It's striking to contrast these two claims:
Some of us (myself included) [Douglas Hofstadter] believe that the late President Reagan was essentially “all gone” many years before his body gave up the ghost, and more generally we believe that people in the final stages of Alzheimer’s disease are essentially all gone…. The “I” has either wholly or partially vanished, gone down the drain, never to be found again.
Only recently have scientists begun to take note of a phenomenon first observed by doctors in 19th-century insane asylums in France, Germany and the U.S. Back then, they called it terminal lucidity.
Patients with severe and chronic mental illness or dementia would suddenly start speaking clearly and rationally before death.
Even those with amnesia often recognised family members for the first time in years, and were able to say goodbye.
More recently, nurses and physicians have been noticing this phenomenon as more people end their lives in hospices.
In 2007, Dr Scott Haig wrote an account of his patient, David, who had lung cancer that had spread to the brain.
First, David’s speech had become slurred and then he’d lost the ability to speak or even move.
A brain scan done by his oncologist showed that there was scarcely any brain left.
For days, said Haig, his patient had ‘no expression, no response to anything we did to him’.
Then, when the doctor made his evening rounds one Friday, he noticed that David had lapsed into the laboured breathing that often presages death.
But an hour before he died, he woke up, and talked calmly and coherently to his wife and three children, smiling and patting their hands.
As Haig noted: ‘It wasn’t David’s brain that woke him up to say goodbye that Friday. ‘His brain had already been destroyed.’
Psychiatrist Russell Noyes had a similar case: a 91-year-old woman who’d lost her capacity for speech and movement as a result of two strokes.
Yet she suddenly broke through those walls shortly before her death.
Smiling excitedly, the woman turned her head, sat up without effort, raised her arms, and called out happily to her dead husband. Then she lay back down and died.
Whether or not she’d had a vision of her husband, the far more difficult and astonishing fact was that she’d regained her speech and mobility.