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Inspiration

Deathbed Visions: What Hospice Research Reveals About Dying

The Diary of a CEO
The Diary of a CEO
Oct 19, 2026
9 min read

From The Diary Of A CEO

Watch · 7

On video, three weeks before he died, a patient named Paul describes something he has been living with for days. He has had roughly fifteen dreams about his late wife. She appears in light blue, sometimes in a suit, sometimes in a gown, and once or twice she has given him a little beauty-pageant wave. He has heard her voice only a handful of times. Hospice physician and neurobiologist Christopher Kerr, who appears in a 2026 episode of The Diary of a CEO, treats Paul's account as data rather than anecdote. Across roughly 1,500 patient interviews and nearly three decades of practice, Kerr says the pattern is common: most dying people have intense dreams or visions, the people in them are usually those who loved them without conditions, and the experiences feel real to the dreamer. He argues that dying is a gradual, peaceful dimming rather than a violent medical event, that priorities collapse toward relationships, and that some people use their final weeks to repair old wounds. This piece works through his findings, the methods behind them, the questions he admits remain open, and what they mean for anyone who will one day sit at a bedside.

Read · 7 sections

Why would a hospice doctor interview people who are about to die?

Kerr did not set out to study deathbed experience. He describes arriving at hospice "completely unprepared to be a doctor of the dying." His explanation for the gap is blunt: "Medical school prepares you really to defeat death, not to care for those who are dying." What changed his thinking was working alongside nurses, who were more attuned to what patients were actually living through. He came to see the patient's perspective as the one that matters, and to see patients as people with "rich emotional and personal lives."

That shift turned into a research program. Kerr says his team deliberately rules out confusion states before counting anything as a meaningful experience. They have also studied whether the suffering of dying produces any post-traumatic growth, looked at the effect of these experiences on children, and examined how they shape bereavement among the people left behind. The method is slow and interview-heavy, and it is built on the premise that what a dying person reports is evidence worth taking seriously.

He also frames the project as a matter of correcting a picture. In his view, the medical model looks at organ failure and disease management, while the patient is living through something far more inward. "Let's look instead what the patients actually experiencing towards the end of their life," is how he puts the aim in the conversation.

What do deathbed visions actually look like?

The headline figure is the one that draws the most attention. Kerr says that "nearly 90% of people start to have very intense dreams or visions as they get closer to death, and it's unlike anything they've ever experienced." The episode's own description puts the share at over 80 percent, so the figure should be read as a strong majority rather than a precise census. The experiences cluster in the final one or two weeks of life, and Kerr says their frequency rises as death approaches. He links this to changes in the body: "Dying is progressive sleep. Your sleep architecture changes, your sleep cycles change." As sleep shifts, people drift into what he calls inner experiences, and reflection and introspection become more prominent.

Two features set these dreams apart from ordinary dreaming, according to Kerr. The first is their realism. The team asks patients to rate how real the experience was on a scale from 0 to 10. "It's always a 10," Kerr says. "So it feels like this actually happened." The second is the absence of dread. "What you'll notice in all these videos that's so striking is the absolute absence of fear," he says. The dreams do not pretend the person is not dying, and the dreamers often struggle to find words for what they have seen. They tend to report that their loved ones seem whole again.

Kerr's team has also measured what brings patients the most comfort. On that scale, seeing the deceased rates above simply being with the living. That result is one reason he argues these visions deserve a place in how clinicians and families understand the process, rather than being dismissed as side effects.

Are these visions memory, delirium, or something more?

This is the most interesting question in the conversation, and Kerr is candid about how his answer has changed. "I would have told you before, when I started doing it, that this was a rekindled memory," he says. "It's like looking at a picture." That was his working assumption, and it is a reasonable one. Memory of a lost parent or spouse is vivid and emotionally loaded.

But the cases he returns to strain that explanation. The first is the richness of detail. He describes a 95-year-old man who lost his mother when he was five, and who, decades later, describes smelling her perfume and hearing her voice. The second is the presence of communication. Kerr notes that these are not still images. "There's communication," he says. "So they're not in still form. This again, not like looking at a picture." That leads him to a cautious position: "There's a couple of features that stand out that suggest there's a lot more of than that, that there's almost this continued consciousness."

Kerr does not claim to have settled whether these experiences are biological, spiritual, or some combination. The conversation moves directly to that question, and he treats it as open. What he is clear about is the methodological point. Visions reported by people who are dying are not automatically explained away by delirium, because the research is designed to check for it.

What do dying people stop caring about?

Another theme that runs through the conversation is a dramatic change in priorities. Kerr says that dying people generally do not dwell on regret in the way outsiders might expect. Asked about it, he responds: "They're not thinking about do they regret something? No. Hell no. No, it's gone." What replaces it is a focus on relationships and on not becoming a burden to the people they love.

Kerr frames this as a kind of stripping away. "Death is this unbelievably truthful place. You're stripped to the bare bones of who you are." He then asks people to think about the best version of themselves, and the answer he describes is not an achievement. "It was never achieving something. It was being a son, it was being a brother, it was being a friend." The career, the status, and the legacy that absorb so much of living fall away. What remains is the quality of connection.

The same logic shapes what Kerr believes families and clinicians should talk about. If the dying are focused on love and on not being a weight, then the most useful conversations are often about presence, not about treatment plans or accomplishments.

Is dying as painful as we assume?

Here Kerr is at his most direct. He names one of the biggest myths outright: "that pain is expected, and that's actually not true." His account is that dying is usually far less painful than people fear. "It's less painful than people think," he says. "Oh gosh, by a mile." He is equally sharp about the silence around the subject: "It's damning how little conversations there are to address that issue."

That silence is part of a larger problem he describes. "After doing this for 30 years, what I've come to understand is we've lost our way with dying. There's such a lack of information, and that void is overwhelmingly felt with fear and mistruths." Much of the dread that surrounds death, in his telling, is not grounded in what dying actually involves. It is filled in by imagination, by media, and by the absence of honest accounts from people who have sat with the process.

This is why the patient-centered work matters so much to him. Video was part of the method for a reason. Kerr explains that the team filmed patients early because they expected a medical audience to carry a picture of dying patients as "either compromised or feeble-minded." Putting the actual people on screen, lucid and speaking for themselves, is a way of correcting that image.

What does this mean for the rest of us?

The episode's broader argument is that human life is defined less by individual accomplishment than by interdependence and love. Kerr's research on post-traumatic growth points in that direction. The episode's summary describes terminal patients who frequently undergo profound psychological transformation and who resolve deep-seated childhood trauma in their final days. Kerr's own framing is that the dying are stripped down to who they are, and that who they are turns out to be defined by the people they loved and were loved by.

For a general reader, the practical takeaways are modest but concrete. Fear of dying is often built on misinformation. Pain is not the default. The visions many people report are not reliably dismissed as confusion. And the conversations that seem to matter most at the end are about relationships rather than achievement. None of this resolves the metaphysical question, which Kerr leaves open, but it changes what a person might prepare for and what they might say.

Where to go from here

  • Watch the full episode of The Diary of a CEO featuring Christopher Kerr, which includes the patient videos and his discussion of misconceptions about death.
  • Read Death Is But a Dream: Finding Hope and Meaning at Life's End, the book Kerr describes as aiming to destigmatize the dying process.
  • If you are caring for someone who is dying, ask them open questions about what matters to them now, and listen without rushing to correct what they describe.
  • Consider talking with your own family, before a crisis, about what you would want the final weeks to look like, including who you would want near you.

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Transcript

[0:00] interviewed 1,500 people as they're

[0:02] about to die. And what our research has

[0:04] shown is nearly 90% of people start to

[0:07] have very intense dreams or visions as

[0:09] they get closer to death and it's unlike

[0:11] anything they've ever experienced. And

[0:13] what's fascinating is these events don't

[0:15] resemble delirium. When we ask them to

[0:17] scale it 0 to 10 on the degree of

[0:20] realism, it's always a 10. So [music] it

[0:22] feels like this actually happened. Tell

[0:24] me about those people. Would it help to

[0:27] see a video?

[0:28] So after doing this for 30 years, what

[0:31] I've come to understand is we've lost

[0:33] our way with dying. There's such a lack

[0:35] of information and that void is

[0:37] overwhelmingly felt with fear and

[0:39] mistruths compounded by the fact that

[0:41] doctors don't have these discussions.

[0:43] >> Can you list them for me?

[0:44] >> First, I don't see people bringing up

[0:46] regret towards the end of their life.

[0:48] They're not thinking about do they

[0:49] regret something? No. Hell no. No, it's

[0:52] gone. [clears throat] Death is [music]

[0:53] this unbelievably truthful place. You're

[0:55] stripped to the bare bones of who you

[0:57] are. And if you think of the best

[0:59] version of yourself, it was never

[1:01] achieving something. It was being a son,

[1:03] it was being a brother, [music] it was

[1:04] being a friend. And then the big myths

[1:06] are that pain is expected and that's

[1:08] actually not true. [music] It's less

[1:09] painful than people think. Oh gosh, by a

[1:12] mile. But it's damning how little

[1:14] conversations there are to address that

[1:16] issue. And then the next, this is what

[1:18] fascinates me. You're going to see why.

[1:19] >> And also we have these six handwritten

[1:21] cards [music] of lessons you've learned

[1:23] from caring for the dying. We'll go into

[1:25] the full list but from everything you've

[1:26] experienced, do you think there is life

[1:28] after death?

[1:29] >> This is probably the most remarkable

[1:30] thing of all. So I think

[1:37] >> Here is a strange fact. Most of the

[1:39] people watching this right now, about

[1:41] 58% of you, aren't yet subscribed to

[1:43] this channel. Statistically, that is

[1:45] probably you. So could I ask you a small

[1:48] favor? If this channel has ever given

[1:49] you any value at all, please could you

[1:51] do me a favor and hit the subscribe

[1:52] button. It costs nothing. It helps us

[1:54] more than you could know. And the bigger

[1:55] the channel gets, as you've seen, the

[1:57] more we invest in the guests and the

[1:59] production. So, thank you so much and I

[2:00] hope you enjoy this episode.

[2:04] >> [music]

[2:06] >> Dr. Christopher Kerr.

[2:08] You've spent three decades of your life

[2:12] experiencing something that most of us

[2:14] probably spend our lives trying to

[2:16] avoid.

[2:17] What is it you've done for the last

[2:18] three decades?

[2:20] >> I was trying to avoid it, too, but more

[2:22] by accident and I ended up

[2:25] becoming a hospice doctor.

[2:27] >> What does that mean?

[2:28] >> A hospice doctor cares for that

[2:30] individual who is no longer deemed

[2:32] treatable.

[2:33] >> So, you've spent 30 years caring for

[2:36] people that are going to die shortly.

[2:39] Yes.

[2:40] And you started interviewing them.

[2:42] >> [clears throat]

[2:43] >> Probably 1,500 at this point.

[2:45] >> Why did you start interviewing people

[2:47] that were about to die?

[2:48] >> Because their perspectives matter. I

[2:51] arrived to that hospice completely

[2:53] unprepared to be a doctor of the dying.

[2:56] Medical school prepares you really to to

[2:58] defeat death, not to care for those who

[3:00] are dying. But my colleagues,

[3:02] particularly in nursing,

[3:04] were much more tuned to what the actual

[3:07] patient was experiencing. What I've come

[3:09] to understand is what the patient

[3:10] perspective is the one that matters.

[3:13] And that when you start to see patients

[3:15] as people, you start to understand that

[3:18] they have these rich emotional and

[3:20] personal lives and that's what matters

[3:22] at the end of life.

[3:23] >> How much research have you done? Cuz

[3:25] I've got I think 15 research papers here

[3:27] that you've published.

[3:28] >> done a lot. And we do very important

[3:30] things. So, we rule out confusion

[3:32] states. We've you done studies on

[3:34] post-traumatic growth to see whether

[3:37] within these negative experience of

[3:38] dying was there actually positive gain.

[3:41] We've looked at the effect on children.

[3:43] >> When children die?

[3:44] >> Mhm.

[3:45] And we've looked at the effect of these

[3:47] things on bereavement. You know, those

[3:49] left behind, how that influenced their

[3:51] bereavement.

[3:52] >> And you've also done a lot of research

[3:54] on the visions people see as they're

[3:57] dying and the dreams they have in the

[3:59] days leading up to their dying.

[4:00] >> Yes, that's the focus. The vast majority

[4:02] of people, nearly 90% of people, start

[4:05] to have very intense dreams or visions

[4:07] and the overriding theme is that they're

[4:09] seeing people who they've loved and who

[4:12] they've lost. And very specifically,

[4:14] it's those that have loved them

[4:15] unconditionally, purely.

[4:18] And those that didn't aren't there.

[4:20] Dying is progressive sleep. Your sleep

[4:23] architecture changes, your sleep cycles

[4:25] changes. And

[4:28] evermore you start to have these kind of

[4:29] inner experiences. It makes sense,

[4:32] right? That as you're dying, you're

[4:33] going to be reflective. You're going to

[4:35] be introspective. And they usually

[4:37] become more prevalent towards the last

[4:40] kind of week or two of life. And what

[4:42] was very interesting in the The

[4:44] frequency of these events increases as

[4:46] people approach death. So, it's all been

[4:49] an attempt to really humanize the dying

[4:51] process. So, take it from a medical

[4:53] model, which looks at organ failure and

[4:56] management of disease, and instead,

[4:58] let's look instead what the patients

[5:00] actually experiencing towards the end of

[5:02] their life. And what's fascinating is

[5:05] when you measure

[5:06] what themes bring them the most comfort,

[5:09] it's seeing the deceased.

[5:11] >> So, if I'm passing away, the thing that

[5:14] brings me the most comfort is seeing my

[5:17] deceased relatives.

[5:18] >> Yes.

[5:19] >> And I've got a graph here which shows

[5:21] the dreams of the dead that were most

[5:23] comforting. I'll throw that up on the

[5:24] screen.

[5:25] >> Yeah. Yes, we measured on a scale what

[5:28] brought them the most comfort, and you

[5:31] can see it goes up between the living

[5:33] and seeing the dead.

[5:34] Um would it help to see a a video?

[5:37] >> Yeah.

[5:37] >> What happened was we videoed patients

[5:39] early because we knew that our audience,

[5:42] particularly medical audience, would

[5:43] have a view of what a dying patient was,

[5:46] that they were either compromised or

[5:47] feeble-minded. And so it became very

[5:50] important to capture them on film. So

[5:53] this is Paul. This is actually 3 weeks

[5:55] before his death.

[5:57] And he kind of covers all the bases. So

[6:00] very vivid these dreams.

[6:03] Very little is said between the dreamer

[6:05] and the person in the dream.

[6:07] What you'll notice in all these videos

[6:09] that's so striking is the absolute

[6:11] absence of fear.

[6:13] So these dreams never deny the fact that

[6:15] they're dying. They they almost

[6:17] transcended. And they really sometimes

[6:20] have trouble to find language for what

[6:22] they're seeing, but they know how their

[6:24] loved felt, which is they're kind of put

[6:26] back together.

[6:27] >> I've probably had 15 dreams about her

[6:30] maybe, somewhere in there.

[6:33] She always wear I I dream of color most

[6:35] like. And she always wears a beautiful

[6:38] light blue.

[6:39] It could be a suit, it could be a gown,

[6:41] it could be a dress.

[6:43] It's always light blue.

[6:45] And a couple of times she's gave me the

[6:47] little beauty pageant wave. And a couple

[6:49] times she sort of greet always with a

[6:51] smile. Doesn't Only one or twice I've

[6:54] ever heard her voice. But uh

[6:57] she only kind of lets me know that she's

[6:58] fine.

[6:59] >> So he's in the lead up to his death,

[7:01] he's having what, 15 dreams about his

[7:03] deceased wife.

[7:04] >> Yeah.

[7:05] >> What you make of that? Like what does

[7:06] that mean?

[7:08] >> Yeah. You Honestly, my view of this is

[7:10] changing. I would have told you before

[7:13] when I started doing it that this was um

[7:16] a rekindled memory.

[7:18] >> So you It was just a memory.

[7:19] >> Yeah. It's like looking at a picture.

[7:21] >> Yeah.

[7:21] >> Right. And uh recalling the imagery.

[7:24] There's a couple of features that stand

[7:26] out that suggest there's a lot more of

[7:27] than that, that there's almost this

[7:28] continued consciousness. And what one is

[7:32] the detail that's rekindled is

[7:34] remarkable. 95-year-old man, he lost his

[7:38] mother when he's five, and he talks

[7:40] about smelling her perfume and hearing

[7:42] her voice.

[7:43] The other is that often these

[7:45] interactions, and you're going to see

[7:47] this in other videos, there's

[7:48] communication.

[7:50] So, they're not they're not in still

[7:51] form. This again, not like looking at a

[7:54] picture.

[7:55] >> Do you believe his wife is still truly

[7:57] accessible?

[7:58] Or are you saying that the memory of her

[8:00] is accessible through his dreams? Cuz

[8:02] they're very different propositions.

[8:05] >> I don't know what this means. I don't

[8:07] know if this I I wouldn't be so bold as

[8:10] to say this speaks to an afterlife. What

[8:12] I am more convinced of is that those

[8:16] who have loved us are never gone.

[8:19] They're accessible to us.

[8:20] And what is fascinating to me is that

[8:24] at the end of life, when people are

[8:26] neurologically compromised, they're

[8:28] fading, they can't move, the remnant of

[8:32] function is still this core sense of

[8:35] being connected to loved.

[8:38] And that remains. It's like we enter the

[8:41] world and leave the world with

[8:43] remarkable symmetry. You know, you come

[8:45] into the world and the infant doesn't

[8:48] know language, undeveloped brain, but it

[8:51] knows its mother's love. It knows it

[8:54] feels connected and secured. And at the

[8:56] very end of life, it's kind of the same

[8:59] thing. They're diminished, they're less

[9:01] capable, but what they're feeling and

[9:04] sensing, even without language, is the

[9:07] same thing.

[9:08] >> Was that one particular

[9:10] video you got with a patient that was

[9:12] approaching their death that was most

[9:14] persuasive to you as it relates to

[9:16] believing that consciousness

[9:19] continues or that our loved ones aren't

[9:21] really ever

[9:23] gone?

[9:25] They are able to be summoned back into

[9:28] this world.

[9:29] >> Definitely the ones where people

[9:32] have injury or harm for having lived and

[9:36] they've struggled with that, often for

[9:38] decades.

[9:40] And no matter how much therapy, talk

[9:42] therapy, medication, they they they've

[9:44] never found peace, and they find it in

[9:46] the end in these experiences. So, an old

[9:49] veteran who suffers with survival death

[9:52] and PTSD, in the last late

[9:56] days of life,

[9:57] he he's brought back to those who died

[10:00] overseas, and he's comforted.

[10:02] And I think some of the most remarkable

[10:04] ones, of course, are the children

[10:06] um who do this so differently. But just

[10:09] the fact that there's so much innate

[10:11] ability within us to heal these harmed

[10:14] and broken pieces. And for children who

[10:17] do this in in ways that are absolutely

[10:20] in inspiring.

[10:21] They're you know, they're often not

[10:23] dramatic. They're very There's no great

[10:25] epiphany, no great reveal. These are

[10:27] moments of just having lived and

[10:29] mattered. They're sitting around a

[10:31] kitchen table. If you want, we can show

[10:34] Florence, and she's an example.

[10:36] She's lost her husband, and she's lost

[10:38] her daughter.

[10:40] And this is 5 days before her passing.

[10:42] >> Tell us about the dreams.

[10:44] >> But the other night, I saw right into a

[10:46] sleep.

[10:48] They were like sitting at kitchen table,

[10:51] laughing. I could see their faces.

[10:54] I could tell them four photos.

[10:57] We were laughing, we were talking, we

[11:00] were eating. And then they felt like

[11:02] they walked 12 years.

[11:05] And never existed.

[11:07] >> Because it was so real that it was he

[11:09] was there in the present.

[11:10] >> And 7 years since my daughter was gone.

[11:13] It was like we were always together,

[11:15] never separated.

[11:17] >> Yeah.

[11:18] How does it make you feel

[11:21] um about the prospect of dying? How does

[11:23] it change with you?

[11:25] >> I'm not

[11:26] >> When you see something like that, people

[11:28] might say, you know,

[11:30] because they are aware that they're

[11:32] going to pass away at some point.

[11:34] They've been given that that diagnosis

[11:36] that prognosis.

[11:38] Presumably, yeah.

[11:40] The end of their life, their family,

[11:42] these are the things that would be on

[11:43] their mind. And if they're on their

[11:44] minds, they'd be in their dreams.

[11:46] So, is it Is it the process of death

[11:48] that's provoking these kind of dreams or

[11:50] visions? Or is it just the case that,

[11:52] you know, you dream about what you think

[11:53] about? And obviously, these people are

[11:54] thinking about the end of their lives.

[11:56] >> Yeah, the only rebuttal to that is when

[12:00] you ask them these these sorts of

[12:02] questions,

[12:03] the thing that gets them most distressed

[12:05] is when you refer to them as dreams.

[12:08] Because these are unlike anything

[12:10] they've ever experienced. So, they're

[12:12] not dreams in the sense they're not

[12:13] metaphorical, they're not fantastical.

[12:15] They don't require interpretation. I've

[12:17] never had a patient say, "Hey, what do

[12:19] you think this means?"

[12:20] They're given the sense of knowing. And

[12:22] they'll often say, "I don't normally

[12:24] dream." Or "I don't recall my dream." Or

[12:26] "No, this was virtual. This was a

[12:27] happening."

[12:29] So, they have no doubt. When we ask them

[12:32] to scale it 0 to 10 on the degree of

[12:35] realism, it's always a 10.

[12:37] So, it feels like this actually

[12:39] happened. And those of them who are

[12:41] having these experiences in the wake

[12:44] state, you can watch them. They're

[12:45] looking right through. They're looking

[12:47] at the room. They're petting the dog

[12:48] that isn't there.

[12:50] >> Oh, so some of them have these visions

[12:51] >> 50% are occurring when they're awake.

[12:53] Yeah.

[12:55] >> Even if it's quite some time before they

[12:57] pass away?

[12:58] >> No, it's usually measurable within

[13:00] weeks. A couple weeks. And it picks up

[13:02] as as you get closer to death.

[13:04] >> And when it gets closer to death, how do

[13:06] these visions change or evolve?

[13:08] >> Become more immersive.

[13:09] So, again, dying is progressive sleep.

[13:12] So, they're living more in this other

[13:14] state where they're deeper and deeper

[13:16] sleep. So, they spend more time there.

[13:19] And they'll often wake up, it's

[13:20] interesting, and wish they were going

[13:23] back into that other state. Often times,

[13:26] they're just warmed by reunion of what

[13:29] they were experiencing.

[13:31] And time and distance go away.

[13:33] So, they're decades have moved and they

[13:35] were calling very vivid memories of a

[13:38] dog they lost in childhood, for example.

[13:41] >> So, do you think this is a biological,

[13:43] physiological thing in that brain, a

[13:45] bunch of chemicals that are

[13:47] slushing around, or do you think it is

[13:50] spiritual?

[13:51] >> I'm also a PhD in neurobiologist been

[13:54] 5, 6 years studying brain. So, I I I

[13:58] I'm drawn to that. No one knows. And I

[14:02] I'm good with that. I I think you could

[14:05] you point parts of the brain here

[14:07] and say, you know, love lives in the

[14:09] certain areas, certain

[14:11] neurotransmitters,

[14:12] you know, are correlated with happiness.

[14:15] You can take all the pieces and you

[14:17] can't make the whole.

[14:18] I can't show you where love is.

[14:21] I can't recreate love in a dish. And I

[14:24] can't create this.

[14:26] I see it really goes beyond

[14:29] brain function into something else.

[14:31] >> So, you think it is spiritual then?

[14:33] >> I do, very much. Yeah.

[14:35] >> Do you believe there is a soul?

[14:36] >> Yes.

[14:37] >> And so, you would

[14:39] posit, I guess, that lives beyond the

[14:40] physiology of the human body and brain.

[14:42] >> Yes.

[14:44] >> Half of Americans say a dead relative

[14:46] has visited them.

[14:48] >> Mhm.

[14:50] >> And the answer here that has that 53% of

[14:52] votes is

[14:54] have you ever felt a dead family member

[14:55] visit you in a dream or in any other

[14:58] form? 53% of people say they have.

[15:01] >> Mhm.

[15:01] >> 34% say in the past year they felt the

[15:03] presence of a dead family member.

[15:06] And 28% say in the past year they've

[15:08] told dead family members about events in

[15:10] their life.

[15:11] >> Mhm.

[15:11] >> Yeah, we remain connected.

[15:13] >> 15% say in the past year they've had a

[15:15] dead family member communicate with

[15:17] them.

[15:17] >> Mhm.

[15:18] >> All the data has always suggested that

[15:20] at least in this country there's a

[15:22] higher degree of spiritual orientation

[15:26] than you would expect. But that's been

[15:28] always been the case.

[15:29] >> When people are in their last days, do

[15:32] they become more religious and more

[15:33] spiritual?

[15:34] >> Yes. We know it because of of what they

[15:38] focus on. They tend to think about these

[15:40] big things and again, they tend to be

[15:42] about relationships. They ask these

[15:45] better questions. We've looked at this

[15:47] question of religion and we've have not

[15:49] found that being having a religious

[15:52] belief changes how you experience these

[15:54] end of life events. It just doesn't seem

[15:57] to matter.

[15:58] >> And most dying patients report end of

[16:00] life dreams and visions. The stats here

[16:02] show that 80% of health care

[16:04] professionals have witnessed or told

[16:06] been told of one.

[16:07] This I didn't realize it was so many

[16:09] people that are having these end of life

[16:11] dreams and visions. I didn't realize it

[16:12] was 80%.

[16:14] And and you know, again, we people might

[16:15] think this is because of delirium,

[16:17] because of their illness.

[16:18] >> No, it's it's a good question and that's

[16:20] what our studies did that was smart is

[16:22] we sorted out the patients who were

[16:24] delirious.

[16:25] So, we screened them every day before

[16:27] they did a questionnaire. Again, these

[16:28] are approved by a university, so you

[16:30] have to be witnessed, you have to have

[16:31] consent, you have to be cognitively

[16:33] intact. So, before they did our

[16:35] questionnaire every day, they had to get

[16:37] a screen for delirium.

[16:38] And these events don't resemble

[16:41] delirium. Delirium is very disorganized

[16:44] and the biggest difference is most

[16:45] people are left frightened or distressed

[16:47] by delirium. These events are recalled

[16:49] with acuity, they're based on real

[16:51] happenings, and they're left with a

[16:53] feeling of comfort, not distress or

[16:55] fear.

[16:56] >> Acuity.

[16:57] >> Acuity, there's sharpness.

[16:58] >> What are the other sort of fundamental

[17:00] misunderstandings people have about

[17:02] death that you've spent your career

[17:04] trying to confront and reverse?

[17:07] >> Oh, there are many. Dying is a process,

[17:10] death is a moment. It changes over time.

[17:13] The big myths are that pain is expected

[17:16] or anticipated and that's actually not

[17:18] true. Pain isn't, and the pain that is

[17:21] there can be resolved. The other

[17:23] misconceptions around eating and

[17:25] drinking, people stop eating and

[17:27] drinking. It doesn't hurt. They're not

[17:29] eating and drinking because they're

[17:31] they're dying. Something happens in

[17:33] nature that we don't die in want. So, it

[17:35] just kind of dwindles. And dying is

[17:38] really like um a dimming of the shades.

[17:40] It's gradual. You start to lose

[17:43] function, do less. If you have the flu,

[17:46] you know to go to bed. It just doesn't

[17:48] pay to do. Sleep is preferred, and most

[17:51] people die in sleep. The The key

[17:55] is to die, you have to be able to sleep

[17:57] well. But to sleep well, you have to be

[17:58] comfortable.

[17:59] And what people tend to think is to be

[18:02] comfortable and mean you need to be

[18:03] physically comfortable, but you also

[18:05] need to be psychologically at peace,

[18:07] existentially at peace.

[18:09] So, the holy grail for us, the vital

[18:11] sign that matters for us is comfortable

[18:13] sleep because you can't sleep if you're

[18:15] in discomfort, and you can't die if you

[18:18] can't sleep.

[18:19] >> There's that famous study by Bronnie

[18:21] Ware, who I think was a palliative nurse

[18:23] in Australia, who interviewed people on

[18:25] their last days and asked them about

[18:27] their regrets.

[18:28] >> Hm.

[18:28] >> Have you ever done any research like

[18:30] that to understand

[18:31] >> and I really have trouble with the

[18:32] study.

[18:33] >> Really?

[18:33] >> Yeah. First of all, it wasn't empirical,

[18:35] right? It was It was conver- based off

[18:37] of conversations.

[18:38] And

[18:40] that's not my experience. I don't see

[18:42] people bringing up regret towards the

[18:44] end of their life. Now, if you ask

[18:46] people

[18:47] what if they had regrets, I'm sure they

[18:49] would give you an answer.

[18:51] It's like if I asked you, "What's your

[18:52] favorite color?" You have an answer, but

[18:55] you don't go around thinking, "Oh, this

[18:57] is my favorite color."

[18:58] >> Sure.

[18:59] >> So, regrets, and this shows in our

[19:01] quantifiable study, don't come to the

[19:03] surface, actually.

[19:05] A lot of that gets let go of. I can

[19:07] honestly say, I've done this for nearly

[19:09] 30 years, and that's It's what I hear.

[19:12] >> So, let's um take a look at this cuz I

[19:14] think this is quite important. And I,

[19:18] funnily enough, had this conversation

[19:20] with my fiance yesterday when we were

[19:21] talking about what actually matters in

[19:23] life. So, here we have 11 things that

[19:27] medical students say they think will

[19:31] matter to a dying patient at the end of

[19:33] their life.

[19:34] And then, you're going to tell me what

[19:36] actually mattered when you did an

[19:38] empirical peer-reviewed study and asking

[19:41] patients with days to live what actually

[19:43] mattered to them.

[19:44] >> Well, the first one the hospice patient

[19:46] cares about

[19:48] is not being a burden.

[19:50] They become selfless.

[19:52] They don't want to tax their family.

[19:53] They don't want their illness to

[19:55] compromise their life. They want to

[19:57] spend time with them.

[19:59] But they don't want to to to interfere

[20:01] with their living. You would think as

[20:04] people are close nearing the end of

[20:05] their life, they would become more and

[20:07] more self-focused and they become

[20:09] other-focused.

[20:11] And what's really interesting is

[20:12] actually this aligns well with that

[20:13] science of happiness work, right? Which

[20:15] says that the happier people derive

[20:18] meaning from doing for others rather

[20:20] than doing for self.

[20:21] These better features kind of come to

[20:23] life at the end.

[20:24] >> If I've got a relative who's passing

[20:26] away, if this is the thing they care

[20:27] about most, not being a burden, is there

[20:30] something I can do as the loved one or

[20:32] the relative to ease this concern for

[20:35] them?

[20:37] >> I think it's

[20:38] aligning your wishes with their hope,

[20:41] which is your wish is you actually want

[20:43] to be a presence.

[20:44] >> And you And you're letting them know

[20:45] that you're not a burden.

[20:46] >> Yeah. Yeah.

[20:46] >> They're not a burden.

[20:47] >> Okay. Number two.

[20:50] They want time.

[20:51] >> Okay, so they want to be around their

[20:52] friends and family. That's what they

[20:54] care about second.

[20:55] >> fundamental here is this relationships,

[20:57] right? That's what it's about.

[21:00] >> And the medical students thought it

[21:01] would be

[21:02] >> feeling that life was meaningful.

[21:04] >> Again, this

[21:04] >> I think this is wonderful. This is one

[21:06] that fascinates me the most. So, you're

[21:07] in your 20s

[21:09] and you're on this journey of

[21:11] development and and

[21:13] that you've had this impact of some

[21:15] sort.

[21:17] That door shut.

[21:18] And they're not living in the rearview

[21:20] mirror and they're not wondering whether

[21:22] they had have meaning or not.

[21:24] >> This is very relevant cuz me and my

[21:25] fiance were in the car the other day and

[21:27] we was yesterday and we were talking

[21:28] about this and she turned to me and said

[21:30] like what's your why?

[21:31] And having sat here on this podcast with

[21:33] a guest a couple of weeks ago who asked

[21:35] me to close my eyes and imagined it was

[21:37] the last day of my life. The only thing

[21:38] that mattered in that moment was who was

[21:41] around my bed and what they thought of

[21:44] me and if were they safe and secure.

[21:48] And it didn't dawn on me in that moment

[21:50] where I visualized being on my deathbed,

[21:51] my legacy or the impact I'd had or the

[21:53] achievements I'd accomplished. It's made

[21:55] me really reconsider what my why is.

[21:59] Cuz really if in the last moments of my

[22:01] life what I'm concerned about is who

[22:02] stood there

[22:03] and what they think of me.

[22:06] And when I say what they think of me,

[22:07] it's like do my kids think dad was a

[22:09] good man and did he leave us with

[22:12] lessons and principles that we so we can

[22:14] live a good life, too.

[22:16] That seems to be most important. So, it

[22:18] was just interesting cuz we go through

[22:19] life and we read Instagram and LinkedIn

[22:21] and it tells us like what's your why,

[22:22] what's your legacy, what impact you want

[22:24] to have on the world, what's your

[22:24] purpose, what's your passion and these

[22:26] are all things that are very

[22:27] self-focused. But actually it appears to

[22:29] me as you've described that actually in

[22:31] those moments it's about others.

[22:33] >> Yeah, I mean and there's good work on

[22:35] this, right? Is is the brain's ability

[22:37] to predict what makes us happy is

[22:40] horribly wrong.

[22:41] What we predict makes us happy is never

[22:43] sustainable.

[22:46] Right? And then what's important is to

[22:48] kind of de-want what matters.

[22:50] >> De-want what matters?

[22:51] >> Yeah, because

[22:53] well we're on this treadmill of things

[22:55] that we think are going to make us

[22:56] happy.

[22:57] >> Job promotion.

[22:58] >> Yeah, yeah, yeah.

[22:59] >> Come on.

[22:59] >> And they're not sustainable things and

[23:01] that's proven over and over and over and

[23:03] over again. Belonging, connection,

[23:06] meaning, those those are the things that

[23:09] I mean, we're fundamentally meant to

[23:11] belong to one another. If you think of

[23:14] the best version of yourself,

[23:16] it was never achieving something. It was

[23:18] being a son, it was being a brother, it

[23:20] was being a friend, it was being a

[23:21] fiance or boyfriend, whatever. It's

[23:24] those things that make us important. And

[23:29] ultimately, what you find out of this

[23:30] research is the enormous value of

[23:33] interdependency.

[23:35] And that's the whole deal, whether it's

[23:38] in the physical world, the natural

[23:40] world, the ecosystems, but as humans,

[23:44] we're we're

[23:46] meant to be inter- interdependent, and

[23:48] that's most clear in moments of

[23:50] vulnerability.

[23:52] So, you pose yourself the question, kind

[23:53] of last day stuff, you're immediately

[23:55] vulnerable.

[23:56] >> Yeah. Yeah.

[23:57] >> Right? And what you did is you pulled in

[23:59] all these other people that matter to

[24:01] you. Yeah. Because we're defined

[24:04] only by our relationships. That's the

[24:07] only surviving thing, not by these other

[24:10] things that seem,

[24:12] in a transient sense, important. And

[24:15] that bears this out. And what's

[24:17] beautiful is their concern shifts from

[24:19] self, and I mean, hope changes in that

[24:21] way, right? It's hope for cure, then

[24:23] just hope for others. It's just this

[24:25] really wonderful story about who we are.

[24:28] >> It's interesting cuz the things you'll

[24:30] say, a lot lot of people will sort of

[24:31] intellectually understand and believe

[24:33] that it's about the relationships in

[24:35] these last moments, but therefore, it's

[24:36] about relationships through our life.

[24:38] But then when you look at how we

[24:39] allocate our time on a weekly monthly

[24:40] basis,

[24:41] >> Proportionate.

[24:42] >> There's a disconnect.

[24:43] >> Yeah, yeah, yeah. Yeah.

[24:44] >> Because we're we're allocating our time

[24:46] towards accomplishment or achievement or

[24:47] money or promotions or cars, whatever,

[24:49] >> Yeah.

[24:50] >> but then in the final hour,

[24:52] it's all about something else. And if I

[24:53] even reviewed the allocation of my time

[24:55] this week and day, I'd be like, wow.

[24:57] >> Yeah.

[24:58] Well, I mean, dying is the death is this

[25:01] unbelievably truthful place.

[25:04] Right? Pretense goes away. All the

[25:06] superficiality goes away. You're You're

[25:09] stripped to the bare bare bones of who

[25:12] you are. And what you end up finding is

[25:14] that we're more alike than unlike, and

[25:16] there's a universality to being human,

[25:19] >> [snorts]

[25:19] >> and it involves being connected to one

[25:21] another. You know, our struggle is to

[25:24] remain humane, and we go through this

[25:27] together, not alone. And that's Again,

[25:30] there's a symmetry. You see at the

[25:31] beginning of life, and you see it at the

[25:33] end of life.

[25:35] Politics falls away.

[25:38] >> I sure as hell hope so. And this is

[25:40] interesting cuz so many people spend

[25:42] their lives getting agitated You see The

[25:44] reason I say that is cuz you said we're

[25:45] more like than we believe.

[25:47] >> Oh, absolutely.

[25:48] >> And so, when you're bare bones, you're

[25:50] not really thinking about the left, the

[25:52] right, this politics, this political

[25:53] issue.

[25:54] >> What you end up

[25:56] um when people are are most vulnerable,

[25:59] you you you see beauty. You see love.

[26:02] You see tenderness. You see

[26:03] vulnerability. There are some awful

[26:05] humans that have lived a bad life, but

[26:09] in the end, when you see them in a more

[26:11] vulnerable state, I I I I think you see

[26:13] their better nature. You see tenderness.

[26:16] You see expressions of love. There's a

[26:18] lot of pretense that people have to work

[26:20] through, personas that they present, and

[26:23] illness kind of strips you of that. It's

[26:25] this great leveling effect to be sick.

[26:29] That what matters to you 2 weeks earlier

[26:31] doesn't matter to you now.

[26:33] >> Okay, so medical students thought the

[26:36] third would be pain symptom management,

[26:38] and according to your hospice patients,

[26:40] >> Yep.

[26:40] >> they agree.

[26:41] >> one right.

[26:41] >> And what does that mean? That's just

[26:43] their concern is not being in pain.

[26:44] >> unfortunately, there's not a lot of

[26:46] conversation about what to expect. We

[26:48] just completed a study on this. If you

[26:50] were told you had a terminal disease, I

[26:52] guarantee one of your first overwhelming

[26:55] thoughts is a suffering.

[26:57] >> Yeah.

[26:57] >> And unfortunately,

[26:59] it's damning how little conversations

[27:02] there are to address that issue in terms

[27:04] of what to expect, when to expect it,

[27:06] what you're going to feel, and reassure

[27:08] people. And these honest conversations

[27:11] actually don't take away hope, they

[27:13] restore agency.

[27:14] >> So, what is the misunderstanding?

[27:15] >> Oh my gosh, that it's far worse than

[27:18] people think, that there isn't a pain,

[27:20] rarely a pain we can't manage.

[27:22] >> It's less painful than people think.

[27:24] >> by a mile. Yeah.

[27:26] That's probably the the biggest myth.

[27:29] >> About death and dying?

[27:30] >> 100%. And honestly, it's compounded by

[27:33] the fact that doctors don't have these

[27:35] discussions.

[27:37] >> Okay. So, number four in terms of what

[27:39] hospice patients say matters most to

[27:41] them?

[27:42] >> Peace with God.

[27:43] >> Being at peace with God. Hmm. And

[27:45] presumably just the religious ones,

[27:47] right?

[27:48] >> I know, it's peace with a belief

[27:51] of something larger. I've asked patients

[27:53] this, and they'll say what I would say

[27:56] is that I don't know. It's an

[27:57] existential feeling that doesn't

[28:00] necessarily have to be attributed to a

[28:01] belief or a god.

[28:03] >> Now, is it because they're concerned

[28:04] they're going to go to hell or that

[28:05] they're going to go to they don't know?

[28:06] >> don't hear that. I'm sure there was a

[28:09] time when judgment the role judgment

[28:12] played in, but just to be at peace.

[28:14] >> What does that mean?

[28:15] >> existentially.

[28:16] >> And is there a way to become at peace

[28:18] that that patients will ask for?

[28:21] >> I don't hear, but I imagine it's to ask

[28:23] for forgiveness in part.

[28:26] >> And the medical students you interviewed

[28:28] thought number four would be being

[28:30] mentally aware.

[28:31] >> Yes, and that does come up, right? So,

[28:33] here we are.

[28:34] >> That's number five.

[28:35] >> Yes. In what hospice Okay.

[28:36] >> And then the next is is dying at home.

[28:40] And this is tragic because 80% of

[28:43] Americans want to die at home, and about

[28:45] 30% do.

[28:47] >> Why is that?

[28:48] >> It's really reflective of of a mostly

[28:51] our

[28:52] medicalization of dying. As a country we

[28:56] under invest in care for at home so that

[28:59] people end up having to go into the

[29:01] hospital and the death that they fear is

[29:03] the one they get. The more tertiary or

[29:05] advanced a hospital is the more

[29:07] aggressive treatment there is. It's part

[29:09] of the death defying approach of

[29:11] medicine. There's always something you

[29:13] can do. They die in units and they die

[29:16] in those sort of and the irony is the

[29:18] more they get it actually hasn't been

[29:21] shown to enhance life and what they get.

[29:24] The more care more aggressive care they

[29:25] get when they're dying.

[29:27] >> So you're saying that we we kind of drag

[29:29] it out a bit unnecessarily sometimes.

[29:31] >> I think medicine does its best to defy

[29:33] death and unfortunately it it often

[29:36] denies it even when it's obvious when

[29:38] things have become futile.

[29:40] And if medicine can't appreciate death

[29:43] when it's objectively there, they're

[29:45] certainly not going to pay attention to

[29:47] the experience of the dying.

[29:50] And I think it's complicated but we've

[29:52] lost our way with dying. You know, dying

[29:54] used to be in the home and in the

[29:56] community when connection to our church

[29:58] and in the last 100 years it's become

[30:00] institutionalized.

[30:02] So death is now like a rumor. You know,

[30:05] it's something that happens somewhere

[30:07] down the line probably to somebody else

[30:09] but it's not proximate to us like it

[30:11] used to be. So you take all these

[30:14] factors together, the fact that we've

[30:15] institutionalized dying, the fact that

[30:18] medicine's become you know, technically

[30:20] focused and no longer artful. We don't

[30:23] it's not okay to be there for presence.

[30:25] I mean people can't die of old age

[30:26] anymore. You know, you you got to have

[30:28] about five diagnoses. So it's lost its

[30:31] grace. It's lost its humanity.

[30:34] >> So if someone knows they're going to

[30:35] die, you would recommend they

[30:37] usually didn't come to a hospice and

[30:39] they

[30:40] >> No, I get get into a hospice so you can

[30:42] die at home.

[30:43] >> Oh, hospice is at home.

[30:44] is more likely to align your wish to an

[30:47] outcome. Hospice is

[30:49] developed out of our communities as as

[30:52] an answer, as a rebuttal to the way

[30:55] dying were traditionally treated in a

[30:57] hospital. Yes, so what is it about dying

[31:00] in a hospital that is

[31:02] worse than dying at home? I don't know

[31:04] where to begin. What matters to the

[31:06] dying patient

[31:08] is familiarity, to be connected, to be

[31:13] where they live,

[31:15] the things that make them comfortable,

[31:17] the people they love. They don't want to

[31:19] be woken in the night, they don't want

[31:20] to be poked, they don't want IVs, they

[31:22] don't want another scan. It goes down to

[31:24] what will make you comfortable. What

[31:26] matters to you in the end? And being at

[31:29] home with your people is what matters to

[31:31] people.

[31:31] >> Makes sense. So number seven,

[31:34] having care directives followed. What

[31:37] does that mean?

[31:38] >> And making sure that what you want to

[31:40] happen is going to happen.

[31:42] >> Okay.

[31:43] >> Yeah. And this one is this is

[31:44] interesting, I think, resolving

[31:46] conflicts.

[31:47] >> So medical students who are asked about

[31:50] what matters most to those that are

[31:51] dying,

[31:52] they ranked the seventh thing that would

[31:54] matter as resolving conflicts.

[31:56] >> And what's interesting is these two

[31:58] writers

[31:59] was life meaningful and resolving

[32:01] conflicts. And the dying patients kind

[32:03] of all good.

[32:05] They don't want to be a They're not a

[32:07] problem to be solved.

[32:08] >> That's interesting You're right, that is

[32:09] the most interesting takeaway so far is

[32:12] living people think the dying will be

[32:14] really concerned with legacy and what

[32:16] they accomplished and did they have any

[32:18] beef with anybody, but dying patients

[32:20] >> And that's why I have trouble with that

[32:21] regret literature, okay, because that's

[32:23] not what they're saying. They're not

[32:25] focused really on the negative aspects

[32:28] of having lived, right? They're trying

[32:30] to preserve what makes them them and

[32:32] what makes them them is their family.

[32:35] And being in their home and being at

[32:37] peace with their God.

[32:39] >> I mean, that speaks to what we should be

[32:41] thinking about in our lives day-to-day

[32:42] to some degree.

[32:43] >> Well, and again, there's a bridge

[32:44] between these two things. It's not that

[32:46] actually The idea that this changes in

[32:49] death actually isn't all that true.

[32:51] I think we're aware of it in dying. Dr.

[32:54] Santos Yell does this wonderful work on

[32:56] happiness. If you go upstream and you do

[32:58] good you do that that her sort of work

[33:01] on happiness, you reveal a lot of these

[33:03] same truths.

[33:04] >> Well, we also live in a commercialized

[33:06] world where

[33:08] we're exposed to marketing and we're

[33:10] told what matters every day when we turn

[33:11] on the TV or open our phones.

[33:13] >> Mhm.

[33:13] >> And we're told that the Louis Vuitton

[33:15] bag matters. Where we clap when someone

[33:17] gets the promotion. So, there is an

[33:19] element of sort of socialization that

[33:21] orientates our values towards being more

[33:22] materialistic and

[33:24] I guess shallow to some degree.

[33:26] >> Those things are transient and

[33:27] non-sustaining. And one of the things

[33:29] that comes out of this happiness work is

[33:31] the the importance of savoring.

[33:34] And savoring things of worth like our

[33:36] relationships.

[33:37] >> Are there any people that were days from

[33:39] their own passing that were truly

[33:41] unhappy

[33:42] because of the way that they'd lived

[33:43] their lives?

[33:44] >> Yeah, you die how you live, right? You

[33:46] can't reinvent it. It's not rainbows and

[33:48] flowers. I've certainly seen that and

[33:51] I've written about them and they're

[33:54] people who had done wrong and they were

[33:56] fearful of dying.

[33:58] >> Fearful of what?

[33:59] >> Well, in in several cases, they'd been

[34:01] raised Catholic and they were worried

[34:03] about judgment. And the one case was

[34:06] actually a police officer. So, he

[34:08] thought that he cuz he'd been

[34:10] raised with confession that he had to

[34:12] tell everybody all the horrible things

[34:14] he did wrong and it was kind of

[34:15] interesting. We had a reporter from the

[34:17] New York Times and she got an earful. He

[34:20] just had to be cathartic and say

[34:21] everything. He's trying to unleash his

[34:23] sins. But, it's very rare.

[34:25] >> In that case, you've got a police

[34:27] officer unleashing their sins.

[34:28] >> Mhm.

[34:29] >> Could that not

[34:30] result in legal consequences if they say

[34:32] things that

[34:34] >> Yeah, you think so because he talked

[34:37] about beating up witnesses and things

[34:39] like that. I never thought of that, but

[34:40] it's certainly true.

[34:41] >> And nothing was done about that?

[34:42] >> No. And

[34:43] what was interesting is we had a

[34:46] criminal, like a guy who'd spent more

[34:48] time in his in prison than out at the

[34:50] same time. And actually he's on film.

[34:53] And he had regrets, true, but they got

[34:55] addressed at the end.

[34:56] >> What do you mean?

[34:57] >> Well, it's one of the most beautiful

[34:58] things. So, about 12% of our patients

[35:01] report dreams that are distressing or

[35:05] uncomfortable. They're not all

[35:07] comfortable. Again, it's not surprising.

[35:09] You're going to die the way you lived.

[35:11] And And what we got wrong was those are

[35:13] sometimes the most transformational.

[35:15] Those are the ones where they find

[35:17] healing.

[35:17] >> He had a dream about some of the bad

[35:19] things he'd done?

[35:20] >> Oh, yeah.

[35:20] >> And that

[35:22] >> caused the transformation. You

[35:24] Dwayne

[35:25] >> And he'd commit crimes in his life?

[35:27] >> Oh, yeah.

[35:27] >> What kind of crimes?

[35:28] >> Two attempted murders.

[35:30] A two murders, sorry, but both were

[35:31] self-defense on the street. Somebody

[35:33] were trying to rob them, sort of thing.

[35:34] He lived on the streets most of his

[35:36] life.

[35:37] But he never Again, he never reckoned

[35:40] with the things he had done wrong. And

[35:43] this is his reckoning.

[35:44] >> And how

[35:45] many days was this before he passed

[35:47] away?

[35:48] >> 12.

[35:48] >> 12 days?

[35:49] >> My dreams, man.

[35:51] You know, my nightmares.

[35:54] I don't like them. I think it's because

[35:57] my my past is coming back to me.

[36:00] >> Mhm.

[36:01] >> You know,

[36:02] from doing wrong. Because I'm not going

[36:05] to say I'm a perfect guy when I was out

[36:08] there. Because I was living right in the

[36:10] streets, you know, doing wrong to

[36:12] individuals. And now they know my

[36:14] symptoms.

[36:16] They know I'm sick. So, now they want to

[36:18] try to hurt me.

[36:19] You know, it was like they were jerking

[36:22] a knife.

[36:23] You know,

[36:24] trying to cut

[36:26] >> Yeah.

[36:26] >> cut out, you know,

[36:28] my neck

[36:29] >> Mhm.

[36:29] >> where my cancer was at.

[36:31] >> Right.

[36:32] >> Stop. Stop trying to fight, you know.

[36:33] I'm sorry. I'm sorry, you know. Trying

[36:35] to fight

[36:37] this guy off from from hurting him. It

[36:39] scared me.

[36:40] I'm not a bad individual, man.

[36:42] A lot of cross

[36:44] a lot of people in my life.

[36:46] >> Mhm.

[36:47] >> You know, and I need help.

[36:49] I need help. You know,

[36:52] I don't I don't want to live my life

[36:55] >> Mhm.

[36:57] >> being

[36:59] I don't live in society walking

[37:00] >> [laughter]

[37:01] >> having to look over my back, man. I just

[37:03] want people to forgive me.

[37:05] And please

[37:07] know that I was sick

[37:08] >> Mhm.

[37:09] >> at the time when I was doing

[37:12] certain things that I was hurting them

[37:15] and their families.

[37:16] You know, that's all I want.

[37:18] >> Mhm.

[37:19] >> I don't want I don't want them to look

[37:21] at me as a bad individual because I'm

[37:23] not.

[37:24] >> Mhm.

[37:24] >> You know, I need help.

[37:27] >> What ends up happening is he can't

[37:28] sleep. And again, going back to this

[37:30] idea that it's very hard to die if you

[37:31] can't sleep.

[37:33] He ends up waking up and he asks to see

[37:35] his daughter.

[37:37] And

[37:38] she comes on the film.

[37:40] And what she describes is for the first

[37:42] time in her life, he holds her for

[37:45] minutes and says how much he loves her

[37:47] and that he's sorry for what he had

[37:49] done.

[37:50] So, this negative experience that was

[37:51] happening when his eyes closed brought

[37:54] this reckoning and this ask for

[37:55] forgiveness.

[37:57] Which, of course, she gave.

[37:59] >> And what do you make of that? Like

[38:01] again, I'm asking you this the same

[38:02] question I asked you earlier. It's like,

[38:03] what do you think is happening there? Is

[38:04] that a spiritual thing? Is that just

[38:06] him, you know, approaching the end of

[38:08] his life and feeling remorseful? So,

[38:10] he's having this dream.

[38:11] >> didn't have conscious control of this. I

[38:13] don't believe that for a second. This

[38:15] was happening when his eyes were closed.

[38:17] I think that he was carrying at a very

[38:20] deep level. He knew the wrongs that he

[38:23] had done.

[38:24] And this something was forcing him to

[38:28] find peace.

[38:29] And it did.

[38:31] >> Something.

[38:32] >> Something. Yeah, I think truth. I think

[38:35] somewhere in him he couldn't joke and

[38:37] contrive around it. Dying brings brought

[38:40] this to a surface and he needed to find

[38:43] peace.

[38:45] And it was wonderful for her. Changed

[38:47] her

[38:48] completely. And what ends up happening

[38:50] was she ends up spending every night

[38:52] with him.

[38:53] Uh and he ends up passing comfortably.

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[41:07] So, back to our board of things that

[41:09] actually mattered. We're on number

[41:10] seven.

[41:11] >> Number eight.

[41:13] Feeling that life was meaningful.

[41:15] >> So, just to

[41:16] zoom out once again on this. Were they

[41:18] given 11 options, or were they given

[41:20] lots of options?

[41:21] >> Lots of options.

[41:21] >> Okay. And these are the 11 that they

[41:22] actually picked. Okay. So, number eight

[41:24] is they

[41:25] cared that life was meaningful. But this

[41:27] is particularly low

[41:28] relative to the others.

[41:31] >> And so is this one.

[41:33] >> Living as long as possible.

[41:34] >> Mhm. And you might know what? I've never

[41:37] heard a dying patient say, "I want to

[41:39] live as long as possible."

[41:41] What they want to do is live as well as

[41:44] they can as long as they can.

[41:46] But unless you've been sick, that's not

[41:49] the goal.

[41:53] Which is antithetical to way

[41:55] medical world looks at patients, right?

[41:57] It's that we we keep going at all costs.

[42:00] >> I mean, this is stats that I was reading

[42:01] here about how many years people spend

[42:04] sick on average.

[42:05] I think it it was in the United States,

[42:07] if I have the stats right. Yeah, it says

[42:09] up to sort of 11 years of our lives are

[42:11] lived in poor health.

[42:13] >> Mhm.

[42:14] >> So, although our health span is, you

[42:16] know, in the Western Pacific 68 years or

[42:18] in Europe 66 years, we spend about a

[42:21] decade in poor health.

[42:23] >> Yeah.

[42:24] >> And actually, what you were saying to me

[42:25] is that people care more about their

[42:26] health span, how many years of good

[42:28] health they have versus

[42:30] their lifespan, which is just how many

[42:32] years they're alive.

[42:33] >> I think that's a perspective that's very

[42:34] hard to understand in health.

[42:37] But it's hard work being sick, you know,

[42:39] and it's hard on those you love, so it

[42:41] makes sense to me.

[42:43] >> What about this um obviously a big

[42:44] subject at the moment is this longevity

[42:46] movement, people wanting to extend life

[42:48] and live forever and all these kinds of

[42:49] things. What is your perspective of

[42:51] seeing of interviewing thousands of

[42:52] people that are dying, how has it shaped

[42:55] your perspective on longevity?

[42:57] >> I think there's a risk of some illusion.

[43:00] There was an article in Science

[43:01] recently, 55% of lifespan is determined

[43:04] by genetics.

[43:06] And it doesn't leave you immune from

[43:09] circumstances of disease and whatnot. I

[43:11] worry a lot

[43:13] of the lack of evidence around some of

[43:16] the efforts.

[43:17] And I think the focus really needs to be

[43:19] on living well. And if you look at the

[43:22] blue zone folks,

[43:25] I mean,

[43:26] that little lady in Japan or Italy isn't

[43:29] waking up from a cold plunge and

[43:31] measuring out creatine.

[43:33] She's just living well. They move, they

[43:36] eat more plants, they're highly social,

[43:39] they take time to downshift through

[43:41] prayer, meditation, would have music,

[43:43] whatever.

[43:44] >> When you think about all the people

[43:46] you've met who were days from their

[43:48] death, are there some who were more at

[43:51] peace with it because they had

[43:52] accomplished more?

[43:54] Like what what is what is the

[43:56] correlatory in terms of those that were

[43:58] most at peace with leaving the this

[44:00] planet?

[44:01] >> The love given and received. That's the

[44:04] only thing that

[44:05] matters. I I I've seen people who have

[44:08] led remarkably simple lives,

[44:11] but they were pure and in the love that

[44:14] they were able to experience.

[44:16] >> And so they were happier to leave.

[44:17] >> Oh, yeah. You want to live in a way that

[44:20] that you can die well and and and that

[44:23] means loving well.

[44:24] >> And have you experienced the opposite

[44:26] where someone had nobody there?

[44:28] >> Oh, [gasps]

[44:29] um

[44:30] I've had some very bad experiences,

[44:32] people who were One of them I've written

[44:35] about who was taken as a child into a

[44:38] home situation that was really for kids

[44:41] with a lot of complexity and had never

[44:44] seen or experienced love and the

[44:47] emptiness she felt. I never forget what

[44:49] she said to me. She was watching

[44:50] somebody kiss on a screen and she goes,

[44:52] "You know, I look at that. I've never

[44:53] understood that."

[44:55] And her dying what was empty.

[44:58] Um

[45:00] and regretful.

[45:01] >> What do you mean? Take me into the

[45:02] nothingness.

[45:03] >> Just that she never She knew she never

[45:05] was loved. She She was denied love,

[45:07] denied love by parents.

[45:09] She was misused by men. So what she knew

[45:12] of love hurt her.

[45:14] And she was aware enough

[45:16] uh to know that.

[45:18] >> And there was no one there when she

[45:19] passed away?

[45:20] >> No.

[45:22] No.

[45:24] It's interesting though.

[45:26] She had one very interesting dream. She

[45:29] had a man who had wanted to marry her,

[45:33] but she had been so taken advantage of

[45:36] that she was doubtful and

[45:39] as soon as he asked her, she moved out

[45:41] of their apartment.

[45:43] And

[45:44] as a way to self-protect.

[45:46] >> Yeah.

[45:46] >> At the end of her life, he came to her

[45:49] and told her

[45:50] that he really did love her.

[45:52] So she was she was shown some version of

[45:57] it that that that was soothing to her.

[45:59] Um that How it.

[46:01] >> A lot of people, because of sort of

[46:03] early traumas are somewhat avoidant of

[46:05] love.

[46:06] >> Mhm.

[46:07] >> You explained that she moved out of the

[46:08] apartment when someone tried to propose

[46:10] to her. I could almost relate to some

[46:11] degree.

[46:12] I remember my early years of my in my

[46:15] early teens,

[46:16] I was extremely avoidant of commitment

[46:19] or relationships or whatever. And I

[46:21] remember this particular person turning

[46:23] around to me after I pursued them for 4

[46:25] years telling me that they would now

[46:26] want to be in a relationship with me and

[46:28] I remember immediately dissuading them.

[46:30] >> After pursuing them for 4 years?

[46:31] >> For 4 years, for sure I think.

[46:32] >> Yeah, but but also a lot of it reads

[46:34] back to our our early models of love and

[46:37] connection and relationships. So,

[46:38] >> Right.

[46:38] >> where we modeled it in a healthy way.

[46:41] >> Right.

[46:41] >> And this kind of brings me to the point

[46:43] around sort of overcoming

[46:46] trauma and wounds. How does the the the

[46:49] process of dying

[46:51] help us confront our earliest traumas or

[46:53] the traumas that have held us back in

[46:54] our lives? Have you seen evidence of

[46:56] that?

[46:56] >> Oh, lots.

[46:58] I'd seen it in this end-of-life process.

[47:00] And again, I think this is the most

[47:02] meaningful, for me personally, the most

[47:04] meaningful ones that I

[47:06] witness. So, I've seen a man who had

[47:09] lost his arm at the age of eight

[47:11] and he was from a an impoverished family

[47:14] and

[47:15] developmentally his whole identity was

[47:17] how was he going to be independent and

[47:20] be able to be a provider, etc.

[47:23] >> [gasps]

[47:23] >> And at the end of his life, he sees

[47:25] himself lying in a bed and everyone who

[47:28] he worked with came by him and told him

[47:30] he was the best worker they had known.

[47:32] A mother whose child was in prison for

[47:35] drug offenses and her her identity as a

[47:39] mother is being questioned. And at the

[47:41] end of her life, her parents come to her

[47:43] and tell her she's loved and she was a

[47:45] good parent.

[47:46] >> In a vision?

[47:47] >> Mhm.

[47:48] >> No No, physically.

[47:49] >> No.

[47:49] >> Okay.

[47:50] >> No, but again, there's something in us

[47:53] that's innate that can heal these kind

[47:56] of broken pieces of us at the end that

[47:59] make us whole. So, a lot of Again, I I I

[48:02] come back to it, the most inspiring

[48:04] people are the people who have been

[48:05] harmed and often from no nothing of

[48:08] their own doing, but that find peace in

[48:11] the end.

[48:12] >> Do you think there is life after death?

[48:15] >> Hm.

[48:16] >> Cuz one train of thought is that, you

[48:18] know, our body's going to the ground or

[48:19] we're cremated and then we become dust

[48:21] and then the trees, you know, we become

[48:22] part of the trees and the bees and the

[48:23] birds,

[48:24] and that's it.

[48:26] >> Yeah, I don't think we go on in a

[48:27] physical form, but I go back to this

[48:30] idea that there's the shared seems to be

[48:32] the shared consciousness that the love

[48:35] that we've experienced at early in life

[48:38] and it's very interesting, it tends to

[48:40] be those who loved us unconditionally

[48:42] and the other ones kind of go by the

[48:43] wayside, they're they're inseparable

[48:47] from us

[48:48] and they become more present to us as

[48:51] we're leaving our physical form.

[48:54] So, it does suggest that there's some

[48:56] sort of collective consciousness that

[48:58] goes on. And back to your survey on the

[49:00] bereaved, the fact that that many people

[49:03] feel that they're accessed

[49:05] by those who have passed is interesting.

[49:08] How do you see that?

[49:09] >> I think the consciousness is a really

[49:11] fascinating thing. You know, I've

[49:12] interviewed lots of people on this

[49:13] subject and

[49:14] I never really thought of consciousness

[49:16] as a thing before.

[49:18] But I've got a couple of hypotheses

[49:19] around what consciousness might be.

[49:23] None of them I can say I necessarily

[49:24] believe, but I remember one in

[49:25] particular, I think it was a physicist

[49:26] telling me

[49:28] that

[49:29] he thinks maybe consciousness is the way

[49:32] that the universe understands itself.

[49:34] And he hypothesized to me that

[49:36] consciousness breaks itself into lots of

[49:38] little pieces, into fish at the bottom

[49:40] of the ocean and then human beings that

[49:42] walk the land and birds that see from

[49:44] the sky,

[49:45] and it's consciousness's way of of

[49:48] learning about itself and understanding

[49:49] itself as it breaks itself into these

[49:50] living organisms. He sends some of them

[49:52] to the bottom of the oceans and some of

[49:53] them to the top of the mountains and

[49:55] they all explore in it. Maybe it

[49:56] explains why humans, but all animals,

[49:58] are so fascinated by novelty. Reason we

[50:00] go on holidays is because we want to

[50:02] have new experiences. We we go and look

[50:04] up in awe at things we've never seen

[50:06] before like mountains and it's

[50:08] interesting, you know, I was telling the

[50:10] story about being in, I think, Gibraltar

[50:11] or Malta or whatever it was and driving

[50:13] down the street after I'd had this

[50:14] conversation with this physicist and and

[50:17] looking at tourists in a completely new

[50:18] light because tourists are stood there

[50:21] for 10 minutes or an hour staring at

[50:23] something they've never seen before. And

[50:25] it's just it's interesting to me that

[50:26] that's part of the the animal experience

[50:29] is this fascination with things we

[50:31] haven't seen. So, maybe this hypothesis

[50:33] that consciousness is

[50:35] this central source that breaks into

[50:37] lots of pieces and goes off into

[50:39] existence to understand itself

[50:41] is a, you know, is a plausible

[50:44] not completely indefensible, but

[50:45] plausible idea. And then maybe when I

[50:47] die, I go I return back to

[50:50] the source of consciousness.

[50:52] >> I like my version better.

[50:53] >> [laughter]

[50:54] >> And you know what's interesting is that

[50:56] you should look at is the work that's

[50:58] done with psychedelics and dying

[51:00] patients.

[51:01] >> Tell me about that.

[51:02] >> Basically, when they give psychedelic

[51:04] drugs, which the indigenous people have

[51:06] been

[51:07] doing for thousands of years

[51:09] they come back structurally altered.

[51:11] First of all, their fear of dying

[51:13] dissipates.

[51:15] And they tend to see themselves as

[51:18] something larger.

[51:19] Immersed within and connected to uh to

[51:22] life at large, but they do they they're

[51:25] at peace

[51:26] in a beautiful way. So, they have this

[51:28] heightened awareness and they come back

[51:30] differently and they die differently.

[51:32] And that's like with this work, they die

[51:34] differently.

[51:36] >> So, back to our board here. What was the

[51:38] 10th thing? What matters most to people

[51:40] at the end of their life?

[51:42] Having finances in order. Hmm,

[51:45] interesting.

[51:46] >> And the last one is resolving conflicts.

[51:49] And that's where I have trouble with the

[51:50] idea of regret. Yeah, because it's not

[51:52] that important to be So if So now invert

[51:55] this. So if you went to people and said,

[51:56] "Do you have conflicts?" They go, "Yeah,

[51:58] I have conflicts." Or "Do you have

[51:59] regrets?" "Yeah, I have them." But when

[52:00] you actually rank order them as

[52:02] priorities, it's not relevant.

[52:05] >> Very interesting.

[52:06] Very, very interesting. It's definitely

[52:07] changed my mind cuz you're right.

[52:09] Because we,

[52:10] you know, we go and talk we talk about

[52:12] regrets at the end of your life and

[52:13] regret generally so often, we end up

[52:15] misunderstanding that to mean that

[52:17] regrets are the most important thing and

[52:19] that you need to live your life in a way

[52:21] where you don't have regrets. But

[52:22] actually, you're saying that having

[52:23] spoken to those that are dying,

[52:25] living their life free from regret seems

[52:27] to be quite low in the priorities of the

[52:30] >> What I think it is is a symptom of our

[52:31] times, right? Which we we become

[52:34] introspective and self-analytical. So if

[52:36] you if you ask these questions,

[52:39] they're going to come up. But in the in

[52:42] the lived experiences, are they actually

[52:44] relevant?

[52:45] >> So,

[52:46] we have these six handwritten cards.

[52:49] >> Um so these are the lessons I've learned

[52:51] from actually caring for dying patients.

[52:53] And probably the one

[52:55] that stands out the most is that love

[52:57] endures after physical loss.

[52:59] >> Love endures after physical loss.

[53:01] >> So the idea that um and this is really

[53:03] what our research bears out, which is

[53:06] that people who have been lost often

[53:09] decades earlier are there for us at the

[53:12] end. And that that part of that dying

[53:14] process is this reunion with and to

[53:17] them.

[53:18] Um so that that survives.

[53:20] >> And on that point, it's probably a good

[53:22] time to touch on the subject of grief

[53:24] Mhm. and how the dying process impacts

[53:26] the grief that those left behind

[53:28] experience.

[53:29] >> Yeah, uh and we've done a lot of work on

[53:32] this. And and a long story short is that

[53:35] how people die um absolutely affects our

[53:38] bereavement.

[53:40] How we witness that changes our our

[53:43] bereavement, and it's measurable. So,

[53:45] people who have had these experiences,

[53:47] who have watched their loved one

[53:49] reconnect, grieve very differently, and

[53:52] it's measurable actually in grief. How

[53:54] they

[53:55] remember, how they recall, how they get

[53:57] through obstacles, how they heal.

[53:59] >> So, if I want to grieve in the most

[54:01] healthy way,

[54:02] what dying experience is most conducive

[54:04] with that?

[54:06] >> Oh, seeing that loved one as rich in

[54:10] love rather than empty and defined by

[54:12] their physical dimensions. And I don't

[54:14] know if it would help you want to show

[54:15] the video of Jennifer.

[54:17] >> Sure.

[54:17] >> This is an interesting video for a

[54:19] couple of reasons, because these

[54:20] end-of-life

[54:22] events are not these great epiphanies or

[54:24] revelations. They're just about very

[54:26] real moments that are symbolic, usually

[54:29] of a relationship.

[54:31] And she's describing her partner,

[54:33] Patrick, who's at the end of his life,

[54:36] and he has these experiences. But, she

[54:37] describes what it means to her.

[54:40] >> Patrick was the only member of his

[54:42] family that knows how to make the sauce.

[54:45] And for all the years I knew him, he

[54:47] insisted something was missing.

[54:51] >> After his grandmother had passed?

[54:52] >> After she had passed. This would be the

[54:54] Sunday before he passed.

[54:57] He woke up in the morning, and I

[55:01] couldn't get him to eat. He wasn't

[55:03] hungry, total loss of appetite.

[55:06] And I'm like, "Baby, we got to make you

[55:08] something for breakfast. What do you

[55:09] want?" He goes, "I'm full."

[55:11] I said,

[55:13] "Pat, you had a snack pack pudding

[55:14] yesterday. You're not full."

[55:17] And he's like, "Oh, no. I ate with with

[55:19] Nana Dolores last night."

[55:21] He believed

[55:23] he made sauce

[55:25] with his grandmother

[55:27] the night before.

[55:29] Said he could smell it. He could still

[55:31] taste it. He was full from it.

[55:34] And she showed him, after all these

[55:36] years, what he had done wrong,

[55:39] which is the very last step before you

[55:41] take it off the burner, was to add

[55:45] a teaspoon of sugar. We spent the next 7

[55:49] and 1/2 hours cuz that's how long it

[55:50] takes

[55:52] making his grandmother's sauce. He added

[55:55] the sugar.

[55:57] Last time Patrick ever ate. Every

[55:59] morning he woke up saying,

[56:02] "Is today the day I'm going to die?"

[56:05] And I said, "Joe, go when you're ready."

[56:08] And he was ready.

[56:10] >> Did that dream help

[56:13] help you accept that reality further?

[56:15] >> Absolutely.

[56:16] >> Yeah.

[56:17] >> Absolutely. And um

[56:19] not only the reality that he is gone,

[56:22] it's made me think of

[56:25] maybe there is something out there after

[56:27] we go.

[56:28] >> So, how she remembers him in death was

[56:32] that he was put back together by being

[56:34] with those he loved.

[56:35] >> So, if I know that one of my relatives

[56:36] is going to pass away, what should I be

[56:39] doing to cuz you know, my first instinct

[56:41] in that scenario is to protect my family

[56:44] from the grief of it, to make sure that

[56:46] the grief process is as healthy as it

[56:49] can possibly be. And I'm not trying to,

[56:50] you know, deny grief in any way cuz I

[56:52] know that it's kind of unavoidable from

[56:53] everything I've read, but

[56:55] is there things we can do as a family to

[56:58] insulate us from having a really

[57:00] negative grieving process?

[57:02] >> Yeah, I think one is obviously

[57:04] communicating and being open with with

[57:07] each other and with what's happening. I

[57:09] think one of the worst outcomes we see

[57:12] and when death is denied. So, if you see

[57:15] it, if it's forecastable and it's

[57:17] obvious and you're proximate to us, it's

[57:20] less of an injury than if it's denied,

[57:22] denied, denied and then

[57:24] >> And then it happens.

[57:25] >> Yes, and we see so much of that in

[57:26] medicine. So, this is a rule for life

[57:28] which is acceptance. Oh gosh, yeah. A

[57:29] third of our patients that come to

[57:31] hospice are dead in 7 days.

[57:33] They didn't just didn't start dying

[57:34] seven days. They became aware of it. So,

[57:37] what we do is we refer this as medical

[57:40] harm. We deny them and separate them and

[57:43] deny their reality. So, they're left to

[57:45] figure it out suddenly and acutely. And

[57:48] that injury is you're robbing people of

[57:51] their agency, their time to spend the

[57:53] way they want, have the conversations

[57:54] they need to have. And the impact to the

[57:57] bereaved is enormous.

[57:58] >> So, acceptance number one. Anything

[58:00] else?

[58:00] >> Yeah, I had presence.

[58:02] >> Presence.

[58:02] >> And it used to be this way. It used to

[58:04] be death was in the home and it was in

[58:06] the community. It was shared. And that

[58:08] shared grief is is wonderful because

[58:11] we're meant to be mutually supportive.

[58:13] The opposite is a sterilized death. So,

[58:16] in an intensive care unit, in a gown,

[58:19] you know,

[58:19] anything that dehumanizes the process of

[58:22] dying is injurious.

[58:24] >> So, acceptance, physical presence.

[58:26] >> Yeah.

[58:27] >> Anything else that helps the grief

[58:28] process?

[58:29] >> Loving each other.

[58:32] Talking, sharing, acknowledging.

[58:36] Anything that's repressive or denying

[58:38] about it, whether it's your own

[58:40] feelings, whether it's what's happening

[58:42] to the patient, is harmful.

[58:45] Period.

[58:46] That's why death in the home is so

[58:48] different.

[58:50] You know, the person's seen as a as a

[58:51] person, not a patient, right?

[58:54] And the patients know us instinctively.

[58:57] That's why they want to get back home.

[59:00] This is your father

[59:01] >> passed away when you were

[59:02] >> Yeah, I was 12.

[59:03] >> You were 12 and he was 41?

[59:05] >> 42, I think.

[59:07] >> He passed away of

[59:08] >> cancer.

[59:09] >> Cancer.

[59:11] In what way was this formative?

[59:14] >> Well, I

[59:16] I think it

[59:17] it shaped life in certain ways that I

[59:20] wouldn't have chosen.

[59:22] Um

[59:23] and that I don't understand.

[59:28] The one thing was that you know, that

[59:30] that sort of loss at that sort of at

[59:33] that point in your life changed the

[59:35] trajectory of your life. You you just

[59:37] you don't just lose the person, you lose

[59:40] the world the way it's supposed to be.

[59:43] And for my for me,

[59:45] my world went off the tracks pretty

[59:48] badly. It was a pretty bumpy road.

[59:51] But you know,

[59:52] and it's so unusual because the last

[59:54] time I saw him,

[59:56] he was having one of these end-of-life

[59:58] experiences.

[1:00:00] I still can't make sense of it all

[1:00:01] because then after he died for many

[1:00:03] years, I could never speak his name. I

[1:00:05] couldn't certainly couldn't talk about

[1:00:07] the last time I saw him.

[1:00:09] So the irony

[1:00:11] that the thing I could never talk talk

[1:00:13] about

[1:00:14] it is the thing that I now share with

[1:00:16] millions of people. I feel like I'm

[1:00:17] getting pumped. Like

[1:00:20] I didn't mean for this to happen.

[1:00:23] And you wonder though, you know, that

[1:00:25] sort of loss does change you, right? It

[1:00:27] it changes what you're sensitive to and

[1:00:29] others, what you see in others,

[1:00:32] what you feel from others, how you want

[1:00:34] to help. Does does grief ever go away?

[1:00:38] Uh, it doesn't.

[1:00:39] >> I think grief uh there's a

[1:00:42] period where grief is unbearable.

[1:00:45] And it's like having this rock in your

[1:00:48] pocket. You know it's there and other

[1:00:49] times you forget it.

[1:00:51] You lose the person in the physical

[1:00:54] form,

[1:00:55] but they still relate to you in other

[1:00:57] ways. It changes how you see the world

[1:01:00] for having known them.

[1:01:02] So they continue on in some way.

[1:01:05] We talk about grief in terms of what we

[1:01:08] lose, but not necessarily what remains.

[1:01:11] And a lot of that person remains.

[1:01:14] And and and and that's remembered. And I

[1:01:18] think

[1:01:19] you grief is probably one of the most

[1:01:21] illuminating things that can happen in

[1:01:24] your life.

[1:01:25] It changes

[1:01:27] your life, the circumstances. I wouldn't

[1:01:29] be talking to you if I hadn't lost my

[1:01:30] father as a boy, for example. Wouldn't

[1:01:33] happen.

[1:01:34] Because a chain of events

[1:01:36] took place.

[1:01:37] >> And you interviewed 750 grieving

[1:01:39] families.

[1:01:40] >> Mhm.

[1:01:42] I think there's a great expression that

[1:01:44] you know, the trick is, the art is, is

[1:01:47] to carry grief in one hand, gratitude in

[1:01:49] the other, and be struck by both. You

[1:01:51] know, you don't deny the grief, but you

[1:01:53] learn how to be grateful. And somewhere

[1:01:56] um there's peace there.

[1:01:59] >> When you interviewed those 750 grieving

[1:02:01] families,

[1:02:02] did you notice

[1:02:04] a difference between those that really

[1:02:07] carried the grief well

[1:02:10] versus those that

[1:02:12] didn't carry it so well?

[1:02:13] >> Yeah, but but we were looking at a very

[1:02:15] specific question. We were looking at

[1:02:17] families who had seen these end-of-life

[1:02:19] experiences.

[1:02:21] And the best example I can give you is

[1:02:24] say you have a couple

[1:02:26] and they've been married for six

[1:02:28] decades.

[1:02:29] And part of their shared life was losing

[1:02:31] a child, an infant.

[1:02:33] And the spouse is looking down at his

[1:02:36] loved one in the bed, the woman in the

[1:02:38] bed.

[1:02:39] And she in in her inner experiences is

[1:02:42] holding this deceased child.

[1:02:45] And she's at peace.

[1:02:47] And

[1:02:49] that that well one connects all lives,

[1:02:52] right? Living and dead, but it reframes

[1:02:56] dying from something that could be empty

[1:02:59] and only defined by its physical

[1:03:01] dimensionality, what you're seeing,

[1:03:03] and it shows that it can be rich in

[1:03:06] meaning and love.

[1:03:07] Because the question always is when you

[1:03:10] care for these families is when that

[1:03:12] patient becomes non-verbal, when you

[1:03:14] become disconnected from them, is the

[1:03:17] question is where are they and how are

[1:03:19] they?

[1:03:20] And if you're seeing that,

[1:03:22] that changes how you experience their

[1:03:25] loss

[1:03:26] and it informs how you grieve.

[1:03:29] You view it very differently.

[1:03:31] >> I've done almost 700 interviews with

[1:03:34] some of the most interesting people in

[1:03:35] the world. And one of the things you

[1:03:36] learn, which is unexpected, is that

[1:03:38] vulnerability is the doorway to

[1:03:40] connection. And after sitting here for 2

[1:03:42] 3 hours with a guest, I feel a deep

[1:03:45] sense of connection to them. And as they

[1:03:46] leave, what I get them to do is to write

[1:03:49] a question in the diary of a CEO. We've

[1:03:52] taken all of the questions from the

[1:03:54] diary of a CEO. We have put the question

[1:03:58] here on this card with the name of the

[1:04:00] person that wrote it. So you can sit at

[1:04:01] home, as I do with my fiance, and my

[1:04:04] colleagues at work, and other people in

[1:04:05] my life, whenever we get a minute, we

[1:04:07] play the diary of a CEO conversation

[1:04:09] cards. And it is incredible what

[1:04:12] happens. These are great if you're in a

[1:04:13] romantic relationship and you want to

[1:04:15] connect your partner more. These are

[1:04:16] also great if you're in a team and you

[1:04:18] want to bond your team together. And I

[1:04:20] have to say they're also great for

[1:04:21] families that want to learn more about

[1:04:22] each other and that need a good excuse

[1:04:25] to spend some time in a digital world in

[1:04:27] the analog environment, connecting

[1:04:29] human-to-human. It is remarkable what

[1:04:32] the right question at the right time can

[1:04:34] do. Go to the diary.com

[1:04:37] and you can get [clears throat] these

[1:04:38] conversation cards right now.

[1:04:41] There should be a button just down below

[1:04:43] here. And if it says subscribe, you're

[1:04:45] already subscribed. If it says

[1:04:46] subscriber, that means you're not yet.

[1:04:49] And if you're not subscribed, please

[1:04:50] could you do us a favor and hit that

[1:04:51] button. It helps to show more than you

[1:04:52] know. And according to the algorithm,

[1:04:54] you're someone that watches our show,

[1:04:56] but you haven't yet hit that button.

[1:04:57] Thank you so much.

[1:04:59] So that was the first point. Love

[1:05:01] endures after physical loss.

[1:05:03] >> Yes.

[1:05:05] >> Number two.

[1:05:08] >> Hope never fades. It changes.

[1:05:12] And it's a very interesting thing.

[1:05:13] >> What does that mean, sir?

[1:05:14] >> Well, when you're diagnosed with

[1:05:16] illness, you hope for cure.

[1:05:20] And then you know, it's unbelievable

[1:05:24] how acceptance comes into play.

[1:05:27] And they kind of get through that, and

[1:05:29] then they hope for other things, but the

[1:05:32] hope doesn't change. It just evolves.

[1:05:35] It It's It's fundamental, and it becomes

[1:05:38] hope I want to be comfortable. Hope I

[1:05:40] want to have time with my family. It

[1:05:42] becomes all those things that they

[1:05:43] become That's all based in hope. So,

[1:05:46] hope didn't go away when they find out

[1:05:48] they're dying. It just changed shape.

[1:05:50] >> They just hope for something else.

[1:05:51] >> And then at the end, it's the most

[1:05:53] beautiful part is it becomes hope for

[1:05:56] others.

[1:05:58] And that's what you hear again and

[1:06:00] again, and it's just this wonderful

[1:06:01] story.

[1:06:02] Somehow we become less selfish. I found

[1:06:06] this when I was when I tried to get the

[1:06:07] study approved. Many says of the The

[1:06:10] university would say, "Oh, you can't You

[1:06:12] know, we want to sterilize the dying.

[1:06:13] They're never going to participate.

[1:06:15] They're dying. Why would they want to

[1:06:16] waste your time with you?" And actually,

[1:06:19] they all did. And they even want to be

[1:06:22] filmed.

[1:06:23] And if you think about it, there's no

[1:06:24] secondary gain. They're never going to

[1:06:26] see It's like the old man that plants

[1:06:28] the trees never going to live under the

[1:06:29] shade, but somebody else does, right?

[1:06:32] And that's what That's what we get from

[1:06:34] that. It mattered that they contributed.

[1:06:37] It mattered that they connected. It

[1:06:39] mattered that they were heard, that

[1:06:41] their words mattered. And that's a form

[1:06:43] of hope.

[1:06:44] So, they've gone from cure when they

[1:06:46] were diagnosed, and they let go of that,

[1:06:49] and then they think about things like

[1:06:50] comfort and having time with family, but

[1:06:53] then at the end, what they always hope

[1:06:55] for is other people.

[1:06:57] >> Maybe that's the essence of us.

[1:06:59] >> Yeah, it's it's a

[1:07:00] It's a better version

[1:07:02] of thinking. I think we live in a

[1:07:04] selfish space.

[1:07:06] I think we're robbed of that when you

[1:07:07] become a parent and whatnot, but I think

[1:07:09] in the end I think it's wonderful that

[1:07:11] hope doesn't extinguish because cure

[1:07:13] has.

[1:07:16] You know.

[1:07:18] The next is people don't stop living

[1:07:21] because they're dying. And when we did

[1:07:23] this study looking at dying analogous to

[1:07:26] post-traumatic growth, the idea that

[1:07:28] that within a negative adverse event

[1:07:31] like war, there's positive things like

[1:07:33] camaraderie. That's what we found with

[1:07:35] this

[1:07:36] is that people were growing and adopting

[1:07:39] and this was measurable and significant

[1:07:41] according to post-traumatic growth

[1:07:42] scales right up until the last days of

[1:07:45] life. And it's paradoxical to the

[1:07:48] physical state. So physically they're

[1:07:50] declining, but psychologically and

[1:07:52] spiritually they're very

[1:07:54] much alive.

[1:07:57] Number four, the dying leave us

[1:07:59] connected.

[1:08:01] This became very important and I wrote

[1:08:03] about this during COVID because so many

[1:08:04] people were removed from their loved

[1:08:06] ones, which was an unbelievable tragedy.

[1:08:09] And what I wrote about was, you know,

[1:08:13] when they're having these inner

[1:08:14] experiences, actually they're immersed

[1:08:15] and very much connected. We don't see

[1:08:18] people have these experiences in

[1:08:20] solitary. We tend to think of

[1:08:22] dying as lonely and a solitary event.

[1:08:26] Yeah. And what happens is in our inner

[1:08:28] world we're bringing people into us.

[1:08:30] We're reflecting on life and in these

[1:08:32] end-of-life dreams and visions we're

[1:08:34] just immersed with people who we love.

[1:08:37] So even though it looks like they may be

[1:08:38] isolated in intensive care unit when

[1:08:40] their eyes are closed, they're also

[1:08:42] surrounded in love. But then externally,

[1:08:45] the dying process brings people

[1:08:47] together.

[1:08:49] Lives stop. You know, that son who has a

[1:08:51] roaring job in California has to fly

[1:08:53] home to New York. It It tends to stop

[1:08:58] the world and we focus on what really

[1:09:00] matters, which is each other. And that's

[1:09:03] very clear.

[1:09:06] The dying can heal when harmed or

[1:09:08] broken.

[1:09:10] And this happens in a multitude of ways.

[1:09:12] Um there's that ex- external peace,

[1:09:15] whether it's making peace with their

[1:09:16] God, making peace with their family.

[1:09:19] It's amazing how many families come

[1:09:21] together.

[1:09:23] And what seemed like an issue of

[1:09:26] contention

[1:09:27] goes away and dissipates. And they're

[1:09:30] able to see beyond that. It reshuffles

[1:09:33] your priorities in ways that you can't

[1:09:35] imagine. The grudge that was held on to

[1:09:38] is let go. So there's this healing

[1:09:40] process that's innate to dying.

[1:09:43] And I think internally what we see again

[1:09:46] and again and again, people who are

[1:09:47] having negative or distressing dreams

[1:09:50] and visions, they're often centered

[1:09:52] around harmful things. Um but they're

[1:09:55] often addressed within that process so

[1:09:58] that somehow, and this is probably the

[1:10:00] most remarkable thing of all. They've

[1:10:01] lived this life with this injury and it

[1:10:05] gets addressed in the end. There's

[1:10:07] almost like this final justice. People

[1:10:09] like Dwayne, you know, who has wrestled

[1:10:11] with these demons his whole life, and

[1:10:14] then at the end he's kind of made whole.

[1:10:19] Lesson number six is there's a better

[1:10:22] story than the one we fear.

[1:10:24] And the best analogy I can give you is

[1:10:27] that famous Dylan Thomas, the famous

[1:10:31] poet. It's a message to his father who

[1:10:34] is who is becoming blind and dying, I

[1:10:36] believe. But he was healthy. And it

[1:10:38] says, you know,

[1:10:40] you basically don't surrender, don't

[1:10:41] fight the dying of the light.

[1:10:44] And most of us in health can relate to

[1:10:46] this idea of the resistance of death,

[1:10:49] you know, that you're going to this is

[1:10:51] the enemy to be fought and you're going

[1:10:53] to muster all your strength and will and

[1:10:55] you're you're to overcome and survive.

[1:10:57] And that's how it happens to the dying.

[1:11:00] The dying aren't fighting against

[1:11:02] anything. If anything, they're fighting

[1:11:05] towards and they're what they're

[1:11:06] fighting towards to get back to those

[1:11:08] that they've loved and they've lost.

[1:11:11] Horace is a great example. So, Horace is

[1:11:13] I believe close to 9 years old and he's

[1:11:16] very near the end of his life.

[1:11:18] And I think what's beautiful about

[1:11:20] Horace

[1:11:21] is that

[1:11:22] his inner world experiences are so

[1:11:25] overwhelming that he actually struggles

[1:11:27] to find language

[1:11:29] for what the beauty that he's

[1:11:30] experiences, the colors that are richer,

[1:11:32] his wife, the relief he feels in seeing

[1:11:36] her. And it really it really highlights

[1:11:38] this notion that they actually aren't

[1:11:40] struggling against anything. If

[1:11:41] anything, Horace wants to go to this

[1:11:44] experience that he's having with his

[1:11:46] eyes closed. So, if we could watch

[1:11:47] Horace, that would be great.

[1:11:49] >> I should look all this beautiful.

[1:11:51] She was even

[1:11:53] feeling pretty. She was

[1:11:58] Mhm.

[1:12:02] She was looking at me inside out.

[1:12:07] Mhm.

[1:12:09] Yeah.

[1:12:11] Mhm.

[1:12:12] And maybe the

[1:12:14] I'm just maybe

[1:12:16] words weren't necessarily

[1:12:19] just looking at each other and

[1:12:21] knew exactly what uh

[1:12:23] I was always

[1:12:25] I was thinking.

[1:12:27] >> And he's describing a vision he's had

[1:12:29] there.

[1:12:29] >> Mhm.

[1:12:30] >> But it's beautiful. And he describes his

[1:12:31] relief like paying a bill. Like it's

[1:12:34] over. And the greens of the grass are

[1:12:36] greener and he's so emoted by it that he

[1:12:39] starts to get very tearful.

[1:12:42] >> How has interviewing these people as

[1:12:44] they're

[1:12:45] leaving this world changed how you live

[1:12:47] your life on a day-to-day, week-to-week,

[1:12:49] month-to-month basis?

[1:12:51] >> Oh.

[1:12:53] I I think a lot. I think cancer

[1:12:56] did more to change how I live on a daily

[1:12:58] basis, probably.

[1:13:00] >> You had stage four?

[1:13:01] >> Mhm.

[1:13:01] >> [clears throat]

[1:13:02] >> Stage four cancer?

[1:13:03] >> Mhm.

[1:13:03] >> Has it changed your perspective of you

[1:13:06] dying yourself?

[1:13:07] >> I can tell you that I'm certainly not

[1:13:09] fearful of the actual process of dying.

[1:13:12] >> Anymore?

[1:13:14] >> No.

[1:13:15] Yeah, I'm not.

[1:13:15] >> Were you before?

[1:13:17] >> Yeah, I think so. Yeah. Yeah. I mean,

[1:13:19] it's innate to us, right? It's why we

[1:13:20] survive. It's we're meant to

[1:13:23] uh resist.

[1:13:24] >> And what in particular has alleviated

[1:13:26] that fear?

[1:13:28] >> Oh, I think seeing so many patients. I

[1:13:30] think having to face it myself, the part

[1:13:34] that possibility

[1:13:35] myself. I had to wrestle that demon.

[1:13:38] >> And where does the comfort come from?

[1:13:40] >> It gets because it becomes less about

[1:13:41] self. It's very interesting. When you

[1:13:44] have a diagnosis like I had, first

[1:13:47] you're confronted with this

[1:13:49] enormous responsibility,

[1:13:51] this reckoning with

[1:13:53] the lives that you're responsible to.

[1:13:56] And you worry about their wounds and how

[1:13:59] they're going to be, particularly if you

[1:14:00] have people who are dependent on you.

[1:14:03] So, I went through that's what you first

[1:14:05] are confronted with. And then it changes

[1:14:08] you in a lot of ways.

[1:14:10] >> What specifically has changed?

[1:14:13] >> I was always um restless. I

[1:14:17] could never sit. But cancer brought that

[1:14:20] to a stop.

[1:14:22] Suddenly.

[1:14:23] And it's a very weird thing because

[1:14:26] there's no period of adaptation. All of

[1:14:28] the sudden, you can't do. You're used to

[1:14:30] going into the world and now the world

[1:14:34] has to

[1:14:35] come to you.

[1:14:36] And it forces you to do what I really

[1:14:40] could never do, which is kind of be more

[1:14:42] more present. I rehabbed basically over

[1:14:46] many, many months

[1:14:47] um on my farm.

[1:14:49] And I would gradually walk a little

[1:14:51] farther down the driveway, then in the

[1:14:53] barn,

[1:14:54] the animals walk in field, then woods.

[1:14:57] And I can't quite describe this, but

[1:15:00] this one day I was there and I'm looking

[1:15:02] at these willow trees that I had planted

[1:15:05] decades earlier.

[1:15:07] And they were the most beautiful things

[1:15:09] I'd ever seen.

[1:15:11] And

[1:15:12] uh you know, the trees hadn't changed.

[1:15:15] I I I changed. Victor Frankl talks about

[1:15:19] this in the book Man's Search for

[1:15:21] Meaning, right?

[1:15:22] >> He was a Holocaust survivor.

[1:15:23] >> Yeah.

[1:15:24] >> Yeah.

[1:15:24] >> And

[1:15:25] somehow he came out of that experience

[1:15:27] and was able to put a lot of definition

[1:15:29] around finding meaning. And he describes

[1:15:32] a day when

[1:15:34] one of the prisoners runs out and says,

[1:15:35] "Look at the sunset." And they all come

[1:15:37] out and they're all admiring it despite

[1:15:39] their despair and destitute. And the one

[1:15:41] says, "Look at what the world could be."

[1:15:44] And the point is is that beauty

[1:15:46] isn't about doing or accomplishing, but

[1:15:49] that's in it's internalized. It's the

[1:15:51] finding meaning in the experience. And I

[1:15:53] never got it, but I got it then when I

[1:15:56] got sick.

[1:15:57] >> And on that point of meaning, which is

[1:15:58] the word on the front of your book here,

[1:16:00] what is the the meaning of life?

[1:16:03] From everything you've experienced and

[1:16:05] all the death, loss, grief you've seen,

[1:16:08] what is the meaning of life?

[1:16:10] >> I don't know about meaning, but I know

[1:16:12] the destination is always love.

[1:16:15] >> [sighs]

[1:16:15] >> And I think that um

[1:16:17] we're meant to get there together.

[1:16:19] And we're meant to endure struggle

[1:16:22] together.

[1:16:23] I think that that's just fundamental. We

[1:16:26] again we're fundamentally interdependent

[1:16:29] and reliant on one another.

[1:16:32] If you think of the best

[1:16:34] parts of yourself, it's always in the

[1:16:36] context of love.

[1:16:39] >> You wrote this wonderful book, Death is

[1:16:40] but a Dream, Finding Hope and meaning at

[1:16:43] life's end.

[1:16:45] Who is this for?

[1:16:47] Hm.

[1:16:48] >> Well, again, it was meant for a medical

[1:16:50] audience, but I think it's anybody who's

[1:16:53] caring for somebody. I think it's

[1:16:54] anybody who's wondering about their own

[1:16:56] mortality. I think what I find a lot of

[1:16:59] people are benefiting is people who have

[1:17:01] witnessed these experiences, but it's

[1:17:03] never been explained.

[1:17:05] And I think it it's nice because it

[1:17:06] includes different types of patients.

[1:17:08] So, it includes patients who are

[1:17:09] cognitively different, includes

[1:17:11] children. In in each one of those is

[1:17:13] very unique.

[1:17:15] >> Dr. Christopher, we have a closing

[1:17:16] tradition on this podcast where the last

[1:17:18] guest leaves a question for the next

[1:17:19] guest, not knowing who they're leaving

[1:17:20] it for.

[1:17:21] The question that has been left for you

[1:17:24] is a question I have to ask. What is one

[1:17:25] thing we haven't talked about that we

[1:17:27] should have talked about?

[1:17:28] >> The children.

[1:17:30] >> Explain.

[1:17:32] >> Children die very differently. I

[1:17:35] think that

[1:17:37] it's not so much lessons, but they're

[1:17:38] certainly inspiration, and I think it

[1:17:41] talks about what's innate in us.

[1:17:43] >> How do children die differently from

[1:17:45] adults?

[1:17:45] >> Oh.

[1:17:47] >> [sighs and gasps]

[1:17:47] >> Well, for one, they don't struggle to

[1:17:50] find acceptance. It's they

[1:17:52] they're already accepting.

[1:17:54] They don't think in terms of finality of

[1:17:56] mortality.

[1:17:57] They just accept the state that is. So,

[1:18:00] they don't talk in terms of regrets and

[1:18:02] what ifs. Children have this amazing

[1:18:04] ability

[1:18:05] to

[1:18:06] take care to make themselves whole, to

[1:18:09] take care of themselves, to reassure

[1:18:10] themselves. So, one of the ways they do

[1:18:13] that is they may not known somebody

[1:18:15] who's died, so who comes back for them.

[1:18:17] And often it's an animal.

[1:18:20] And and children don't have the same

[1:18:22] distinctions, obviously, between the

[1:18:24] human and the animal world. And they

[1:18:26] come with the same message, which is

[1:18:28] that they're loved and that they're not

[1:18:29] alone.

[1:18:31] The other thing that's just fascinating

[1:18:32] is they become very self-informed by

[1:18:35] these inner experiences. By that, I mean

[1:18:38] they end up understanding where they

[1:18:40] are. You don't have to tell them they're

[1:18:42] dying. They seem to put this together in

[1:18:44] remarkable ways.

[1:18:47] And

[1:18:48] far and away

[1:18:49] the most remarkable thing about children

[1:18:53] is that have this quiet courage and how

[1:18:56] they care

[1:18:58] for those around them. So they become so

[1:19:01] utterly selfless. It's almost hard to

[1:19:03] describe. There's a young lady who was

[1:19:06] taking her pain medicine. She didn't

[1:19:09] want to take her pain medicine because

[1:19:11] she was enjoying being awake and plugged

[1:19:13] in.

[1:19:14] But she she was sensitive to what other

[1:19:17] people were observing and she didn't

[1:19:19] want her mother to see her grimace.

[1:19:21] Another one who was from Syria. She knew

[1:19:24] she was dying. Her parents couldn't talk

[1:19:26] to her about it, but she had already

[1:19:27] gone ahead on Facebook and said goodbye

[1:19:30] and given life lessons.

[1:19:32] >> Do they have the same visions and

[1:19:33] dreams?

[1:19:33] >> Oh yeah, they do it better.

[1:19:35] Um and we could show that with Jessica.

[1:19:39] >> So tell me about Jessica.

[1:19:40] >> Jessica's 13 years old and she's raised

[1:19:43] by a single mother.

[1:19:45] And

[1:19:46] she sees this deceased friend of her

[1:19:48] mother's playing with her curtains.

[1:19:50] >> Mhm.

[1:19:51] >> [clears throat]

[1:19:51] >> And she doesn't want to tell her mom

[1:19:53] because they didn't want to scare her,

[1:19:55] but it made her feel good because she

[1:19:57] was a good person and again she's not

[1:19:59] going to be alone. So they tend to look

[1:20:01] after, despite being children

[1:20:04] and being robbed of life, they somehow

[1:20:07] tend to worry about others and try to

[1:20:08] protect others and that's what she does.

[1:20:11] >> I had a feeling that she was just coming

[1:20:13] and telling me that you're going to be

[1:20:15] okay. Everything's fine, but she didn't

[1:20:18] look at me.

[1:20:19] She was just looking, but I had a

[1:20:21] feeling if I called out her name, she

[1:20:24] would look at me, but I didn't want to

[1:20:26] scare my mom. I felt a sign of relief.

[1:20:29] >> Yeah.

[1:20:31] >> And happiness because

[1:20:34] she was a very strong person and I know

[1:20:37] that I'm strong and my mom tells me all

[1:20:39] the time that I was I'm like her.

[1:20:43] >> Wow.

[1:20:44] >> And you told me that you thought that oh

[1:20:46] mom I saw an angel.

[1:20:47] >> That's how you said you felt and you

[1:20:49] said felt peace and then you were able

[1:20:51] to go to sleep.

[1:20:52] >> And then I was able to go to sleep.

[1:20:54] >> So it was really comforting.

[1:20:55] >> It was comforting, yeah.

[1:20:57] >> You weren't afraid?

[1:20:58] >> I wasn't afraid of it at all.

[1:21:00] >> So children have this way of of

[1:21:04] self-healing that's remarkable. We have

[1:21:06] another children child on video who she

[1:21:08] creates this castle

[1:21:10] and she can feel the warmth of light

[1:21:12] coming through the window and all the

[1:21:14] animals are well and playing and when

[1:21:16] asked what the castle meant she said it

[1:21:18] meant that there's a safe place.

[1:21:24] >> Dr. Christopher Kerr

[1:21:26] what a wonderful reminder of what

[1:21:27] actually matters.

[1:21:29] >> Good.

[1:21:30] >> And also when we [clears throat] think

[1:21:32] about how many of us ourselves fear

[1:21:35] our own death it's quite quite high.

[1:21:37] It's about half half of people, men and

[1:21:39] women, fear their own death.

[1:21:41] But actually I think through your

[1:21:42] research, through the book that you've

[1:21:43] written, and through the studies that I

[1:21:45] have here in front of me, it's certainly

[1:21:46] made me think a lot less about the fear

[1:21:48] of my own death cuz you're right people

[1:21:49] think of it as being this sort of

[1:21:50] painful, prolonged process.

[1:21:52] [clears throat]

[1:21:53] But that's not what you report.

[1:21:54] >> No, and actually we've looked at that

[1:21:55] and what they actually fear is isolation

[1:21:59] >> Yeah.

[1:22:00] >> and being disconnected.

[1:22:01] >> And

[1:22:03] more so than fearing our own death we

[1:22:04] fear losing someone else.

[1:22:06] >> Right. I haven't ever come with the

[1:22:08] right way to frame it but all of this

[1:22:10] comes back to this better idea that the

[1:22:12] concern is for others than self more

[1:22:14] than self.

[1:22:15] >> And that's a beautiful thing.

[1:22:16] >> Yeah.

[1:22:17] >> Death is but a dream, finding hope and

[1:22:19] meaning at life's end by Dr. Christopher

[1:22:21] Kerr. I'll link this book below for

[1:22:23] anyone that would like to read it and

[1:22:24] dive deeper into these subjects. They

[1:22:25] are

[1:22:26] illuminating subjects. Again because

[1:22:28] people in those moments of their life

[1:22:30] have such a wonderful retrospective

[1:22:31] clarity. But maybe it's just clarity.

[1:22:34] Yeah, maybe it's just clarity on what

[1:22:36] actually mattered the whole time, as you

[1:22:37] say. Thank you so much for doing this

[1:22:39] work because again it's destigmatized a

[1:22:40] bunch of

[1:22:42] prevailing myths and ideas about the

[1:22:44] last stages of our life that probably

[1:22:45] cause us undue harm

[1:22:47] both to those that are left behind but

[1:22:49] also to those that pass on and

[1:22:53] it does it raises more questions about

[1:22:54] the nature of consciousness and

[1:22:57] spirituality and religion and the

[1:22:59] afterlife and all these things which

[1:23:01] I guess are

[1:23:05] are individual questions to answer.

[1:23:07] >> [clears throat]

[1:23:07] >> Thank you. Thank you.

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Christopher Kerr says nearly 90 percent of the patients he has interviewed report intense dreams or visions as death approaches, and the figures in them are usually people who loved them unconditionally. He describes these experiences as unlike anything the patients have had before, and rates the realism as a 10 out of 10 in patients' own assessments.
Kerr says his research rules out confusion states before counting an experience as meaningful, and he states that these visions do not resemble delirium. He admits his own view has shifted from seeing them as rekindled memories toward thinking there may be a continued consciousness at work, while still treating the question as open.
According to Kerr, the big myth is that pain is expected at the end of life. In his experience, dying is less painful than people think, and he argues the lack of honest conversation about this is a major source of fear.
Kerr says regret is rarely the dominant theme for dying people. He describes their focus shifting to relationships and to not being a burden on family, and says the best version of a person is defined by roles like son, brother or friend rather than by achievements.
Kerr uses the phrase to describe how a dying person's sleep architecture and sleep cycles change over time. As that happens, people drift more into inner experiences, which he links to the dreams and visions that become more frequent in the final week or two of life.
The episode's summary says terminal patients frequently experience profound psychological transformation and resolve deep-seated childhood trauma in their final days. Kerr's research includes studies of post-traumatic growth, which examine whether the negative experience of dying produced any positive gain.

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