Dr. Christopher
Kerr, author of the 2021 essay “Experiences of the Dying: Evidence of Survival
of Human Consciousness” written for the Bigelow Institute for Consciousness,
writes:
When I became a hospice doctor
23 years ago, neither my medical training nor my doctoral degree in
neurobiology could have prepared me for what I would witness at bedside of
patients nearing death. I used to believe that my job was caring for life
predeath. Instead, I came to realize that there is more to dying than death.
My observations at bedside have
led me to the counterintuitive claim that the survival of human consciousness
after death may be nowhere more evident than in what happens to the dying before
death. These are moments of transition when the mind’s elevation transcends
the body and brain’s deterioration. Put another way, we can’t look into the
continuity of consciousness past death by having an exclusive focus on the
after. Doing so would assume a before/after division that the dying experience
itself renders irrelevant. The dying process is a continuum within which our
patients experience a heightening of consciousness and an acute awareness of
their past and present existence. This experience includes a consciousness that
is most often shared with others who died before them and but who are now fully
present to them. The dying process reveals a connectivity between and across
lives, both living and dead. This continuity of connectivity persists
regardless of time or bodily existence and supports the hypothesis that
consciousness survives beyond bodily death.
I used to believe that end of
life includes processes that understandably draw us inward towards
introspection and reflection, processes that distill life into what truly
counts and in so doing, validate having lived and mattered. That the dying
process would alter the patient’s perception made sense. What was unexpected if
not jarring was that the process entails so much more than just a changed
outlook in patients. Shortly before death, the dying have dreams and visions of
their predeceased loved ones, scenes of vivid and meaningful reunions that
testify to an inexplicably rich and transformative inner life. The phenomenon
includes a lived, felt, often lucid experiential reality whereby those loved
and “lost” return to the dying in ways that cannot be explained by memory
alone. Children and parents sometimes lost decades earlier come back to put
patients back together and help them transition peacefully. At the precise
moment we associate with darkness, loss, physical decline, and sadness, their
presence helps the dying achieve peace, comfort, and forgiveness, which
suggests an existence beyond our bodily form. A failing brain does not imply a
failing mind, and biological decline does not diminish the soul. In fact, in
our final days, our physical form does not follow function: patients are
spiritually and perceptually alive and vibrant despite a failing body. This is
the paradox of dying.
A remarkable body of work on
Near-Death Experiences (NDE) has been cited as evidence that consciousness is
more than a byproduct of our brain and survives our mortal form (1-5). Skeptics
offer physiologic explanations and argue that the memories or sensations of
NDE-like experiences are actually triggered by the brain as it shuts down or
reboots; they attribute the phenomena to causes including oxygen shortage,
anesthesia, neurochemical responses to trauma and “post-resuscitation syndrome”
(6-8). Critics of NDE study protocols also suggest that this research does not
“exclude that the reported memories were based on retrospective imaginative
(re)constructions built up from memories, prior knowledge, and/or expectations
about the world” (9). Others explain NDEs based on spiritual or psychological
interpretations, ranging from the theories of Expectancy to Dissociation (6, 9,
10).
Proving consciousness beyond
death must not only account for neurobiological changes associated with
“clinical death” but also address factors that define and inform consciousness,
such as changes in awareness, wakefulness, and connectedness. At Hospice, we
routinely care for dying patients who are not only neurologically intact but
fully aware and awake. Whereas physical death is a circumscribed event, dying
for most is a prolonged process that inherently alters consciousness. The dying
processes we witness are anticipated, non-acute and physically irreversible.
Yet, instead of exhibiting a waning consciousness, many of our patients display
a heightened acuity and a rich inner life which includes changes in perception
as well as an awareness of both their internal and external existence. Not surprisingly, such experiences of
consciousness are qualitatively distinct from those events described in
traumatic or acute death, alterations in brain function from anesthesia or
recovery from recusation. The studies conducted at Hospice Buffalo for over a
decade further corroborate that the dying are paradoxically often emotionally
and spiritually alive, even enlightened, despite their terminal physical
decline, not just in the minutes or hours before physical death, but in the
days and weeks. In other words, these extraordinary inner experiences that have
been attributed to a failing brain with NDEs occur during the dying process on
a continuum that goes from intact cognition to the fluctuating states of
consciousness and failing organs that define the immediate hours before death.
We hypothesize that only those
who are actively dying have the vantage point and the language to define their
changing and enlightened existence, the keyhole through which to see what’s
beyond. Our work focuses not only on the dying process but specifically, on the
experiencing of it, the subjective or conscious dimensions of dying. The tragic
physical process of dying often obscures the experiential, inner or subjective
dimensions of dying which represent a heightened form of consciousness, an
awakening of feelings, wonderous perceptual experiences, insights into one’s
present and future existence as well as a feeling of connectivity, wholeness
and belonging. Our patients exhibit changes in awareness of thought, memories,
feelings, sensations, and environments. Not only are such experiences near
universal, but they are remarkably similar. This is why to find evidence of the
survival of human consciousness after death, we need to look at what happens before
death, in these moments of transition when the before and after merge to
the point of irrelevance and the enlightened mind transcends the body and
brain’s deterioration.
The following is a video of our
patient Florence, six days before death. She is free of neurologic disease and
has not taken any psychoactive medication. Although dying, Florence is
physically unburdened and cognitively intact while describing the closing of
her life. To her, dying is a conscious experience that is vibrant as well as
self-fulfilling. Her consciousness is lucid: she is fully awake, aware and
connected. Through this keyhole, Florence doesn’t dream, analyze or simply
remember, but instead feels the familiar and comforting presence of those she
has loved and lost. Unlike the epiphanies or revelations often associated with
NDEs, there are no great insights or messages. In fact, language is near absent
and not needed. Florence is instead at her family’s kitchen table in the
company of her deceased husband and daughter; she has been put back together
and is truly home. Her awareness is acute, complete and secured in the
certainty of what has always defined who she is: her relationships. She is now
restored in a promise of what lies ahead. Florence doesn’t have any feeling of
being out of her body or any perception that she is dead: her existence, as
defined by love, is understood and sustained. These experiences are not only
validating but remove any fear of physical death. Florence is already on her
journey, her consciousness continuing where her body can no longer go (Link to:
Florence Interview Video).
These moments of life-affirming
enlightenment at the time of death have been acknowledged across cultures and
throughout history. Indeed, while modern medicine has been resolutely silent on
the topic of dying, often reducing it to mere “medical failure”, the
humanities, the realm of culture and religion, have long testified to its
significance to humanity. From writers, poets and philosophers as far back as
ancient Greece, from Buddhist and Islamic texts to accounts from China,
Siberia, Bolivia, Argentina, India and Finland, from the religious and sacred
traditions of Native Americans and other indigenous peoples around the world,
meaningful pre-death dreams and visions have been widely recognized and
celebrated. They are mentioned in the Bible, Plato’s Republic, and in
medieval writings such as the 14th century mystic Julian of Norwich’s The
Revelations of Divine Love. They show up in Renaissance paintings and in
Shakespeare’s King Lear. They appear in 19th-century American and
British novels, in T.S. Eliot’s poetry, and last but not least, in the Dalai
Lama’s meditations on death. If anything, the medicalization of death has
obscured a language that has always been available to make sense of our
finitude and that has been integral to humanity’s need to maintain connection
with the departed. This awareness that we remain intertwined beyond death is
central to the story of our shared humanity.
Starting in the twentieth
century, reports on pre-death experiences began to be collected systematically
through eyewitness accounts (11-16). More recently, a research team at Hospice
Buffalo, has conducted studies on over 1,500 patients and families. The process
of dying is a reality that only the dying could tell us about, from a vantage
point that the living do not share. It was the testimonies of these patients as
well as our subsequent systematic studies of their inner experiences that
helped us reframe dying and our notion of a before and an after death and of
consciousness itself. The data confirmed that the vast majority of dying
patients, shortly before death, have these comforting dreams and visions that
most commonly summon predeceased loved ones. After witnessing how these bonds
of love re-emerge as unbreakable at life’s end, the question we were left
pondering was “are the deceased ever really gone?” Indeed, those who returned
were not just random appearances; they were most commonly, as with Florence,
people who best loved and secured the dying in life and were reuniting at a
depth that suggests they were never gone. One ninety-five-year-old gentleman
claimed to smell his mother’s perfume as she whispered “I love you” in his ear.
His mother had passed ninety years earlier when he was five years old, yet his
vision of her was as crisp as if she had just left him. Such experiences return
at life’s end in ways that transcend mere recollection and are instead
tangible, material, and lived. With full lucidity, these patients claim such
experiences are “more real than real” and rich in detail not previously
recalled but now vividly summoned.
“Transcendence” is typically
the concept used to denote an existence or experience beyond the normal or
physical level. The word literally means “going beyond.” It is also a state
that is associated with the afterlife and that best represents the work that
pre-death experiences do in helping patients transition to death. In fact, the
power of the spiritual transformation and “transcendence” they occasion in
patients’ lives cannot be overstated. Near death, the boundaries between the
experiential and the spiritual, body and mind, present and past, conscious and
unconscious impulses dissolve to provide comfort through a process of
connectivity across the living, the dying, and the dead. The process brings
about a form of spiritual and emotional solace that is rooted in lived
experience rather than just dreams or memories. Recognizing people’s experience
of dying as the gateway to continued consciousness beyond life and death is
crucial if we are to become more literate on what constitutes our mortality.
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.
Bridget shared
her recurring dream of two deceased aunts who were standing and watching over
her. These experiences were followed by visions of her mother, dressed in a
long, luminous white dress and sitting at the dining room table, crocheting.
Although without voice, this motherly figure was a powerfully felt presence.
Bridget could not come to terms with what she herself described as her
“visions.” They created somewhat of a crisis of faith since at life’s end, she
could not reconcile what she saw with the precepts of her religion. She had
expected to see angels, not dead people. Like so many, the deceased return to
the dying in a way that feels as though they were never gone but waiting to
reunite at the appointed hour. As with most patients, such reunions feel not
only needed but right. Bridget’s consciousness was not only vibrant, defined by
love but was now shared with those she loved most. These were the relationships
that had defined her in life. The reunion of the deceased with the dying
suggests that consciousness, beyond our physical existence, may be shared or
unifying. As Fenwick postulates, in this way consciousness appears to act as a
filter, one that arises and opens up towards the end of life. 
