In March 1992, Matthew Botsford walked out of a restaurant in Atlanta and found himself in the middle of a gun battle. He was struck in the back of the head with a 9mm bullet. Before he knew it, he had died and gone to hell.

“I felt a hot, needlelike pierce, excruciatingly painful, for a brief moment on the top of my head,” Botsford wrote in A Day in Hell, an account of what he experienced in the underworld during the 27-day coma that followed the shooting. “Utter darkness enveloped me as if thick, black ink had been poured over my eyes.” He later described being “hung over an abyss” as heat blasted up from below. Pairs of demonic eyes crept toward him before a divine entity grabbed him by the waist and said, “It’s not your time.”

Clearly, this is not the near-death experience we typically hear about. Most of the time, it’s the visits to heaven that are followed by visits to the New York Times bestseller list, like in the case of 4-year-old Colton Burpo in Heaven Is for Real: A Boy’s Astounding Story of His Trip to Heaven and Back, or Dr. Eben Alexander in Proof of Heaven: A Neurosurgeon’s Journey Into the Afterlife (which was excerpted as a Newsweek cover story). Likely because far fewer Americans believe in hell than in heaven, descents into the lake of fire make less frequent appearances on Good Morning America. But to judge by bookstore shelves and the work of a small number of researchers who study this type of thing, they happen quite regularly.

Occasionally they do break into the mainstream consciousness. In 2005 art professor Howard Storm rose to fame after claiming he had been “viciously attacked” by evil creatures in hell while unconscious before emergency surgery, an experience he described in his book My Descent Into Death. He tried to pray, which only provoked the angry creatures. “They screamed at me, ‘There is no God!’ ... They spoke in the most obscene language, worse than any blasphemy said on earth.”But hell stories circulate most prominently among various stripes of evangelical Christians who fear ending up there. The lore is particularly influential among “Pentecostal” evangelicals who place a heavy emphasis on invisible spiritual forces; stories of near-death experiences of hell play a powerful role in evangelism. Some Pentecostals like Bill Wiese, who claims to have seen 12-foot-tall “foul creatures” in hell in 1998, have built entire ministries around their experiences in the pit.It’s not all fire and brimstone, however. Reported visions of hell are “all over the map,” says Nancy Evans Bush, author of Dancing Past the Dark, who has examined and written about “distressing” near-death experiences, including some that involve descriptions of something like hell. “Some are hot, some are cold, some are like deserts, some are like swamp. Some are too bright, in terms of fire, and some are full of wet, slimy, nasty stuff. I’ve heard descriptions of wells with slimy creatures in them, but I’ve also heard barren wastes with nothing.”As for the devil himself? “I’ve never heard a description of a red being with a pointed tail,” Bush says.The appeal of these hellish visions isn’t confined to religious believers, though those many claim to have been there often use familiar religious language to describe their subsequent conversions. It is hell, in fact, that is sometimes credited with inspiring the modern study of near-death experiences. In 1943, during World War II, George Ritchie was pronounced dead at an Army hospital, only to wake up nine minutes later. Ritchie went on to become a psychiatrist and write several books about those nine minutes, in which he claimed to tour the devastation of hell in the company of Jesus Christ. “Everywhere spirits were locked in what looked like fights to the death, writhing, punching, gouging,” he wrote in Return From Tomorrow, originally published in 1978. “Even more hideous than the bites and kicks they exchanged, were the sexual abuses many were performing in feverish pantomime. Perversions I had never dreamed of were being vainly attempted all around us.” Ritchie’s story inspired Raymond Moody, who coined the term “near-death experience” and published the runaway 1975 bestseller Life After Life. By the late 1970s, several researchers in psychology and psychiatry had begun studying near-death experiences in clinical settings and charting similarities between them. “Roughly one out of every three people who come close to death will have transcendental experiences,” Kenneth Ring, one of the researchers, told the The New York Times in 1988. “I found that it doesn’t matter how you almost die, with respect to the kind of experience you have when you come close to death—whether it’s in an accident, an operation, or a suicide attempt. Experiences didn’t vary whether you were religious or not.” Bush, who worked alongside several of the early researchers of near-death experiences at their organization, the International Association for Near-Death Studies, said the scientific community was initially skeptical. “I think there is a substantial population of working scientists for whom there is no evidence that would be convincing,” she said. “On the other hand, the number of accounts from reputable people who are clearly not psychotic adds up.” Though she is not a professional scientist, Bush assisted with several scientific studies and became something of an advocate for the reality that not all near-death experiences involve heavenly lights and divine love. Research methods, like Dr. Bruce Greyson’s “NDE scale,” skewed toward pleasant, heavenlike experiences. But spurred by her own traumatic experience decades earlier and testimony from others, Bush did a literature review of near-death accounts published in scientific studies and realized that roughly one out of five was frightening, traumatic, or otherwise “hellish.” Working with Greyson, Bush identified several types of what she calls “distressing” near-death experiences. Some have the same features as heavenly experiences—bright lights, life flashing before your eyes, etc.—but the person simply interprets them negatively. Another type featured a “void” like Matthew Botsford’s overwhelming blackness or some other type of absolute sensory deprivation. And yet another class, by far the most varied, involved visions of actual hell. Not surprisingly, the study of near-death experiences has been met with some medical skepticism—studying mystical visions seems suspiciously religious. But these experiences actually present a problem to doctrinaire believers with specific notions of what hell is like and who goes there. “Mystical experiences in general do not follow doctrinal precepts,” Bush says. “They are what they are, and the doctrines are off in another room somewhere.”

“I’m called New Age–y by the Christians, and the non-Christians call me a Christian fanatic,” Howard Storm said while he was promoting his own trip to hell. Nevertheless, he believed he was on a “mission from God.”

Hell experiences further complicate matters for religious believers, because they have no discernable relation to what kind of life a person has lived. In other words, being a good person who goes to church is no guarantee that you won’t get into a terrible car accident and suddenly find yourself experiencing what feels, in a very real sense, like hell. As Bush has seen, “What we think people deserve has nothing to do with whether they have a glorious experience or a terrible one.”

Whether you go to heaven, hell, or somewhere in between, a near-death experience has a way of shaking up a person’s previous worldview. “You never recover your original self,” Kenneth Ring told the Times. “That is lost to you. It’s not your physical body that has died, but something in you. You won’t be the same again.” It’s no surprise then, that these events are often taken as proof of an afterlife and written about and marketed as urgent messages to the complacent souls still going through the motions of everyday life.

“I’m not about to say they’re real in a geographic sense or in any kind of real or material sense,” Nancy Evans Bush says. “But personally, I give them enormous evidence as experiences, because they do change people’s lives.”

Attempts to reach Lucifer for comment went unanswered.