Review of To Heaven and Back by Mary C. Neal

I am grateful to Patheos for the opportunity to participate in the book club about Mary C. Neal’s book To Heaven and Back: A Doctor’s Extraordinary Account of Her Death, Heaven, Angels, and Life Again: A True Story. This is not a scholarly or academic book, but a personal account by this medical doctor of the experience she had of drowning, and of finding strength from her near-death experience, and belief in divine providence, as she and her family passed through still other tragedies, including the death of her son.

I find this a difficult subject to write about, since in my younger days, although I never had a near-death experience, I inhabited the worldview that Dr. Neal and many other Christians share, one that expects angelic actors to be present on the stage of human history, and rejects the notion of “coincidence” in favor of the affirmation that God is in control, and that everything happens for a providential reason. I can appreciate the comfort that Neal and others find in this view of things, particularly when trying to live in light of what could otherwise seem like senseless tragedy.

But having reflected critically on my earlier views, I cannot inhabit that world, nor would I now find it comforting to do so, and To Heaven and Back served only to reinforce the problematic nature of this worldview.

There is no need to be skeptical about Neal’s description of her near-death experiences or out-of-body experiences. That someone who underwent the oxygen deprivation that Neal did would see and hear things is something that no one is likely to deny, although their explanations will differ. It is how those experiences are fitted into the framework of a broader worldview – one that she seems to have had or at least been influenced by even prior to her kayaking accident.

Neal depicts in her book a world in which human souls existed prior to coming into the world, and persist after departure. The reason for our current bodily existence becomes somewhat puzzling, but Neal suggests that it is because we have something we need to learn from the experience. But that in turn sits oddly with the joint emphasis on this being a universe full of divine/angelic “nudgings” to which it is apparently important to respond, and yet in which it seems as though everything that happens, whether seemingly good or ill, is for the best, and part of a divine plan, which is at times depicted as alterable but at other times seems not to be.

A worldview of this sort presents many puzzles and seemingly unanswerable questions. Neal believes that she was brought back from death to be there for her family to cope with the later death of their son. But surely that makes no sense whatsoever – it would have been just as straightforward to spare her her accident, and have the son survive his own accident after a near-death experience.

The book highlights the fact that, if we look for the good in the pattern of life that is woven by the intersection of human lives, we will find it. And I do not disagree in the slightest. But I do think that, in making a personal God the weaver who tugs and at times forces the threads into a foreordained pattern, it actually undermines the attributes of God that Neal herself wants to emphasize, including most importantly love. A God who micromanages an adult’s kayaking accident to ensure her survival, but not the careless running down of her son by a texting driver, or perhaps who micromanages both to at times reduce and at times intensify human agony, does not seem to provide anything other than personal comfort for one who, like Neal, wants to find comfort in the idea that such events are supernaturally meaningful.

But for me, an “explanation” that can fit any evidence is not an explanation, and a God whose mercy and providence are posited as ensuring Neal’s survival down to the last detail, and yet supposedly as also foreordaining her son’s death before age 18, only to grant him a reprieve, and then take it away again, and yet who in other instances micromanages even the breaking of an ankle in order to bring about a meeting, does not seem to me to offer comfort, or a God who is “loving” in anything like what we mean by that term, or indeed anything at all.

The last line of the book prior to a Q&A with the author says that God commands us to (among other things) “Live a life of gratitude, giving thanks in all circumstances.” I appreciate and share this emphasis on giving thanks in all circumstances. I appreciate and share Neal’s emphasis on looking back on our lives and seeing with hindsight how things have worked for good, and how even from the painful and seemingly unbearably tragic we have learned and grown.

But to insist that God is micromanaging the details, every flower blossom and bird, and every injury and threat to us and those we love, seems to add nothing positive and indeed to detract from this very point. If every tragedy is divinely ordained, there would be no point in trying to avoid them or to reduce the suffering of those around us.

Neal’s worldview is even more problematic than that at times. She says early on in the book, “It has taken many years to truly learn that when everything seems difficult and feels as though you are swimming upstream, it is usually because you are not following the direction of God’s will. When you are doing God’s will, everything seems to happen without much effort or many obstacles” (p.12). If Neal really believed this, she presumably would write about her experiences differently, since her life’s course – in which she says time and time again she detects divine or angelic providence – has not been without obstacles by any means. But the truth is that sometimes things really come together wonderfully, and we can delight in such moments without assuming that they will not lead on to severe difficulties later on, then coming to question why God made it so easy only to then make it so hard. No, sometimes things that are really worth doing will involve incredible struggles, and sometimes the easy path is that of the coward. If we insist on treating difficulty or smoothness as indications of divine favor or disfavor, we will in all likelihood not engage in the really hard things that Neal herself recognizes as important, such as the loving and the forgiving of those who do not seem worthy to receive our love and/or forgiveness.

One of the points that I found really meaningful early on in the book is an account of the attitude of an elevator operator who worked in a hospital building that Neal visited regularly during her medical training. That person said that her positive outlook, despite the negativity of those around her, came from the Lord: “She knew the only part of life she could control was her reaction to it, so she chose to react with love.”

If the book had made that point, without offering confident statements about how those things that we cannot control may or may not be providentially organized, I would have had a much more favorable impression of the book’s message. Instead, while I find myself glad that Neal and her family have found comfort in the worldview reflected in the book, but it is not one that I myself find comforting or would recommend to others for their comfort.

You can learn more about the author, the charities to which part of the proceeds from the book are given, and how others have responded to it, on the author’s web site.

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  • jlswope

    You should read Heaven is for Real and review it. The kid says the same thing and has no way of knowing any of it except from the experience.

  • palmcanyon

    Not a particularly well thought out review. Unhappily, McGrath bases his review on his own biased assumptions and seems simply to be writing to hear himself speak, so to speak. For example he writes “But for me, an “explanation” that can fit any evidence is not an explanation”. That in itself is a rather startling statement. It would seem that an explanation that would fit any evidence would be the most likely explanation. He also states “That someone who underwent the oxygen deprivation that Neal did would see and hear things is something that no one is likely to deny..” Where did he come up with that? If McGrath had bothered to do a minimal amount of research he would find that a majority of the medical profession would indeed dispute that Dr. Neal would have seen or heard anything! Despite his homespun introduction in which he professes to be sympathetic to those poor ignorant souls who wish to inhabit a spiritual world for comfort and peace of mind, his review actually reflects that he possesses no such sympathy and instead is simply fronting his own not particularly well disguised agenda. It is this type of nonsense that renders this review basically worthless. Pathoes should be more discriminating in their selection of reviewers. It is unfortunate reviews such as this one which degrades their own credibility.

    • James F. McGrath

      Could you kindly provide evidence for your claim that the majority of medical professionals would disagree with my point? I am perfectly happy, indeed eager, to accept correction from those who know more about a subject than I do. But since you don’t cite any sources or provide any evidence, how do you expect me to know whether you are in that category, or whether you are of a different sort, and simply disagree with me and are happy to make up statements about what experts say without having knowledge yourself? It is unfair to leave such a comment without providing the evidence that you say is available even after a minimum amount of research, is it not?

      • palmcanyon

        I will do so. Give me a minute.

      • palmcanyon

        O.K. Maybe I was a little harsh. I apologize. But, although my response may seem unfair to you, it was just my opinion as the review seems to be yours. First, I don’t profess “to know more about the subject than you do,” because, frankly, nobody knows. That’s sort of the point. We’re dealing with a person’s subjective experience and to find fault with it seems hubristic. You say that it would be unlikely that anyone would deny that Dr. Neal would see and hear things. That presumes consciousness and memory, etc. But frankly nobody has been able to satisfactorily explain consciousness or memory for that matter. The conventional scientific view of consciousness (i.e. the hard problem of consciousness) is that consciousness is the result of biological processes in the brain. Any other explanation would rely on some type of mystical/spiritual theory. Do you agree? See the many writings of Sam Harris. See Also Leonard Mlodinow’s discussion in Part 4, chapter 12, War of the World Views. There are many more but I am at sort of a disadvantage to give an on the spot response to your demand for authority as we are in the process of moving and I have packed my entire library into boxes and stuffed it in a $90 a month storage room. However, if you agree, then Dr. Neal’s experience, per the scientific/medical community, would require some type of cognitive brain/memory function. If consciousness and a functioning brain are required I believe that the mainstream medical community would largely agree that, as she claims, a minimum of 15 minutes and perhaps as many as 30 minutes of oxygen deprivation would render Dr. Neal’s brain incapable of any sort of cognitive ability. I realize that’s also a general statement, but if you want supporting authority, the National Institute of Neurological Disorders and Stroke has some good information. But if your criticism of Dr. Neal’s book is less based on your disbelief that she experienced the things she reports from a physiological standpoint and more on you inability to justify her view of life’s events and how they gel with “God’s” plan, then I think you are on even thinner ice. Who of us can possibly know if cartesian dualism is a fact, or just how many dimensions there really are, or the meaning of life, and on and on. Those are esoteric questions that we many never know the answers to, at least not with our current human senses and abilities. But that doesn’t mean, and in fact, can’t mean, that there are not answers to these questions. If you’re a Bible thumper, then you should be familiar with the myriad of passages that reflect that we are not even supposed to know, like references to God working in mysterious ways and these holy mysteries, etc., etc. Bottom line: We cannot prove or disprove the validity of Dr. Neal’s experience. If you’re review is just meant to say “Well, I just don’t believe her”, then, O.K. I guess you’re entitled to your opinion. I just don’t think it’s a very good one.

        • James F. McGrath

          I am skeptical that, when you referred to the possibility of my finding things out easily through some basic research, you had in mind your books which are in your own personal collection. Instead, you insist that your books would show me wrong if only you had access to them. I am not impressed. I am not sure that anyone can give us a precise amount of time during which Dr. Neal was deprived of oxygen, and so there is good reason to approach these sorts of claims with the same kind of skepticism one would apply to similar ones which feature much the same kind of near-death experience and yet a very different if not contradictory account of what lies beyond this life.

          • palmcanyon

            I withdraw my appology.

          • Beau Quilter

            Too bad. Because the person who failed to do a “minimal amount of research” is you – not Dr. McGrath.

            A “minimal amount of research” would show you that Dr. McGrath is completely correct in stating that “someone who underwent the oxygen deprivation that Neal did would see and hear things is something that no one is likely to deny”.

            And your baseless assertion that “a majority of the medical profession would indeed dispute that” is completely false.

            Since you don’t seem to have access to your personal library, try a simple internet search:


            “People who report near-death experiences have elevated levels of carbon dioxide in their blood and may be suffering oxygen deprivations, according to a new study published in the medical journal Critical Care.”


            “At this time, there is strong research evidence to indicate that many of the symptoms of NDEs may be caused by anoxia, or a lack of oxygen to the brain.”


            “Oxygen deprivation–and even just a sense of fear–can cause the oxygen to stop flowing, and both of those are symptomatic of dying. In Nelson’s research, simply fainting was enough to cause several of the effects related to near-death experiences, like a feeling of being out of your own body, or a sense of euphoria.”


            “As one would expect from Siegel’s explanation, classic near-death experiences generally involve oxygen deprivation.”


            “Additionally, a study at the University of Maribor in Slovenia found that carbon dioxide levels in the blood were higher in heart attack victims who reported NDEs. Researchers found no other variables common to those patients.”


            “Although the specific causes of this part of near-death experiences remain unclear, tunnel vision can occur when blood and oxygen flow is depleted to the eye, as can happen with the extreme fear and oxygen loss that are both common to dying.”

  • mgareader

    This reviewer does a good job of showing us the positives Neal puts forward (looking for the good and noting how even the bad/painful/difficult provided opportunities for growth, and living with gratitude), while pointing out the contradictions inherent in a theological view of pre-destination where everything is ordained or orchestrated by a micro-managing God. Maybe, as the reviewer suggests, it is best to put aside conjecture about God’s providence and to keep one’s theology simple–“react with love” as the elevator operator says.

    Overall, I found this book very engaging and well written (the accident and her rescue and journey to aid is extraordinary), and I was impressed with Neal’s incredible energy, athleticism, intelligence, and career achievements while having a husband and raising four kids while being involved with church and community (SuperWoman!).