Pediatric patients: Kerr excerpt #5

Dr. Christopher Kerr writes: The study of end-of-life dreams and visions typically focuses on adults; however, children with terminal diagnoses also have these experiences, further demonstrating that this is an occurrence related to the transition to death and not to age or physical decline.

Our third publication was a pediatric case series*. Although children and adolescents process the experience of illness and impending death in ways that are distinct from adults, they still contend with existential and spiritual concerns no matter how difficult these may be for them to express. When facing serious illness, children are often confronted with an unimaginable reality for which both context and language are limited. As they struggle with illness, they also must cope with fears around death, including existential questions that are challenging to communicate and equally difficult for clinicians to answer. We have been fortunate to be able to film several of these children.

The study of end-of-life dreams and visions typically focuses on adults; however, children with terminal diagnoses also have these experiences, further demonstrating that this is an occurrence related to the transition to death and not to age or physical decline.

 

In several pediatric cases, the children’s ELDVs didn’t deny their impending death but informed and transcended the inevitable. In all cases recorded, their ELDVs provided comfort and meaning. For example, Ginny was a 15-year-old girl whose dreams and visions heavily impacted her dying process and her mother Michele’s bereavement experience (Link to Ginny and Michelle Interview Video: https://www.youtube.com/watch?v=hykQVBYDmsM).  

 

With exceptional detail, Ginny recounts a dream in which she is playing dolls and singing songs with her deceased aunt. She describes being in a beautiful castle filled with warmth and light. Adorning one of the walls is a stained-glass window depicting ‘‘a baby and you can see the sun through it.’’ In her own words, Ginny describes the castle as a “safe place” and emphasizes that she is “not alone.” In addition to her aunt, the castle is also populated with numerous pre-deceased family pets that now appear alive, healthy, and playful. 

 Upon waking from sleep, Ginny found immediate meaning in her ELDV experience, telling her mother, ‘‘I’m going to be okay, I’m not alone.’’ Four days before her death, on what had been a quiet afternoon, Michele heard an animated conversation through a baby monitor that was kept beside Ginny’s bed. When Michele asked Ginny whom she was talking to, Ginny responded, ‘‘I was talking to God.’’ She added ‘‘He’s old, but he’s kinda cute.’’ 

 

She said to her mother, ‘‘I’m not going to be sick; you know. where I’m going. You know, to the castle.’’ Ginny’s conversation with God also addressed her concern as to whether her family would be able to join her when their time came.

 

*Levy, K, Grant, PC, Kerr, CW, End-of-Life Dreams and Visions in Terminal Children/Adolescents: A Case Study. J Pall Med. 2020; 23(11);1549-1552.

Christopher Kerr, “Experiences of the Dying: Evidence of Survival of Human Consciousness,” an essay written for the 2021 Bigelow Institute for Consciousness Studies in response to the question: “What is the best evidence for survival of consciousness after bodily death?” Dr. Kerr, MD, PhD, is the Chief Medical Officer and Chief Executive Officer for Hospice & Palliative Care Buffalo. The full text with notes is available at https://bigelowinstitute.org/contest_winners3.php.