JANIS AMATUZIO, M.D.
Known as the "compassionate coroner," Dr. Amatuzio writes and speaks about her personal experiences and insights regarding life after death and how to apply those lessons to live a richer, more rewarding life. The founder of Midwest Forensic Pathology, P.A., a company offering private autopsy services, she serves as coroner and provides forensic pathology services for several counties in Minnesota and Wisconsin. She has authored Forever Ours: Real Stories of Immortality and Living from a Forensic Pathologist and Beyond Knowing: Mysteries and Messages of Death and Life from a Forensic Pathologist. For more information, visit www.foreverours.com.
Back in 1978, I was in my last month of my internal medicine internship and doing a rotation at the University of Minnesota Hospital, working a grueling schedule of thirty-six hours on and twelve hours off. Thank God I was in my twenties, because I couldn't do that now! One night, I nodded off to sleep at 2 AM but it didn't last long. At 2:30, a nurse called and said, "Doctor, we need you to get up and start an IV for a man whose IV catheter dislodged. He needs a heparin infusion."
I considered myself a pretty seasoned intern by then, having spent eleven months at it. I said, "Tell you what, hot-pack it [to make the veins more pronounced] and call me in thirty minutes." I really, really wanted that extra thirty minutes of sleep.
The nurse knew I had a habit of sleeping through phone calls, so thirty minutes later she strode into the room, flipped on the light, stood at the foot of the bed, and said, "Get out of bed now, Dr. Amatuzio. This man's arm has been hot-packed for thirty minutes and he's waiting for you."
Exhausted and half-conscious, I dragged myself out of bed, grabbed a couple IV catheters and a tiny 25-gauge butterfly catheter, and trudged down the hall. I remember being envious because I could hear people snoring. There's a certain intimacy to 3 AM in a hospital ward. As you walk down the halls, it's quiet, dark, and the only sound you hear is rhythmic breathing. I could see in the distance that one of the rooms had a light on. I walked around the corner and into the room. The light coming from the ceiling made a cone over my patient, Mr. Stein, who was in the bed closest to the door.
When I looked at him, my heart sank. He was a very large man and was immensely swollen. The only thing that looked bright about him was his eyes. I thought, How am I ever going to start an intravenous catheter quickly on this poor man?
I sat down next to the bed and unpacked the moist hot packs from his arm. Since men don't have as much subcutaneous fat as women do, they usually have good veins that are close to the surface. But I couldn't see a vein anywhere on his arm, so I had to try to find one by palpation.
I introduced myself and told him I had to start a catheter. As I was feeling for a vein, this man looked at me and said, "You know, doc, I died once." My first thought was, Whoa, he's off his rocker. He's sundowning. He read my thoughts like he was reading a book and said, "You don't believe me," with such sadness that I was terribly embarrassed.
I said, "It's not that I don't believe you, but you know that's a pretty extraordinary thing you just said."
He said, "I know. But I did."
While I was feeling for a vein, I thought, Well, I'm going to be here a long time; I might as well hear a good story. So I asked him to tell me what had happened.
He said, "Well, you know I've got blood clots in my legs and they like to travel up to my lungs."
"I know," I said, "that's why it's so important to get this medication into your veins." He told me he had had a filtering screen put in his interior vena cava, the large vessel that brings the blood from the lower extremities up to the heart, to stop the clots from passing to his lungs.
"That was two years ago," he said. "And that's when I died."
I nodded. "Yeah, but you're here now."
"Yep, I came back to life." I felt a shiver go down my neck and remember thinking, What is this? But he looked so earnest. He told me that when the doctors had finished implanting the screen in his heart, which had taken five hours, he had been wheeled into the PAR (post-anesthesia recovery room). "I remember laying there, trying to come to consciousness," he said. "A nurse was squeezing my shoulder, trying to awaken me, but I just couldn't quite wake up."
By this time, I had palpated for a vein, found one, and was taping on the IV. "Then the strangest thing happened," he said. "All of a sudden, I left my body."
I looked at him and asked, "And how did you do that?"
He said, "Right through the top of my head."
"Really?" I said.
He said, "I remember looking down at my body from the ceiling. And I had such a sense of compassion for my body; I felt really sorry for it. All of a sudden, I noticed that the doctors and nurses were all rushing to my bedside. That puzzled me because I felt absolutely fine. But the most amazing thing was that I could hear all their thoughts. I could feel their concern; I could feel their love except for one nurse, who was upset because she had a date after work and my cardiac arrest was delaying her. It was amazing. I went to the doctor's side and tapped him on the shoulder. He didn't feel me so I got right in front of him and tried to grab his arms. I said, 'Stop all of that, I'm fine.' But he didn't hear me."
"You could really hear every thought they had?" I asked incredulously.
"Yes," he said, "it was like reading their minds. And I watched them work furiously on my body. I watched them bring the paddles out and open up my gown to expose my chest. I saw my body jump every time they shocked me." I was already staring at him in disbelief, but he was just getting warmed up. "And then the most amazing thing happened," he said. "The man in the bed next to me, he had a cardiac arrest!"
"I suppose he left through the top of his head, too?" I asked.
"Yep," he said, "and was he ever surprised to see me!"
I laughed and asked what the two of them did next. He said, "Well, I communicated with him by just thinking and told him what had happened. When we realized we couldn't communicate with the doctors and nurses, we watched them work on our bodies for a while. There was only one crash cart and they had used most of the supplies on me. I watched the doctor shock me, turn around and shock him, turn back and shock me, then shock him again, and so forth. We saw them call for another crash cart. It was absolute havoc down there. Finally, we decided to leave. I know it sounds odd, but we really didn't feel attached to our bodies."
I had the IV in by now and had taped it down, but I was hooked on his story, even though it was now 3:30 in the morning. In my typical twenty-something fashion, I said, "And how did you do that?"
He said, "Doc, you're not going to believe this, but we just thought our way through the wall."
I said, "You thought your way through the wall?"
"Yep," he said, "we didn't go through a door or a window, we just thought ourselves through the walls and into the next room."
"Where did you end up?" I asked.
"In the waiting room. There were several people sitting there, and I could feel their concern for the well-being of their loved ones. But we couldn't communicate with them either, so we decided to leave the hospital."
"Did you use the elevator this time?" I asked.
He smiled. "No, we just thought our way through the hospital wall. I remember looking back and seeing the red brick and mortar."
"Well, what happened then?" I asked. "I mean, you're here now."
"Doc," he said, "when we got outside it was nice and warm and comfortable. And then...I saw it." He paused for a moment to collect himself. With tears streaming down his cheeks, he said, "Off in the distance I saw no, I felt the most amazingly beautiful light. It was so bright, and it was made up of every color of the rainbow and more. I was instantly drawn to it and so was my companion. As we approached it, I felt the most incredible joy and awe and sense of grandeur I've ever experienced. Then, the light opened up into a tunnel. I felt a rush as I moved through it. It was like standing in an enormous wind," he said, pausing to gesture at my long hair, "only your hair wouldn't blow. When I got there, it burst open into a magnificent display of colors; colors I had never seen before even though they seemed so familiar.
"And then, I saw my mother and my father and my brother who had all died in an accident forty years ago. My dog was there too. I was overjoyed. It was a wonderful reunion. As I traveled upward toward the source of all this joy, I grew more aware. The brilliant dazzling colors shimmered, and I began to realize, well, everything. I can't explain it. I saw my life in its entirety, and I saw that everything that had happened to me had been perfect. Then suddenly, I knew with crystal clarity that I couldn't stay and why."
He paused again, so I asked, "Well, what happened then?"
He said, "You know that other guy?"
I said, "Yeah?" And he said with an absolutely distraught voice, "The other guy got to go on and I had to come back." And he just wept.
After a few moments, he was able to compose himself. He confided that he hadn't told that entire story to anyone before, that he had been afraid to talk about it. I squeezed his hand and thanked him for sharing his story. We sat there together in silence for a minute or two, sharing the intimacy of his story and of the early morning hours.
Finally, he spoke again. "When I got back, everything in my body hurt. My chest was burned from the paddles; my ribs were broken from the CPR; there were needle puncture marks everywhere on my body. But even though everything hurt, I was filled with an overwhelming sense of peace that I had never experienced before or since. When I was up there, with my family, I had been overwhelmed and stunned by the loving kindness that surrounded me.
"The next day, in the recovery room, my doctor told me what had happened I had had a heart attack, and they had almost lost me. I didn't say anything, but a month later, I went to see him for a checkup and told him about my experience. I was still experiencing that sense of incredible peacefulness and purpose. I told him about leaving my body through my head, about floating up near the ceiling, about watching him try to resuscitate both me and the other guy, about that wonderful light.
"The doctor looked confused. All he could say was, 'You must have had a reaction to a medication.' I said, 'No, it wasn't a reaction, it was the most real thing that has ever happened to me.' And the doctor said, 'Listen, you don't know what you're saying. You were dead, dead and gone for fifteen minutes. Your heart wasn't pumping. Then, bango, your heart started again, and here you are.' I said, 'Doctor, I watched you during that resuscitation. I saw the man in the bed next to me die too. You only had one crash cart and not enough medications, and you were using the same set of paddles on both of us. And I felt how worried, frustrated, and concerned you and the staff were.'
"He shook his head and said, 'Absolutely impossible. You could not have known any of that. You were unconscious. The nurse must have told you.' He held up his hand and said, 'You know what, I don't know what you believe, I don't know what happened to you, but for all intents and purposes you were dead.' And I said, 'I know.'"
I looked at the clock. It was almost 4 AM. I sat there for a few minutes. And then I asked, "Did it change your life?"
"Oh, yes," he said, "in several ways. First of all, I don't fear death. I know we don't die. The experience that the doctor called dying was the most magnificent thing that's ever happened to me. Secondly, I know that love is all that counts. I still love my stuff, my things, but they don't matter to me the way they did before. It's who we're being that matters, not what we're doing. And lastly, I try to learn something each day, to gather knowledge, and then try to apply it to make this world, my world, a better place."
After that, he was very quiet. I remember how embarrassed I felt that I had doubted him. I told him that I believed him and the incredible journey he had taken. And I remember thinking, I'm going to remember this wisdom. And I have. It's made a difference in my life. It's helped me to remain sensitive to patients and their families. And when my loved ones die, it comforts me to know that it will not simply be the end, that we will all be together again someday.
Copyright © 2008 by Phil Bolsta