Back from the dead: Fabrice Muamba and other modern Lazaruses
More souls turned away from the Pearly Gates
A 34-year-old woman whose heart stopped for a record six hours was brought back to life by doctors in a Barcelona hospital. Audrey Schoeman, an English teacher born in Kent but who resides in the Spanish city was hiking in the Pyrenees with her husband Rohan Schoeman, 36, on 3 November 2019. They became lost during a blizzard and sheltered behind a rock for several hours, where Rohan managed to phone friends and alert emergency services.
By this time, Audrey had no pulse – hypothermia had triggered cardiac arrest. When rescuers reached her at around 3.40pm, she was displaying no vital signs; nevertheless, when she arrived by air ambulance at Barcelona’s Vall d’Hebron Hospital at 5.45pm, her body temperature was 18°C (64.4°F), half the normal 37°C (98.6°F), and in addition, her lungs and kidneys were failing. Nevertheless, doctors thought there was a slim chance of survival – because the hypothermia had set in prior to the cardiac arrest, they hoped her frozen brain might not have deteriorated during the period it was not receiving blood (or oxygen), since, effectively in a state of suspended animation, it required neither.
They hooked her up to an ECMO (extracorporeal membrane oxygenation, aka a life support machine), which replaces the functions of the heart and lungs.
When rescuers reached her, she was displaying no vital signs
The patient’s blood is pumped from their body to an artificial lung where carbon dioxide is removed and oxygen added, then pumped back into the body. In this case, the ingoing blood was gently warmed so that her body temperature gradually increased. When it reached 30°C (86°F), medics attempted to start her heart again using a defibrillator, eventually succeeding at 9.46pm – at least six hours after she had first lost consciousness. She was heavily sedated for 48 hours but woke three days later and began talking, leaving hospital after 11 days with no apparent side-effects other than some sensitivity and mobility difficulties with her hands.
Dr Eduard Argudo, who led the medical team, said: “This is an exceptional case, the longest cardiac arrest ever recorded in Spain. There are practically no cases of people whose hearts have stopped for so long and have been able to be revived”. Audrey Schoemann recalls little of her rescue. “The more I learn the more miraculous it seems”, she said. “I’m incredibly lucky. I feel so incredibly grateful to all the doctors, medics and rescue teams”. Despite her brush with death, she is keen to go mountain hiking again as soon as she is able.
Earlier in 2019, Joao Araujo, 48, from Linden, Gloucester, baffled doctors after being admitted to hospital with a cardiac arrest, which occurred suddenly as he drove his wife to work (FT386:20). Medics attempted to revive Mr Araujo, at the time a lorry driver, with injections and CPR, but after six hours they pronounced him dead. As he was being wheeled to the morgue, nurses spotted signs of movement – and tests indicated that his circulation had somehow returned. He remained in a coma for three days, and doctors warned relatives that his brain might be permanently damaged due to a lack of oxygen over a 21-minute period. He woke up, initially confused and disorientated, but after two weeks his condition had dramatically improved such that he was discharged and returned to work a week later.
The medical team responsible for Mr Araujo’s care had no exact explanation, recording “spontaneous return of circulation” on his notes. On the cardiac ward at Gloucestershire Royal Hospital, he became known as ‘Miracle Man’. He said of his mysterious return from death: “It changed me. I say thank you that I am alive, thank you that I have a job”.
Another strange case was observed during a study in a Canadian intensive care unit where four terminal patients had their life support systems switched off. One of them showed persistent brain activity for more than 10 minutes, despite clinical death being pronounced based on several observations,
including no pulse and unreactive pupils. The patient appeared to be undergoing the same brainwaves (delta wave bursts) as we experience during deep sleep. This was distinguished from the sudden ‘death wave’ observed in rats one minute after decapitation in a 2011 study, whose researchers at the Netherlands’ Radboud University interpreted as reflecting “the ultimate border between life and death” (see FT368:36-43). However, such massive waves were not observed in any of the four patients in the study, conducted by the University of Western Ontario. Its research team suggested that death may be unique to each individual, since each of the four patients’ frontal electroencephalographic (EEG) recordings showed few similarities both before and after death was declared.
Struggling to explain this persistent brain activity after the heart had ceased functioning, the researchers wondered whether the results were due to an EEG recording error – but the equipment otherwise showed no signs of malfunction. “It is difficult to posit a physiological basis for this EEG activity given that it occurs after a prolonged loss of circulation”, said one. “The waveform bursts could be artefactual [i.e. due to human or machine error] in nature, although an artefactual source could not be identified.”
While this may seem frustratingly inconclusive, it is not atypical of research in the relatively new and rather niche field of necroneuroscience, where other oddities have been observed. A pair of 2016 studies found over 1,000 genes still functioning several days after death. They had not simply taken longer to die off; this gene activity was observed to have increased at the moment of death.
Neither Audrey Schoeman or Joao Araujo appear to have any recollection of their state of mind during the period in which they were clinically dead, which is unsurprising, given that a lack of brain activity is one diagnostic sign of death. However, in March 2012, footballer Fabrice Muamba collapsed during an FA Cup match between his then team Bolton Wanderers and Tottenham Hotspur. He was diagnosed as having suffered a heart attack and was pronounced clinically dead.
Later asked if he could recall any impression of what had occurred, Muamba said he had felt a surreal dizziness, as though he was running alongside another person’s body. Perhaps surprisingly, he did not mention any pain. His experience could be interpreted as an out-of-body
experience (see FT307:16-17, 323:40-42), but is perhaps too vague to be of much use; clearer recollections have been recorded by others pronounced dead.
In 2000, Sam Parnia, a medical researcher, interviewed 63 patients who had survived heart attacks at Southampton General Hospital. Of those 63, seven were able to recall thoughts from the time they were unconscious. These included coming to a border or point of no return, feelings of peace, and in one instance the impression of jumping off a mountain.
An extension of the study encompassing several European and US hospitals employed wooden boards painted with writing and symbols on their upper surfaces, which were then hung from hospital ceilings, the idea being that only patients having a genuine out-of-body experience would be able to see what was on the board. Although two patients recalled looking down at their bodies, neither had been resuscitated in an area of their hospital having one of the hanging boards.
Whilst the results of Parnia’s study were inconclusive, it may suggest that some patients undergoing (near) death by heart attack do not suffer pain, either experiencing nothing at all, or a vaguely pleasant and slightly mystical state. But there is only one way to truly know… Guardian, 2 Mar 2015; sciencealert. com, 8 Mar 2017; W.Daily Press, 25 Mar; D.Mail, Sun, 6 Dec 2019. For more resurrections, see: FT131:8, 143:10, 151:22, 254:9, 323:26, 334:10-11, 340:20, 381:21, 386:21.