n\n\n

Leaving the workshop, the attendees saw in the phenomenon the potential not just for improved caregiving practices but perhaps even a new understanding of the nature of dementia. And for some of them, the potential went even further. As Eldadah told me, paradoxical lucidity seemed to offer an opportunity to scientifically investigate \u201cthe most fundamental question that we as humans have to grapple with\u201d: the relationship between the body and the mind \u2014 and the nature of consciousness itself.<\/p>\n\n\n\n

In 2018, when Eldadah convened the workshop, the Alzheimer\u2019s field was going through a shift, as decades of research into treatments had come up frustratingly short. The atmosphere \u2014 and a recent funding increase at the N.I.H. \u2014 meant there was more willingness, as Eldadah put it, to \u201ctake a risk.\u201d The year after the workshop, the N.I.A. began a $10 million initiative to study lucidity in people with late-stage dementia.<\/p>\n\n\n\n

When Andrea Gilmore-Bykovskyi, an associate professor in emergency medicine at the University of Wisconsin-Madison, saw that the N.I.A. was interested in video research on lucid episodes, she knew one way to approach the problem. Her past work had involved filming people with dementia during interactions with nursing staff and then meticulously analyzing the videos, second by second, to assess which types of care affected patients\u2019 behavioral symptoms. She proposed retooling those video methods to study lucidity.<\/p>\n\n\n\n

Gilmore-Bykovskyi knew that people with dementia showed modest fluctuations in cognition frequently enough, particularly at the mild and moderate stages; she had also seen firsthand how, in the right environment and the presence of good caregivers, the behavioral symptoms of dementia could sometimes lessen. But the turnarounds described by the N.I.A. were said to be more pronounced and especially likely to occur in the final days or hours of life, a deeply sensitive time for cameras to be rolling at a patient\u2019s bedside. Knowing she would need to closely partner with a medical facility and its staff to have any chance of success, Gilmore-Bykovskyi reached out to a hospice nearby, Agrace, which had a 12-bed memory care unit. The hospice agreed to work with her team, and in 2020 the N.I.A. awarded her a grant.<\/p>\n\n\n\n

Lucid episodes were thought to be quite rare; Gilmore-Bykovskyi suspected her odds of documenting the phenomenon in such a small study were low. The cameras were set up in December 2021, and to the U.W. team\u2019s surprise, the first episodes occurred not long after. By then, Alison Coulson, a nurse who served as the team\u2019s data collector, had worked with Joan Stephen, an 89-year-old resident, for a few months \u201cand not gotten a lot of back-and-forth,\u201d she told me. Stephen had largely stopped speaking and had appeared not to recognize her family members for several months. Suddenly, while looking at old photos of her children one day, she named them. Cameras were running not long after when she recalled her late husband, John, and shared, in full sentences, specific details about his job (\u201cHe worked for Comstock Tire\u201d). She also recognized a picture of the award-winning rose bushes she tended for decades, before Alzheimer\u2019s took away her focus and made them wither. When Coulson showed the videos to Stephen\u2019s daughter, she said she was amazed. \u201cIt was extremely exciting,\u201d Coulson told me. (The U.W. team protects the anonymity of its study\u2019s participants; some of the subjects\u2019 family members permitted the team to share details with The Times.)<\/p>\n\n\n\n

Sometime later, another participant, an elderly man with Alzheimer\u2019s whose verbal output the researchers assessed to be \u201cminimally coherent,\u201d showed an even starker change. The man had been mobile throughout the full 10 years of his illness, but over a two-week period, his energy notably declined and he began spending more time sleeping in bed. Seeing this, nurses made the decision to tell his family to gather \u2014 the end seemed to be near. By the time his family members arrived, however, the man had gotten out of bed and begun speaking. During his decline, he had reverted, as many bilingual patients with Alzheimer\u2019s do, to his native language. Now he spoke clearly in English again, reminiscing about his childhood and his father. The nurses and his family were stunned. He stayed alert like this for two days, at one point telling his family, \u201cI\u2019m leaving soon.\u201d Nine days after the episode ended, he died.<\/p>\n\n\n\n

Along with the U.W. team, the N.I.A. sent funding to five other research groups. One of those teams, based at the Mayo Clinic, focused its efforts on surveying caregivers about their experiences with lucid episodes. As the data came back, they found that there appeared to be different types. Some episodes resembled the prototypical cases of terminal lucidity like those that Nahm and Batthyany reported, with heightened recoveries occurring close to death. But many more were subtle instances \u2014 a flash in the eyes, a few meaningful words \u2014 that occurred weeks or even months before death. Many caregivers were deeply moved, but the events were not always positive on balance. \u201cSometimes they\u2019re totally negative,\u201d Joan Griffin, the lead researcher on the Mayo Clinic team, told me. \u201cWe had one caregiver who was like: \u2018My dad was an [expletive] when I was young, and he had a lucid episode \u2014 and he was an [expletive] when he came back. He was a terrible father, and it reminded me about why he was so bad.\u2019\u201d<\/p>\n\n\n\n

The Mayo Clinic group found that some events seemed to be triggered by the environment \u2014 for instance, by familiar music or old friends who reminisced in the person\u2019s presence. The triggers did not appear to be reliable or replicable, but many caregivers made elaborate attempts to elicit the episodes again. Griffin recalled a woman in her study who said her husband had not spoken for years. One night, as they ate his favorite dinner \u2014 eggplant Parmesan \u2014 he looked at her and said her name. Thinking the meal had triggered the moment, the woman made the dinner again the following week and served it to him, hoping he would \u201ccome back.\u201d He never did. Andrew Peterson, an investigator on a research team at the University of Pennsylvania, told me about a report of a man with advanced dementia who, seeing his son approach the top of a staircase, suddenly said, \u201cBe careful.\u201d The son repeatedly returned to the stairs and pretended he was about to fall, hoping to hear his father\u2019s voice again.<\/p>\n\n\n\n

By the time the U.W. team approached Ed Janus about joining the study in 2023, his partner, Mary Moebius, had lost most of her ability to speak. For 33 years, Mary had taught middle-school language arts in Verona, Wis., not far from Madison. She had been sharp-witted and a little shy. But in 2014, Ed noticed her personality starting to change. She grew paranoid and combative; she began to get lost. The woman who once spent hours spilling out her thoughts to him in all their complexity struggled to find her words. She was diagnosed with Alzheimer\u2019s, and as the disease progressed, their conversations became fewer, her sentences more and more confused. Now 74 and in hospice at Agrace, Mary tended to get stuck in repetitive, rhyming loops of sounds when she spoke. Ed chose to believe that Mary had learned a coherent, lost language that he simply couldn\u2019t understand; he called it \u201cancient Sumerian.\u201d<\/p>\n\n\n\n

Then on Oct. 13, 2023, with a camera focused on her, Mary spoke clearly again. In a small common area, a nurse\u2019s assistant prepared a lunch of beans and casserole for her. Mary, dressed in a red shirt, sat in a specialized ergonomic wheelchair; her thick gray hair shot out in all directions. A rerun of \u201cThe Price Is Right\u201d played on a nearby TV. Suddenly, Mary\u2019s eyes appeared to light up. She reached toward the nurse\u2019s assistant with an index finger extended. The assistant pulled away and laughed to someone nearby: \u201cShe tried to shove her finger up my nose!\u201d<\/p>\n\n\n\n

Mary dropped her face into one hand. Quietly, she said, \u201cI\u2019m getting ready to go.\u201d<\/p>\n\n\n\n

\u201cYou\u2019re getting ready to go?\u201d the assistant said. \u201cThat was a full sentence! Where are you going?\u201d<\/p>\n\n\n\n

\u201cI don\u2019t know,\u201d Mary said. \u201cThat\u2019s why I\u2019m looking to you.\u201d<\/p>\n\n\n\n

\u201cYou\u2019re looking to me? I don\u2019t have directions.\u201d<\/p>\n\n\n\n

The assistant offered her a spoonful of food, but Mary took her by the hand and stopped her: \u201cNot yet.\u201d<\/p>\n\n\n\n

Mary looked around the room. The assistant, seemingly preoccupied with making sure Mary ate, held out a carton of chocolate milk with a straw, but Mary didn\u2019t take it. Instead she took the assistant\u2019s hand, made eye contact and said, somewhat haltingly, \u201cI can\u2019t kill myself here.\u201d<\/p>\n\n\n\n

The assistant seemed caught off guard and stumbled for a second. \u201cNo, we don\u2019t want to do that,\u201d she said. Mary\u2019s gaze dropped. She leaned forward and covered her eyes with her hand.<\/p>\n\n\n\n

\u201cDo you have a headache?\u201d the assistant asked.<\/p>\n\n\n\n

Mary looked up. \u201cYes, I do.\u201d<\/p>\n\n\n\n

Hearing Mary\u2019s reply from across the room, Robyn Shearer, the nurse on shift at the time, responded in surprise. \u201cOK! That was pretty clear.\u201d<\/p>\n\n\n\n

Some time passed. Shearer came with a cup of painkiller-infused ice cream. When Mary tasted the dessert, she said, \u201cThat\u2019s what I wanted.\u201d<\/p>\n\n\n\n

Shearer joked with Mary, giving her a second helping of ice cream and doing a celebratory dance: \u201cWe did it!\u201d<\/p>\n\n\n\n

Mary laughed. \u201cYou did it,\u201d she said. She kept talking to Shearer, but her speech was now dipping in and out of intelligible words. The flash of lucidity seemed to be ending.<\/p>\n\n\n\n

Shearer and the nurse\u2019s assistant went back to work and didn\u2019t mention what happened. But several weeks later, a graduate student who was screening the tapes flagged the moment. Coulson gathered the two in a kitchenette to review the video. As part of the study protocol, she needed to make sure that people familiar with Mary thought something atypical had occurred.<\/p>\n\n\n\n

The answer was clear. Seeing themselves going about their work as Mary tried, quietly but consistently, to communicate with them was jarring. The nurse\u2019s assistant broke out in tears. As soon as the video ended, she went to find Mary in the unit\u2019s activity room. \u201cShe hugged Mary,\u201d Shearer told me, \u201cand said: \u2018I am so sorry that you have been trying to talk to me and I have not been listening to you, and I\u2019m sorry that you could not find the language to tell me that you were in pain. And I promise you I will never ignore these signs again \u2014 not for you and not for anyone else.\u2019\u201d<\/p>\n\n\n\n

When Ed saw the video, he felt conflicted. He said he was happy to hear Mary\u2019s voice again. He noted the apparent increase in her awareness, the disappearance of the \u201cancient Sumerian.\u201d But he found her tone inscrutable and struggled to understand what she could have meant. When she said \u201cI can\u2019t kill myself here,\u201d was she asking the nurse for reassurance that she was safe? Was she trying to say something about the way she\u2019d been treated? Did she feel trapped, depressed, afraid?<\/p>\n\n\n\n

\u201cIt may well be that Mary\u2019s soul is back,\u201d he told Coulson.<\/p>\n\n\n\n

In a 2011 paper in The Archives of Gerontology and Geriatrics, Michael Nahm, the parapsychologist who first identified terminal lucidity, and the University of Virginia psychiatrist Bruce Greyson noted what they saw as a deeper mystery revealed by episodes of lucidity in dementia: The phenomenon seemed to show that the mind could continue to function even when the brain was significantly impaired. This was hard to reconcile, they observed, with the mainstream scientific belief in reductive materialism, which holds that consciousness originates from biophysical processes in the brain. \u201cIf you believe that everything we see and hear and feel and think and decide comes solely from the brain,\u201d Greyson told me recently, \u201cthen you have to propose a mechanism for how the brain does that when it\u2019s been deteriorating for years and years and not been able to do those things. How does it suddenly recover those abilities?\u201d It was because of this that Nahm and Greyson thought lucid episodes could teach scientists about the mind-body relationship and the nature of consciousness itself.<\/p>\n\n\n\n

When the N.I.A. announced the funding for research into paradoxical lucidity in 2019, the potential to explore these questions also caught the interest of Sam Parnia, a brain and consciousness researcher at New York University who now leads one of the N.I.A. studies. Parnia is best known for conducting the largest and most rigorous studies to date of near-death experiences in survivors of cardiac arrest. (He prefers to call these \u201crecalled experiences of death,\u201d and considers \u201cnear-death experience\u201d vague and unscientific.) It was these studies that laid the foundation for his thinking about consciousness in those with late-stage dementia. In a series of conversations over the last five years, he explained how he saw unexpected episodes of lucidity as part of a growing evidence base that seriously challenges the materialist paradigm.<\/p>\n\n\n\n

Studies have shown that up to 20 percent of people who survive a cardiac arrest report clear memories from the time when they were clinically dead. In his research, Parnia found that survivors\u2019 memories followed a distinct narrative arc: They felt themselves separate from their bodies, sometimes hovering above the scene and watching with a sense of detachment as doctors tried to revive them; they began traveling to a destination, through what many perceived as a tunnel of light; they accessed a vast store of memory and underwent a review of every moment in their lives from multiple points of view simultaneously, judging the way their actions and intentions had affected others; and finally, although many protested, they re-entered their bodies, often utterly changed. The transformative nature of the experience could be seen in survivors\u2019 reduced fear of death, a newfound desire to seek deeper meaning in life and \u2014 some other researchers have found \u2014 sky-high divorce rates.<\/p>\n\n\n\n

In a pair of studies known as AWARE-I and AWARE-II, conducted from 2008 to 2020, Parnia tried to figure out if these subjective reports could be verified. To do so, he placed images above the patients\u2019 heads in rooms throughout various hospitals. His thinking was that a person who had a near-death experience while undergoing CPR might be able to report seeing the images and thus provide proof that the mind could truly separate from the body. In AWARE-II, an EEG machine was used to monitor for signs of brain activity in patients during CPR.<\/p>\n\n\n\n

The EEG readings showed that, during the time when they were clinically dead \u2014 meaning their hearts had completely stopped \u2014 some patients\u2019 brains had periods of electrical activity consistent with conscious experience. But for some hopeful watchers, the AWARE studies ended in anticlimax: While one survivor in AWARE-I recalled details of the procedures he\u2019d seen himself undergo that were later verified, he had been resuscitated in a room where Parnia\u2019s images weren\u2019t installed. (In AWARE-II, Parnia added a sound component: Bluetooth headphones placed over patients\u2019 ears during CPR cycled through the names of three fruits \u2014 \u201capple,\u201d \u201cpear,\u201d \u201cbanana.\u201d Survivors were asked to list three random fruits that came to mind when they thought of their resuscitation. One named the correct three, but the sample size was too small to be sure it wasn\u2019t by chance.) Even some scientists who believed Parnia\u2019s studies were a fool\u2019s errand praised the ambition and thoroughness of his approach. But the results were ambiguous enough that anyone involved in the debate over the nature of consciousness, materialist or not, could find evidence to support the beliefs they already held.<\/p>\n\n\n\n

In his 2009 paper coining the phrase \u201cterminal lucidity,\u201d Nahm cited Parnia\u2019s work on near-death experiences, noting what he saw as a commonality between the two phenomena: their relation to death. As his N.I.A. study on paradoxical lucidity progressed, Parnia also came to feel that, in certain cases, the experience of dying couldn\u2019t be ignored. In some episodes, Parnia said that people reconnected with their old sense of self \u2014 but they also looked forward, their words relating to \u201ca preparation for their departure.\u201d He told me: \u201cThey\u2019re expressing something lucid, but it isn\u2019t to do with their ordinary lives. It\u2019s something to do with what seems to be ahead of them.\u201d They often spoke about feelings of contentment, the presence of deceased loved ones and a sense that they would soon be heading to a new destination, all features resonant with near-death experiences. \u201cGenerally,\u201d Parnia said, \u201cthe frequency of these terminal lucidity experiences seems to go up more in proximity to death.\u201d<\/p>\n\n\n\n

The N.I.A. program has not investigated the brain mechanisms that enable episodes of lucidity in late-stage dementia. But Parnia thought the parallels he saw between lucid episodes and near-death experiences suggested a shared mechanism \u2014 what neuroscientists call \u201cdisinhibition.\u201d In normal life, our brains are constantly blocking some neural pathways while keeping others open. This balance helps us focus on what matters to us most \u2014 eating, relationships, work \u2014 and prevents us from being flooded by all the information we\u2019re taking in at any given moment. \u201cOur general perceptions are that when your brain is disordered, you lose all function,\u201d Parnia told me. \u201cWhat we\u2019re finding is that, paradoxically, in disordered states, sometimes that disorder actually opens up pathways to new abilities that were hidden before.\u201d These instances of disinhibition seem to connect people, in Parnia\u2019s view, \u201cto parts of their consciousness that they couldn\u2019t access before.\u201d<\/p>\n\n\n\n

Parnia has a level of institutional prominence rarely seen in the world of near-death research. This authority made followers of the AWARE studies especially curious to know what he thought of his findings: Did he feel he had evidence that the mind could exist apart from the brain? That there was life after death? He responded cautiously while the studies were ongoing. But in his 2024 book, \u201cLucid Dying,\u201d Parnia firmly staked his position in the mind-body debate. \u201cWe are at the cusp of the exploration of a new frontier in science,\u201d he wrote, declaring himself \u201cquite optimistic that the nature of human consciousness \u2014 our very selfhood \u2014 will be discovered to be a flux of energy like electromagnetic waves that interacts with the brain and body but is not produced by them.\u201d<\/p>\n\n\n\n

Basil Eldadah, who left his role at the N.I.A. last April to become the director of a natural burial ground in Maryland, told me that the first AWARE study had partly inspired his approach to the lucidity research program. When I asked him what he thought paradoxical lucidity indicated about the mind-body relationship, he said that he felt the phenomenon did not offer the same kind of clear-cut challenge to the materialist paradigm as near-death experiences did. \u201cI think you could easily propose that there is some residual capacity of the brain that, somehow, is able to be unleashed during lucid episodes in dementia,\u201d he told me. \u201cYou don\u2019t have to invoke an alternative to materialism to explain all of lucidity, at least for now. We just don\u2019t understand enough about what\u2019s going on.\u201d<\/p>\n\n\n\n

Parnia told me his belief that consciousness most likely is not produced by the brain \u201cdoes not mean consciousness is magic, and it doesn\u2019t mean it\u2019s not scientific.\u201d The challenge, he said, is that scientists do not have ways to directly measure consciousness \u2014 whatever it is \u2014 and so investigating its nature has usually been left to philosophers. Parnia thinks that scientists should not shy away from pursuing those questions themselves, building off whatever evidence is available \u2014 and following the answers wherever they lead. \u201cThe reason why I\u2019m more open to this is because, when you look at people who die and come back \u2014 definitely, their brain shuts down,\u201d he told me. \u201cAnd definitely, at best, it is highly dysfunctional. At worst, it is nonfunctional. Yet we have five decades\u2019 worth of data that tells us there is lucidity. There is paradoxical lucidity in death.\u201d<\/p>\n\n\n\n

The U.W. team published its findings last August in The Gerontologist, one of the top journals in the field. In evaluating the phenomenon, the study didn\u2019t just rely on how the nurses and caregivers responded. The video recordings offered the U.W. team something no one had ever seen before: the first objective data on the way people experiencing episodes of lucidity communicate.<\/p>\n\n\n\n

In each of the three people who had lucid episodes captured by the study, the team found significant shifts in communication and behavior. Some of the findings seemed obvious to anyone who watched the videos: Overall, each person spoke with a higher rate of meaningful vocalizations during a lucid episode. But the shifts went beyond words. In Mary\u2019s case, the study showed that in the moments when she appeared to be lucid, she held more eye contact and laughed more.<\/p>\n\n\n\n

Even the tiniest moments offered a wealth of insight. Both Mary and Joan Stephen, for instance, showed a higher propensity for using filler words like \u201cum\u201d and \u201cuh,\u201d which tell the listener that the speaker is aware of them and asking them to wait while they find the word they need. And when the nurse\u2019s assistant asked Mary if she had a headache, Mary\u2019s seemingly simple reply, \u201cYes, I do,\u201d suggested that her working memory \u2014 which temporarily holds and processes information and is often one of the first forms of memory to become impaired by Alzheimer\u2019s \u2014 was back.<\/p>\n\n\n\n

In some of the other N.I.A. studies, similarly surprising levels of cognitive and functional recovery have been reported. Griffin, the head of the Mayo Clinic team, told me about a family in her study who spent their Christmas dinner debating where one of the children should go to college \u2014 an expensive private university in another part of the country or a more affordable state school that was close to home. \u201cThere was a lull in the conversation, and the grandfather, who had not spoken in something like six months, said: \u2018I think he should probably go to the state school. It\u2019s more valuable, and it seems like it would be a better fit for him.\u2019 Everyone around the table dropped their forks.\u201d The episode showed the family that not only could the grandfather speak \u2014 he had been processing the conversation the whole time.<\/p>\n\n\n\n

Gilmore-Bykovskyi emphasized that the U.W. team\u2019s study was just a small, early piece of the immense body of research that will be needed to understand episodes of lucidity. \u201cPeople could spend their entire careers studying this,\u201d she told me. Recently, she and Griffin introduced a cross-disciplinary effort they call the Lucidity in Alzheimer\u2019s and Dementia Network, bringing together Parnia and about a dozen other researchers to systematically approach the phenomenon. They hope that these studies will one day help scientists explain what it is, why it occurs and how to help those who witness or experience it.<\/p>\n\n\n\n

When I first began research for this article, many of the available written accounts of lucid episodes seemed like chapters from a book of lost fables: Like Sleeping Beauty, Anna Katharina Ehmer is robbed of her voice and her mind and spends her life unresponsive in bed \u2014 only to sing hymns at the hour of death. The videos I saw were remarkable but decidedly less literary. People\u2019s words weren\u2019t always clear. They answered one question, then fell silent to any follow-ups. They remembered the names of three of their children and, shown a photo, didn\u2019t name the fourth. There were no hymns or spontaneous poems here, but the words still reached people with an impact that reverberated in unpredictable directions.<\/p>\n\n\n\n

On a brisk morning in January, I met Coulson, the U.W. nurse in charge of data collection, at Agrace. Coulson is friendly and inquisitive; she has kept in touch with some of the caregivers from the study. Despite having worked most of her nursing career in hospices, she told me she hadn\u2019t seen paradoxical lucidity until she began working with the U.W. team.<\/p>\n\n\n\n

The study had enrolled its 33rd participant not long before, and Coulson was there to collect data. The memory care unit was a locked world unto itself, with carefully selected art meant to evoke familiar scenery from the residents\u2019 lives \u2014 sun-drenched bales of hay, a wooden dock on a lake in the Wisconsin Dells, the dome of the State Capitol towering over modest homes on the Madison isthmus. Coulson greeted the participants as she went around the unit. She looked each person in the eyes and asked if it was OK for her to film; not detecting any signs of dissent, she set the cameras up. One man lay in bed, opening his eyes every few moments to stare at the verdant blur of pine trees just beyond his window. Coulson tiptoed in and attached a microphone to his headboard, where it could pick up anything he might say.<\/p>\n\n\n\n

Later that afternoon, Ed Janus, who had agreed to watch the tapes of Mary\u2019s lucid episodes with me, came by in a buoyant mood. But I detected a hint of reservation in his voice. \u201cI hope you\u2019re not going to make me watch that awful video,\u201d he said, only half joking. Altogether, the study found that Mary briefly became lucid on four separate days. The video Ed had in mind was the only episode he had been present for. He opened his laptop and pressed play.<\/p>\n\n\n\n

In the video, Mary sits in a wheelchair in a hallway of the hospice. Ed enters the frame and puts a knit blanket over her shoulders. \u201cSnug as a bug in a rug,\u201d he says to her. He steps off camera and starts talking to Coulson.<\/p>\n\n\n\n

\u201cLooks like something from that movie where they\u2019re in the pods,\u201d Ed jokes.<\/p>\n\n\n\n

\u201c\u2018Cocoon\u2019?\u201d Coulson asks.<\/p>\n\n\n\n

\u201cNo.\u201d<\/p>\n\n\n\n

\u201cI don\u2019t know what movie you\u2019re talking about.\u201d<\/p>\n\n\n\n

\u201cNeither do I.\u201d<\/p>\n\n\n\n

The camera captures Mary as she trains her eyes on them. Coulson suggests Ed watch the 2016 movie \u201cArrival,\u201d in which aliens descend and baffle the planet with indecipherable messages until an enterprising linguist decodes their language. \u201cIt\u2019s a little scary, but it\u2019s fascinating \u2014 fascinating to think about interspecies communication.\u201d<\/p>\n\n\n\n

Ed laughs. \u201cSometimes I feel that way about Mary \u2014 \u2018interspecies communication.\u2019\u201d<\/p>\n\n\n\n

At that moment, looking toward Ed, Mary lets out a rolling laugh. Then, softly, she says, \u201cCome this way.\u201d<\/p>\n\n\n\n

Ed doesn\u2019t hear Mary, but Coulson does: \u201cShe said, \u2018Come this way.\u2019\u201d<\/p>\n\n\n\n

Surprised, Ed turns and faces Mary. He pats her shoulder. He gently brushes a hand over an errant tuft of her gray hair. Then he turns around and begins chatting with Coulson again.<\/p>\n\n\n\n

As we watched the video together in January, Ed\u2019s entire body tensed up. Seeing himself turn away from Mary, and joke as if she weren\u2019t sitting right there, left him feeling an ache of regret. Loss in dementia is often conceived of as the destruction of the sick person\u2019s self. But what Ed felt was the pain of a shared loss: the loss of his ability to connect his mind to Mary\u2019s. When he watched the videos, I saw him struggling to understand Mary\u2019s tiniest gestures and words, unable to settle on a convincing interpretation. Even the moments of lucid speech brought only more questions. Mary was undeniably acting in those moments in ways she hadn\u2019t for many years \u2014 but if lucidity implies clarity, Ed\u2019s experience of the episodes was anything but clear.<\/p>\n\n\n\n

A couple of months after Mary arrived at Agrace in 2023, Ed could see that she was slipping into the final depths of her illness. On Jan. 25, 2024, around 4 a.m., a nurse called Ed to tell him Mary was dying. Ed and a friend of Mary\u2019s, Marilyn Rhodes, gathered at Agrace. Rhodes sat at Mary\u2019s bedside, listening to her breaths. At the moment Mary breathed out for the final time, Rhodes recalled, everyone in the room looked out the window to see \u201cthis bright red bird in this misty green backdrop\u201d \u2014 Mary\u2019s favorite, a cardinal. \u201cIt was one of those experiences where it doesn\u2019t matter what the explanation is,\u201d Ed said. \u201cIt\u2019s not the point.\u201d<\/p>\n\n\n\n

Ed scheduled a memorial service for Mary in a park that July. As the day approached, he tried to write a eulogy, but his words fell flat. He wrote a dozen drafts and discarded them all. One day he realized that rather than listening to him talk about Mary, maybe people would want to hear Mary speak \u2014 \u201cbecause Mary could be quite talkative, and she, for sure, still had a lot to say.\u201d As he sat at his computer, an image came to him: a cardinal carrying a letter in its claws. The letter was from Mary. He imagined opening it. He began to type the words he saw.<\/p>\n\n\n\n

\u201cI suspended disbelief,\u201d he told me. \u201cI let Mary write.\u201d<\/p>\n\n\n\n