‘10 MINUTES 38 SECONDS IN THIS STRANGE WORLD’
What Literature Teaches Us About Memory, Consciousness and Finding Peace in Death
Written By Lema Delara
‘Her name was Leila.’
Tequila Leila, a sex worker in Istanbul, has just been murdered. Her body lies discarded in a metal bin on the outskirts of the city, her purple slingback stilettos still fastened to her cold feet. In that darkness, she arrives at a devastating reality: ‘... she now realized with a sinking feeling that her heart had just stopped beating, and her breathing had abruptly ceased, and whichever way she looked at her situation there was no denying that she was dead.’
And yet, her mind remains incandescently alive – for precisely ten minutes and thirty-eight seconds.
In death, Tequila Leila’s consciousness continues to flicker. Her memories surface in luminous fragments, every minute tethered to a sensory trigger: the amniotic tang of salt, spiced goat stew, lemon and sugar dissolving into wax, cardamom coffee shared in secret, watermelons split open in the summer heat, burning wood, bitter soil, the smell of sulphuric acid, chocolate bonbons, deep-fried mussels, wedding cake, single malt whisky and homemade strawberry cake. Each memory is inseparable from the friends who shaped her life – her chosen ‘water family’ that anchored her in a world that cast her to its margins.
Tequila Leila, as she is nicknamed by her beloved friends, is the protagonist of Elif Shafak’s ‘10 Minutes 38 Seconds in This Strange World’. The novel is divided into three parts – ‘The Mind’, ‘The Body’ and ‘The Soul’ – each tracing a different dimension of existence after death. The first part, ‘The Mind’, charts the stream of recollections that emerge in the ten minutes and thirty-eight seconds following Tequila Leila’s death, many of which are deeply painful and rooted in the violence and vulnerabilities of her childhood. This time span was inspired by a 2017 case report by researchers at the University of Western Ontario that documented persistent delta-wave brain activity lasting ten minutes and thirty-eight seconds in a terminally ill patient after their cardiac arrest and clinical death. The second part, ‘The Body’, moves our focus to Tequila Leila’s ‘water family’ of friends as they grieve her death and attempt to retrieve her body from the Cemetery of the Companionless, a graveyard reserved for those forgotten and unclaimed by society. Finally, ‘The Soul’ tenderly depicts Tequila Leila’s spiritual emancipation, as her friends help free her from the indignities, sorrows and traumas that once bound her in her earthly existence.
While the story is fictional, its premise is far from whimsical. It leans into a question that medicine has never been able to confront with complete certainty: what exactly happens to consciousness once the heart stops beating?
Clinically, death is defined by the irreversible cessation of circulation or cerebral function. We understand that when the heart stops beating, cerebral perfusion ceases and consciousness is lost within seconds. However, emerging research has documented transient bursts of organised electrical activity in the brain immediately after cardiac arrest, which suggests that the brain may briefly persist beyond the moment at which we declare its end. These findings remain tentative and are far from evidence of sustained awareness after death, but they certainly complicate the notion of death as a single, clean rupture.
‘10 Minutes 38 Seconds in This Strange World’ thus inhabits a liminal space that is at once literary and biological, speculative and empirical. Within this charged interstice, memory becomes the architecture of life and consciousness is no longer simply the subjective experience of being, but the iridescent thread from which identity is spun. Through Tequila Leila’s story, Shafak invites us to consider whether the end of life is truly a swift extinguishing or whether, for a fleeting interval, some strange glimmer of the self persists, flickering against the encroaching dark.
What does the research show?
The neuroscience of the dying brain emerges as a field marked less by certainty than complexity. Both animal and human studies have shown that the decline of brain activity following cardiac arrest generally unfolds over seconds to minutes. But under certain physiological conditions, brain activity may persist even beyond the point of clinical death, challenging our assumptions about consciousness and its temporal boundaries.
In controlled animal experiments, researchers have directly recorded the electrophysiological changes that accompany cardiac arrest. Borjigin et al. (2013) performed continuous electroencephalography (EEG) on rats undergoing experimental cardiac arrest and observed that shortly after cardiac arrest, there was a transient surge of synchronous, high-frequency electrical activity, including gamma oscillations, that exceeded levels seen during normal wakefulness, before eventually fading away. These organised oscillations occurred in the first tens of seconds after arrest and suggest that neural networks can remain structured very briefly, even in the absence of blood flow.
Another interesting piece of evidence comes from human EEG recordings collected in intensive care units. In a retrospective case series of patients who died from cardiac arrest while undergoing continuous EEG monitoring, Matory et al. (2021) found that electrical brain activity sometimes persisted for several minutes after the cessation of cardiac and cerebral blood flow, even when the heart had stopped supporting circulation. In addition to this, a study by Vicente et al. (2022) examined an EEG from an 87-year-old patient who had experienced cardiac arrest after a traumatic subdural haematoma and found relative increases in gamma-band activity and cross-frequency coupling, even after cessation of cerebral blood flow, phenomena that persisted beyond what might be expected in a completely inactive brain.
A scoping review by Pana et al. (2016) of studies tracking the loss of cerebral function after circulatory arrest found that in both animal and human contexts, measurable EEG activity typically disappears within 30 seconds after abrupt cessation of systemic circulation. Notably, this time frame is variable and sensitive to methodological differences in how brain activity is measured. In some cases, cortical evoked potentials – electrical responses generated by stimuli – may persist for a few minutes beyond the cessation of circulation.
Accounts of near-death experiences further complicate our understanding of the dying brain. Survivors of cardiac arrest sometimes describe vivid, structured perceptions: an altered sense of time, heightened clarity, sensory intensification or rich autobiographical recall. Common features include out-of-body sensations, a sense of peace, tunnel-like transitions and enhanced sensory awareness, even in situations where physiological function has been severely compromised. For many, these experiences feel incredibly real – they are coherent, meaningful and emotionally transformative – and the consistency of these features across hundreds of case reports suggests that they are neither random illusions nor purely dream-like events (Hashemi et al., 2023). Neuroscience offers possible mechanisms for these experiences, including cerebral hypoxia, surges in catecholamines and other neurotransmitters, or transient disinhibition of cortical networks under extreme physiological stress, but these cannot diminish the vividness or psychological authenticity of what was felt.
Importantly, none of these studies have been able to demonstrate sustained conscious experience after death. Organised electrical activity, even at gamma frequencies, is not synonymous with subjective awareness, as gamma oscillations can occur in many neurological contexts that do not correlate with consciousness as we ordinarily understand it. Moreover, the mere presence of electrical signals does not necessarily indicate coherent, meaningful cognition or lived experience. But taken together, these findings converge on an insight that resonates with Shafak’s narrative device: death is not a single, instantaneous event, but a process. This understanding enriches the conversation about the boundary between life and death, inviting scientists, clinicians and writers alike to reflect on what it means for consciousness to fade, rather than spontaneously disappear.
Memory as Identity
In medicine, we are repeatedly confronted with the fragility of memory and the devastation of its loss. Patients with dementia gradually lose their autobiographical continuity, where names detach from faces, once-familiar routes become meaningless streets and entire decades of lived experience recede into a disorientating blur. Patients recovering from traumatic brain injury often struggle to reconstruct a coherent sense of self from their fractured recollections. In intensive care units, patients drift in and out of sedation, their inner worlds inaccessible to those around them and their identities suspended between lucidity and oblivion.
Memory does more than archive our experiences; it continually shapes and reconstructs our sense of self, weaving our past into the narrative through which we understand and recognise who we are. It binds childhood to adulthood, lends depth to love and contour to grief and allows us to recognise ourselves as the same soul moving through the ever-changing seasons of life. Without memory, existence would fracture into a series of isolated, unmoored instants that touch but do not belong to each other. Memory empowers us with the understanding that our joys and our wounds are not coincidental, but foundational forces that mould us, refine us and render us unmistakably our own.
If memory is the thread that binds identity, what becomes of identity when that thread loosens – or when it frays at the very threshold of death?
In ‘10 Minutes 38 Seconds in This Strange World’, Shafak envisions that in the immediate moments after death, memory gathers itself, intensifies and rises to the surface with colour and clarity. Every sensory cue – the salt of birth, the sweetness of strawberry cake, the sting of sulphuric acid – unlocks an entire constellation of emotions and experiences, carrying with it all the beings who were part of it. Tequila Leila’s memories are entwined to the friends who offered her dignity and belonging in a society that sought to ostracise her; her identity is woven from these beautiful connections. So she is, in many ways, the sum of every human interaction she has survived and cherished.
Even though neuroscience has not been able to demonstrate proof of the persistence of consciousness after death, this novel resonates for a much more profound reason. Shafak suggests that what matters most at the threshold of death is the way lived experience is retrospectively gathered into narrative and meaning. This is especially pertinent for us as medical students and future doctors, as when we certify death, we are trained to focus on physiology – or rather, the lack of it: the lack of a central pulse, the lack of heart and breath sounds, the lack of pupillary and motor reflexes. These measurements are absolutely necessary. But the person before us is never merely a body approaching biological cessation. The heart that now lies motionless within their chest once quickened with fear, with love, with laughter. The hands resting still at their sides once touched others in comfort, in affection, perhaps even in conflict. Within that now-quiet body resides a lifetime of memories: childhood landscapes, classrooms and kitchens, friendships fostered and fractured, hopes, dreams, betrayals, joys, regrets both spoken and unspoken. Even when the voice quietens and responsiveness wanes, that marvellous tapestry of lived experience does not cease to define who that person is and now was.
Tequila Leila tenderly reminds us of this. While her body lies discarded, her inner world persists with astonishing vitality on the page. In death, she is restored through memory to the fullness of who she has been.
To sit beside a person at the end of their life, then, is not only to manage their symptoms or monitor their physiological decline, but to sit at the boundary of an immense interior landscape. Even if we cannot see it, even if we cannot access it, it is irrevocably there.
‘Free at last.’
We continue to learn more about death every day. We can trace the cascade that follows cardiac arrest; our measurements and instruments have never been more precise. And still, even at their most sophisticated, they cannot tell us what it feels like for a life to come to its close.
Shafak refuses to let the story conclude in the indignity of a metal bin. Instead, Tequila Leila’s friends reclaim her from the Cemetery of the Companionless and, in an act of defiance and devotion, carry her to the Bosphorus Bridge and grant her last wish: not to be buried in the neglected earth, but released into the ocean.
As she descends through the deep blue, she sheds anger, sorrow and regret. Beneath the surface, the world is soundless and boundless, awash with colour and life. She is greeted by a strange, beautiful freedom: ‘The ghastly and the graceful – everything was present around her, in rich abundance. Everything but pain. There was no pain down here.’
In that luminous expanse, she is no longer defined by the brutality of her death or the marginalisation of her life. The ocean does not judge her like society did; it cradles her, granting her the dignity, autonomy and rest that was denied on land. She is accompanied by memory, love and the loyalty of those who refused to let her vanish, forgotten: ‘She was happy to be part of this vibrant realm, this comforting harmony that she had never thought possible, and this vast blue, bright as the birth of a new flame. Free at last.’
There is a certain beauty in appreciating the intersection between medicine and literature, where medicine teaches us how life ends, while literature reminds us why it mattered – and, perhaps, how the threshold between life and death is not as clear-cut as it may seem. As future doctors, we cannot accompany our patients beyond that threshold, nor can we define with absolute certainty the precise moment at which consciousness ceases. But we can celebrate in each person a story that will never be replicated, a consciousness that once loved and feared and hoped in ways that no instrument can measure. A consciousness that may, for an interval however fleeting, still be in the process of receding.
And in doing so, we honour not only how life ends, but that it was lived at all.
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References
Borjigin, J., Lee, U., Liu, T., Pal, D., Huff, S., Klarr, D., Sloboda, J., Hernandez, J., Wang, M.M. and Mashour, G.A. (2013). Surge of neurophysiological coherence and connectivity in the dying brain. Proceedings of the National Academy of Sciences, [online] 110(35), pp.14432–14437. doi:10.1073/pnas.1308285110.
Hashemi, A., Ali Akbar Oroojan, Rassouli, M. and Hadis Ashrafizadeh (2023). Explanation of near-death experiences: A systematic analysis of case reports and qualitative research. Frontiers in Psychology, [online] 14. doi:10.3389/fpsyg.2023.1048929.
Matory, A.L., Ayham Alkhachroum, Chiu, W.-T., Andrey Eliseyev, Doyle, K., Rohaut, B., Egbebike, J.A., Velazquez, A.G., Der-Nigoghossian, C., Paniker, L., Prager, K.M., Agarwal, S., Roh, D., Park, S. and Claassen, J. (2021). Electrocerebral Signature of Cardiac Death. Neurocritical Care, 35(3), pp.853–861. doi:10.1007/s12028-021-01233-0.
Pana, R., Hornby, L., Shemie, S.D., Dhanani, S. and Teitelbaum, J. (2016). Time to loss of brain function and activity during circulatory arrest. Journal of Critical Care, 34, pp.77–83. doi:10.1016/j.jcrc.2016.04.001.