Exploring the Brain’s
Final Frontier:
The Neuroscience of Our Last Words and Moments
Where science meets the mystery of consciousness — uncovering what happens in the brain as life transitions beyond death.
Exploring the Brain’s Final Frontier:
The Neuroscience of Our Last Words and Moments
Where science meets the mystery of consciousness — uncovering what happens in the brain as life transitions beyond death.
As a Neuroscience Intensive Care physician, I have been intrigued by what happens in the injured brain as it approaches, or defies, death. The brain does not transition quietly from life to death. Instead, there is a twilight zone between slow electrographic (EEG) waves (the “wave of death”) and, surprisingly, high-frequency gamma waves, previously associated with consciousness, as my patients die. I’d like to share with you my patients’ stories… stories that illustrate what is most important to us all at the end.
The electrical storm may explain covert consciousness, the universal themes of patients who survive cardiac arrest and live to tell us about near-death experiences (NDE). Across cultures, nations, and religions, patients have felt the presence and memory of those they have loved who have died before them. They also report seeing a brilliant light, lifting them upward. Thanks to modern neurotechnology in the ICU, we now have scientific correlates of these experiences. We are beginning to find answers to previously mysterious questions: what happens to us as we die?
About Tarvez
I am a neurointensivist at Oregon Health & Science University, where I care for patients and their families with catastrophic neurological illness and injury. I have been at the bedside of hundreds of patients as they near death, or are transiently victorious over death….hearing their last words to those they have loved, their thoughts and hopes for the afterlife, their regrets and joy in their life’s memories. I trained in Neurology at the University of California San Francisco, and completed a fellowship in neurocritical care at the University of Cincinnati. I specialized in treating headache, as Director of Case Western Reserve’s Headache Center in Cleveland, OH.
I have always loved horses and competed (very unsuccessfully!) in Three-Day Eventing. I have also served as a neurologist for the Cincinnati Bengals, examining players suspected of having a concussion….a harrowing experience!
Follow On Substack
I post articles on topics that relate to experiences I’ve had in the NeuroICU. Topics include the “twilight” zones of consciousness: vegetative (unresponsive wakefulness) and minimally conscious states. You’ll discover how and when brain death (as distinct from cardiorespiratory death) is diagnosed. Articles also discuss how we can broaden the opportunity for organ donation in brain-dead patients. I talk about brain plasticity, its ability to change, whatever our age. You’ll also get practical tips for navigating the ICU, where one in six Americans will die.
Podcast
Dr. Tucker and her son, Dr. Alex Lewis, also a neurocritical care physician, have developed a podcast titled “TWILIGHT: The Neuroscience of Our Last Words and Moments”, in which they present a real-life patient story, followed by a spontaneous discussion of the brain’s role as that story unfolds.
Episodes
What Will Your Last Words Be?
I invite you to share with me what your own last words might be. And who would you like to be there with you?