A man in an auto accident and believed dead on arrival at the hospital later told Anderson about his experience. “He said there was a momentary flash of pain when he hit the tree. Next thing he knew, he was floating above the wreck looking down and feeling really peaceful. He said, ‘I got the sense that I was dead, but I had never been dead before, so I wasn’t exactly sure what to do, so I just followed the ambulance to the hospital and that’s when you guys worked on me.’”
Not all physicians care for patients across levels of consciousness, Anderson explained. It takes buying into a “non-local” frame of reference.
“My residents are becoming family physicians, meaning they are going into a specialty seeing patients not just as bodies or organ systems or disease processes, but as people who have a psyche, a soul, who have a context.” That means they take life events, including death, into account in their treatment.
A local perspective is the idea that the body is what’s real, and consciousness is basically the firing of synapses in the brain, he said. “So when the body dies and the brain ceases to function, then of course there is nothing after that. The problem with that is that there is an awful lot of evidence to show that something is happening even if your cortex isn’t functioning real well.”
In contrast, the non-local perspective is that “bodies are really important and brains are really important, but that’s not the end all and be all,” he said. “Consciousness exists before you got into that body, it certainly exists while you’re in that body, and it will exist separate from the body when you’re getting ready to transition.”
In essence, it’s the time when treating patients based on book knowledge ends. “If you’re one of my young physicians, you know there’s a time to do things to people, but there’s also a time when you be with people, and we teach them how to differentiate.”
Having a rapport with patients is critical, in Anderson’s thinking. Applicants for residencies at his center in Provo are gauged not only on medical school grades and board scores, but emotional intelligence and sense of humor.
Anderson breaks the ice with one-liners. He closes his e-mail messages with them, subtly drops one in his otherwise stolid biographical outline, and peppers his lectures to industry colleagues with quips. In conversation, Anderson exudes a warm, inviting tone.
He carefully measures the style of his relationship with his patients.
“I use the language of the person I’m working with,” he said. “If I’m with a 21st century empiricist, we might talk about the dying process as going from matter to energy. If I’m sitting with a person whose Christian religious faith is central to their being, we’ll draw on biblical passages and their particular tradition to inform the process.”
Making a connection with patients and, in some cases, their families, grows the trust that Anderson treasures.
There was Ruth, a woman from Germany, a cancer patient, who shared with Anderson her fondness for brown beer that she enjoyed back home and talked with him about death. He helped to ease her through bouts of nausea that came with her treatment and continued to work with her late in her illness, when she went into congestive heart failure.
When he checked in with her one Friday, she told him, “It’s getting close.’”
His experiences with death, Anderson said, give him no special vision about it. His patients know better when it’s their time to go.
“Early in my career, people would say, ‘Well, Bob, today is the day we say goodbye.’ And I would say, ‘Oh, no, I’ve seen your labs, I’ve seen your blood work.’ And, of course, they would go because they knew more about this stuff than I did. They have an intuitive sense about what’s going on.”