ELDVs testify to our greatest
needs--to love and be loved, to be nurtured and feel connected, to be
remembered and forgiven. They are centered on self-understanding, concrete
relationships, personal histories and singular events. They are made of images
and vignettes that emanate from each person’s life experiences rather than from
abstract preoccupations with the great beyond: a walk in the woods relived
alongside a loving parent, car rides or fishing trips taken with close family
members. Long-lost loved ones come back to reassure; past wounds are healed;
loose ends are tied; lifelong conflicts are revisited; forgiveness is achieved.
And based on the content of these dreams, it’s obvious that the forgiveness and
love that count the most come from family. For thirteen-year-old Jessica, who
was nearing death, her greatest fear was being alone in an afterlife without
her mother, that is until Jessica’s ELDV conjured up her mother’s best friend
Mary who predeceased her. In her own words, Jessica knew with certainty that
she was “not going to be alone” after death, and that she would be “loved.”
Jessica’s profound and enduring feelings of being loved and secured didn’t
emerge from a distant dream. Jessica was clear: she observed Mary in
wakefulness. Jessica also had dreams of her deceased dog Shadow who reaffirmed
that she was “ok,” secured in love.
Although ELDVs, like Near Death
Experiences (NDEs), entail the same paradox of a vibrant mind in a declining
body, there are critical qualitative differences between NDEs and ELDVs.
Characteristics of NDEs include impressions of being outside one’s physical
body, awareness of being dead, a “tunnel” experience, movement toward and/or being
immersed in “light”, life review and entering another realm of existence. These
characteristics are not typically described in patients experiencing ELDVs.
ELDVs are reported with much less abstraction or complexity. NDEs are commonly
associated with a dramatic and lasting change in personality and outlook on
life, whereas ELDVs leave the dying restored rather than changed.
ELDVs are felt and aligned with
the life led – personal and core to self and one’s relationship to others.
Unlike the person experiencing NDEs who is often motivated to analyze and share
their experiences, the patient experiencing ELDV is not. A critical distinction
between NDEs and ELDVs are that NDEs are often explained or dismissed in terms
of changes in physiological function as part and parcel of the biological
changes occurring as a result of “clinical” or nearing dying. The same
criticism cannot be used to dismiss or refute ELDVs. Patients in our studies
were not just interviewed in the last minutes and hours before death but longitudinally,
in the days and weeks before death. All our study patients were screened for
confusion, and many were high functioning and living independently when their
ELDVs began. In other words, the experience of NDE occurs within clinical death
whereas the ELDV experience occurs irrespective of how strong or tenuous the
link between body and mind is or has become.
The results of our studies
clearly reveal ELDVs as a state of consciousness that is different from other
states of mind we may experience in health. For example, we have shown that
ELDVs are distinct from dreams in several ways. Regular dreams are often
defined as projections of latent psychodynamic processes and are rich in
symbolism. By contrast, pre-death dreams and visions rarely contain the
abstraction, behind-the-scene or metaphorical meanings we have come to expect
from typical dreams. We have yet to have a patient emerge from an ELDV and ask
for interpretation, analysis, or input. The time for introspection and therapy
has passed. In fact, this is what patients tell us loud and clear: these dreams
are different and unlike other dreams, because they are lived, virtual,
experienced, and “more real than real.” They are a form of communication and
connectivity that exit on a different plane which might be called
transcendental and in which there is no distance between the dreamer and their
dream experience. They often offer blueprints for a peaceful, visionary, and
certainly revisionary end of life, and the meaning transcends the relation to the
self to emanate from and in our relationship with loved ones. The following
video is of a dying patient named Horace. In the video you will notice how
Horace struggles to find language to describe what he is experiencing when his
eyes are closed. He is overwhelmed just trying to describe his feelings of
“happiness”, comfort, reunion, and love. He describes his deceased wife as even
more beautiful than he remembered and felt “everywhere was “happiness” (Link
to Horace Interview Video: https://www.youtube.com/watch?v=Ssfw-sRiNuo).
ELDVs are also most commonly
defined by unique communication between the dying patient and those individuals
featured within the ELDV. They entail reframing the communication they stage as
something that transcends language: participants typically report very little
verbal exchange with those who pre-deceased them. The smile of the
long-deceased child or the wave of a departed wife doesn’t require language or
explanation. The exchange resides in a dimension of consciousness that is
simply felt, understood and shared.
As the data revealed, End-of-Life
Dreams and Visions also challenge the parameters of typical recollection or
memory. Recollecting implies retrieving a prior time from the vantage point of
the present, and ELDVs go beyond what we consider re-accessed or rekindled
memories. The dying do not remember a person as in a picture, but rather, they
are themselves immersed in a larger experience that is lived, rich and sense
filled rather than simply conjured from memory. There is a qualitative change
in perception or state of awareness, of something within oneself. Simply put,
patients are not looking back; they are ensconced within the experience,
sometimes communicating with someone whose recent death they had not been informed
of, or resurrecting smells, sounds, and details that go well beyond our usual
cognitive interpretations.
The following video is of Jennifer who is describing
the inner experiences of her dying partner Patrick. In it, Patrick relives
eating his family’s “secret” spaghetti sauce with his deceased grandmother. His
consciousness is immersed and responding to unseen surroundings that exist in a
shared mental space, and Patrick now relays an awareness of feelings,
perceptions and senses that may not be shared with the living but is shared
with the dead, including the sensation of being full after having shared a
meal. Patrick’s ELDVs even include new “memories”: just before death, Patrick
now remembers the long-forgotten and missing ingredient in the secret sauce
(Link to Jennifer Interview Video: https://www.youtube.com/watch?v=InncrCm_O18).
ELDVs are inherent to our human
existence and are evident in dying patients regardless of age or cognitive
ability. As noted in our case study, ELDVs challenge our limited understanding
of cognition and mental ability: patients who experience ELDVs aren’t confused
but rather display heightened acuity, insight and consciousness, and such
experiences occur in patients who are cognitively different such as those with
dementia or Downs Syndrome. Past events that may not have previously been
recalled with such vividness and detail prior to their terminal decline now
return to resurrect a life rich in emotional tones, meaning and history. More
than recalled, these experiences are relived and felt with a renewed sense of
existence. Such patients often re- experience the best parts of having lived
beyond even their conscious control. Based on their compromised cognitive
status, such patients were not included in our formal studies, but we did
document, and even videotape, family reports of their loved ones’ end-of-life
experiences. An elderly woman named Irene, who suffered with advanced dementia,
kept re-experiencing the presence and love of her long-departed husband Gary.
The following video is of Irene’s daughter, Sue, describing her
mother’s experiences at life’s end. Irene was joyful and complete in her final
days. Days before death, Irene attempted to leave the nursing home: she was
reexperiencing the best day of her life, her wedding day, and needed to get to
the service (Link to: Sue Interview Video: https://www.youtube.com/watch?v=ozNGcExMqa8).
It has been noted--by our
research team and others--that patients rarely report religious content in
their end-of-life experiences (15, 41). Still, while this may be surprising, it
is also not the point. While there are relatively few references to the symbols
of faith, the tenets of faith, love and forgiveness, are common themes within
pre-death dreams and visions.
This is an insight that is beautifully expressed
in the writings of Kerry Egan, a hospice chaplain in Massachusetts.* In her
short but powerful piece “My Faith: What people talk about before they die,”
Ms. Egan explains that she is routinely called to the bedside of dying patients
who want to talk, not about God but about their families and “the love they
felt, and the love they gave .... people talk to the chaplain about their
families because that is how we talk about God”. To Ms. Egan, not
mentioning God directly does not create conflict with her own religious faith
or role as chaplain because it is in the love felt by family members for each
other that she recognizes God and the teachings of her religion: “If God is
love, and we believe that to be true, then we learn about God when we learn
about love. The first, and usually the last classroom of love is the family...
We don’t have to use words of theology to talk about God; people who are close
to death almost never do. We should learn from those who are dying that the
best way to teach our children about God is by loving each other wholly and
forgiving each other fully - just as each of us longs to be loved and forgiven
by our mothers and fathers, sons and daughters.” At the hour of our death,
spiritual transformation is no longer external to the self. It happens in the
innermost recesses of our being. As we progress toward acceptance, illness and
death place us on a spiritual path that that reunites us with consciousnesses
that were never gone and ultimately re-affirm who we are through their returned
love.
We have lost our way with dying
and with death. It has become easier to live longer, but harder to die well. I
had been trained to view dying as medical failure when I began working at
Hospice in 1999. Sadly, the acceleration of the science of medicine has
obscured its art, and medicine, less comfortable with the subjective, has been
more concerned with disproving the unseen than revering its meaning. Amid the
current madness of medical excess, there is a need for spiritual and cultural
renewal that medicine alone cannot address. It is when medicine can no longer
defy death that nature assumes its rightful role, and the process of dying
becomes what it has always been: a human experience with physical and spiritual
dimensions, seen and unseen. From this vantage point, the dying process, which
includes transformative subjective or inner experiences such as end-of-life
dreams and visions, becomes less about finality than about life’s resilience.
As Hospice work demonstrates
again and again, when the patient is kept comfortable and otherwise left to
follow the natural course of things, death becomes more enlightening than a
simple pulling down of the shades. This enlightenment is one that encompasses
altered forms of consciousnesses, a double consciousness as it were, those of
the departed as well as the patients. Whereas traditionally, consciousness is
defined as an awareness of self and of the world around, ELDVs include
alternative forms and beings that include not just dreams and visions of them
but the lucid consciousness of others as constitutive of the self. The departed
loved one’s consciousness exists as an extension of one’s own and their
surroundings become indistinguishable from the patient’s as inner and outer
worlds collide and become one. What observers may view as a sudden change in
perception is lived, in other words, as an expanded consciousness rather than
as a change by the patient. It is not that an alternate reality supplants
theirs, but rather that their reality grows to include what is an “other world”
only to outsiders. To the patient, the distinction does not exist, and their
loved one’s world is merely an expansion of their immediate surroundings. As
such, the tragedy of human existence is not the fact of death or suffering or
the inability to defeat these but our inability to think dying as anything
other than the “diming of the light.” By exploring the nonphysical and
subjective experiences of dying in an objective fashion, through both research and
film, we have worked to reframe and humanize dying from an irredeemably grim
reality to an experience that contains richness and continuity of meaning and
relationships for patients and loved ones alike.
At life’s end, dying patients
summon up comforting processes at life’s end are beset by symptoms of a failing
body over which they have limited control. They are at their most frail and
vulnerable, existing within suffering states of aching bones and air hunger.
Catheters, IV’s and pills may now be part of their everyday, sometimes
literally functioning as extensions of their bodies under the daily medical
management that is their new and irreversible lot. They may experience various
degrees of cognitive, psychological and spiritual dissonance. Yet even as the
inexorable march of time is taking its toll on their bodies and minds, many
also display remarkable awareness and mental sharpness in the context of their
inner experience, an awareness that resides in their consciousness, a
consciousness that transcends death and its limitations.
*Kery Egan, "What People Talk About Before They Die," https://www.cnn.com/2016/12/20/health/what-people-talk-about-before-dying-kerry-egan/index.html.
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.
