The book became, unwittingly it seems, the first of a trilogy ultimately concerned with what conscious is and does. The second book, This is Your Mind on Plants (2021), extends Pollan’s project to three mind-altering compounds found in plants: opium, caffeine, and mescaline, and the third, A World Appears (2026), is his attempt to discern consciousness itself. Here I cover Pollan’s investigation into consciousness across the three books, the results of which frustrated him and required a reconciliation.

The Trips Begin

In How to Change Your Mind, Pollan gives a brief summary of the bumpy history of psychedelics. He recounts how the intense and well-supported interest in them as therapeutic agents during the 1950s was almost completely snuffed out in the 1960s when “a moral panic about LSD engulfed America, and virtually all psychedelic research and therapy were either halted or driven underground” (p. 185). The panic reached its apogee when counterculture movements and their leaders, among them Timothy Leary of “turn on, tune in, drop out” fame, were seen as threats to mainstream society in general. The few remaining embers, though, reignited in the 1990s and by 2006 serious interest in psychedelics revived and research into clinical use resumed through legal means. Structures were in place allowing psychedelic use for specific purposes, opening the way for Pollan’s investigation.

Pollan arranged three separate “trips,” one each for the psychedelics LSD, psilocybin, and 5-MeO-DMT (i.e., “The Toad”). He carefully chose a tour guide for each one. He came through these sessions with what he interpreted as a dissolution of his ego, which made more room for his consciousness: “I was present to reality but as something other than my self” (p. 264). After these experiences and interviews with many scientists, psychologists, counselors, and users, Pollan constructed an argument about how the altered consciousness states psychedelics produce can offer benefits to individuals who are healthy or sick, and to societies that are stable or fractious, by sending “a life or culture down a new path” (p. 407). He is inspiring, vague, and fantastical at times; he gets more so in his follow-up book, Your Mind on Plants.

There’s No Place Like Home

Pollan expands his investigation of consciousness-altering substances by marrying it with his passion for plants and gardening. Therefore, he need not look further than his kitchen and garden for sources serving his interest at this stage: opium (poppy), caffeine (coffee and tea), and mescaline (San Pedro cacti). He explained his rationale for choosing these three mind-altering agents:

Taken together, these three plant drugs cover much of the spectrum of the human experience of psychoactive substances, from the everyday use of caffeine, the most popular psychoactive drug on the planet; to the ceremonial use of mescaline by Indigenous peoples; to the age-old use of opiates to relieve pain. (p. 4)

Pollan received guidance and supervision for his trials of opium and mescaline. As a self-described “heavy caffeine user,” he withdrew from it by giving up coffee and tea, thinking he could make inferences about caffeine effects through reverse engineering the experience.

While Pollan describes the effects these three agents had on his consciousness, he went further morphing from his role as an investigative journalist into roles of historian and anthropologist. Pollan covers how opium, caffeine, and mescaline altered the consciousness of millions of people through the millennia, and in doing so, says they figure in world history and human development, often in rather breathtaking terms. Opium spurred “the Romantic revolution in poetry” (p. 31). “Caffeine was the perfect drug not only for the age of reason and the Enlightenment but for the rise of capitalism, too” (p. 119). “The sins of slavery and imperialism, in a global system of production…could only have been fueled by caffeine” (p. 138).

While he does not credit mescaline with having contributed to human progress in such grand scales, Pollan speaks of its power in healing the most devastating wounds. But insofar as affecting consciousness, for him, mescaline does “what all psychedelics do—not so much change how we feel inside as imbue the world around us with never-before-appreciated qualities” (p. 217).

Pollan may have imbibed too much caffeine while writing this book judging from some of the conclusions he makes, but it may have fueled his subsequent quest to understand just what consciousness is rather than just what it does to his mind and its impact on world history. What he found on this quest, or more appropriately, what he didn’t find, became the basis for his next book, A World Appears.

Pollan Trips into a Cave

If psychedelics and mind-altering plants can change consciousness, then, as Pollan surmises in describing his objective with A World Appears, “consciousness is, at its core, a material phenomenon…[or there is] at least some credence to the idea” (p. xx). So off he goes on more trips, this time to experts working on finding a discernible form of consciousness, a trip that in the end fails, but still produces some value towards the way we think about artificial intelligence.

Pollan’s trips takes him to four ports of call, or “four different dimensions of consciousness” (p. xxxi). His first stop is “sentience,” which refers to consciousness as where in living beings sensations are perceived and responses to them generated. The next stop is “feelings,” the awareness of biological phenomena, the communication link between the body and the mind, serving homeostasis, for example. “Thought” is Pollan’s third stop, accounting for “the stream of thoughts that all of us experience every waking moment” (p. xxxii). His trip ends at “self,” or the ’I’ that takes in all of our experiences.

Each trip constitutes a chapter comprising what is known about consciousness from a particular dimension. Pollan describes and evaluates them with the help of people involved in their development. Across the four dimensions, he consults or references a wide range of experts including among others: neuroscientists, physicists, biologists, philosophers, psychologists, screenwriters, novelists, poets, and Buddhists. He combs through their theories, constructs, data, analogies, stories, and metaphors. Pollan, nevertheless, comes up empty, and is “abashed to say I know less now than I did when, naively, I set out to unravel the mystery of consciousness” (p. 225). It took several days in a cave at a Buddhist retreat high in the mountains of New Mexico for Pollan to reconcile with this outcome, “to let go into not-knowing.” He wound up accepting consciousness “as less a scientific or philosophical puzzle to be solved and more as a practice…Consciousness is a miracle, truly, and remains the deepest of mysteries” (p. 239).

So be it, but what then are we to make of the artificial intelligence industries’ determined attempts to integrate or discern consciousness in their machines? Pollan might say they will need a miracle.

Citations:
Pollan M. How to Change Your Mind. Penguin Books; 2019. 464 pages
Pollan M. This Is Your Mind on Plants. Penguin Press; 2021. 288 pages
Pollan M. A World Appears: A Journey into Consciousness. Penguin Press; 2026. 320 pages

Links:
My blog post elaborating on Pollan’s How to Change Your Mind is here, and on Your Mind on Plants is here.

Along with cohost, Dan Albrant, here’s a link to our podcast episode in which we focus on: consciousness, spirituality, and mysticism as what is at work in the effects psychedelics produce, and how they may delineate limits to biomedicine (rational or not), that is, how they brighten or blur the line between classic biomedicine and whatever isn’t. 

Edited by Lucy Bruell.
Web Image: Cave Man, Tim Brown, CC BY 3.0 <https://creativecommons.org/licenses/by/3.0>, via Wikimedia Commons

Why did you write this book?

I’m encountering more and more people over the last few years, particularly post-COVID, who have the perception that the categories we use in psychiatry have a kind of fixed, objective, and quite rigid reality. Twenty years ago, when I started as a GP, I might have seen somebody who said, “I feel anxious all the time,” whereas now I’m more likely to meet somebody who’ll say, “Well, I have generalized anxiety disorder.” That’s a shift in the way that society talks about mental illness. At the same time, a lot of people are questioning these categories’ usefulness, so there’s a paradox—a sort of polarization.

I wanted to write a book which explains, from my perspective, A, how the way we think about mental illness has always been shifting and evolving. How we think about mental illness changes with culture, time, and geography. And B, if we can adopt a more flexible and humble approach to our current understanding, that actually offers more hope to patients. Because believing “I have generalized anxiety disorder,” rather than “I feel anxious,” can sometimes be helpful, but it can also box you in and become self-fulfilled. I’m seeing that same shift across the whole spectrum of mental illness and suffering, and the book is a call to question that and reassess where we’re at in the mid-2020s—and a plea for a little bit more kindness and flexibility.

What would that look like in practice?

For example, if somebody comes to me saying, “Well, I have generalized anxiety disorder, so I can’t do this stuff,” part of my work is to help that patient adopt a more hopeful perspective: that there are strategies that they can learn, that there are medications that can help, and that our mind is shaped by many different influences. There may be explanations for their anxiety that have to do with the brain and neurotransmitters and so on. But in most people, there are also more influential factors that have to do with their early childhood experiences and their current social setup, the precarity of their relationships or their economic situation, the quality of their sleep, or the substandard nature of their housing. There are all sorts of other factors that are having a bearing on their anxiety that I would seek to help them explore, rather than them just blanketly saying, “I have generalized anxiety disorder—can you give me the pill for that?” I’m trying to encourage my patient to say, “Yeah, there are pills that can help. But there are all these other factors that we need to think about. And do I really find that label helpful?” For some people, once you start to dig into it, they don’t.

We can extend that way of thinking to people who’ve had a psychotic episode. Between 10% and 20% of people who have a psychotic episode will never have another. For substantial numbers of people, their psychotic episode is actually a product of all sorts of stressors that are on them at that time. If you can find a way to modify their stressors, put them in a more supported state, and understand what place that episode has in the story of their life, you can then make a story that makes sense of that episode as the product of a uniquely difficult moment in their life. That can help people get over that episode and also, I hope, make it more likely that they don’t have subsequent episodes. Or, if they do, then they’re able to return fully to their normal functioning in between.

You write, “For the last forty years much Western psychiatry has behaved… as if our thinking is a simple matter of chemical levels in the brain. The truth is far more complicated.” For example, a 2023 study you cite challenged the serotonin theory of depression. [1] Why do you think that the chemical imbalance narrative has persisted?

There’s a number of reasons. That hypothesis came through at a time when our lab technology was starting to be able to measure neurotransmitters, and it offered a good story. If you become depressed, you feel as if you’re lacking something—as if you’re lacking some kind of fuel or energy. That lack translates very easily, in our metaphor-making minds, to the idea that there must be some kind of lack between our brain cells.

At the same time that this technology was becoming widespread, there was the promotion of a drug which seemed to help: Prozac. There’s no doubt that SSRIs do make a difference. Again and again, they’re shown to be better than placebo. The effect is probably a lot smaller than a lot of the drug companies would tend to promote in their materials, but they do help, and I continue to prescribe them. But what that study you’re referring to was saying was that, even if these drugs help, they don’t help by boosting serotonin levels. We can’t find evidence that substantiates that theory.

The first half of the 20th century was governed by Freudian ideas. Psychiatry in much of the West was dominated by those kinds of psychoanalytic ideas. Then, during the ’50s and ’60s, as we started to develop tricyclic antidepressants and experiment with other kinds of antidepressants—the first were anti-tuberculosis drugs—the idea grew that there might be a chemical solution, which fit very well into our technologically and pharmaceutically focused medical culture. Then, from the late ’90s, there was a huge explosion of the idea that, actually, a lot of it was genetic.

Now, even the idea that neurotransmitters are strictly excitatory or inhibitory is starting to be questioned. Essentially, the whole picture is vastly more complicated than the neurotransmitter hypothesis from the ’90s suggested. I don’t take that as a great failure of the hypothesis; it was an attempt to make sense of something very complicated, and the drugs that spoke to that metaphor are useful and are still among some of the most widely prescribed in the world. But the fact that we no longer think that low mood is purely because of low serotonin is a really positive step forward. It encourages us to embrace more fully the biopsychosocial approach to mental illness. The field of psychology and psychiatry is not known for consensus, but one thing everybody agrees on is that it’s not just biology, it’s not just psychology, and it’s not just sociology—it’s all these influences that have an effect on our mental health.

Are there other common assumptions about mental illness that you think deserve closer scrutiny?

Every age uses the metaphor of its highest technology to make sense of the mind. In the 19th century, the mind was famously described as an enchanted loom; the mind was thought to be weaving our experience, moment by moment. We’ve now got these very pervasive metaphors of wiring, which I find quite unhelpful because the brain is nothing like a circuit board. It would be like a circuit board made of jelly that can fix itself. So I think the wiring metaphor, although it has its uses, has gone too far because it’s too deterministic. It’s not organic enough.

Half a century ago, Stanford psychologist David Rosenhan wrote, “A psychiatric label has a life and an influence of its own.” To what extent can psychiatric labels help, and to what extent can they hinder?

There’s a lot of controversy about the Rosenhan experiment. [2] He’s been accused of being a charlatan and fabricating quite a lot of his data. But I think the value of his reflections still stands. I’ve definitely seen in my clinical practice that people will be treated differently because of a label that has been put in their notes, even though that label might have changed several times. I’ve had patients who’ve had four or five different labels in the course of their career, while they’ve had actually pretty much the same kinds of experiences and distress throughout all of those.

What I find really helpful in my conversations with patients is the fact that we don’t always have to give a label. If someone is really keen for one, then I’m happy to explore that with them and tell them, “These are the psychiatric categories that are on offer in the current edition of the DSM. Some people find them really useful, but with every new edition of the manual, they change, so they’re not describing something discrete, fixed, or in the natural order of things. They’re a way of describing and approaching distress, so let’s talk about how much they would be helpful for you.”

Now, in the U.S., I understand that labels can be essential because of insurance-based medical payments. In a U.K. context, a label may not be as useful because our psychiatric services are organized differently. I gently explore with each patient how much for them it’s going to be transformative. If it’s going to help ease their suffering and get them the treatments that they want, then I embrace it and help them get the one that fits best. But if it’s not going to be transformative in terms of how they can access care, then I tend to try to avoid giving a label because that can allow a level of optimism and dynamism about their state of mind. It more genuinely reflects the possibility of change and adaptation, rather than risking somebody changing the way they think of themselves.

As human beings, we’ve got such a huge tendency to put shame on one another. What labels seem to do in our current moment is absolve people of that shame in a really helpful way. I’ve had patients say to me, for example, that until they got their diagnosis of ADHD, they felt so ashamed of not being able to focus properly at work, and what that label did was offer a kind of absolution from that shame because it said, “There is this category of being that is separate from you and which seems to be affecting you, but it’s not your fault.” That can be wonderfully liberating. In those kinds of situations, I’m often keen to embrace the label if it’s going to help the patient cast off their shame. But I’m also questioning: Why have we got that shame? Isn’t it a pity that people often feel that they need to embrace a medical diagnostic label in order to rid themselves of that shame?

What strengths do primary care physicians bring to mental healthcare compared to someone more specialized?

One great advantage of somebody in my kind of role is that I’m embedded in the community. I often know the whole family, and I’m seeing people for all kinds of other problems which have a bearing on their mental health. I’ve become more aware of the connections between families and individuals; a specialist only sees the one individual with a particularly distressing problem—for longer appointments, granted, but removed from that context.

There’s a wonderful GP writer in the U.K. called Iona Heath, who has written a lot about the fact that it’s in the primary care consulting room where suffering is either given a label and understood within a medical model, or not. Some people see primary care physicians as essentially holding a line, or acting as some kind of gatekeeper, between the huge mass of human experiences that are out there and which ones become medicalized. A lot of people will come and see me about something fairly banal—almost to try me out, to try and figure out whether I’m going to be kind, compassionate, friendly, or approachable. Once they’ve tried me with a symptom that they’re not too fussed about, then they’ll risk sharing the one that they’re really worried about.

As a primary care physician, I feel I have a very privileged role: You’re not part of the family, but you’re not part of the establishment—you’re somewhere between the two. I’m often the first port of call for people hoping to make sense of their experience.

One line from your book that struck me: You write that today’s DSM categories will one day “seem as overconfident as the old phrenology charts.” How literal or hyperbolic do you mean that comparison to be?

Phrenology was debunked about 130 years ago. By the late 19th century, it was already starting to lose its traction because good thinkers were realizing it was a load of rubbish. If I could fast forward to 2176 and ask the doctors of that time what they’ll make of the DSM-5, I don’t think they would see it as phrenology, but they would certainly see it as utterly obsolete and unhelpful to them because it’s a cultural document of the West in the early 2000s. We can’t imagine what Western culture is going to look like in 2176. I’d argue that it’s quite likely that it will be very different from our current culture, that our neuroscience and genetics will have progressed in huge leaps and bounds, and that the organization of our society—while it may not have progressed—will have changed utterly. The DSM-5 will be of purely historical interest. When I was born in the ’70s, they were using the DSM-II, which is now considered very much a historical document—and that’s within my lifetime. I’m hopeful that the DSM-6, if and when it ever appears, is going to be an improvement on the DSM-5.

What inspired the book’s title?

From my chair in the clinic, I don’t see people’s minds as brittle and fragile. I see people as immensely resourceful, resilient, adaptive, and dynamic. People are incredible; they always amaze me with their ability to get over even the most extraordinary difficulties, suffering, and traumas. In my seat, I see the mind as far more unfragile than a lot of the rhetoric in our culture suggests.

The Unfragile Mind: Making Sense of Mental Health
Gavin Francis
Publisher: The Experiment, New York. 2026. 256 pages.

[1] Moncrieff, J., Cooper, R. E., Stockmann, T., Amendola, S., Hengartner, M. P., & Horowitz, M. A. (2023). The serotonin theory of depression: A systematic umbrella review of the evidence. Molecular Psychiatry, 28, 3243–3256. 
https://doi.org/10.1038/s41380-022-01661-0

[2] In the 1970s, Rosenhan and eight pseudo-patients feigned auditory hallucinations to gain admission to a dozen psychiatric hospitals across the U.S. Once inside, Francis writes, they “declared themselves free of the hallucinated noises, but found it very difficult to be believed, and be discharged” (p. 47).

Web image created from book cover by Medhum.

Although Stevenson’s fieldwork was unusually thorough, mainstream scientists rejected reincarnation as a viable explanation and instead focused on potential methodological weaknesses such as retrospective testimony, cultural influence, and the difficulty of ruling out information leakage. Stevenson described the cases as “suggestive,” but he made clear that reincarnation—or at least the survival and transfer of some aspect of personality—was, in his view, the most plausible interpretation.

The twenty cases in the 1966 volume represented only a fraction of the material Stevenson had been collecting since 1960. His early publications had attracted the attention of Chester Carlson, the inventor of the Xerox process, who left a bequest of one million dollars to the University of Virginia upon his death in 1968. The Department of Psychiatry used the gift to establish the Division of Perceptual Studies (DOPS), with Stevenson as its founding director. The name provided an academically respectable umbrella for research that included, but did not explicitly advertise, the study of children’s past-life memories.

Over the next three and a half decades, Stevenson and his colleagues expanded their investigations across Asia, the Middle East, Africa, Europe, and the Americas. By the time of his death in 2007, Stevenson had published twelve additional books and more than three hundred papers, documenting over 2,000 cases. In 1999, journalist Tom Shroder’s detailed investigation, Old Souls. The Scientific Evidence for Past Lives offered an intimate portrait of Stevenson’s fieldwork and helped bring the research to wider public attention.²

Leadership of the program passed to child psychiatrist Jim Tucker in 2002, when Stevenson retired.³ Tucker became Director of DOPS in 2014 and, in 2021, published Before, an updated synthesis of his own two earlier books. ⁴ Tucker reports that the DOPS database now includes more than 2,500 cases worldwide, including many from North America. Only a minority—roughly 15–25 percent—qualify as “strong cases,” meaning that the child’s statements were independently verified as matching a specific deceased individual.

The strongest cases share several converging features: verified statements about the previous life, verified identification of the deceased individual, physical correspondences such as birthmarks or birth defects, behavioral continuities, and early onset of statements. One of Stevenson’s most striking findings involved physical correspondences. By 1997, he had documented 210 cases in which a child had a birthmark or birth defect corresponding to a wound on the deceased individual, and in 49 of these, he obtained autopsy reports confirming the precise wound locations.⁵ These findings were presented in detail in Where Reincarnation and Biology Intersect and in his massive two-volume monograph Reincarnation and Biology.⁶

Here is an example of one of Ian Stevenson’s earlier strong cases. When Swarnlata Mishra was three years old, she began singing unfamiliar songs and performing dance steps her family had never seen, dances from a region of India more than a hundred miles from the family’s home. Soon she was describing a former life as a woman named Biya Pathak, recalling the layout of Biya’s house, the names of her children, and even a stash of money hidden in a wall. Stevenson documented her statements before any contact with the Pathak family, and when they eventually visited, Swarnlata greeted them with an ease and specificity that startled everyone present. She correctly identified family members, teased one man with a childhood nickname only Biya had used, and pointed out a brother’s limp. The encounter had the uncanny feel of a reunion rather than an interview, and for Stevenson it became one of the clearest examples of a case where detailed memories, personality traits, and verifiable facts converged before any possibility of normal information transfer.

More than half a century later, Jim Tucker encountered a very similar pattern in the case of “Ryan,” a young boy from the American Midwest. At age four, Ryan began speaking urgently about a previous life in Hollywood—describing movie sets, agents, and a bustling life in Los Angeles. His parents, who had no interest in reincarnation, tried to reassure him, but the boy’s distress grew until Tucker became involved. Using Ryan’s spontaneous statements, Tucker and the family identified a long-forgotten bit-part actor and Hollywood extra from the 1930s and 40s. Ryan had given more than fifty details about this man’s life, including the street he lived on, the name of a restaurant he frequented, and the fact that he had danced on Broadway before moving west. Many of these details were later verified in archives and autobiographical sources unavailable to the family. What made the case especially compelling to Tucker was not only the accuracy of the statements but the emotional tone: Ryan spoke of the former life with longing and confusion, as if caught between two identities, until the memories gradually faded around age six.

Here is an example of a case in which the child had birthmarks corresponding to the deceased person’s wounds. In rural Burma, a young boy began speaking at age three about having been a man who was shot from behind while walking along a road. His parents were startled not only by the specificity of his statements but by his two unusual birthmarks: a small, round mark on his chest and a larger, irregular one on his back. When Stevenson later investigated, he found that the boy’s descriptions matched the death of a man from a nearby village who had been killed by a close-range gunshot. Eyewitness accounts and medical documentation confirmed the wound pattern, which corresponded closely to the boy’s birthmarks. The child also showed a deep, visceral fear of guns and loud noises, reacting with panic in ways that seemed disproportionate to anything in his current environment. The case combined early and detailed verbal statements, independently verifiable information about a violent death, and physical marks on the child’s body that mirrored the trauma he described.

Stevenson’s long-term research program—and Tucker’s continuation of it—poses a direct challenge to the assumption that consciousness is wholly generated by the brain. Across more than 2,500 investigated cases, they documented young children who spontaneously described memories, behaviors, and emotional dispositions corresponding to identifiable deceased individuals. While most cases are incomplete or ambiguous, a substantial minority meet stringent evidential criteria, and more than two hundred combine multiple independent lines of evidence: verified statements, behavioral continuities, and physical correspondences. Critics have proposed cultural contamination, suggestion, fraud, or loose investigative methods, but none of these explanations plausibly account for the best-documented cases, especially those with medical records, multiple independent witnesses, and physical anomalies. Even the most skeptical reviewers have struggled to articulate a coherent alternative hypothesis that explains the full pattern of data.⁷

For more than sixty years, however, mainstream scientists have dismissed the research. Critics argue that the stories of past lives are most likely due to coincidence, misinterpretation, parental influence, observer bias, or other sources of error. They emphasize the complexities of contextualizing and translating these “memories,” especially in cultures with strong beliefs in reincarnation.⁷ Yet critics rarely engage with the case narratives themselves; instead, they rely on hypothetical sources of error. To attribute all of these cases solely to flawed methodology would require assuming that Stevenson, Tucker, and DOPS have repeatedly committed the same errors for six decades despite their detailed rebuttals of such claims.

The deeper criticism, however, is philosophical. Although surveys show that most Americans and physicians believe in a soul or spirit, most philosophers and neuroscientists endorse a materialist-reductionist view: the brain creates the mind through electrochemical activity, and consciousness ends with the death of the body. Clinically, there is ample evidence that consciousness depends on a functioning brain—brain injuries and diseases clearly alter mental states, and imaging techniques reveal neural pathways associated with various emotions and thoughts. For clinical purposes, consciousness appears entirely dependent on the physical brain.

Yet this dependence does not settle the metaphysical question of what consciousness is. Critics of Stevenson and Tucker often assume, without argument, that the physical world as described by contemporary physics is the totality of what exists, and that consciousness must therefore be a byproduct of physical interactions. But subjective experience—the interior world of personal identity—does not obviously follow from any known property of quarks, electrons, photons, neutrinos, or the forces that govern them. The gap between third-person description and first-person experience is conceptually radical. No arrangement of particles, however complex, seems to entail subjectivity, i.e. interior life, in the way that arrangements of particles entail objects, organisms, or chemical bonding. To assume that this gap will close through further study of neural circuitry is to smuggle in a metaphysical conclusion under the guise of scientific optimism.

The quantum world is exceptionally weird – in many ways it violates common sense. Particles are also waves and waves are particles. An electron can be in multiple places at once. The behavior of one particle may determine the behavior of another, even though they are too far apart for a message to pass between them. Particles can tunnel through barriers apparently without having enough energy to do so. However, none of this weirdness suggests that large accumulations of particles (e.g. atoms, molecules, brains) could generate an interior world of personal identity There must be a deeper, more complete, theory of what exists in the universe that does account for the generation of consciousness; a quantum of subjectivity, if you will. As science writer Jim Holt summarized in Why Does the World Exist?, “The properties of a complex system like the brain don’t just pop into existence from nowhere; they must derive from the properties of the system’s ultimate constituents. Those ultimate constituents must therefore have subjective features themselves.”⁸

This is why the possibility that consciousness has a fundamental place in the universe is not mystical speculation but a legitimate philosophical alternative. Some philosophers and neuroscientists propose that consciousness may be an intrinsic aspect of matter, or that the universe contains a fundamental “interior” dimension alongside its measurable exterior. Panpsychism—the view that consciousness is woven into the structure of matter—is endorsed by a small, but growing, minority of philosophers, including David Chalmers⁹, Philip Goff¹⁰, and Galen Strawson.¹¹ Another group, notably Thomas Nagel¹² and John Searle¹³, acknowledge that our current physical ontology is incomplete, although not fully endorsing panpsychism. Physics has repeatedly revised its understanding of matter; it is not unreasonable to suspect that consciousness may require a similarly deep revision. To quote Thomas Nagel, “Consciousness is the most conspicuous obstacle to a comprehensive naturalism that relies only on the resources of physical science. The existence of consciousness seems to imply that the physical description of the universe, despite its richness and explanatory power, is only part of the truth.”¹²

Given these considerations, the continuation of consciousness, at least in some form, after death seems at least a possibility. Stevenson and Tucker’s work may well represent the identification of a previously unknown natural phenomenon, perhaps analogous to reported near-death experiences — well-documented yet difficult to explain. To my mind, this conclusion is more likely than is six decades of repeated errors.

However, that doesn’t mean the “former lives” data necessarily support a traditional doctrine of reincarnation, in which a unitary soul passes from one body to another. If a psychic dimension of the cosmos exists, a one-to-one transmission of “mind-stuff” to a newborn baby in the same country and culture seems overly simplistic, more in line with supernatural beliefs than with an unknown natural phenomenon. It is notable that the phenomenon is rare and the memories transient and strongly associated with traumatic death. Could it be that, under certain conditions, a “package” of psychic impressions may transfer from a dying person to a newborn, occasionally even influencing the child’s body? This, like any other scenario, is speculative, given our ignorance of the origin and meaning of consciousness in the physical world.

The broader point is that most philosophers and neuroscientists begin with an unexamined premise: that everything real must be physical in the sense described by current physics. But consciousness—the one phenomenon we know from the inside—does not obviously fit within that framework. Before declaring that mind must be reducible to matter, we should ensure that our conception of matter is adequate to account for mind at all. Consequently, Stevenson’s and Tucker’s six-decade quest to understand the experience of children who report having lived former lives should, if anything, leave us wondering whether we really know what we think we know about the way the universe works.

References 

1. Stevenson, Ian Twenty Cases Suggestive of Reincarnation, University of Virginia Press, 1980 [First published in 1966] 
2. Schroder, Tom. Old Souls. The Scientific Evidence for Past Lives. New York, Simon & Schuster, 1999 
3. Tucker, Jim B. Ian Stevenson and Cases of the Reincarnation Type, Journal of Scientific Exploration. 2008; 22: 36-43 
4. Tucker, Jim. B. Before: Children’s Memories of Previous Lives, St. Martin’s Press, 2021 
5. Stevenson, Ian. Where Reincarnation and Biology Intersect. Westport. Praeger, 1997 
6. Stevenson, Ian. Reincarnation and Biology: A Contribution to the Etiology of Birthmarks and Birth Defects, Westport, Praeger, 1997 [Two volumes] 
7. Matlock, J. G. ‘Reincarnation Case Studies: Criticisms’. Psi Encyclopedia. London: The Society for Psychical Research. <https://psi-encyclopedia.spr.ac.uk/articles/criticisms-reincarnation-case-studies/>. (2022, retrieved 24 March 2026) 
8. Holt, Jim. Why Does the World Exist? London, W. W. Norton & Company, 2012, p. 194 
9. Chalmers, David J. The Conscious Mind: In Search of a Fundamental Theory. Oxford University Press, 1997 
10. Goff, Philip. Galileo’s Error. Foundations for a New Science of Consciousness. New York, Pantheon Books, 2019 
11. Strawson, Galen. Consciousness and Its Place in Nature, Imprint Academic, 2024 
12. Nagel, Thomas. Mind & Cosmos. New York, Oxford University Press, 2012, p. 35 
13. Searle, John. Mind: A Brief Introduction, Oxford University Press, 2005 

Web image by Medhum.org

Alive: Our Bodies and the Richness and Brevity of Existence by Gabriel Weston 

Boston: David R. Godine, 2025, 304 pages 
ISBN 9781567928235 

The physician experience, medical history, motherhood, anatomy, and worries about her diseased mitral valve are tenderly sutured together by ENT surgeon Weston in her exploration of “the poetry of the body.” In thirteen chapters, she eloquently contemplates “the strange, unbridgeable gap that exists between the body science describes and the one each of us is living inside right this moment” (p194). In describing the anatomy of bones, brain, breasts, genitals, gut, heart, kidneys, liver, lungs, skin, and womb, Weston writes with a wit and intense curiosity reminiscent of popular science writer Mary Roach. But the book’s splendor arises from its attention to the art of doctoring. Weston notes how good physicians require a kind of “bifocal vision” that allows them to see the generalities of the human body but also the unique details of an individual patient. She extols empathy and elevates vulnerability: “We are not separable from those we care for, just as our strength is not separable from our vulnerability” (p263). Melding science and sentiment, mixing professional life with personal life, Weston enlivens anatomy and pays homage to the physician-patient relationship.  

The Land in Winter by Andrew Miller 

London: Sceptre, 2024, 384 pages 
ISBN 9781529354270 

Andrew Miller’s remarkable 1997 debut novel Ingenious Pain chronicles the complex life of an 18^th century highly skilled English doctor incapable of feeling pain. Twenty-seven years and many novels (Oxygen, Pure, The Optimists) later, Miller’s latest book spotlights a main character who also happens to be an English physician – but this flawed human being hurts (especially emotionally). Eric Parry is a 36-year-old country doctor having an extramarital affair with a married woman while his wife Irene is pregnant. Next door to their cottage is a farm owned by Bill Simmons and his pregnant wife Rita who suffers from mental illness and enjoys reading science fiction. It is winter (December, 1962 – January, 1963) and for a time the rural community is paralyzed by a brutal blizzard. Happy endings are in short supply here. One of the pregnant women has a miscarriage while sitting on the toilet. Characters get injured. Some patients die. Eric’s infidelity is exposed. Still, compassion and empathy occasionally sprout amidst the bleakness and the cold. Irene is cognizant that her husband’s work is hard as he “had to deal with people’s suffering all day” (p55). Eric excels at examining patients with a manner that “calmed” them. Secrets, loneliness, belonging, complicated personal relationships, and poor decision-making are essential elements of the plot. The story asks readers to contemplate whether virtuousness is a necessary requirement to be a “good doctor.” 

Doc or Quack: Science and Anti-Science in Modern Medicine by Sander L. Gilman 

London: Reaktion Books, 2025, 320 pages 
ISBN 9781836390152 

Bloodletting and purging (“heroic medicine”) employed for a wide array of diseases. Laetrile (a chemical present in apricot seeds) used for treating cancer. Hydroxychloroquine and Ivermectin prescribed for COVID-19. Spanning centuries, the list of wacky, ineffective, and sometimes dangerous remedies for illness is quite lengthy. In this standout history of scientific medicine from the mid-19^th century to the present, Gilman navigates “the ever-shifting boundary between good medicine and quackery” (p15). He reviews the rise of allopathic medicine that resulted from “following the science” as discovery and knowledge migrated from the laboratory to the bedside. He writes about the model of the physician-healer, the placebo effect (along with the morality of deception), superstitions (of both doctors and patients), and the faddish nature of medical practice. Gilman is rightly concerned about physicians experiencing burnout and patients feeling disconnected from their doctors in truncated office visits. He wonders if empathy and efficacy can coexist in contemporary healthcare. Three “case studies” are presented: peptic ulcer disease, the development of ophthalmic surgery, and acupuncture for back pain. A thoughtful study of historically “good” and “bad” medicine and the occasional blurring between the two. 

Additional recommended books published in 2025: 

The Mind Electric: A Neurologist on the Strangeness and Wonder of Our Brains
by Pria Anand 

The Age of Diagnosis: How Our Obsession with Medical Labels Is Making Us Sicker
by Suzanne O’Sullivan 

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