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The Brain at Twilight
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08 December 2026

What happens in the brain on the brink of death? One person’s last words might be lucid, revealing deep-seated thoughts and emotions. Another person might be brought to intensive care and never awaken. Electroencephalograms of dying patients record surprising activity in portions of the brain that control vision and memory. Death is not a discrete event in which all cerebral processes abruptly cease but a complex transition, whose many mysteries neuroscientists are beginning to unravel.
Interweaving the powerful stories of patients with accessible explanations of neuroscience, The Brain at Twilight illuminates consciousness, mortality, and the critical decisions that define our final moments. Tarvez Tucker—a neurologist with decades of experience treating patients with critical brain illnesses and injuries—takes readers inside the world of neurological intensive care. She shares insights into the structure and functions of the brain as well as the social and emotional complexities of end-of-life care. Tucker also explores zones of partial consciousness, such as vegetative and minimally conscious states, which challenge preconceptions about what being alive truly means.
Showing how neuroscience is providing new insights into the last moments of life, this book is for all readers interested in the brain, near-death experiences, and the social and medical meanings of death and dying.
— Alan R. Cohen, MD, author of Comfort Always: Healing in the Age of Technology
Few physicians encounter the boundary between life and death as intimately as neurointensivists. In The Brain at Twilight, Tucker transforms these encounters into compelling stories that reveal what the injured brain can teach us about consciousness, memory, courage, love, and meaning. Scientifically illuminating, deeply humane, and profoundly moving.
— Michael DeGeorgia, MD, professor of neurology and director of the Neurocritical Care Center, Case Western Reserve University
The Brain at Twilight explores the neuroscience behind experiences of death and severe brain injury from an empathetic perspective. Tucker weaves together compelling case stories that highlight the human stakes for patients, their families, and the clinical teams who care for them.
— Helmi Lutsep, MD, Oregon Health and Science University
Tucker’s presentations of cases are amazingly vivid. I found The Brain at Twilight hard to put down. Readers with a wide range of educational and medical backgrounds will learn much from this engaging book.
— Robert L. Ruff, MD, PhD, former national director of neurology services, US Department of Veterans Affairs
Preface
Introduction
Before We Begin: Brain Basics
1. Beginnings and Endings
2. A Matter of Life and Death
3. Words and Music
4. Caring
5. This Cannot Be Happening
6. Decisions, Decisions
7. It’s Always Something
8. Hello, Goodbye
9. The Moral of the Story
10. Odds and Ends
11. Life After Death
Epilogue: My Own Last Words
Glossary
Notes
Bibliography
Index