Ann. N.Y. Acad. Sci. ISSN 0077-8923 ANNALS OF THE NEW YORK ACADEMY OF SCIENCES Issue: Rethinking Mortality: Exploring the Boundaries between Life and Death Reversing death: the miracle of modern medicine Steve Paulson, 1 Lance B. Becker, 2 Sam Parnia, 3 and Stephan A. Mayer 4 1 Wisconsin Public Radio, Madison, Wisconsin. 2 Center for Resuscitation Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. 3 Stony Brook University, Stony Brook, New York. 4 Columbia University, College of Physicians and Surgeons, New York, New York Breakthroughs in emergency medicine have enabled science to halt and even reverse death. However, these advances have inadvertently led science into a domain that has traditionally been the purview of theology and philosophy. Steve Paulson, executive producer and host of To the Best of Our Knowledge, moderated a discussion that included emergency medicine experts Lance B. Becker and Sam Parnia, and neurosurgeon Stephan A. Mayer; they discussed recent discoveries and emerging technologies in resuscitation science and the ethical dilemmas they sometimes confront during medical crises. The following is an edited transcript of the discussion from October 9, 2013, 7:00– 8:30 PM, at the New York Academy of Sciences in New York City. Keywords: resuscitation; death; ethics; emergency medicine Steve Paulson: Thank you so much. It’s wonderful to be here and great to be back at the New York Academy of Sciences—a huge thanks to the Academy and the Nour Foundation for making this series possible. I wouldn’t ordinarily quote a Hollywood movie to set the stage for our discussion, but I want to mention a scene from The Princess Bride, which happens to be an old family favorite. At one point, the hero Westley has been tortured and is presumed dead. He’s taken to a kind of medicine man, Miracle Max, played by Billy Crystal, who tells one of Westley’s buddies, “It just so happens that your friend here is only mostly dead. There’s a big difference between mostly dead and all dead.” Well, it turns out Miracle Max was onto something, given what we know about today’s science of resuscitation. The line between life and death is not as clear as we once thought. Not only have doctors learned to bring people back from the dead—or at least from a state where the heart has stopped beating— where the brain has flatlined, but also, in some cases, they’ve managed to do this with little or no damage to the brain—it’s quite remarkable. Tonight we’ll be talking about this revolution in the science of resuscitation and the implications for medical care, and we’ll get into some fascinating questions about this gray zone between life and death. What’s happening when people are hovering right at that point of death? How do we make sense of those amazing stories from some people who do come back and have these stories to tell? What does this suggest about the nature of consciousness and the brain? Is death really the end? We have a great evening ahead of us, a terrific panel—three leaders in this field of resuscitation. Lance Becker is an MD and professor of emergency medicine; he’s the director of the Center for Resuscitation Science at the University of Pennsylvania. He has a particular interest in the role of mitochondria in life- versus-death decision making for cells and tissues when deprived of oxygen and glucose. Stephan Mayer is an MD and professor of neurology and neurological surgery at Columbia University, College of Physicians and Surgeons, and he’s the director of neurocritical care at New York–Presbyterian Hospital; he’s also the coauthor of several textbooks, including Therapeutic Hypothermia. Sam Parnia has a doctorate in cell biology and an MD, and is an assistant professor of medicine at Stony Brook University, where he is director of cardiopulmonary resuscitation research. He’s the author of two popular science books, Erasing Death: The Science That Is Rewriting the Boundaries Between Life and Death and What Happens When We Die: A Groundbreaking Study into the Nature of Life and Death. Welcome, all of you. doi: 10.1111/nyas.12475 1 Ann. N.Y. Acad. Sci. xxxx (2014) 1–15 C  2014 New York Academy of Sciences.