What separated the before from the after was an infection. Bacterial meningitis to be exact; an explosion of E. coli bacteria transported by arteries to the brain, inflaming his spinal cord and brain to the point of almost cutting off blood flow entirely, leaving neurosurgeon Eben Alexander III fighting for his life.

On Nov. 10, 2008, a Monday, Alexander went into a coma for a week, with essentially no brain activity.

Alexander claims he spent that time in heaven.

Heaven, at first, didn’t look so different from earth. Past the white light at the end of a tunnel, he saw a valley blushing with flowers, waterfalls tumbling into pools, revelers whirling arm in arm, and a girl flying on a giant butterfly. He says the chants of angel choirs made him aware of what he calls “the Core” — an “unending inky blackness filled to overflowing with the infinite healing power of the all-loving deity at the source.”

Thus began Alexander’s seven-day spiritual odyssey. On this journey, he says he traveled through different realms of heaven, learning the true nature of space, time, mass, energy, causality, meaning, and purpose.

A week later, he opened his eyes in a hospital room.

Alexander doesn’t dispute that his brain had almost no activity during his coma; actually, it’s one of the facts about his experience that he stresses most. He couldn’t have been hallucinating, because his brain wasn’t working. His apparent journey to the other side, he claims, is evidence that something about us — a soul, a consciousness, a spirit — is independent from our bodies: that we come from, and return to, the universe itself.

This idea stands in direct opposition to materialism, the philosophical doctrine that everything, including our consciousness, is generated by the physical world. Materialism is the basis of modern science as we know it. Alexander, though, believes the spirit exists separately from matter.

To Alexander, this conclusion is borne of logical reasoning, not of a disposition towards religiosity. He doesn’t ask his followers to believe in what he says regardless of scientific evidence; he asks them to believe because of it.

In Alexander’s telling, his near-death experience changed his life. At the time, he was the clinical director of the Brain Program at the Focused Ultrasound Surgery Foundation in Charlottesville, Virginia. Today, his professional trajectory bears little resemblance to the more traditional medical career path he was on then. He has authored several best-selling books, appears on daytime television, and hosts public speaking engagements across the globe, all with the intention of spreading his philosophy to the world.

But what separates Alexander from others with similar stories of the afterlife is his authority — by the time he had his near-death experience, he had been a neurosurgeon for more than 20 years, holding appointments at numerous prestigious medical schools, including Harvard.

Alexander is, for obvious reasons, a controversial figure in the medical world. Many professionals, perhaps most famously the late Oliver W. Sacks, have publicly disputed the medical claims in Alexander’s account of his near-death experience. They attribute many aspects of his experience to tricks the brain plays when it’s shutting down — for example, changes in blood pressure can produce what look like tunnels in one’s vision and bursts of neurotransmitters can create the impression of bright lights. Others worry that he is peddling snake oil to the sick, using his story to sell false hope to a vulnerable population.

But Alexander takes issue with the charge that encouraging the public to develop their spiritual lives makes him a quack. He envisions 1a type of medicine that is continuous with religion in its commitment to heal a patient’s full self — both their body and their spirit.

As a professor who spent more than a decade — 1988-2001 — teaching at Harvard Medical School, Alexander is an admirer of the former Harvard psychologist and philosopher William James, whose work at the American Society for Psychical Research applied the tools of empiricism to questions of spirituality.

In “The Will to Believe,” a lecture delivered to Harvard students in 1896, James described a distinction between what he deemed a “live hypothesis” and a “dead hypothesis.” A live hypothesis refers to an idea that one is capable of believing — an idea, in other words, that can spark an “electric connection” with one’s nature. A dead hypothesis, by contrast, cannot fit into a person’s understanding of the world.

For many, the claim that there exists an independent soul and afterlife is a dead hypothesis. But by redefining the spiritual in terms of science, Dr. Alexander is trying to resuscitate it.

Medical Politics

Eben Alexander grew up in the sixties in North Carolina; he was adopted by a family that boasts a long line of distinguished physicians, all also named Eben Alexander. His father, Eben Alexander, Jr., was a neurosurgeon who graduated from Harvard Medical School, where Alexander himself would eventually become a professor.

Alexander received his undergraduate degree from The University of North Carolina at Chapel Hill in 1975, graduated from Duke University School of Medicine in 1980, and completed his neurosurgical residency at Duke University Medical Center in 1987. The following year, he took up a joint appointment teaching at Harvard Medical School and practicing at Brigham and Women’s Hospital.

“I absolutely adored my time at Harvard,” Alexander says. He rebuts the assumption that HMS culture was scornful of spirituality, arguing that it was “certainly an advanced enough institution” to permit free religious expression.

“I will confess that it was not something that was really part of our teaching,” he says. “If I were up there now, teaching residents and medical students, I would be more open-minded to the power of belief and the role of mind over matter, and the beautiful ways that we can truly manifest free will, in ways that I never was able to do back then, mainly due to my own limitations.”

He characterizes his religious beliefs during his time at Harvard as somewhat agnostic; though he attended church, he thought that “science was the absolute pathway to truth.”

But his doubt devolved into disbelief in 2000, when he tried to contact his birth family, whom he had never met. They didn’t want to speak to him.

He would find out years later that his birth family was still grieving the death of his biological younger sister, who had died two years earlier. They told him they didn’t have the capacity to meet a new child as they mourned another. Still, the rejection stung. In the following months, he stopped going to church and stopped praying with his children. “I kind of went through a dark night of the soul,” he says.

Alexander doesn’t mention it to us, but the following year, in 2001, he was also terminated from his position at Brigham and Women’s. In other interviews, he says that “medical politics” forced him to leave. Alexander was also sued for medical malpractice the year before he left by a patient who claimed he failed to inform her a surgery she underwent might result in facial paralysis — which it did.

Alexander moved on to UMass Memorial Medical Center, from which he resigned in 2003 after being suspended for alleged medical malpractice, the details of which have not been publicly disclosed.

In 2006, he began to work at Lynchburg General Hospital in Lynchburg, Virginia. While working there, he faced another malpractice suit in April 2008, this time for fusing the wrong vertebrae together in a patient. The plaintiff alleged Alexander noticed soon after his error that he’d made a mistake, but covered it up with a fraudulent operative report.

Alexander challenges that narrative, however, claiming that though he had indeed operated on the wrong vertebrae — a mistake he admits — his patient had displayed positive results, causing him to reevaluate the “surgical reasoning” that had led him to target the intended vertebrae in the first place. He asserts that he changed the surgical note to reflect this — not as an attempted coverup — and his patient only chose to pursue a lawsuit after he offered to cover the costs of follow-up surgery. Though he was required to pay a fine and attend a weekend continuing medical education course on recordkeeping, he says all the investigations that followed the incident eventually exonerated him.

Alexander brings to his defense a New England Journal of Medicine article that found neurosurgeons to be the medical speciality most at-risk for facing malpractice suits due to the treacherous situations with which they deal. “I have never been found guilty of malpractice, but I have settled several cases brought against me,” he writes in an emailed statement. “Settlements are made to avoid the steep costs of litigation, not as any admission of guilt.”

Still, when Dr. Alexander entered the coma that changed his life, he was being sued for nearly $3 million dollars.

No Signs of Death or Decay

Given the havoc the E. coli wreaked on his brain, it is a miracle that Alexander is alive and speaking right now. When he was initially hospitalized for his coma, his doctors gave him a ten percent chance of survival. As his coma stretched on, they changed that to two percent. When, against the odds, he woke up, his doctors were confident that his brain would never fully recover. Yet it did. He places the odds of this somewhere between one in ten million and one in a billion.

Doctors use the Glasgow Coma Scale to determine “the depth and duration of coma and impaired consciousness.” The scale ranges from three to 15, where three is death and 15 is completely awake. Nine or below is a coma.

During his coma, Alexander ranged between a five and a seven. In other words, he shouldn’t have had any experience in his coma at all. But according to him, that’s not what happened. When he recovered the ability, he wrote almost 20,000 words about his experience, which later became his first book, “Proof of Heaven.”

On the first day of his coma, he says he woke not in his hospital room, but “in a primitive, coarse, unresponsive realm” that had a “‘scorched-earth’ intensity” — one that stripped him of all language, knowledge, or memory.

He was delivered out of this desert by a “slowing, spinning, clear white light” into a glen he calls the “Gateway Valley.”

“The Gateway Valley was filled with many earth-like and spiritual features: vibrant and dynamic plant life, with flowers and buds blossoming richly and no signs of death or decay,” he writes.

“The chants and hymns thundering down from [the] angelic choirs provided yet another portal to higher realms, eventually ushering my awareness into the Core,” he continues.

After seven days in his coma, a boy, whom he later identified as his son, earnestly told him that he was needed back on earth, and he returned to the reality of his hospital room.

Dr. Alexander claims that he wrote all of this down as soon as he was able, with little pre-existing knowledge about other narratives of near-death experiences. He says that initially, he thought it had all been a hallucination, perhaps something superimposed by the mind as he returned to consciousness. In his own words, “I was my own worst skeptic.” It was only later, as he compared his experience to that of others that he noticed similarities. His secular worldview began to shift.

But one aspect of his vision eventually convinced him to embrace the spiritual: the girl on the butterfly, who had guided him through heaven. He says he recognized her, four months later, in a photo from his birth family; she was his deceased younger sister.

Alexander refutes any notion that he has been “chosen”. “Experiences are always tailored to teach the individual soul. And it just so happens that sometimes a lesson [for an individual] is a lesson that is also valuable for the world at large,” he says.

For almost a decade now, Alexander has been telling his story to a public audience. In 2012, he released his first book; he has since written two more, chronicling his experience in a coma and his outlook on life and death. He has appeared on “Fox and Friends”, Oprah, and Goop, among others.

Dr. Eben Alexander is speaking at a podium. By Courtesy of Eben Alexander

He regularly gives talks to faith- and medical-based groups — often in popular vacation destinations, like Virginia Beach or the Bahamas. Currently, he runs workshops around the world, with titles like, “Becoming More Whole — Retreat in the Bahamas,” “Living in a Mindful Universe — Weekend Retreat,” and “Dying With Purpose: Consciously Crossing to the Other Side — Webinar.”

The “Becoming More Whole” event description, for example, promises patrons that they will harness “advanced brainwave entrainment technology produced by Sacred Acoustics to improve stress, anxiety, depression, addiction, and insomnia.”

Rock Bottom

Hearing Alexander speak, you might be surprised by his politics.

He inherited his light drawl, along with his name, from generations of Southern surgeons and scholars, and there seems to be an impulse to typecast Alexander as an evangelical conservative. His recount of his experience in the afterlife are similar to those of other evangelical Christians, and some of his media appearances echo conservative rhetoric as well — as an Esquire profile pointed out, he once appeared as a guest on Fox News to reassure viewers that the child victims of the Sandy Hook Massacre were being warmly welcomed in Heaven.

But Alexander’s belief system draws upon liberal politics in surprising ways. He supports transgender rights and individualized gender expression, an upshot of his belief that souls have no gender. He is appalled by our country’s class divide, and he is not an admirer of Donald Trump.

“I kind of chuckle when I think about what Trump has said in these last few days about Nancy Pelosi, who prays for him,” Alexander says, referring to the then still-ongoing impeachment trial. “He has no idea what that means. He doesn't understand that the power of praying for your enemy is really a tremendous power.”

In the same progressive spirit, Alexander asserts that the loving and creative source he encountered in Heaven — which he has named “Om” after the reverberating sound he heard in that realm — is too vast to be claimed by any one religion.

For Alexander, orthodoxy obscures meaning. There is no Hell, he says. Rather, souls experience — and learn from — the pain they have wrought in the lives of others through reincarnation. This model asks people to conduct themselves with a strong sense of justice, lest their deeds be answered back upon them.

Alexander’s theology also fits into a larger worldview. He believes we are now living at “rock bottom,” as disaster — in forms like climate change, income inequality, and increasing gun violence — looms. He also describes a pervasive sense of abandonment: the public abandoned by corporations, the middle class by the one percent, and people by their politicians.

Dr. Eben Alexander is chatting at a conference. By Courtesy of Eben Alexander

Abandonment should resonate with no one better than Alexander, whose birth parents gave him up. To adopt his worldview is, in a way, to be adopted by his God — a forgiving, loving, and obliging parent, as described by Alexander.

So what’s stopping people from signing on? The problem of science, mostly. For many of the liberal-minded, the tenets of empiricism are incompatible with a god. Alexander, however, prophetizes the coming of a second scientific revolution — one in which spirituality will explode into the mainstream of progressive, empirical thought.

“By 2028, no self-respecting, scientifically minded, well-read person on earth will doubt the reality of the afterlife and reincarnation based on the scientific evidence,” he says.

For Alexander, the tool of revolution will be none other than the fledgling field of quantum mechanics — an elusive discipline about which the physicist Richard Feynman once quipped, “If someone tells you they understand quantum mechanics, then all you’ve learned is that you’ve met a liar.”

Alexander cites quantum entanglement, or what Einstein called “spooky action at a distance” — a phenomenon in which two particles separated by huge swaths of distance continue to influence each other — as evidence for the metaphysical realm in which consciousness ultimately resides.

Tear it Up and Throw It Out

Dr. Alexander isn’t the first person to have had a near-death experience; people have recorded similar instances since humans invented written language. Alexander takes this as further evidence for his theory.

However, many scientists believe the exact opposite — that the frequency and reproducibility of these experiences show that the brain is wired in ways that can trick us into believing that we are coming into contact with the supernatural.

In a 2012 article in The Atlantic, “Seeing God in the Third Millennium,” the late physician and author Oliver Sacks explains that the “bright light at the end of a tunnel,” almost universal in near-death experiences, is a “constriction of the visual fields due to compromised blood pressure in the eyes.” The light, meanwhile, is caused by “a flow of visual excitation from the brainstem… to the visual cortex.” He attributes the rest of Alexander’s experience to a standard hallucination.

Our perception of time, as Sacks points out, is not the same as the actual passage of time; Alexander’s experience, which he describes as being years long, could have easily taken place over the span of a few seconds — namely, when his neocortex (the part of the brain that produces hallucinations) was recovering function.

Alexander is aware of Sack’s skepticism, as well as that of his other detractors. “He didn’t even read the book,” he says. If Sacks had taken the time to read “Proof of Heaven” and his medical report, Alexander claims, Sacks would “tear up his original article and throw it out.”

If Death Ends All

But the criticisms of Sacks and others have not dissuaded Alexander’s followers, who fill conference halls and retreat centers to hear him speak.

For many, hearing someone like Alexander recount his transcendent experience is faith-sustaining and affirming. For those who are suffering — perhaps those grappling with life-shattering situations like terminal illness or the death of a loved one — accounts like Alexander’s are comforting.

Maybe there are simply some phases of life that aren’t adequately dealt with by scientific reality — regardless of what is actually true, there might be a place for alternative modes of belief inasmuch as they make the tragedies of life a little more bearable.

Some suggest that Dr. Alexander is motivated by profit.

Alexander strongly disputes these claims. He allows that he has benefited from the publication of his books; at the same time, he says that profit is an inevitable result of going with a mainstream publisher, which he had to use in order to effectively spread his message. He cites numerous free resources he has provided, from programs on his website to YouTube recordings of his lectures.

Alexander is hardly the only evangelist who has had a near-death experience; the internet is filled with them. Maybe they’re all cynical actors trying to get rich. Nevertheless, there are many others who believe the same thing happened to them, and have been much less public about it.

Perhaps profit is beside the point. Rather than investigating how Alexander’s story benefits him, it seems relevant to ask how it affects others.

The leading precept ingrained in medical school students is “do no harm.” Martin A. Samuels, a neurologist who once worked with Alexander at Brigham and Women’s hospital, applies this oath to the ethics of belief. “You can believe whatever you want, as long as you don't hurt people,” he says.

Tracy A. Balboni, an oncologist who helms Harvard Medical School’s Initiative on Health, Religion, and Spirituality, says that spirituality can be a source of comfort and solace for many of her patients. “In medicine in general, but definitely in cancer care, I think we’re faced with death and tragedy and suffering so often it’s hard not to wonder about that reality,” she says.

Balboni is well versed in western medicine’s rich “spiritual heritage” — albeit one largely obfuscated by an obsession with materialism. She explains that hospitals as we know them were “birthed” in monasteries, and notes that the ubiquitous symbol of medicine is the Rod of Asclepius, the God of medicine in classical antiquity.

And yet, she says that medical training is so focused on the technical aspects of care that some physicians might shut out patients’ spiritual needs or experiences. “I think there are definitely some that just feel like they can’t go there — like that’s not in their purview, and that they would be frankly uncomfortable,” she explains.

Balboni says that she recently lectured at a course offered jointly between HMS and the Divinity School, titled, “Spirituality and Healing in Medicine.” The class surveys how different religious traditions interface with the patient experience, and also teaches practical skills on how to take a patient’s spiritual history and provide pastoral care.

According to Balboni, the course’s student body also boasts a large contingent from the School of Public Health. She cites a number of studies — including Harvard’s Nurses’ Health Study — which suggest that community religious engagement promotes group flourishing.

Balboni mentions in our discussion on the continuity of spiritual and medical care that one of her patients, who had advanced metastatic cancer, gave her Alexander’s “Proof of Heaven” as a gift.

Dr. Eben Alexander at a recent conference in Budapest, Hungary. By Courtesy of Eben Alexander

Balboni says that reading Alexander’s book struck in her patient the realization that he could choose whether or not to accept materialism, an idea which he had never thought to question. “There’s an assumption that there’s nothing more than what’s around us — the material world that we can see, touch, and feel,” she says. “It’s easy to forget that [materialism], in and of itself, is a form of belief and we can’t prove that that’s the case. We can’t prove that’s all we are.”

Perhaps the way to read Alexander’s book, then, is not as a doctrine, or a commandment, but rather as a “live hypothesis” — one that empowers the sick and the scared with a choice to believe that something exists for them in the beyond.

Shahram Khoshbin, a neurologist and Harvard professor in the medical humanities, expresses reservations about the utility of such stories. “Dogmatic religions,” he says, “can be pernicious. Medicine, and ethical decisions around treatment, are so complicated that there is little room for modes of belief that are not fact-based.”

However, that doesn’t mean that he thinks religion is useless. “I would be damned if I walked up to any person and took away their hope,” he says. “One of the things about religions that I adore as a physician is that allows for hope.”

According to Alexander, there is no better example of hope manifesting in medicine than the placebo effect — a phenomenon in which a patient’s condition improves simply because they believe in the power of a treatment, though it has no real therapeutic effect. Alexander also cites cases of spontaneous remission in patients with cancer, advanced infections, and congenital deformities.

“A patient believed that they could get better,” he says. “And so what we find in medicine is this reality that mind can have a tremendous influence over matter.”

Perhaps Alexander’s philosophy could function as a sort of placebo. What doctor — sworn to the Hippocratic Oath — would tell their vastly improved patient that they had taken only a sugar pill?

In “The Will To Believe” — the 1896 lecture in which William James made the distinction between “live” and “dead” hypotheses — James concludes with the following: “We stand on a mountain pass in the midst of whirling snow and blinding mist, through which we get glimpses now and then of paths which may be deceptive. We do not certainly know whether there is any right one. What must we do?”

He answers, “Act for the best, hope for the best, and take what comes… If death ends all, we cannot meet death better.”

And if Alexander is right, perhaps in meeting death, we also meet new life.

Correction: March 10, 2020

A previous version of this article incorrectly stated that Eben Alexander recognized a woman he saw in a vision in his deceased younger sister in a photo years later. In fact, it was four months later.

Correction: March 10, 2020

A previous version of this article incorrectly stated that Alexander has written three books since 2012. In fact, he has written two.

Correction: March 10, 2020

A previous version of this article incorrectly quoted physicist Richard Feynman as saying “If you think you understand quantum mechanics, you don't understand quantum mechanics.” In fact, he said “If someone tells you they understand quantum mechanics, then all you’ve learned is that you’ve met a liar.”

—Staff writer Juliet E. Isselbacher can be reached at juliet.isselbacher@thecrimson.com. Follow her on Twitter @julietissel.

—Magazine staff writer Rebecca E. J. Cadenhead can be reached at rebecca.cadenhead@thecrimson.com. Follow her on Twitter @ibuprofenaddict.