Cosmologist Anthony Aguirre, while personally skeptical of most accounts of the many-worlds interpretation, in his book "Cosmological Koans" writes that "erhaps reality actually is this bizarre, and we really do subjectively 'survive' any form of death that is both instantaneous and binary." Aguirre notes, however, that most causes of death do not fulfill these two requirements: "If there are degrees of survival, things are quite different." If loss of consciousness was binary like in the thought experiment, the quantum suicide effect would prevent an observer from subjectively falling asleep or undergoing anesthesia, conditions in which mental activities are greatly diminished but not altogether abolished. Consequently, upon most causes of death, even outwardly sudden, if the quantum suicide effect holds true an observer is more likely to progressively slip into an attenuated state of consciousness, rather than remain fully awake by some very improbable means. Aguirre further states that quantum suicide as a whole might be characterized as a sort of "reductio ad absurdum" against the current understanding of both the many-worlds interpretation and theory of mind. He finally hypothesizes that a different understanding of the relationship between the mind and time should remove the bizarre implications of necessary subjective survival.