Afterlife — Joe Ponepinto

When people come back from the dead they come back from heaven or something like it, not from hell. Except for Dr. Bennett Bentivoglio, who said his certainty about the afterlife that he’d experienced could not be shaken, despite his agnostic ways and his twenty-four years in neurosurgery at St. Athanasius. This was a man who understood more about the physiology of the human brain than perhaps any other physician in the region, and had spoken often about the corporeal origins of mystical belief. Then the meningitis killed him, and the monitors all said brain dead; and then it let him live—or something did.

But no angels for Dr. Ben Ben, as his patients sometimes called him. No cherubim, seraphim—no saints or pearly gates. No hosannas or fluffy clouds, no blinding light, not even a few moments hovering close to the hospital room ceiling, watching the doctors work on his lifeless body. In the half hour he spent away from this world, he did not know God.

“What I remember most is the smell,” he said in the interview. “The stench of burned flesh and raw sewage so strong my eyes could not stop tearing.”

He embellished that statement for effect. The air hadn’t been quite so noxious. He’d have to remember to describe it the same way in the book manuscript, for consistency. Critics and naysayers always looked for a flaw they could exploit in the story, and thereby expose what they saw as a fraud. The idea that they would label him a liar made him nervous enough to pause in mid-sentence, to weigh his words before he committed them to record. But why give in to the public’s expectations? The truth should be enough. He cleared his throat and pulled at his collar. But the radio show host gave no sign of going on the attack. She smiled and asked how the incident had changed him.

“I was not a believer,” he said. “I haven’t been one since childhood. But everything is changing.” That was true, at least.

He related faces with scars and boils, features distorted by punishment.

“Were you scared?” The host’s voice raised an octave as she spoke.

“I’ve never been so afraid,” he said. “I faced damnation, after all.”

“Everlasting torture? I can’t imagine the pain.”

Ben paused and shook his head. “Despair,” he said. “Total despair. There’s no other way to describe it. And then a voice said I could go back to my life, and that I would eventually remember everything I’d seen. It said I’d been given a message to deliver. I awoke in the recovery room, shaking and sweating.”

“But—” The host seemed reluctant to continue. “How do you know you were dead?”

“The EEG. It flatlined. I have no doubt.”

The host brought in a second guest, a neuroscience expert from the local university, who offered a conciliatory dissent. Dr. Helen Castro had studied dozens of near-death trips and remained convinced the explanation lay with science, not faith. “The mind plays tricks. We still know too little about how it functions. And instruments can be misleading,” she said. “But your wish to believe is understandable. In such circumstances, people often conjure dreams that reflect long suppressed ideas about an afterlife.”

“Exactly what I would have said—until it happened,” Ben said. “I know what I saw. It’s not something I ever desired. There is a hell.”

The host interjected. “And now you’re writing a book about it.”

“I have to share what I’ve learned.”

The days of his recovery went on, days of contemplation amid a series of gray, lingering storms. He remembered the stories of others who had come back from the brink, the people Dr. Castro had interviewed. To a one they’d offered glimmers of salvation—proof that their lifetimes of belief in the face of a secular world would be vindicated. But for the most part those people were the devout, the ones who already had faith. Of course they remained unshakeable when confronted with science. He would have to be as well. The public, especially the people who would buy his book, expected no less. He would deliver the sermon they craved, only from the opposite perspective. Divine justice ordained that a man who hadn’t attended church for more than three decades could only glimpse the beyond in terms of punishment, instead of reward. He would repent for them, publicly, and they would drink it up. If he didn’t falter, the market for this was huge.

He planned the chapters carefully. A loving childhood with parents involved in the church. Three years as an altar boy, imbibing doctrine from dedicated priests. Good schools. A growing dedication to the well being of others, and the eventual decision to devote his life to medicine, which drew him away from those early teachings. Yes, yes. Then honors and publications; the material rewards of a successful practice. But something was always missing. The two failed marriages he would explain were testament to his commitment to his patients. The crushing debt from alimony and child support, and the stupid investments born of his desperation to maintain his lifestyle would paint him as the prodigal son, ready to begin his return to faith.

The outline came quickly to him, which he read as a sign of its genius. But as he worked, Ben paused to massage his shoulder, which had begun to rub against his shirt, as though he had scraped it on something. The irritation grew, and then he remembered— He stood up and clawed at the buttons to get at his skin, and ran to look in the bathroom mirror. Three lines, like scars from knife wounds, glowed pink in the harsh light. They hadn’t been there yesterday.

Of course Castro was right. Causality, physicality were what really mattered. Magic and chance—faith—didn’t enter into the equation. Things happened because events and states converged to determine them. Never mind that the monitors in the hospital room reported zero neural activity. Never mind the doctors declared him clinically dead for thirty minutes. Consciousness was essentially a chemical function of the brain, an evolved communication between its hemispheres that manifested in an illusion of individuality, complete with a little voice to provide occasional advice, not a dispensation from some deity. He knew that. He saw the evidence every time he pushed into a patient’s temporal lobe and made him recall forgotten pasts or visit imaginary places with a touch of a probe.

The instruments simply had been wrong. Some part of his brain, deep in its folds, had remained active, undetected. He had dreamed it all—a dream that was anathema to the once-dead who believed they’d seen heaven, but a dream nonetheless. So many dreams felt real.

He remembered the sensation—a hand the size of a catcher’s mitt on his shoulder, with carefully manicured daggers for nails. The creature did not speak, yet Ben judged it to be Satan. And though every logical impulse urged him to dismiss the experience as a wretched, disease-induced fantasy, he was paralyzed by the improbable reality of it, even the fact that he could question its veracity while it occurred.

The weight of the hand was palpable, the nails razor sharp against his flesh, but when they dug into his skin he felt no pain, only an intense and surprising loneliness, as though the hand was siphoning away the memories of his accomplishments, emptying his mind of its connections to the living. For an instant Ben felt his body become brittle, like a desiccated insect, and he was terrified the hand would close and crush him. He reached up to try to pry away the polished claws, but instead of fighting him, the creature rested both hands on his shoulders, the weight of the embrace holding him still, and directed him to preview the revels of hell. A good deal of it was sex: man and woman, men and women, men with men, women together, humans and animals, a mindless, irresistible urge overtaking them all, the act performed without any sign of enjoyment. Flesh, sweating and stinking, everywhere. And yet, Ben remembered thinking, this was not so different from the world he’d left behind—if the curtain could be pulled back from people’s private lives.

A naked man ran up and stopped in front of him, and then masturbated to climax. He maintained a look more like pain than pleasure during the entire exercise. Ben wondered if sex was allowed in heaven, or if its residents had done away with carnal desire. From behind walls he heard the screams and moans of people suffering, as though in a special circle of agony. Those must represent hell’s greatest sinners. Their howls echoed in the air, and Ben cried, not knowing if he cried for them or for himself.

Afterwards, in the ICU, still only half aware, he began to piece together the hallucination, amazed that he had survived the meningitis, amazed that his mind had drifted so far, all the way back to the fables and guilt of his boyhood. And in that half-sleep, he knew there were others who had never abandoned those childish beliefs, and that they longed to hear such a story—his story—and would take it as fact and divine intervention.

Ben peered deeper into the mirror and ran his fingers over the remnants of the incisions. He couldn’t have dreamed these into being. The devil’s daggers— And then he smiled at himself. How tempting to blame the supernatural. This could have happened at any time—in the hospital during one of the procedures, inflicted by himself in a semi-conscious reverie. All could be explained by science, but then, that was not the explanation most people wanted.

He should just listen to Prajapati.

“Never mind the meaning, just write the damn book. Get the payoff for what you’ve been through.” Dr. Nagesh Prajapati’s ghostwritten volume, about his relationship with an unusual patient—although mostly about him—had stayed on the bestseller list for two weeks. “Trust me,” he said after cornering Ben in the surgeon’s lounge. “Just tell the people what they want to hear. Do it. One more little hell to endure and then you’re home free.”

How much of Prajapati’s book was fantasy, Ben wondered. “Would you believe I actually visited hell? Would anyone?” he asked.

Prajapati shook his head. “It doesn’t matter, don’t you see? You tell your story and nothing changes. People who believe in hell still believe. And if they don’t, nothing you can say will change their minds. Just take the money. They offered you good money, yes?”

“Oh, yes,” Ben said.

“Then go for the gold, man.”

The writing should have come easily. He’d authored dozens of studies and articles in his tenure at the center, but then he’d never made himself the focus of any of them. And in those cases the facts he related had evidence to back them up. Now even the pages about his childhood proved torturous, as though they hadn’t happened either, at least not in the way he remembered them.

Night after night he sat in front of the laptop’s monitor, staring at the blinking cursor for hours, composing only a paragraph or two before giving up and putting the computer to sleep. The scratches on his shoulder had refused to heal, even after he’d applied an antibiotic and a steroid, and when the pain didn’t subside, he began again to entertain the possibility that his experience had been real, despite his training and his convictions; visited on him, as he’d told the radio host, to send a message to the world. After all, such was the basis for belief—a comfort to fill the void of unanswered questions. That he had come even this close to considering the experience as real scared him, but he couldn’t, in his agitated state, continue to deny it categorically. His science was evidentiary, but not conclusive. No one could prove the origin of consciousness or dreams, just as no one could confirm the existence of worlds after death. But could he so easily abandon decades of learning and experience in favor of what he had always judged a fantasy? Perhaps that was the key to faith—to be able to do exactly that. But then, that desertion of the truth would make Prajapati right.

Alone, without anyone to counter him, he rationalized: the visions of heaven went to the believers; for doubters like him, a glimpse of the cruelties that awaited if they didn’t change. A simple message, as he’d promised. A brief purgatory for his transgressions so far. But maybe not so brief—maybe his punishment was to never know whether the experience had been real. Maybe hell was largely irony.

Ben had expected his publisher to ask why the chapters he’d promised were so late. He’d try to relate the torment he was going through and hope she’d understand.

“The TV networks are interested in your story,” she said. “We can promote the book on some of the afternoon talk shows, so tell me you’re nearly done with that first draft.”

“Abby, I—” But Ben paused. The free publicity meant the book could be worth millions now. He might even quit the hospital and begin a motivational journey across the country. “I could use a couple of extra weeks. At least one more week.”

“Just get it down,” she said. “We have people who can clean it up. This window won’t stay open for very long.”

If he took a leave, told admin that he still wasn’t feeling ready to go back into the operating room, they’d surely give him the time. He would work day and night; just type whatever came into his head, as long as he could say at the end that he’d found himself. Give him a day to get motivated, to select the proper starting point, and he would write, not think or worry anymore about the truth. How could so many people be so sure of what to believe?

At the Revival Tabernacle he sat in the back row while the congregation chanted hymns and responses to the pastor’s prompts. He’d driven here on a whim, having seen the purple façade on a trip into downtown. The building stuck in his memory—an old theater, the marquee lettered with an updated version of the eighth commandment. Maybe it shouldn’t have been a surprise that the auditorium still had the velour movie house seats instead of pews. Still, Ben refused to get comfortable, preferring to recall the hard pine benches of his youth.

“The Lord never wavers in his faith in you,” The pastor said. “Why should you falter in your faith in him?”

The service followed no liturgy Ben could remember; yet no one needed a prayer book to answer the pastor’s calls. None except for him looked away from the altar. Even during the sermon their attention never waned. It seemed not so much that the congregants were mesmerized by the service, but instead that while their bodies remained present, their minds transcended the physical surroundings. All stayed riveted to the proceedings, as though a collective entity replaced their individual consciences, as though they had become hemispheres of a brain connected telepathically to each other, and to their shared idea of heaven. Any of these people, should he or she suffer a near-fatal aneurism in this place, might experience the kind of vision of heaven he’d been denied, and once resuscitated would thrill the rest of the attendees with the details of cool, wispy clouds, verdant fields and overwhelming joy.

“Come with me to the house of the Lord,” the pastor said.

The congregation answered: “We go with you to heaven.”

He wanted to be one of them. For the first time in his life he wished he could abandon his intellect, shed the opinions and doubt he’d developed in his decades of school and residency, and become simple. But he remembered, instead, the complexity of his life.

“Who is that man,” the pastor shouted, “who does not believe?”

Ben began to itch. He scratched, at first as inconspicuously as possible, slipping his hand inside his jacket and shirt to massage the skin on his scarred shoulder. But the irritation only became worse, and spread quickly down his torso, into his loins and beyond. He rubbed his pant leg against the seat cushion, and squirmed to get at his back. It wasn’t possible to scratch everywhere at once, and the places he could reach refused to calm. He couldn’t imagine that the wound could fester so badly as to cause this much discomfort, and he groped again to touch it. When his fingers reached his shoulder he felt them—insects! They poured from the hole in his flesh and ran over him, crawling and biting, covering him under his clothes, the formication so great it rendered him impotent to fight it, as impotent as when he stood in hell’s dominance. He writhed in place, held erect by some power he couldn’t account for.

Yet he saw that the service went on in front of him, with the congregation so enraptured that everyone remained oblivious to his agony, and he heard himself call, “Help me, won’t you?”

He cried out again to get their attention, began to beg for help, but still they did not hear.

Finally Ben could endure the affliction no longer. Amid the chorus of “Amazing Grace,” he tore off his clothes—his jacket and shirt first, then his shoes, socks, pants and underwear—and stood naked in the church, flailing and grabbing at himself without relief, the insects so many that they made his body a swarming, black mass, yet still ignored by the others and even the pastor, who appeared to look right at him.

He ran screaming from the church into the street, where a car had to swerve to avoid hitting him. He staggered back to the curb and sat down in the filth of the gutter, curling into himself and shutting out the world, and remained there until well past dark, until the temperature dropped nearly to freezing. No one called the police. Not a single person offered to help him or even asked if he needed assistance.

When he awoke he was fully dressed again, but he knew he had not done it. Ben rummaged to find his keys and made his way through the cold to his car.

The next evening, after sleeping all day, Ben sat down at his computer and wrote the foreword for his book. He wrote that in his experience as a doctor, as a man who based his life and beliefs on empirical evidence, he had long believed that the concepts of heaven and hell were human constructs, but that since his near-death experience, he saw reason to question that opinion. He would say it on TV too.

He stood, a month later, in Operating Room 6 at St. Athanasius, looming over the supine patient before him. Ben stepped back for a moment to appreciate the equipment and lights in this theater—something he had never done before—and the team of specialists and nurses who had applauded his return a week ago at the surgeon’s meeting. And a decent challenge too, this peanut-sized tumor on the boundary between the occipital and temporal lobes.

Even the senior administrators had clapped when he tried to sneak into the back of the bi-weekly gathering. They asked him how he felt, and he said, “Fine. I am my old self again.”

He wouldn’t tell them about the weeks of depression and self-doubt, or the despicable scene at the tabernacle. He wouldn’t mention those on TV or even in the book. “I’ve come to realize that what happened to me was a warning to the world,” he had written in those first pages. The advance check had cleared and a book tour would guarantee more. Maybe he should give stronger consideration to leaving the hospital; at least take a sabbatical and think through all this. He wished he could be done thinking. As he sanitized his hands, though, he thought of Prajapati and his greedy advice.

At the first bore into the patient’s cranium Ben shuddered as the control that had escaped him since he’d succumbed to the meningitis returned. Whatever God, the devil, or his conscience had in store for him subordinated, finally, to his surgical art. Whichever power had called him to witness that sliver of hell, and had made him explode in discomfort at the tabernacle would at least allow him a respite while he restored this poor man’s memory and perception. He’d visited him in his room the night before—a Mr. Lazar, an executive at an insurance company: wife, two grown children, four grandkids, a textbook life except for the disease eating at his brain. But although he’d wanted to ask the man about his religious beliefs, he knew he couldn’t.

The operation would take several hours, but Ben felt a full reserve of stamina, despite the layoff. He donned the loupes and peered at the man’s shaved head, at the stencil marking the places where he would cut and remove a portion of the skull, where he would extract the cancer with the precision of a jeweler. He relaxed beneath the surgical mask. He had lost nothing.

An hour into the operation, however, Ben encountered complications. The tumor lodged within a fold of the brain and proved difficult to access, let alone remove. The excision would require a delicate carving away of the malignancy, slice by slice, or he might damage the man’s brain, and that meant he might not get it all. But he couldn’t deny the feeling he had of being able to cope with any surgical issue. The puzzle of the tumor lay before him; its solution just out of reach. He would probe more deeply.

Such was his focus on the task that he didn’t hear his nurse when she reported, “BP eighty over forty.”

“Awfully low, Ben,” the anesthesiologist said.

Before Ben could comprehend, before he could respond, the patient went into cardiac arrest. The man’s body jerked. Vital signs cascaded. The assisting had the paddles in his hands and had called for them to be charged. “Dr. Bentivoglio? Ben?”

The surgeon looked at his dying patient and knew the man had embarked on a journey—maybe real, maybe dreamed. Was it heaven this time, or another trip to hell? What would he see? What would he bring back? At another time administering the life-restoring surge would have been a reflex, applied without delay or consideration. But instead, he watched, transfixed by the patient’s form.

“Ben!” the assisting said. “What are you waiting for?”

Machines chirped their alarms. He did not know how long it might take for the man to have a visitation. Perhaps his own, despite his half hour in death’s grip, had implanted the experience of hell in only a second.

The instruments showed that heart and brain activity had ceased. Dr. Bentivoglio leaned in close and pried the patient’s eyelid open with his finger. The pupil had dilated. Then he moved to within a few inches of the patient’s face. The assisting pushed against his shoulder. A nurse took his arm and pulled. The anesthesiologist reached around his waist, but Ben refused to move.


He had to know. Where was this man?


Joe Ponepinto’s novel, Mr. Neutron, will be published by 7.13 Books in spring 2018. He is the winner of the Tiferet: Literature, Art & the Creative Spirit 2016 fiction contest, and has been published in many literary journals in the U.S. and abroad. Joe lives in Washington State with his wife, Dona, and Henry the coffee-drinking dog. He is the founding publisher and fiction editor of Tahoma Literary Review, and teaches at Seattle’s Hugo House and Tacoma Community College.