Dr Matthew Doré – Palliative Care Consultant and Dr Alan McPherson
Northern Ireland Hospice & Belfast Trust
Hon Sec of APM and Co-lead Clin ECHO
Do you know what ‘epiphenomenalism’ means? If you don’t, it means you are normal, but for completeness it is the study of the ‘mind’ versus ‘body’ problem. When your body dies, does your mind also? Well, within this blog … … I do know I sound mad talking about this but please bear with me.
Within every neuron of your brain lies a delicate, intricate scaffold of proteins called microtubules. Originally thought of as simple structural beams, however emerging research suggests they may be the heart of a profound mystery: the seat of consciousness itself. This theory, known as Orchestrated Objective Reduction (Orch-OR), proposes that these microtubules are not just passive components but active quantum processors.1,2,3 Recent research by Wiest suggest they may be capable of tuning into quantum vibrations with superpositions – a “quantum superstate” (like Schrodinger’s Cat – both alive and dead simultaneously) – that underpin our moment-to-moment conscious experience.4 Please stay with me on this.
Where do we ‘go to’ under anaesthesia? This bizarre question has a point. The intriguing link to quantum processes gains traction when we consider anaesthesia. Unlike natural sleep, where the brain is actively cycling through different states, general anaesthesia switches consciousness off entirely. Anaesthetic gases don’t just randomly dampen brain activity neurone to neurone; they appear to selectively calm the vibrations of these intracellular neuronal microtubules. This is in contrast to sleep in which the vibrations continue.
Recent research4 support the theory from the 1990’s by Sir Roger Penrose and prominent anaesthetist Stuart Hameroff, which suggest that it is these tuned vibrations of microtubules that are essential for maintaining our conscious waking reality. Why tubule micro-vibrations manifests in consciousness is not clear, but the superstate of quantum mechanics reveals a possible bridge; by existing in superposition within the brain, a non-computable, field of awareness is speculated to arise. Classical brain activity is merely the organisational aspect of the arisen consciousness.
If the lively quantum tuning of microtubules is fundamental to full, alert consciousness, what happens as this process naturally winds down at the end of life? Is the transitional ‘actively dying’ phase actually the tuning down of these microtubule quantum vibrations?
In palliative care, clinicians and families often observe a gradual change in patients as death approaches. This can include a glazed effect, slow affect, and a decreased level of consciousness. While traditionally we attribute this primarily to global reductions in brain metabolism, blood flow and sometimes medications, the microtubule perspective offers an alternative (or complementary), microscopic view. I believe it is plausible that this gentle withdrawal from the world involves the progressive slowing and de-tuning of the brain’s quantum vibratory framework. You become less tuned in.
Just as anaesthetics gently quiet microtubule vibrations to induce unconsciousness for surgery, the body’s final transition may involve a natural, irreversible slowing of this same quantum-cellular orchestra. The EEG changes observed in dying patients – such as a marked decrease in co-ordinated brain activity – could be the macroscopic echo of this microscopic process coming to rest.
This is not a clinical conclusion, but I hope you agree a fascinating theoretical lens. It invites those in palliative care to see the calming of a patient’s consciousness not merely as a neurological physiological shutdown, but potentially as the quieting of the deepest biological infrastructure of the ‘self’, the de-tuning of consciousness.
Understanding consciousness, from its quantum tuning in wakefulness to its gentle dimming at life’s end, maybe a bonkers theory, or a possible truth for the philosophical age old debate on the ‘mind’ versus ‘body’ problem. Indeed, I wonder how this could be experimentally tested. It reminds me of how much we do not know or understand and the mystery that awaits us all, from the profound biological and experiential process of consciousness, with its vibrant symphony to its final, peaceful note.
References
- Cantero, M.d.R., Villa Etchegoyen, C., Perez, P.L. et al. Bundles of Brain Microtubules Generate Electrical Oscillations. Sci Rep 8, 11899 (2018). https://doi.org/10.1038/s41598-018-30453-2
- Ondřej Kučera, Daniel Havelka, Michal Cifra, Vibrations of microtubules: Physics that has not met biology yet, Wave Motion, Volume 72, 2017, Pages 13-22, ISSN 0165-2125, https://doi.org/10.1016/j.wavemoti.2016.12.006.
- Hameroff, Stuart. “Discovery of Quantum Vibrations in ‘Microtubules’ inside Brain Neurons Supports Controversial Theory of Consciousness–ScienceDaily.” Accessed November 6 (2014). https://www.sciencedaily.com/releases/2014/01/140116085105.htm
- Wiest, Michael C. “A quantum microtubule substrate of consciousness is experimentally supported and solves the binding and epiphenomenalism problems.” Neuroscience of Consciousness 2025.1 (2025): niaf011. https://academic.oup.com/nc/article/2025/1/niaf011/8127081
Declaration of interests
I have read and understood the BMJ Group policy on declaration of interests and declare the following interests: None.