Recently a woman from Pilibhit (Uttar Pradesh) who had reportedly been “declared brain-dead” at a Bareilly hospital jolted back to life after the ambulance ferrying her home for the last rites went over a pothole. The “miracle” brought much joy to the family, but also threw up disconcerting questions.

How was the woman declared dead? How did she “come back to life” ? And how is “brain dead” defined?

Doctors are clear — this was no miracle, but a case of misdiagnosis. They caution that misinformation erodes trust in critical care.

“Brain death is irreversible... and if someone is waking up from ‘brain death’, they were never brain dead to begin with,” says Dr Prem Kumar, Senior Anaesthesiologist and Intensivist, Kauvery Hospitals. Put simply, brain death is the irreversible loss of all brain functions, including the brainstem.

“The brainstem controls breathing, pupillary reflexes, and other vital functions. Brain death usually occurs after catastrophic brain injury such as severe head trauma or a massive stroke. It is not reversible, as the brain tissue is irreversibly damaged,” says Dr Rajeev Jayadevan, Convenor, Research Cell, Kerala State IMA.

Other causes

Some conditions, though, mimic brain death. “Toxins or drugs with sedative effect entering the body in large doses, or metabolic problems like very low blood glucose can suppress brain function so profoundly that the person becomes unconscious, stops responding, and may even sometimes have dilated pupils and weak breathing. This can sometimes be mistaken for brain death, but is often fully reversible when the toxins disappear from the system or metabolic disturbances are resolved. In fact, certifying brain death first requires ruling out toxins and similar reversible causes,” Jayadevan explains.

While it may not be possible to determine the exact sequence of events in the Bareilly case without the patient’s medical records, the presence of reversible factors would mean that it was not brain death to begin with, he says.

That distinction is crucial because diagnosing brain death is not a matter of clinical impression. It follows a rigorous protocol. Under India’s organ transplant rules, a panel of four doctors must conduct a series of tests — including assessment of brainstem reflexes, pupillary reflexes, and apnoea test — and repeat them after a gap of six hours, while also ruling out confounding factors such as drugs, toxins or metabolic disturbances.

In contrast, the Glasgow Coma Scale (GCS), cited in such reports, as a yardstick to assess the depth of unconsciousness, is not sufficient to establish brain death. Patients with low GCS scores can, and do recover if the underlying cause is treated, Kumar observes.

Doctors say the reported “miracles” are fertile grounds for myth generation, blur the poorly understood distinction between brain death and coma, and give give misplaced hope to families.

Such misinformation also affects cadaver organ donation decisions — where brain death is the basis for consent — leading to loss of trust in the system, Kumar rues. Once the brain is dead, there is no coming back, no matter how large or frequent the potholes, say the doctors.

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Published on March 23, 2026