ELDVs of hurting others: Kerr excerpt #13

Dr. Christopher Kerr writes of dying patients having dreams or visions of relationships with relatives, friends, and victims of the patient's violence:   

End-of-life experiences do not always occur in a context of love, togetherness and seeming purity of mind or intent however. In fact, they occur irrespective of the life led or rather as an extension of it. While devoid of judgment, the capstone they provide is in keeping with the type of existence each individual lived: people die the same way they lived. In Dwayne’s case, a 48- year-old patient who was dying of throat cancer after a lifetime of substance abuse, the end-of- life experiences that would bring him to consciousness were as violent as the life he had led.

The Dwayne we admitted to the Hospice inpatient unit was a puzzle: he was charming, funny, sociable, warm, and completely unfazed by the life of delinquency and crime from which his disease provided a reprieve. He had lived “ripping and running” as he put it, but his demeanor was that of a person with a clear conscience. He was not known as a violent man, even though he had killed two men in self-defense. And although the courts acquitted him on both counts, it was hard to reconcile his past deeds with the casual nonchalance that was now his trademark. He acted as if his actions did not define who he was.

Despite his weakened bodily condition, he jigged and jogged when he shuffled across the hallway floors, even as he had to lean on his medical walker for support. He would say things like “everything is gonna be ok man, God loves you” or “We are on a roll man, we can go to the mountain”. And with his inimitable cheerful and beaming smile, he would add “but I may need another cold one”. It did not take long for me to understand that his casual manner was actually a survival mechanism. If Dwayne was carefree and seemed to float on clouds made of jokes and funny asides, it was not because he didn’t care. He did not have the luxury to do so. He had spent a lifetime living on the street and relying on hard drugs to counter the stress, fear and pain that came hand in hand with it. His life had been about substance abuse since he was 16 years old. The only thing that mattered was scoring the next hit and avoiding the dull and numb feelings that overtook him when the effects wore off.

For Dwayne, the drug detoxification that came from being physically confined with terminal illness did not change his outlook on life. His survival instincts remained in high gear, all the more so since he was terrified at the prospect of being sent back to “the street,” a place overrun with malevolent and violent people, constant threats, injustice, crime, fear, and pure terror. The Dwayne who arrived at Hospice could not look back. Resurrecting the past was too risky an endeavor for a man who had finally reached a place of safety and physical comfort. It would have meant processing the irreconcilable, the abandonment, hunger, injustice and murder.

In avoiding his demons, Dwayne was experiencing end of life much as he had lived, by guarding himself from the shame and guilt that overcame him were he to glance back at his failures and crimes. It was ultimately his distressing ELDVs that would bring him the awakening and awareness he needed, albeit just under the wire. In his most troubled dreams, Dwayne was grabbed and stabbed at the site of his cancer: “It was like I was fighting somebody. I probably done something wrong to somebody on the street in the past, and now they caught up with me, and now they know my symptoms. It was like they were jigging the knife, trying to cut off my neck where the cancer was at. That is how I was feeling. It stopped but I still couldn’t let my shoulders down, I was in pain”. Dwayne experienced this violent dream as an avenging attempt on his life.

When he told the attending nurse about his stabbing nightmare, she reassured him that this was probably nothing, since “a lot of people talk in their sleep”. But Dwayne would not have any of it. “No, this was real,” he insisted. The nurse inquired if he needed some medication, and he nodded “because this nightmare I just had was hurting my neck anyway”. Hearing him describe the real-life effects of a wound that was inflicted in an ELDV was one of the most heartrending illustrations of the concept of “total pain” described by Hospice pioneer Dr. Cicely Saunders. It dawned on me that the dying patient’s pain was even more multidimensional than originally conceived: it includes not just psychological or emotional turmoil but also physical pain. And ELDVs strike such a cord in the patient near death that the very line between bodily reality and the spiritual world comes undone in the process.

Dwayne’s recurring dreams and visions led to a radical shift in his demeanor and attitude at life’s end. This became clearer when Dwayne was filmed for the documentary on end-of-life experiences (Link to Dwayne Interview Video: https://www.youtube.com/watch?v=1B05llRYXeI). He was on camera and was just about to tell us about his recurring dream when the man whose sashaying and quipping was legendary at Hospice, started sobbing uncontrollably. Nothing used to faze the Dwayne we knew, everything was cause for laughter, and here he was, an unrecognizably vulnerable soul who was crying, trembling, and shaking, while talking in an unbroken stream of tears and words we could neither interrupt nor bear to hear. It was the distress with which Dwayne was sharing his end-of-life experience that was overwhelming. Dwayne was finally allowing himself to confront rather than evade. He was now a soul in search of redemption, talking about his cancer as karma and regretting his life of ‘ripping and running’: “One thing I do know is I hurt a lot of people and I feel bad about doing it, you know, very bad and I just hope and pray that they do forgive me because they see what influence I was under at the time when I was trying to scheme and scam and be sick with them.... I am not gonna lie to you, I have used drugs in my past, that is not a good thing man, ... I don’t want to go back to that lifestyle. It is not good for you, it is not good for me.... And I just pray to my higher power that he keeps me away from it with the help of my peers, hospice, you know, I am not really gonna say friends in the street. I had no friends because 95-98% of my friends were doing the same thing I was doing.”

Dwayne was facing his day of reckoning. He went on to have variations of this recurring dream, recounting that “the guy was pouring acid down my neck, burning a hole in my neck.... It is because my past is coming back at me from doing wrong. Because I am not gonna say I am a perfect guy when out there because I was ripping and running the street doing wrong to individuals, I should not have...”. There was no doubt in Dwayne’s mind that his subjective experiences were making him pay for his past mistakes and misdeeds, and pay he was willing to do, provided he could make amends to the person he cared most about, his daughter Brittany.

Bereaved family members also benefit from the effects of their dying relative’s end-of-life experiences, sometimes years down the line. After being estranged from his daughter Brittany, Dwayne went through a transformation at the threshold of death that carried over into his daughter’s life. Indeed, their deathbed reunion and the forgiveness that flowed from their love is what would eventually help his daughter forge a commitment to turn her own life around. The incidence of drug abuse among children of drug addicts is disproportionately high, and his oldest daughter had not escaped the trend. In honor of the father who had changed the course of his life at the eleventh hour, she set out to do the same. Her dad’s love was restored to her through the coming together of consciousnesses that were once embroiled in hostility but that were now enacting a much-needed reckoning. She herself credited her father’s ELDVs for the transformation in both of their lives, and this awareness led her to a regained sense of self.

Despite a lifetime of denying certain realities of his life, Dwyane’s consciousness not only returned but did so with a vengeance. His ELDVs were more than just memories, they were well thought-out and organized processes that were not just retold but relived, and whose material and ripple effects were felt across lives and beyond his and others’ death. He was not only lucid as he experienced them but described feeling the sensation of being stabbed. The lives Dwayne had taken and tried to forget could not be forgotten. They continued to exist as part of Dwayne’s existence, within a consciousness that was shared between and across lives.

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.