Vision of deceased aunt: Kerr excerpt #17

Dr. Christopher Kerr writes of dying patients having dreams or visions of renewing friendships with deceased friends and relatives:

No words can adequately describe the relief on the face of a parent who watches their dying child go from fear of the unknown to acceptance. For Michelle, it was her daughter Ginny’s last dream that made her realize that, while the end was near, it would be a peaceful one. Indeed, it was following her pre-death dream about God that Ginny stopped calling out to Michele every five minutes and started sleeping soundly. It was also in its wake that Michele herself felt inexplicably calm and settled, so much so that she finally found the strength to inquire about funeral arrangements that would honor her daughter’s legacy.

Ginny told me about the shadows she’d sometimes see flitting around her when she woke up at night. They used to frighten her, but after one particular dream
experience, she started finding them comforting. The shift occurred during an MRI when Ginny fell asleep inside the pulsing machine and had a vision of her beloved Aunt Mimi, who had recently died. Like Jessica, Ginny did not have or need a complex vocabulary for dying, so she imagined a new reality based on the language and imagery she had at hand. In her dream, she saw her aunt in a castle “with a baby in the window, and you can see the sun through it.” Ginny described her castle as ‘a safe place’ for Aunt Mimi as well as for Grandma Rose, who had also died not long ago. Ginny could feel Mimi hugging her and whispering in her ear, ‘You’ve got to go back down there and fight.’ When she woke up after the MRI, she was almost euphoric and proclaimed to her mother: “I’m going to be okay, I’m not alone.”

Both Ginny and Jess were met with loved ones who provided them with what their actual world could not – the opportunity to be made whole again. They knew that they would be leaving the reality of the living but only insofar as the living fail to recognize the connectivity that imposes itself as real through ELDVs. In their alternative world, the one that encompasses both the living and the dead, the knowledge of impending death is seamlessly integrated within the certainty of love, and continued life.

Children may lack language for death or a full understanding of mortality, yet they innately have deep inner processes at life’s end that not only inform and guide them but enlighten and expand their sense of existence, both present and beyond. All this suggests that consciousness is not only inherent but vibrant regardless of age and years of physical existence prior to physical death. The cases illustrate that the consciousness of children is rich in sense, perception, resonance, memory and emotion; like that of adults, it can accommodate the departed and give them voice and countenance, sometimes in ways we don’t expect, all the while ensuring that the dying child is still living vibrantly even as her body fails. 

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.

13-year-old girl's ELDVs: Kerr excerpt #16

Dr. Christopher Kerr writes of dying patients having dreams or visions of renewing friendships with deceased friends and relatives:

The power the resurrected consciousnesses in ELDVs have in facilitating the dying process as well as the grief of those left behind is at no time more resonant than in the case of the passing of young children, whose innocence defies understanding. Children have an intuitive ability to understand when death is imminent, including when the reality of it is kept from them. It is often in the show-not-tell of their dreams and visions that they get informed and inform us.

I remember meeting thirteen-year-old Jessica. As I walked into her room, trying to be the doctor I thought she would want me to be, I quickly realized that no level of experience would match her innocence, or the innocent wisdom reflected in her ELDVs. Her consciousness was not clouded by any of the considerations that often darken an adult one. She dreamed in distinct tones and textures, which not only created awareness of her impending death but also secured her in love. The knowledge of death that adults first experience as grief and sadness was to Jessica an intuition reframed by her ELDVs into sensory images of joy, color, warmth, and security; what we perceive as separation, she experienced as a loving reunion. Whereas we obsess about the border that separate the living from the dying, Jessica did not so much as see a distinction between her immediate world and the imaginary one of her dreams and vision. (Link to Jessica Interview Video: https://www.youtube.com/watch?v=qCMtnkoxgs0.)

Where I was bracing myself for an excruciating conversation, I instead encountered a bright-eyed little who was eager to chat about her day, her mom, her pets, and her dreams. Jessica did not pause to mourn the life she would not get to live, or to talk about the career or kids she would not have.; she had no regrets to mull over, or could-have-beens, or missed opportunities to work through. She was too busy living in the now, and her ELDVs were part of that present, an extension of the life she was living and where the dead roamed as freely as if they were visible to all.

Children’s end-of-life experiences, like those of other patients, feature ‘loved ones’ who come back to them. The difference is in the lack of questioning and of the boundaries with which we preoccupy ourselves. Recurring dreams are lived as certainties, as if they are actual visions, visible in this world as well as in theirs, because the two worlds are one. It is not that they cannot tell which is which but that they know they are inseparable, an extension of one another. It is not a matter of failed perception but of a transcended one.

Jessica went on to dream about Mary, her mother’s best friend who’d died at 35, when Jessica was only 8: “Mary is one of my mom’s best friends who passed away from leukemia. I think I was pretty close to her, and she was very close to my mom. I liked her. She was very nice. I’d seen her in my mom’s room. Coming up the stairs, I was going into my room and stopped when I saw from the corner of my eye something playing with my mom’s curtains. She had her favorite shirt on, my mom told me that it was. Because I told my mom it was a grey and blue, checkered flannel shirt.” 

Jessica was the only child of a single mother, which left one last uncertainty once her concern about dying had been resolved: ‘What will I do without my mom?’ The vision of this mother surrogate, her mother’s best friend, in her mother’s room, brought tremendous peace to her. She felt “relief and happiness”. She continued, “Mary was a very strong person, and I know that I am strong, and my mom tells me all the time that I was, am like her.” Kristin, who never left her daughter’s side, reminded her that “You told me all the time that: ‘Mom I saw an angel,’ and then you were able to go to sleep.” “Yes,” Jessica nodded, “I was able to go to sleep... it was really comforting, and I was not afraid of it at all.” Again, ELDV’s typically address our individual needs or the wounds that need tending.

Until Jessica, I could not imagine that children would have access to their own set of tools during the dying process. I assumed that a young mind was not fit to handle a conversation about life’s end, and I failed to appreciate the sophisticated ways in which they may already have had one. Jessica had an understanding of death that exceeded anything I could have imagined; she created connections we could not have given her, in details she should not have remembered.

A child’s innocence goes infinitely deeper than ignorance. Unbeknownst to her, Jessica’s ELDVs were teaching her, as well as her caretakers, how to cope with the inconceivable. Most importantly, for her mother, they helped initiate the process she could not consciously accept, that of letting go. But it was not of her daughter that Kristin had to let go—she could never do that--it was of denial.

Mother and daughter shared an unspoken language and a spiritual bond that have carried over to this day. Six years after her daughter’s death, Kristin still feels Jessica’s presence. She still decorates her house to fit the themes of each coming holiday because “Jess would not have it any other way”. She still cares for her little girl’s spoiled and overweight orange cat Lulu, who continues to wear the silly ornament Jess once attached to its collar. She still smiles at the memories and the presence she continues to feel alongside her. 

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.

Dying 98 year-old waits for son: Kerr excerpt #15

Dr. Christopher Kerr writes of dying patients having dreams or visions of renewing friendships with deceased friends and relatives:

Those who were loved and lost and come back through end-of-life dreams and visions help fulfil each patient’s unique needs, whether it is the need to be forgiven, to be loved, or to be granted peace. For many, their longing is so overwhelming that it affects not just ELDV content but also their external reality. We often hear of dying patients who wait for a particular anniversary, birthday or visitor before taking their last breath. Prior to working at Hospice, I assumed this phenomenon to be part of the lore that was passed around hospitals and whose origin may have been as nebulous as the evidence evoked to support it. Then I met Maisy, a 98-year-old matriarch, who simply refused to pass before her son Ronnie made it to the hospital.

Maisy had not seen her son in 8 years. This may have been due to an interpersonal conflict or just time’s swift passage. I was not about to inquire. She had stopped eating several days earlier and was no longer verbal, so we knew her to be teetering at the threshold of death. Her relatives had gathered around and were talking freely, not with her, who had seemingly lost consciousness, but certainly about her, the woman who had taken in over 100 foster kids in her lifetime. They didn’t know that she could hear them. Someone mentioned that they had had the police track down her biological son Ronnie in Oregon, and that he had booked a flight to Buffalo. They were now worried he would not make it in time to see her. The next day Maisy opened her eyes, sat up in bed, and cried out her husband’s name: “Amos! My Amos!” she said, followed by “I can’t come to you now. My son’s coming.” Ronnie arrived on the same day, and 24 hours later, Maisy closed her eyes for the last time.

As a scientist, I could give a protracted explanation for what happened to allow Maisy to stall a process over which she seemingly had no control. It would have to do with sleep patterns and their relation to the dying process. I could explain that dying is progressive sleep, and that to sleep deeply one must be able to relax and let go. I could go on providing evidence about the biological processes involved in not yet dying, but that would not do justice to what I and others commonly witness. It would not even come close. Maisy’s mind was unable to find peace until Ronnie arrived. In the final analysis, dying, like living, is about love and consciousnesses that endure no matter what, and that finds a way to persist within and beyond the confines of our existence. 

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.

Nightmares of dying WW2 soldier: Kerr excerpt 14

Dr. Christopher Kerr writes of dying patients having dreams or visions that may help them find peace after reliving horrible repressed memories:

 

Sometimes, ELDVs uncover aspects of a patient’s past that they had long hidden from view. This was the case for John Stinson, the 87-year-old man who had fought his whole life to suppress his experience of war. John had never told his family about the horrors he had witnessed during his rescue mission on the shores of Normandy. He suffered silently until his final days, when distant memories fought to surface.

It was through John’s end-of-life experiences that his family got to meet the man they had never known of, the 20-year-old soldier who would one day become their father. “I learned more about my dad in the last 2 weeks than I did during his lifetime”, John’s son explained while reminiscing about his father’s end-of-life reckoning. His sister corroborated the sentiment: “My brother (as well as the rest of us) knew very little about my father’s war experience. He rarely spoke of that time in his life. Some of what we learned in those last few weeks of his life we had never heard before. He just never really talked to us about it!” They may have been in the dark about the details of the past their father was finally revisiting, but not about the positive outcome of what transpired on his deathbed. Several years after their dad’s passing, the account of their father’s peaceful transition still brought tears of gratitude.

John was only 20 when he enrolled as a gunner on the SS James L. Ackerson which entered Normandy beside the USS Texas. He was and would always remain a proud Texan who took his duty as a soldier to heart and believed in the ideals of his country. On June 7, 1944, he was part of the Infantry Division that was sent ashore to Omaha, the bloodiest of the D-Day beaches. Their assignment was to retrieve the soldiers who had been isolated from the rest of the forces ashore. The mission was successful, and the landing craft came back with the wounded Rangers they had been sent to rescue. Still, John could never wipe away the vision of the bloodied beach strewn with the mutilated bodies and floating limbs he saw upon landing. This was the experience in the war that, unbeknownst to his family, was going to haunt him for the rest of his life.

As he lay dying at Hospice, John was assailed by nightmares about the fallen American soldiers he could not save: "There is nothing but death, dead soldiers all around me." I had witnessed people in a state of fear before, but John was not just frightened. He was terrified. His terror was palpable. I had never been able to adjust to the idea of a young man facing the horrors of war, the possibility of death at life’s beginning, but watching John return to that site of terror a second time as an old man defied words. He described his nightmares as so intensely real that they felt embodied. He could not overcome his pain, and his dreams reflected it.

This is why the complete transformation he underwent a few days later was all the more remarkable. I went to see him, and he was visibly comfortable, even at peace; he could sleep, he said smiling. He credited two of his more recent dreams for this welcome development. In a first joyful dream, he had relived the day he had finally gotten his discharge papers from the military. His second dream sounded more like a nightmare, but to him it was anything but. He dreamt he was approached by a soldier who had been killed on Omaha Beach and had come back to tell him: “Soon, they are going to come and get you.” John instinctively knew that “they” referred to his fellow soldiers, and that the dream was about reuniting with his comrades, not judgment. He finally had closure. He could close his eyes and rest.

Far from denying his reality, or his war, John’s ELDV’s recast these in such as to grant him his hard-earned peace. The soul of that courageous 20-year-old boy that had fought the ghosts of war for 67 years was finally released from his sense enormous obligation and from its injustice. John’s story exemplifies the process through which even the most difficult dreams can provide substantial psychological or spiritual benefits to the dying patient. For him, the tortured memory of the deadliest of the D-Day assaults morphed into the site of the very military camaraderie he thought he had betrayed. He needed to be released from the obligation he had been unable to fulfill and from the overwhelming shame he could not escape. Most importantly, he needed to forgive himself for his inability to save his brothers in arms. Thankfully, their consciousness returned allowed him to do just that.

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.

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.

 

Dying wife with dead husband: Kerr excerpt #12

Dr. Christopher Kerr writes of dying patients having dreams or visions of renewing friendships with deceased friends and relatives:  

There are times when End-of-Life Dreams and Visions (ELDVs) transcend the boundary that separate the living from the dead to meet spiritual and emotional needs, those that tie couples and that restore bonds. Sometimes, ELDVs do not interrupt the reality of the bereaved so much as replace it. This often happens with elderly couples who, following a lifetime of togetherness, cannot shift to living without their other half. And so, they don’t. Instead, they maintain their unbreakable bond through and in end- of-life dreams and visions. Attention wholly switches to this other world where they go on co- existing with their deceased partner and can feel whole again. That is when bereavement does not involve a before and an after, only a different, a more so, and a with.

After Sonny’s death, Joan kept her husband alive through recurring pre-death visions that occurred in her dreams as well as when awake. Her health began to deteriorate rapidly, but her end-of-life experiences and visions helped her, as well as her family, cope with the deep wound left by Sonny’s loss. When Joan returned to her daughters’ home from the Hospice Inpatient Unit, her dreams kept Sonny alive. During many nights, Lisa and her family could hear Joan calling out to her husband: “Come get me. I miss you! Sonny, come and get me!”. The strength of these dreams would soon carry from sleep to wakefulness and Joan, fully lucid, would often claim to see Sonny in the room.

Joan and Sonny’s story exemplifies the uniqueness and the intensity with which end-of-life dreams and visions are experienced as a site of togetherness. Joan lived for two months beyond Sonny’s death but never without him. She would call out to him every night and have visions of him every day. After Joan’s death, Lisa and her family sat down for a filmed interview (Link to Sonny & Joan Family Interview Video: https://www.youtube.com/watch?v=kYnHPTmSmLo).

As seen in the film, Joan’s ELDVs not only kept Sonny present as her husband but was also shared with Lisa, their daughter and caregiver. As a result, it was only when Joan passed that her daughter finally took stock of her loss, a now double one. Lisa felt that her parents both died but only when Joan did because their consciousness was shared, whether physically present or not. She only realized the full impact of her mother’s ELDVs when her mother’s visions no longer embodied her father’s felt presence. Joan’s own consciousness had been heightened to the point that Sonny was present, not just for her but for Lisa too; this awareness was shared.

And when the time came for Joan and Sonny to be reunited and for Lisa to take stock of the reality of her double loss, the knowledge that their remarkable love story had survived death helped their daughter come to terms with her own grief and sorrow. Her bereavement process was aided by the recognition that her parents’ bond had remained unbroken thanks, in large part, to her mother’s ELDVs. 

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.

Dreams of deceased grandpa: Kerr excerpt #11

Dr. Christopher Kerr writes of dying patients having dreams of renewing friendships with deceased friends and relatives: 

Sometimes a patient’s consciousness may be intact without including the kind of obvious awareness of one’s surroundings the definition of the term implies. Sometimes, a patient’s consciousness is not visible to others. This was true in the case of Sierra, a vibrant young lady who was only 28 years old when she was transferred from our local cancer hospital to our Hospice Inpatient Unit (Link to Sierra Interview Video: https://www.youtube.com/watch?v=z8NrYTyRaJI). Upon transfer, it was clear that Sierra had only days to live yet seemed in denial about the severity of her condition; there had been so little time for Sierra to process the implications of her being transferred from hospitalized treatment to Hospice. Despite unrelenting pain and a rapidly deteriorating condition, she insistently told her puzzled Hospice nurses and doctors that “I am going to beat this.”

We prioritized symptom management, but it was also urgent to help her and her family understand that her time was limited, so they could find some level of acceptance and the words to be reconciled with the reality of physical death. We were particularly concerned for her young son. We had come to understand that end-of-life dreams and visions help patients come to terms with death, but in Sierra’s case, we naturally assumed that her denial meant the absence of such experiences.

Sierra was struggling to reconcile the different realities that were clashing around her. She needed clarity about her condition so that she could acknowledge the inevitable. This was something that the science of medicine alone could not bring forth. It was also one which, unbeknownst to her caretakers, Sierra’s end-of-life experiences had already initiated. They were preparing her for the reality which her loved ones were so hesitant to put into words, and they were doing it by bypassing language altogether.

Her care team became aware of Sierra’s inner processes only after her physician, Dr. Megan Farrell, asked Sierra if she had had any dreams. Fully lucid, Sierra replied “Yes, strange dreams and they don’t always make sense. Sometimes, I don’t remember them very well” Dr. Farrell continued, “Sierra is there anyone you have been dreaming about or someone in particular who comes to you in your dreams?” A long pause ensued. With eyes half-opened, Sierra looked over her doctor’s shoulder, smiled and whispered, “Hi Grandpa!”

Sierra had been dreaming of her deceased grandpa Howard, an army veteran and a man who had loved and nurtured her. But now, in the stillness of her Hospice room, surrounded by loved ones, what Sierra’s vision represented was so much more than just a recurring dream. It was a state of being that brought clarity and made words like “dying” and “terminal illness” irrelevant. When her mother Tammy asked: “Sierra, what is grandpa saying?” Sierra answered “He says he is proud of the young woman and mother I have become... He does not want me to suffer.” We had entered the room thinking Sierra may need an intervention but were instead subjected to one, a reminder that the best lessons are often witnessed, not given.

Sierra’s experiences at the end of her life provided her with a sense of unconditional love and guidance at the threshold of death. And for her mother Tammy, that awareness helped usher the sorrow she had not given herself permission to feel. ELDVs often pull together multiple losses and consciousnesses, those that occur across generations and wide swathes of time, across the living and the dead, for the dying as well as their loved ones. As can be seen in the video, Sierra’s care team were left in awe of an unseen but powerful exchange between the living and the dead. Sierra’s grandfather reached Sierra in a way the clinical team could not. 

 

 
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.