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We've interviewed 1,500 people as they're about to die.

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And what our research has shown is 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.

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And what's fascinating is these events don't resemble delirium.

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When we ask them to scale it zero to 10 on the degree of realism, it's always a 10.

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So it feels like this actually happened.

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Tell me about those people.

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Would it help to see a video?

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So after doing this for 30 years, what I've come to understand is we've lost our way with dying.

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There's such a lack of information and that void is overwhelmingly filled with fear and mistruths, compounded by the fact that doctors don't have these discussions.

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Can you list them for me?

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First, I don't see people bringing up regret towards the end of their life.

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They're not thinking about, do they regret something?

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No!

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Hell no.

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No, it's gone.

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Death is this unbelievably truthful place.

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You're stripped to the bare bones of who you are.

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And if you think of the best version of yourself, it was never achieving something.

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It was being a son.

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It was being a brother.

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It was being a friend.

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And then the big myths are that pain is expected, and that's actually not true.

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It's less painful than people think.

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Oh, gosh, by a mile.

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But it's damning how little conversations there are to address that issue.

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And then the next, this is one that fascinates me.

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You're going to see why.

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And also, we have these six handwritten cards of lessons you've learned from caring for the dying.

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We'll go into the full list, but from everything you've experienced, do you think there is life after death?

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This is probably the most remarkable thing of all.

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So I think...

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Guys, I've got a favour to ask before this episode begins.

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The algorithm, if you follow a show, will deliver you the best episodes from that show very prominently in your feed.

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But also, it's the simple, easy, free thing that you can do to help us make the show better.

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And I would be hugely grateful if you could take a minute on the app you're listening to this on right now and hit that follow button.

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Thank you so, so, so much.

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Dr. Christopher Kerr.

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You spend three decades of your life experiencing something that most of us probably spend our lives trying to avoid.

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What is it you've done for the last three decades?

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I was trying to avoid it too, but more by accident I ended up becoming a hospice doctor.

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What does that mean?

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A hospice doctor cares for that individual who is no longer deemed treatable.

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So you've spent 30 years caring for people that are going to die shortly?

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Yes.

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And you started interviewing them?

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Mm-hmm.

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Probably 1,500 at this point.

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Why did you start interviewing people that were about to die?

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Because their perspectives matter.

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I arrived at hospice completely unprepared to be a doctor of the dying medical school, prepared really to defeat death, not to care for those who are dying.

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But my colleagues, particularly in nursing, were much more attuned to what the actual patient was experiencing.

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what I've come to understand is what the patient perspective is the one that matters.

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And that when you start to see patients as people, you start to understand that they have these rich emotional and personal lives, and that's what matters at the end of life.

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How much research have you done?

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Because I've got, I think, 15 research papers here that you've published.

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Yeah, we've done a lot.

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And we do very important things.

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So we rule out confusion states.

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We've done studies on post-traumatic growth to see whether within these negative experience of dying, was there actually positive gain.

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We've looked at the effect on children.

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When children die.

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And we've looked at the effect of these things on bereavement.

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You know, those left behind, how did that influence their bereavement?

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And you've also done a lot of research on the visions people see as they're dying, and the dreams they have in the days leading up to their dying.

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Yes, that's the focus.

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The vast majority of people, nearly 90% of people, start to have very intense dreams or visions.

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And the overriding theme is that they're seeing people who they've loved and who they've lost.

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And very specifically, it's those that have loved them unconditionally, purely.

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And those that didn't aren't there.

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Dying is progressive sleep.

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Your sleep architecture changes.

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Your sleep cycle changes.

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And ever more you start to have these kind of inner experiences.

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It makes sense, right, that as you're dying, you're going to be reflective.

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You're going to be introspective.

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And they usually become more prevalent towards the last kind of week or two of life.

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And what was very interesting in the frequency of these events increases as people approach death.

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So it's all been an attempt to really humanize the dying process.

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So take it from a medical model, which looks at organ failure and management of disease.

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And instead, let's look instead what the patient's actually experiencing towards the end of their life.

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And what's fascinating is when you measure what themes bring them the most comfort, it's seeing the deceased.

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So if I'm passing away, the thing that brings me the most comfort is seeing my deceased relatives.

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Yes.

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And I've got a graph here which shows the dreams of the dead that were most comforting.

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I'll throw that up on the screen.

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Yeah.

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Yes.

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We measured on a scale what brought them the most comfort.

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And you can see it goes up between the living and seeing the dead.

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Would it help to see a video?

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Yeah.

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What happened was we videoed patients early because we knew that our audience, particularly medical audience, would have a view of what a dying patient was, that they were either compromised or feeble-minded.

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And so it became very important to capture them on film.

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So this is Paul.

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This is actually three weeks before his death.

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And he kind of covers all the bases.

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So very vivid, these dreams.

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Very little is said between the dreamer and the person in the dream.

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What you'll notice in all these videos, which is striking, is the absolute absence of fear.

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So these dreams never deny the fact that they're dying.

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They almost transcend it.

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And they really sometimes have trouble to find language for what they're seeing, but they know how they're left felt, which is they're kind of put back together.

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I've probably had 15 dreams about her, maybe, somewhere in there.

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She always wears, I dream of color most times, and she always wears a beautiful light blue.

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It could be a suit, it could be a gown, it could be a dress, but it's always light blue.

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And a couple of times she's given me the little beauty pageant wave, and a couple of times she's always with a smile.

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Only one or twice I've ever heard her voice, but...

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She always kind of lets me know that she's fine.

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So in the lead up to his death, he's having, what, 15 dreams about his deceased wife?

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Yes.

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What do you make of that?

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Like, what does that mean?

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Yeah, honestly, my view of this is changing.

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I would have told you before when I started doing it, this was a rekindled memory.

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So it was just a memory.

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Yeah, it was like looking at a picture.

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Yeah, right, and recalling the imagery.

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There's a couple of features that stand out that suggest there's a lot more than that, that there's almost this continued consciousness.

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And one is the detail that's rekindled is remarkable.

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Yeah.

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95-year-old man, he lost his mother when he's five, and he talks about smelling her perfume and hearing her voice.

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The other is that often these interactions, and you're going to see this in other videos, there's communication.

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So they're not in still form.

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Again, not like looking at a picture.

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Do you believe his wife is still truly accessible or...

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Or are you saying that the memory of her is accessible through his dreams?

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Because they're very different propositions.

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I don't know what this means.

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I don't know if this, I wouldn't be so bold as to say this speaks to an afterlife.

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What I am more convinced of is that those who have loved us are never gone.

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They're accessible to us.

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And what is fascinating to me is that

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At the end of life, when people are neurologically compromised, they're fading, they can't move, the remnant of function is still this core sense of being connected and loved.

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And that remains.

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It's like we enter the world and leave the world with remarkable symmetry.

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You know, you come into the world and the infant doesn't know language, undeveloped brain, but it knows its mother's love.

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It knows it feels connected and secured.

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And at the very end of life, it's kind of the same thing.

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They're diminished.

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They're less capable.

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But what they're feeling and sensing, even without language, is the same thing.

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Was there one particular video you got with a patient that was approaching their death that was most persuasive to you as it relates to believing that consciousness continues or that our loved ones aren't really ever gone before?

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they are able to be summoned back into this world.

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Definitely the ones where people have injury or harm for having lived, and they've struggled with that, often for decades.

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And no matter how much therapy, talk therapy, medication, they've never found peace, and they find it in the end in these experiences.

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So an old veteran who suffers with survival, death, and PTSD, in the last days of life, he's brought back to those who died overseas, and he's comforting.

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And I think some of the most remarkable ones, of course, are the children who do this so differently.

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But just the fact that there's so much innate ability within us to heal these harmed and broken pieces, and for children who do this in ways that are absolutely inspiring.

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You know, they're often not dramatic.

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They're very, there's no great epiphany, no great reveal.

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These are moments of just having lived and mattered.

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They're sitting around a kitchen table.

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If you want, we can show Florence, and she's an example.

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She's lost her husband and she's lost her daughter.

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And this is five days before her passing.

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Tell us about the dreams.

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Yeah.

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But the other night, I fell right into a sleep.

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We were, like, sitting at the kitchen table, laughing.

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I could see their faces.

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I could tell it in full of clothes.

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We were laughing.

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We were talking.

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We were eating.

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It made me feel like that whole 12 years had never existed.

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Because it was so real that he was there in the present.

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And seven years since my daughter was back.

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It was like we were always together, never separated.

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Yeah.

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How does it make you feel about the prospect of dying?

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How does it change with you?

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I'm not afraid.

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When you see something like that, people might say, you know, because they are aware that they're going to pass away at some point, they've been given that diagnosis, that prognosis,

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presumably yeah the end of their life their family these are the things that would be on their mind and if they're on their mind they'd be in their dreams so is it is it the process of death that's provoking these kind of dreams or visions or is it just the case that you know you dream about what you think about and obviously these people are thinking about the end of their lives

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Yeah, the only rebuttal to that is when you ask them these sorts of questions, the thing that gets the most distressed is when you refer to them as dreams because these are unlike anything they've ever experienced.

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So they're not dreams in the sense they're not metaphorical, they're not fantastical, they don't require interpretation.

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I've never had a patient say, hey, what do you think this means?

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they're given the sense of knowing.

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And they'll often say, I don't normally dream, or I don't recall my dream, or no, this was virtual, this was a happening.

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So they have no doubt.

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When we ask them to scale it, zero to 10, on the degree of realism, it's always a 10.

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So it feels like this actually happened.

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And those of them who are having these experiences in the wake state, you can watch them.

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They're looking right through.

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They're looking at the room.

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They're petting the dog that isn't there.

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Oh, so some of them have these visions.

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50% occurring when they're awake.

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Yeah.

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even if it's quite some time before they pass away?

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No, it's usually measurable within weeks, a couple of weeks.

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And it picks up as you get closer to death.

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And when it gets closer to death, how do these visions change or evolve?

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Become more immersive.

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So again, dying is progressive sleep.

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So they're living more in this other state where they're deeper and deeper sleep.

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So they spend more time there.

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And they'll often wake up, it's interesting, and wish they were going back into that other state.

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Oftentimes, they're just warmed by reunion of what they were experiencing.

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And time and distance go away.

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So their decades have moved, and they're recalling very vivid memories of a dog they lost in childhood, for example.

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So do you think this is a biological, physiological thing in their brain, a bunch of chemicals that are sloshing around, or do you think it is spiritual?

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I'm also a PhD in neurobiology.

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I spent five, six years studying the brain.

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So I'm drawn to that.

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No one knows.

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And I'm good with that.

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I think you could, you point parts of the brain here and say, you know, love lives in certain areas, certain neurotransmitters, you know, are correlated with happiness.

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You can take all the pieces and you can't make the whole.

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I can't show you where love is.

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I can't recreate love in a dish, and I can't create this.

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I think it really goes beyond brain function into something else.

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So you think it is spiritual?

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I do, very much, yeah.

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Do you believe there is a soul?

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Yes.

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And so you would posit, I guess, that lives beyond the physiology of the human body and brain?

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Yes.

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Half of Americans say a dead relative has visited them.

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Mm-hmm.

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And the answer here that has that 53% of votes is, have you ever felt a dead family member visit you in a dream or in any other form?

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And 53% of people say they have.

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34% say in the past year, they felt the presence of a dead family member.

226
00:15:11.900 --> 00:15:16.882
And 28% say in the past year, they've told dead family members about events in their life.

227
00:15:17.762 --> 00:15:18.983
Yeah, we remain connected.

228
00:15:19.636 --> 00:15:23.359
15% say in the past year they've had a dead family member communicate with them.

229
00:15:24.260 --> 00:15:32.666
All the data has always suggested that, at least in this country, there's a higher degree of spiritual orientation than you would expect.

230
00:15:33.246 --> 00:15:34.587
But that's always been the case.

231
00:15:35.468 --> 00:15:40.272
When people are in their last days, do they become more religious and more spiritual?

232
00:15:40.392 --> 00:15:40.572
Yes.

233
00:15:41.044 --> 00:15:44.685
We know it because of what they focus on.

234
00:15:45.125 --> 00:15:50.126
They tend to think about these big things, and again, they tend to be about relationships.

235
00:15:50.246 --> 00:15:51.847
They ask these better questions.

236
00:15:52.187 --> 00:16:01.789
We've looked at this question of religion, and we have not found that having a religious belief changes how you experience these end-of-life events.

237
00:16:02.549 --> 00:16:03.850
It just doesn't seem to matter.

238
00:16:04.270 --> 00:16:06.811
And most dying patients report end-of-life dreams and visions.

239
00:16:07.051 --> 00:16:12.654
The stats here show that 80% of healthcare professionals have witnessed or been told of one.

240
00:16:14.075 --> 00:16:17.617
I didn't realize it was so many people that are having these end-of-life dreams and visions.

241
00:16:17.637 --> 00:16:18.337
I didn't realize it was 80%.

242
00:16:19.972 --> 00:16:24.135
And, you know, again, people might think this is because of delirium, because of their illness.

243
00:16:24.735 --> 00:16:25.856
No, it's a good question.

244
00:16:25.956 --> 00:16:30.659
And that's what our studies did that was smart, is we sorted out the patients who are delirious.

245
00:16:31.539 --> 00:16:34.101
So we screened them every day before they did a questionnaire.

246
00:16:34.121 --> 00:16:36.902
Again, these are approved by a university, so you have to be a witness.

247
00:16:36.942 --> 00:16:37.863
You have to have consent.

248
00:16:38.183 --> 00:16:39.644
You have to be cognitively intact.

249
00:16:40.024 --> 00:16:44.047
So before they did our questionnaire, every day they had to get a screen for delirium.

250
00:16:44.747 --> 00:16:47.309
And these events don't resemble delirium.

251
00:16:47.849 --> 00:16:49.569
Delirium is very disorganized.

252
00:16:49.869 --> 00:16:53.590
And the biggest difference is most people are left frightened or distressed by delirium.

253
00:16:54.270 --> 00:16:56.071
These events are recalled with acuity.

254
00:16:56.511 --> 00:16:58.251
They're based on real happenings.

255
00:16:58.731 --> 00:17:01.512
And they're left with a feeling of comfort, not distress or fear.

256
00:17:02.012 --> 00:17:02.552
Acuity.

257
00:17:02.992 --> 00:17:03.352
Acuity.

258
00:17:03.372 --> 00:17:04.212
There's sharpness.

259
00:17:04.692 --> 00:17:12.874
What are the other sort of fundamental misunderstandings people have about death that you've spent your career trying to confront and reverse death?

260
00:17:13.906 --> 00:17:14.486
Oh, there are many.

261
00:17:15.047 --> 00:17:16.087
Dying is a process.

262
00:17:16.127 --> 00:17:16.867
Death is a moment.

263
00:17:17.328 --> 00:17:19.148
It changes over time.

264
00:17:19.509 --> 00:17:24.591
The big myths are that pain is expected or anticipated, and that's actually not true.

265
00:17:24.831 --> 00:17:28.072
Pain isn't, and the pain that is there can be resolved.

266
00:17:28.613 --> 00:17:33.415
The other misconceptions around eating and drinking, people stop eating and drinking.

267
00:17:33.495 --> 00:17:34.395
It doesn't hurt.

268
00:17:34.795 --> 00:17:37.497
They're not eating and drinking because they're dying.

269
00:17:37.977 --> 00:17:42.819
Something happens in nature that we don't die and want, so it just kind of dwindles.

270
00:17:43.419 --> 00:17:46.462
And dying is really like a dimming of the shades.

271
00:17:46.522 --> 00:17:47.142
It's gradual.

272
00:17:47.502 --> 00:17:50.805
You start to lose function, do less.

273
00:17:51.205 --> 00:17:53.127
If you have the flu, you know to go to bed.

274
00:17:53.147 --> 00:17:54.808
It just doesn't pay to do.

275
00:17:55.389 --> 00:17:56.570
Sleep is preferred.

276
00:17:57.210 --> 00:17:58.691
And most people die in sleep.

277
00:17:59.272 --> 00:18:02.975
The key is to die, you have to be able to sleep well.

278
00:18:02.995 --> 00:18:04.816
But to sleep well, you have to be comfortable.

279
00:18:04.836 --> 00:18:05.617
And...

280
00:18:05.717 --> 00:18:10.338
And what people tend to think is to be comfortable means you need to be physically comfortable.

281
00:18:10.718 --> 00:18:14.459
But you also need to be psychologically at peace, existentially at peace.

282
00:18:15.179 --> 00:18:19.761
So the holy grail for us, the vital sign that matters for us is comfortable sleep.

283
00:18:20.181 --> 00:18:24.542
Because you can't sleep if you're in discomfort and you can't die if you can't sleep.

284
00:18:25.178 --> 00:18:33.903
There's that famous study by Bronnie Ware, who I think was a palliative nurse in Australia, who interviewed people on their last days and asked them about their regrets.

285
00:18:34.803 --> 00:18:37.204
Have you ever done any research like that to understand?

286
00:18:37.224 --> 00:18:38.945
No, and I really have trouble with the study.

287
00:18:39.186 --> 00:18:39.406
Really?

288
00:18:39.586 --> 00:18:39.746
Yeah.

289
00:18:40.106 --> 00:18:41.507
First of all, it wasn't empiric, right?

290
00:18:41.607 --> 00:18:44.108
It was based off of conversations.

291
00:18:44.909 --> 00:18:47.110
And that's not my experience.

292
00:18:47.470 --> 00:18:50.812
I don't see people bringing up regret towards the end of their life.

293
00:18:51.212 --> 00:18:52.773
Now, if you ask people...

294
00:18:53.750 --> 00:18:56.431
What, if they had regrets, I'm sure they would give you an answer.

295
00:18:57.151 --> 00:18:59.411
It's like if I asked you, what's your favorite color?

296
00:18:59.431 --> 00:19:00.251
You have an answer.

297
00:19:00.771 --> 00:19:04.332
But you don't go around thinking, oh, this is my favorite color.

298
00:19:04.732 --> 00:19:04.932
Sure.

299
00:19:05.032 --> 00:19:10.434
So regrets, and this shows in our quantifiable study, don't come to the surface, actually.

300
00:19:11.214 --> 00:19:12.934
A lot of that gets let go of.

301
00:19:13.194 --> 00:19:17.035
I can honestly say I've done this for nearly 30 years, and that's not what I hear.

302
00:19:18.236 --> 00:19:22.558
So let's take a look at this, because I think this is quite important.

303
00:19:23.298 --> 00:19:30.001
And I, funnily enough, had this conversation with my fiancé yesterday when we were talking about what actually matters in life.

304
00:19:30.661 --> 00:19:39.545
So here, we have 11 things that medical students say they think will matter to a dying patient at the end of their life.

305
00:19:40.445 --> 00:19:50.271
And then you're going to tell me what actually mattered when you did an empirical peer-reviewed study and asking patients with days to live what actually mattered to them.

306
00:19:50.651 --> 00:19:52.913
Well, the first one the hospice patient cares about.

307
00:19:54.439 --> 00:19:55.360
is not being a burden.

308
00:19:56.100 --> 00:19:57.041
They become selfless.

309
00:19:57.861 --> 00:19:59.522
They don't want to tax their family.

310
00:19:59.682 --> 00:20:02.164
They don't want their illness to compromise their life.

311
00:20:02.864 --> 00:20:08.487
They want to spend time with them, but they don't want to interfere with their living.

312
00:20:08.907 --> 00:20:16.072
You would think as people are close, nearing the end of their life, they would become more and more self-focused, and they become other-focused.

313
00:20:16.832 --> 00:20:21.453
And what's really interesting is actually this aligns well with that science of happiness work, right?

314
00:20:21.533 --> 00:20:26.734
Which says that the happier people derive meaning from doing for others rather than doing for self.

315
00:20:27.595 --> 00:20:30.175
These better features kind of come to life at the end.

316
00:20:30.635 --> 00:20:41.838
If I've got a relative who's passing away, if this is the thing they care about most, not being a burden, is there something I can do as the loved one or the relative to ease this concern for them?

317
00:20:42.870 --> 00:20:49.696
Oh, I think it's aligning your wishes with their hope, which is your wish is you actually want to be a presence.

318
00:20:50.116 --> 00:20:51.878
And letting them know that you're not a burden.

319
00:20:51.898 --> 00:20:52.658
Yeah, yeah.

320
00:20:52.758 --> 00:20:53.359
They're not a burden.

321
00:20:53.519 --> 00:20:53.739
Okay.

322
00:20:53.979 --> 00:20:54.420
Number two?

323
00:20:56.221 --> 00:20:56.802
They want time.

324
00:20:57.366 --> 00:20:59.608
Okay, so they want to be around their friends and family.

325
00:20:59.688 --> 00:20:59.848
Yeah.

326
00:20:59.928 --> 00:21:00.709
That's what they care about.

327
00:21:00.769 --> 00:21:04.031
Again, fundamental here is just relationships, right?

328
00:21:04.311 --> 00:21:05.232
That's what it's about.

329
00:21:06.012 --> 00:21:07.734
And the medical students thought it would be...

330
00:21:08.274 --> 00:21:09.635
Feeling that life was meaningful.

331
00:21:10.156 --> 00:21:10.716
Again, this...

332
00:21:10.736 --> 00:21:11.617
I think this is wonderful.

333
00:21:11.637 --> 00:21:13.238
This is one that fascinates me, the boys.

334
00:21:13.338 --> 00:21:21.744
So you're in your 20s, and you're on this journey of development, and that you've had this impact of some sort.

335
00:21:22.785 --> 00:21:23.686
That door's shut.

336
00:21:24.586 --> 00:21:29.547
And they're not living in the rear view mirror, and they're not wondering whether they have meaning or not.

337
00:21:29.967 --> 00:21:34.848
This is very relevant, because me and my fiancée were in a car the other day, and it was yesterday, and we were talking about this.

338
00:21:34.908 --> 00:21:36.788
And she turned to me and said, like, what's your why?

339
00:21:37.748 --> 00:21:52.671
And having sat here on this podcast with a guest a couple of weeks ago who asked me to close my eyes and imagined it was the last day of my life, the only thing that mattered in that moment was who was around my bed and what they thought of me, and were they safe and secure?

340
00:21:53.091 --> 00:21:53.291
Mm-hmm.

341
00:21:53.991 --> 00:22:00.973
And it didn't dawn on me in that moment where I visualized being on my deathbed, my legacy or the impact I'd had or the achievements I'd accomplished.

342
00:22:01.453 --> 00:22:04.713
It's made me really reconsider what my why is.

343
00:22:04.733 --> 00:22:11.175
Because really, from the last moments of my life, what I'm concerned about is who stood there and what they think of me.

344
00:22:12.095 --> 00:22:16.056
And when I say what they think of me, it's like, do my kids think dad was a good man?

345
00:22:16.216 --> 00:22:21.237
And did he leave us with lessons and principles so we can live a good life too?

346
00:22:21.257 --> 00:22:21.357
Yeah.

347
00:22:22.257 --> 00:22:23.578
That seems to be most important.

348
00:22:23.658 --> 00:22:28.422
So it was just interesting because we go through life and we read Instagram and LinkedIn and it tells us like, what's your why?

349
00:22:28.462 --> 00:22:29.162
What's your legacy?

350
00:22:29.182 --> 00:22:30.363
What impact you want to have on the world?

351
00:22:30.383 --> 00:22:31.024
What's your purpose?

352
00:22:31.044 --> 00:22:31.744
What's your passion?

353
00:22:32.145 --> 00:22:33.846
And these are all things that are very self-focused.

354
00:22:34.467 --> 00:22:39.030
But actually it appears to me, as you've described, that actually in those moments, it's about others.

355
00:22:39.571 --> 00:22:42.113
Yeah, I mean, and there's good work on this, right?

356
00:22:42.613 --> 00:22:46.996
The brain's ability to predict what makes us happy is horribly wrong.

357
00:22:47.757 --> 00:22:50.259
What we predict makes us happy is never sustainable.

358
00:22:51.907 --> 00:22:52.707
Right.

359
00:22:52.727 --> 00:22:56.069
And what's important is to kind of de-want what matters.

360
00:22:56.529 --> 00:22:57.529
De-want what matters?

361
00:22:57.549 --> 00:22:58.990
Yeah, because- What does that mean?

362
00:22:59.070 --> 00:23:03.092
Well, we're on this treadmill of things that we think are going to make us happy.

363
00:23:03.372 --> 00:23:04.152
Job promotion.

364
00:23:04.452 --> 00:23:04.932
Yeah, yeah.

365
00:23:05.072 --> 00:23:05.352
Car.

366
00:23:05.433 --> 00:23:07.273
And they're not sustainable things.

367
00:23:07.393 --> 00:23:10.014
And that's proven over and over and over and over again.

368
00:23:10.415 --> 00:23:18.498
Belonging, connection, meaning, those are the things that, I mean, we're fundamentally meant to belong to one another.

369
00:23:18.518 --> 00:23:18.918
Right.

370
00:23:19.018 --> 00:23:24.161
If you think of the best version of yourself, it was never achieving something.

371
00:23:24.221 --> 00:23:25.161
It was being a son.

372
00:23:25.222 --> 00:23:26.042
It was being a brother.

373
00:23:26.062 --> 00:23:26.802
It was being a friend.

374
00:23:26.842 --> 00:23:30.144
It was being a fiancé or boyfriend, whatever.

375
00:23:30.304 --> 00:23:33.946
It's those things that make us important.

376
00:23:34.567 --> 00:23:40.190
And ultimately, what you find out of this research is the enormous value of interdependency.

377
00:23:41.838 --> 00:23:48.024
And that's the whole deal, whether it's in the physical world, the natural world, the ecosystems.

378
00:23:48.544 --> 00:23:56.931
But as humans, we're meant to be interdependent, and that's most clear in moments of vulnerability.

379
00:23:57.792 --> 00:24:00.755
So you pose yourself the question, kind of last day stuff.

380
00:24:01.135 --> 00:24:02.276
You're immediately vulnerable.

381
00:24:02.557 --> 00:24:03.237
Yeah.

382
00:24:03.378 --> 00:24:03.658
Right?

383
00:24:03.958 --> 00:24:07.702
And what you did is you pulled in all these other people that matter to you.

384
00:24:07.962 --> 00:24:08.162
Yeah.

385
00:24:08.222 --> 00:24:12.566
Because we're defined only by our relationships.

386
00:24:12.626 --> 00:24:14.508
That's the only surviving thing.

387
00:24:15.029 --> 00:24:17.691
Not by these other things that seem...

388
00:24:18.452 --> 00:24:20.453
in a transient sense, important.

389
00:24:20.933 --> 00:24:22.054
And that bears this out.

390
00:24:22.694 --> 00:24:25.616
And what's beautiful is their concern shifts from self.

391
00:24:25.676 --> 00:24:27.817
And I mean, hope changes in that way, right?

392
00:24:27.857 --> 00:24:30.319
It's hope for cure than just hope for others.

393
00:24:30.939 --> 00:24:34.041
It's just this really wonderful story about who we are.

394
00:24:34.421 --> 00:24:43.646
It's interesting because the things you're saying, a lot of people will sort of intellectually understand and believe that it's about the relationships in these last moments, but therefore it's about relationships through our life.

395
00:24:44.006 --> 00:24:47.268
But then when you look at how we allocate our time on a weekly, monthly basis...

396
00:24:47.688 --> 00:24:48.369
proportionate.

397
00:24:48.730 --> 00:24:49.330
Is it disconnect?

398
00:24:49.350 --> 00:24:50.271
Yeah, yeah, yeah.

399
00:24:50.392 --> 00:24:55.218
Because we're allocating our time towards accomplishment or achievement or money or promotions or cars, whatever.

400
00:24:55.438 --> 00:24:55.618
Yeah.

401
00:24:55.919 --> 00:24:59.143
But then in the final hour, it's all about something else.

402
00:24:59.283 --> 00:25:03.588
And if I even reviewed the allocation of my time this week and day, I'd be like, well, yeah.

403
00:25:04.204 --> 00:25:10.308
Well, I mean, death is this unbelievably truthful place, right?

404
00:25:10.688 --> 00:25:11.969
Pretense goes away.

405
00:25:12.510 --> 00:25:14.331
All the superficiality goes away.

406
00:25:14.711 --> 00:25:18.734
You're stripped to the bare bones of who you are.

407
00:25:19.094 --> 00:25:24.838
And what you end up finding is that we're more alike than unlike, and there's a universality to being human.

408
00:25:25.578 --> 00:25:28.140
and it involves being connected to one another.

409
00:25:28.600 --> 00:25:34.303
You know, our struggle is to remain humane, and we go through this together, not alone.

410
00:25:35.003 --> 00:25:37.204
And that's, again, there's a symmetry.

411
00:25:37.224 --> 00:25:40.006
You see it at the beginning of life, and you see it at the end of life.

412
00:25:41.567 --> 00:25:42.867
Politics falls away?

413
00:25:42.887 --> 00:25:46.449
I sure so hope so.

414
00:25:46.509 --> 00:25:49.051
It's interesting, because so many people spend their lives getting agitated.

415
00:25:49.191 --> 00:25:52.473
The reason I say that is because you said we're more alike than we believe.

416
00:25:52.493 --> 00:25:53.033
Right.

417
00:25:53.478 --> 00:25:54.278
Oh, absolutely.

418
00:25:54.518 --> 00:25:59.980
And so when you're bare bones, you're not really thinking about the left, the right, there's politics, there's political issue.

419
00:26:00.220 --> 00:26:09.942
What you end up seeing when people are most vulnerable, you see beauty, you see love, you see tenderness, you see vulnerability.

420
00:26:10.462 --> 00:26:12.443
There are some awful humans that...

421
00:26:13.123 --> 00:26:14.544
You have lived a bad life.

422
00:26:15.025 --> 00:26:20.870
But in the end, when you see them in a more vulnerable state, I think you see their better nature.

423
00:26:21.351 --> 00:26:22.312
You see tenderness.

424
00:26:22.512 --> 00:26:23.953
You see expressions of love.

425
00:26:24.494 --> 00:26:28.578
There's a lot of pretense that people have to work through, personas that they present.

426
00:26:29.058 --> 00:26:30.860
And illness kind of strips you of that.

427
00:26:31.540 --> 00:26:33.883
It's this great leveling effect to be sick.

428
00:26:34.903 --> 00:26:38.407
That what matters to you two weeks earlier doesn't matter to you now.

429
00:26:39.723 --> 00:26:44.104
Okay, so medical students thought the third would be pain symptom management.

430
00:26:44.424 --> 00:26:46.745
And according to your hospice patients, they agree.

431
00:26:46.765 --> 00:26:47.565
Yep, they got that one right.

432
00:26:47.625 --> 00:26:48.265
And what does that mean?

433
00:26:48.285 --> 00:26:50.086
That's just their concern is not being pain.

434
00:26:50.146 --> 00:26:54.127
I mean, unfortunately, there's not a lot of conversation about what to expect.

435
00:26:54.167 --> 00:26:55.727
We just completed a study on this.

436
00:26:56.347 --> 00:27:02.369
If you were told you had a terminal disease, I guarantee one of your first overwhelming thoughts is suffering.

437
00:27:03.509 --> 00:27:14.936
And unfortunately, it's damning how little conversations there are to address that issue in terms of what to expect, when to expect it, what you're going to feel and reassure people.

438
00:27:15.556 --> 00:27:19.938
And these honest conversations actually don't take away hope, they restore agency.

439
00:27:20.079 --> 00:27:21.679
So what is the misunderstanding?

440
00:27:21.840 --> 00:27:28.203
Oh my gosh, that it's far worse than people think, that there isn't a pain, rarely a pain we can't manage.

441
00:27:28.443 --> 00:27:29.904
It's less painful than people think.

442
00:27:29.984 --> 00:27:30.805
Oh gosh, by a mile.

443
00:27:30.825 --> 00:27:31.405
Yeah.

444
00:27:31.425 --> 00:27:31.565
Yeah.

445
00:27:32.468 --> 00:27:34.772
That's probably the biggest myth.

446
00:27:35.353 --> 00:27:36.094
About death and dying?

447
00:27:36.234 --> 00:27:37.196
A hundred percent.

448
00:27:37.476 --> 00:27:41.903
And honestly, it's compounded by the fact that doctors don't have these discussions.

449
00:27:42.925 --> 00:27:43.125
Okay.

450
00:27:43.746 --> 00:27:47.152
So number four, in terms of what hospice patients say matters most to them?

451
00:27:48.668 --> 00:27:49.309
Peace with God.

452
00:27:49.529 --> 00:27:50.931
Being at peace with God.

453
00:27:51.231 --> 00:27:51.651
Hmm.

454
00:27:51.671 --> 00:27:53.553
And presumably just the religious ones, right?

455
00:27:54.394 --> 00:27:58.259
No, it's peace with a belief of something larger.

456
00:27:58.579 --> 00:28:03.004
I've asked patients this, and they'll say what I would say is that I don't know.

457
00:28:03.384 --> 00:28:04.526
It's an existential belief.

458
00:28:05.186 --> 00:28:08.627
feeling that doesn't necessarily have to be attributed to a believer or God.

459
00:28:08.987 --> 00:28:12.728
Now, is it because they're concerned they're going to go to hell or they're going to go, they don't know?

460
00:28:12.748 --> 00:28:13.809
No, I don't hear that.

461
00:28:14.389 --> 00:28:22.171
I'm sure there was a time when judgment, the role of judgment played in, but just to be at peace with the universe existentially.

462
00:28:22.491 --> 00:28:26.633
And is there a way to become at peace that patients will ask for?

463
00:28:27.333 --> 00:28:31.214
I don't hear, but I imagine it's to ask for forgiveness in part.

464
00:28:32.876 --> 00:28:37.001
And the medical students you interviewed thought number four would be being mentally aware.

465
00:28:37.021 --> 00:28:37.221
Yes.

466
00:28:37.501 --> 00:28:38.642
And that does come up, right?

467
00:28:38.683 --> 00:28:39.403
So here we are.

468
00:28:40.204 --> 00:28:40.945
That's number five.

469
00:28:40.965 --> 00:28:41.045
Yes.

470
00:28:41.085 --> 00:28:41.946
In what hospital?

471
00:28:42.006 --> 00:28:42.226
Okay.

472
00:28:42.887 --> 00:28:46.011
And then the next is dying at home.

473
00:28:46.651 --> 00:28:51.637
And this is tragic because 80% of Americans want to die at home and about 30% do.

474
00:28:53.525 --> 00:28:53.945
Why is that?

475
00:28:54.886 --> 00:28:59.828
It's really reflective of mostly our medicalization of dying.

476
00:29:00.408 --> 00:29:10.392
As a country, we underinvest and care for at home so that people end up having to go into the hospital and the death that they fear is the one they get.

477
00:29:10.932 --> 00:29:14.435
The more tertiary or advanced a hospital is, the more aggressive treatment there is.

478
00:29:14.975 --> 00:29:17.918
It's part of the death-defying approach of medicine.

479
00:29:18.198 --> 00:29:19.899
There's always something you can do.

480
00:29:20.640 --> 00:29:22.902
They die in units and they die in those sorts.

481
00:29:23.022 --> 00:29:28.827
And the irony is, the more they get, it actually hasn't been shown to enhance life.

482
00:29:28.887 --> 00:29:29.647
The more what they get?

483
00:29:29.767 --> 00:29:32.590
The more care, the more aggressive care they get when they're dying.

484
00:29:32.610 --> 00:29:36.673
So you're saying that we kind of drag it out a bit unnecessarily sometimes?

485
00:29:36.693 --> 00:29:36.833
Yeah.

486
00:29:36.893 --> 00:29:46.019
I think medicine does its best to defy death, and unfortunately, it often denies it even when it's obvious, when things have become futile.

487
00:29:46.859 --> 00:29:55.305
And if medicine can't appreciate death when it's objectively there, they're certainly not going to pay attention to the experience of the dying.

488
00:29:56.005 --> 00:29:59.407
And I think it's complicated, but we've lost our way with dying.

489
00:29:59.827 --> 00:30:04.089
You know, dying used to be in the home and in the community in connection to our church.

490
00:30:04.790 --> 00:30:08.031
And in the last hundred years, it's become institutionalized.

491
00:30:08.512 --> 00:30:10.152
So death is now like a rumor.

492
00:30:10.673 --> 00:30:18.297
You know, it's something that happens somewhere down the line, probably to somebody else, but it's not proximate to us like it used to be.

493
00:30:18.917 --> 00:30:28.462
So you take all these factors together, the fact that we've institutionalized dying, the fact that medicines becomes, you know, technically focused and no longer artful.

494
00:30:28.502 --> 00:30:30.883
We don't, it's not okay to be there for presence.

495
00:30:31.203 --> 00:30:33.104
I mean, people can't die of old age anymore.

496
00:30:33.644 --> 00:30:35.565
You know, you got to have about five diagnoses.

497
00:30:36.105 --> 00:30:37.486
So it's lost its grace.

498
00:30:38.066 --> 00:30:39.387
It's lost its humanity.

499
00:30:40.276 --> 00:30:48.823
So if someone knows they're going to die, you would recommend they usually didn't come to a hospice and they... No, get into a hospice so you can die at home.

500
00:30:49.284 --> 00:30:50.024
Oh, versus it.

501
00:30:50.105 --> 00:30:53.527
So hospice is more likely to align your wish to an outcome.

502
00:30:54.108 --> 00:31:03.996
Hospice is developed out of our communities as an answer, as a rebuttal to the way dying were traditionally treated in a hospital.

503
00:31:04.537 --> 00:31:07.500
Yeah, so what is it about dying in a hospital that is...

504
00:31:08.838 --> 00:31:10.059
worse than dying at home?

505
00:31:10.199 --> 00:31:11.320
I don't know where to begin.

506
00:31:11.840 --> 00:31:23.928
What matters to the dying patient is familiarity, to be connected, to be where they live, the things that make them comfortable, the people they love.

507
00:31:24.388 --> 00:31:25.889
They don't want to be woken in the night.

508
00:31:25.909 --> 00:31:27.050
They don't want to be poked.

509
00:31:27.090 --> 00:31:28.051
They don't want IVs.

510
00:31:28.071 --> 00:31:29.392
They don't want another scan.

511
00:31:29.992 --> 00:31:33.815
It goes down to what will make you comfortable, what matters to you in the end.

512
00:31:34.355 --> 00:31:37.257
And being at home with your people is what matters to people.

513
00:31:37.657 --> 00:31:38.037
Makes sense.

514
00:31:38.417 --> 00:31:43.000
So number seven, having care directives followed.

515
00:31:43.040 --> 00:31:43.660
What does that mean?

516
00:31:44.461 --> 00:31:47.662
And making sure that what you want to happen is going to happen.

517
00:31:48.223 --> 00:31:48.523
Okay.

518
00:31:48.863 --> 00:31:49.023
Yep.

519
00:31:49.303 --> 00:31:52.865
And this one is, this is interesting, I think, resolving conflicts.

520
00:31:53.245 --> 00:32:02.513
So medical students who are asked about what matters most to those that are dying, they rank the seventh thing that would matter as resolving conflicts.

521
00:32:03.234 --> 00:32:07.978
And what's interesting is these two, right, is was life meaningful and resolving conflicts?

522
00:32:08.498 --> 00:32:09.979
And the dying patient's kind of all good.

523
00:32:11.541 --> 00:32:14.265
They don't want to be, they're not a problem to be solved.

524
00:32:14.705 --> 00:32:15.186
That's interesting.

525
00:32:15.206 --> 00:32:15.486
You're right.

526
00:32:15.506 --> 00:32:24.878
That is the most interesting takeaway so far is living people think that dying will be really concerned with the legacy and what they accomplished and did they have any beef with anybody.

527
00:32:25.159 --> 00:32:26.220
But dying patients.

528
00:32:26.280 --> 00:32:27.662
And that's why I have trouble with that regret.

529
00:32:28.062 --> 00:32:28.922
literature, okay?

530
00:32:28.942 --> 00:32:30.643
Because that's not what they're saying.

531
00:32:30.883 --> 00:32:35.225
They're not focused really on the negative aspects of having lived, right?

532
00:32:35.425 --> 00:32:44.369
They're trying to preserve what makes them them, and what makes them them is their family, and being in their home, and being at peace with their God,

533
00:32:45.198 --> 00:32:48.920
I mean, that speaks to what we should be thinking about in our lives day to day to some degree.

534
00:32:49.220 --> 00:32:51.862
Well, and again, there's a bridge between these two things.

535
00:32:52.202 --> 00:32:56.705
It's not that actually, the idea that this changes in death actually isn't all that true.

536
00:32:57.645 --> 00:32:59.506
I think we're aware of it in dying.

537
00:32:59.847 --> 00:33:03.029
Dr. Santos at Yale does this wonderful work on happiness.

538
00:33:03.309 --> 00:33:10.313
If you go upstream and you do good, you do that like her sort of work on happiness, you reveal a lot of these same truths.

539
00:33:10.753 --> 00:33:18.600
Well, we also live in a commercialized world where we're exposed to marketing and we're told what matters every day when we turn on the TV or open our phones.

540
00:33:19.340 --> 00:33:24.385
And we're told that the Louis Vuitton bag matters, where we clap when someone gets the promotion.

541
00:33:24.465 --> 00:33:31.851
So there is an element of sort of socialization that orientates our values towards being more materialistic and I guess shallow to some degree.

542
00:33:32.195 --> 00:33:34.297
Those things are transient and non-sustaining.

543
00:33:34.697 --> 00:33:43.025
And one of the things that comes out of this happiness work is the importance of savoring and savoring things of worth like our relationships.

544
00:33:43.445 --> 00:33:50.111
Are there any people that were days from their own passing that were truly unhappy because of the way that they'd lived their lives?

545
00:33:50.792 --> 00:33:52.194
Yeah, you die how you live, right?

546
00:33:52.254 --> 00:33:53.315
You can't reinvent it.

547
00:33:53.355 --> 00:33:55.277
It's not rainbows and flowers.

548
00:33:55.777 --> 00:34:04.506
I've certainly seen that, and I've written about them and their people who had done wrong, and they were fearful of dying.

549
00:34:04.867 --> 00:34:05.487
Fearful of all.

550
00:34:05.688 --> 00:34:10.332
Well, in several cases, they had been raised Catholic, and they were worried about judgment.

551
00:34:10.913 --> 00:34:13.194
In the one case, it was actually a police officer.

552
00:34:13.595 --> 00:34:20.859
So he thought that he, because he had been raised with confession, that he had to tell everybody all the horrible things he did wrong.

553
00:34:21.299 --> 00:34:22.219
And it was kind of interesting.

554
00:34:22.239 --> 00:34:25.601
We had a reporter from the New York Times, and she got an earful.

555
00:34:25.941 --> 00:34:28.063
He just had to be cathartic and say everything.

556
00:34:28.103 --> 00:34:29.683
He's trying to unleash his sins.

557
00:34:30.304 --> 00:34:31.284
But it's very rare.

558
00:34:31.585 --> 00:34:34.186
In that case, you've got a police officer unleashing their sins.

559
00:34:35.006 --> 00:34:39.389
Could that not result in legal consequences if they say things that

560
00:34:40.565 --> 00:34:45.266
Yeah, you'd think so, because he talked about beating up witnesses and things like that.

561
00:34:45.286 --> 00:34:47.107
I never thought of that, but it's certainly true.

562
00:34:47.247 --> 00:34:48.327
And nothing was done about that.

563
00:34:48.567 --> 00:34:48.788
No.

564
00:34:49.048 --> 00:34:57.230
And what was interesting is we had a criminal, a guy who had spent more time in prison than out at the same time.

565
00:34:57.250 --> 00:34:58.390
And actually, he's on film.

566
00:34:59.051 --> 00:35:01.931
And he had regrets, true, but they got addressed at the end.

567
00:35:02.692 --> 00:35:03.052
What do you mean?

568
00:35:03.072 --> 00:35:03.652
Yeah.

569
00:35:03.772 --> 00:35:05.013
Well, it's one of the most beautiful things.

570
00:35:05.053 --> 00:35:12.257
So about 12% of our patients report dreams that are distressing or uncomfortable.

571
00:35:12.277 --> 00:35:13.498
They're not all comfortable.

572
00:35:13.518 --> 00:35:15.039
And again, it's not surprising.

573
00:35:15.059 --> 00:35:17.261
You're going to die the way you lived.

574
00:35:17.501 --> 00:35:20.823
And what we got wrong was those are sometimes the most transformational.

575
00:35:21.563 --> 00:35:23.565
Those are the ones where they find healing.

576
00:35:23.765 --> 00:35:25.666
He had a dream about some of the bad things he'd done.

577
00:35:25.686 --> 00:35:26.246
Oh, yeah.

578
00:35:26.266 --> 00:35:26.506
Yeah.

579
00:35:28.160 --> 00:35:29.541
caused a transformation.

580
00:35:30.301 --> 00:35:30.682
Dwayne.

581
00:35:31.162 --> 00:35:32.483
And he'd committed crimes in his life.

582
00:35:33.163 --> 00:35:33.443
Oh, yeah.

583
00:35:33.724 --> 00:35:34.344
What kind of crimes?

584
00:35:34.624 --> 00:35:35.525
Two attempted murders.

585
00:35:36.365 --> 00:35:38.947
Two murders, sorry, but both were self-defense on the street.

586
00:35:38.967 --> 00:35:40.528
Somebody were trying to rob him, sort of thing.

587
00:35:40.568 --> 00:35:42.389
He lived on the streets most of his life.

588
00:35:43.029 --> 00:35:48.213
But he never, again, he never reckoned with the things he had done wrong.

589
00:35:48.853 --> 00:35:49.954
And this is his reckoning.

590
00:35:50.194 --> 00:35:53.656
And how many days was this before he passed away?

591
00:35:53.896 --> 00:35:54.177
Twelve.

592
00:35:54.537 --> 00:35:54.957
Twelve days.

593
00:35:55.477 --> 00:35:56.438
My dreams, man.

594
00:35:57.749 --> 00:35:58.803
You know, my nightmares.

595
00:36:00.820 --> 00:36:01.460
I don't like them.

596
00:36:01.760 --> 00:36:09.463
I think it's because my past is coming back to me, you know, from doing wrong.

597
00:36:09.943 --> 00:36:14.145
Because I'm not going to say I'm the perfect guy when I was out there.

598
00:36:14.705 --> 00:36:18.886
Because I was up and running the streets, you know, doing wrong to individuals.

599
00:36:18.986 --> 00:36:21.067
And now they know my symptoms.

600
00:36:21.908 --> 00:36:22.708
They know I'm sick.

601
00:36:23.408 --> 00:36:25.929
So now they want to try to hurt me, you know.

602
00:36:26.429 --> 00:36:28.450
It was like they were jigging a knife.

603
00:36:29.754 --> 00:36:36.776
You know, trying to cut, cut out, you know, my neck, where my cancer was at.

604
00:36:37.116 --> 00:36:37.876
Right.

605
00:36:37.896 --> 00:36:39.456
Stop, stop trying to fight, you know.

606
00:36:39.736 --> 00:36:44.518
I'm sorry, I'm sorry, you know, trying to fight this guy off from hurting him.

607
00:36:44.818 --> 00:36:45.498
It's scary to me.

608
00:36:46.198 --> 00:36:47.878
I'm not a bad individual, man.

609
00:36:48.578 --> 00:36:54.520
But I don't cross a lot of people in my life, you know, and I need help.

610
00:36:55.521 --> 00:36:56.922
I need help, you know?

611
00:36:57.902 --> 00:37:00.644
I don't want to live my life.

612
00:37:03.425 --> 00:37:08.728
Being out in society walking, you have to look over my back, man.

613
00:37:09.269 --> 00:37:10.810
I just want people to forgive me.

614
00:37:11.670 --> 00:37:16.933
And please know that I was sick at the time when I was doing

615
00:37:18.552 --> 00:37:21.897
Certain things that was hurting them and their families.

616
00:37:22.718 --> 00:37:24.460
You know, that's all I want.

617
00:37:25.441 --> 00:37:29.767
I don't want them to look at me as a bad individual because I'm not.

618
00:37:30.768 --> 00:37:32.130
You know, I need help.

619
00:37:33.437 --> 00:37:38.621
What ends up happening, and he can't sleep, and again going back to this idea that it's very hard to die if you can't sleep.

620
00:37:39.441 --> 00:37:43.244
He ends up waking up and he asks to see his daughter.

621
00:37:43.264 --> 00:37:45.426
And she comes on the film.

622
00:37:46.366 --> 00:37:55.153
And what she describes is for the first time in her life, he holds her for minutes and says how much he loves her and that he's sorry for what he had done.

623
00:37:55.933 --> 00:38:04.720
So this negative experience that was happening when his eyes closed brought this reckoning and this ask for forgiveness, which of course she gave.

624
00:38:05.300 --> 00:38:06.501
And what do you make of that?

625
00:38:06.721 --> 00:38:09.143
Like, again, I'm asking you the same question I asked you earlier.

626
00:38:09.343 --> 00:38:10.504
What do you think is happening there?

627
00:38:10.604 --> 00:38:11.885
Is that a spiritual thing?

628
00:38:12.005 --> 00:38:15.948
Is that just him, you know, approaching the end of his life and feeling remorseful?

629
00:38:15.968 --> 00:38:16.989
So he's having these dreams.

630
00:38:17.009 --> 00:38:18.770
Oh, no, he didn't have conscious control of this.

631
00:38:19.170 --> 00:38:20.311
I don't believe that for a second.

632
00:38:20.731 --> 00:38:22.493
This was happening when his eyes were closed.

633
00:38:22.513 --> 00:38:22.813
Yeah.

634
00:38:23.756 --> 00:38:27.099
I think that he was caring at a very deep level.

635
00:38:27.599 --> 00:38:34.865
He knew the wrongs that he had done and that something was forcing him to find peace.

636
00:38:35.785 --> 00:38:36.646
And it did.

637
00:38:37.186 --> 00:38:37.647
Something.

638
00:38:38.047 --> 00:38:38.487
Something.

639
00:38:38.928 --> 00:38:39.128
Yeah.

640
00:38:39.368 --> 00:38:40.089
I think truth.

641
00:38:40.509 --> 00:38:44.652
I think somewhere in him, he couldn't joke and jive around it.

642
00:38:44.832 --> 00:38:49.676
Dine brought this to a surface and he needed to find peace.

643
00:38:51.070 --> 00:38:52.713
And it was wonderful for her.

644
00:38:52.753 --> 00:38:54.816
It changed her completely.

645
00:38:55.017 --> 00:38:58.362
And what ends up happening was she ends up spending every night with him.

646
00:38:59.825 --> 00:39:01.688
And he ends up passing comfortably.

647
00:39:04.490 --> 00:39:07.394
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648
00:39:07.694 --> 00:39:14.303
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649
00:39:14.423 --> 00:39:16.506
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650
00:39:16.606 --> 00:39:22.093
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651
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652
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653
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654
00:39:42.098 --> 00:39:43.518
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655
00:39:43.658 --> 00:39:50.500
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656
00:39:50.920 --> 00:39:53.701
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657
00:39:53.801 --> 00:40:02.364
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658
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659
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660
00:40:07.485 --> 00:40:10.146
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661
00:40:11.486 --> 00:40:16.969
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662
00:40:17.449 --> 00:40:22.132
But just one sip of Comiteer Coffee made him invest.

663
00:40:25.677 --> 00:40:27.197
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664
00:40:27.297 --> 00:40:30.518
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665
00:40:30.838 --> 00:40:40.421
And then I'd say within about an hour and a half, the Slack channel that we have starts blowing up with people asking, what the hell is that thing that's been left in the kitchen?

666
00:40:40.821 --> 00:40:42.122
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667
00:40:42.242 --> 00:40:47.803
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668
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669
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670
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671
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672
00:41:02.754 --> 00:41:08.600
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673
00:41:08.760 --> 00:41:11.343
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674
00:41:13.489 --> 00:41:15.950
So back to our board of things that actually mattered.

675
00:41:15.970 --> 00:41:16.871
We're on number seven.

676
00:41:17.731 --> 00:41:18.132
Number eight.

677
00:41:19.212 --> 00:41:20.953
Feeling that life was meaningful.

678
00:41:21.394 --> 00:41:26.757
So just to zoom out once again on this, were they given 11 options or were they given lots of options?

679
00:41:26.777 --> 00:41:27.457
Lots of options.

680
00:41:27.537 --> 00:41:27.817
Okay.

681
00:41:27.857 --> 00:41:29.338
And these are the 11 that they actually picked.

682
00:41:29.638 --> 00:41:35.461
So number eight is they cared that life was meaningful, but this is particularly low relative to the others.

683
00:41:35.562 --> 00:41:35.782
Yeah.

684
00:41:37.282 --> 00:41:38.003
And so is this way.

685
00:41:38.978 --> 00:41:40.178
Living as long as possible.

686
00:41:41.239 --> 00:41:41.899
And you want to know what?

687
00:41:42.339 --> 00:41:46.680
I've never had a dying patient say, I want to live as long as possible.

688
00:41:47.601 --> 00:41:51.322
What they want to do is live as well as they can, as long as they can.

689
00:41:52.182 --> 00:41:56.203
But unless you've been sick, that's not the goal.

690
00:41:58.864 --> 00:42:03.105
Which is anathetical to the way the medical world looks at patients, right?

691
00:42:03.145 --> 00:42:05.246
Is that we keep going at all costs.

692
00:42:05.833 --> 00:42:11.075
I mean, there's some stats that I was reading here about how many years people spend sick on average.

693
00:42:11.756 --> 00:42:14.397
I think it was in the United States, if I have the stats right.

694
00:42:14.917 --> 00:42:18.399
Yeah, it says up to sort of 11 years of our lives are lived in poor health.

695
00:42:19.160 --> 00:42:19.340
Mm-hmm.

696
00:42:19.981 --> 00:42:29.130
So although our health span is, you know, in the Western Pacific, 68 years, or in Europe, 66 years, we spend about a decade in poor health.

697
00:42:29.390 --> 00:42:29.531
Yeah.

698
00:42:30.071 --> 00:42:38.580
And actually what you're saying to me is that people care more about their health span, how many years of good health they have versus their lifespan, which is just how many years they're alive.

699
00:42:38.600 --> 00:42:38.700
Yeah.

700
00:42:38.720 --> 00:42:41.743
And I think that's a perspective that's very hard to understand in health.

701
00:42:43.023 --> 00:42:47.065
But it's hard work being sick, you know, and it's hard on those you love.

702
00:42:47.165 --> 00:42:48.426
So it makes sense to me.

703
00:42:48.786 --> 00:42:52.428
What about this, obviously a big subject at the moment is this longevity movement.

704
00:42:52.728 --> 00:42:55.469
People wanting to extend life and live forever and all these kinds of things.

705
00:42:55.889 --> 00:42:59.691
What is your perspective of seeing, of interviewing thousands of people that are dying?

706
00:43:00.131 --> 00:43:02.513
How has it shaped your perspective on longevity?

707
00:43:02.933 --> 00:43:05.994
I think there's a risk of some illusion.

708
00:43:06.014 --> 00:43:10.997
There was an article in Science recently, 55% of lifespan is determined by genetics.

709
00:43:12.037 --> 00:43:17.061
And it doesn't leave you immune from circumstances of disease and whatnot.

710
00:43:17.481 --> 00:43:22.945
I worry a lot of the lack of evidence around some of the efforts.

711
00:43:23.746 --> 00:43:26.608
And I think the focus really needs to be on living well.

712
00:43:27.369 --> 00:43:37.916
And if you look at the blue zone, folks, I mean, that little lady in Japan or Italy isn't waking up in a cold plunge and measuring out creatine.

713
00:43:39.080 --> 00:43:40.861
She's just living well.

714
00:43:41.481 --> 00:43:44.622
They move, they eat more plants, they're highly social.

715
00:43:45.082 --> 00:43:49.663
They take time to down gear through prayer, meditation, music, whatever.

716
00:43:50.444 --> 00:44:00.107
When you think about all the people you've met who were days from their death, are there some who were more at peace with it because they had accomplished more?

717
00:44:01.407 --> 00:44:01.687
No.

718
00:44:01.787 --> 00:44:06.868
What is the correlatory in terms of those that were most at peace with leaving this planet?

719
00:44:07.348 --> 00:44:08.689
The love given and received.

720
00:44:09.169 --> 00:44:12.369
That's the only thing that matters.

721
00:44:13.130 --> 00:44:21.611
I've seen people who have led remarkably simple lives, but they were pure in the love that they were able to experience.

722
00:44:22.151 --> 00:44:23.572
And so they were happier to leave.

723
00:44:23.812 --> 00:44:24.212
Oh, yeah.

724
00:44:24.472 --> 00:44:29.873
You want to live in a way that you can die well, and that means loving well.

725
00:44:30.753 --> 00:44:33.294
And have you experienced the opposite, where someone had nobody there?

726
00:44:34.054 --> 00:44:38.355
Oh, I've had some very bad experiences.

727
00:44:38.415 --> 00:44:53.918
People who were, one of them I've written about, who was taken as a child into a home situation that was really for kids with a lot of complexity and had never seen or experienced love and the emptiness she felt.

728
00:44:54.639 --> 00:44:55.959
I never forget what she said to me.

729
00:44:55.979 --> 00:45:00.260
She was watching somebody kiss on a screen, and she goes, you know, I look at that, I've never understood that.

730
00:45:01.300 --> 00:45:06.483
and her dying was empty and regretful.

731
00:45:06.823 --> 00:45:07.243
What do you mean?

732
00:45:07.683 --> 00:45:10.004
Take me into the last moments.

733
00:45:10.024 --> 00:45:14.767
Just that she knew she was denied love, denied love by parents.

734
00:45:15.507 --> 00:45:16.968
She was misused by men.

735
00:45:17.488 --> 00:45:23.931
So what she knew of love hurt her, and she was aware enough to know that.

736
00:45:24.311 --> 00:45:25.952
And there was no one there when she passed away?

737
00:45:26.432 --> 00:45:26.672
No.

738
00:45:28.213 --> 00:45:28.413
No.

739
00:45:28.433 --> 00:45:28.493
No.

740
00:45:30.465 --> 00:45:31.306
It's interesting, though.

741
00:45:32.407 --> 00:45:34.068
She had one very interesting dream.

742
00:45:34.669 --> 00:45:43.496
She had a man who had wanted to marry her, but she had been so taken advantage of that she was doubtful.

743
00:45:44.116 --> 00:45:47.739
And as soon as he asked her, she moved out of their apartment.

744
00:45:48.159 --> 00:45:48.340
Hmm.

745
00:45:49.160 --> 00:45:51.643
And as a way to self-protect.

746
00:45:52.444 --> 00:45:57.528
At the end of her life, he came to her and told her that he really did love her.

747
00:45:58.750 --> 00:46:04.855
So she was showing some version of it that was soothing to her.

748
00:46:06.177 --> 00:46:06.577
That was it.

749
00:46:07.118 --> 00:46:11.462
A lot of people, because of sort of early traumas, are somewhat avoidant of love.

750
00:46:13.051 --> 00:46:16.134
you explained that she moved out of the apartment when someone tried to propose to her.

751
00:46:16.654 --> 00:46:17.915
I could almost relate to some degree.

752
00:46:18.735 --> 00:46:26.721
I remember in my early years, in my early teens, I was extremely avoidant of commitment or relationships or whatever.

753
00:46:27.261 --> 00:46:33.866
And I remember this particular person turning around to me after I pursued them for four years, telling me that they would now want to be in a relationship with me.

754
00:46:33.946 --> 00:46:37.388
And I remember immediately dissuading them after pursuing them for four years.

755
00:46:37.408 --> 00:46:38.529
Careful what you ask for sort of thing.

756
00:46:38.549 --> 00:46:40.591
Yeah, but a lot of it roots back to our...

757
00:46:41.171 --> 00:46:43.952
our early models of love and connection and relationships.

758
00:46:44.012 --> 00:46:46.574
So where we modeled it in a healthy way.

759
00:46:47.754 --> 00:46:53.077
And this kind of brings me to the point around sort of overcoming trauma and wounds.

760
00:46:53.757 --> 00:47:00.961
How does the process of dying help us confront our earliest traumas or the traumas that have held us back in our lives?

761
00:47:00.981 --> 00:47:02.081
Have you seen evidence of that?

762
00:47:02.641 --> 00:47:03.402
Oh, lots.

763
00:47:04.162 --> 00:47:06.184
I've seen it in this end-of-life process.

764
00:47:06.204 --> 00:47:12.951
And again, I think this is the most meaningful, for me personally, the most meaningful ones that I witness.

765
00:47:13.331 --> 00:47:19.797
So I've seen a man who had lost his arm at the age of eight, and he was from an impoverished family.

766
00:47:20.198 --> 00:47:28.186
And developmentally, his whole identity was how was he going to be independent and be able to be a provider, etc.

767
00:47:28.166 --> 00:47:28.186
?

768
00:47:29.620 --> 00:47:37.584
And at the end of his life, he sees himself lying in a bed, and everyone who he worked with came by him and told him he was the best worker they had known.

769
00:47:38.645 --> 00:47:46.429
A mother whose child was in prison for drug offenses, and her identity as a mother is being questioned.

770
00:47:47.210 --> 00:47:51.772
And at the end of her life, her parents come to her and tell her she's loved and she was a good parent.

771
00:47:51.932 --> 00:47:52.513
In a vision?

772
00:47:52.533 --> 00:47:54.013
Mm-hmm.

773
00:47:54.194 --> 00:47:54.794
Not physically?

774
00:47:55.174 --> 00:47:55.354
No.

775
00:47:55.734 --> 00:47:55.974
Okay.

776
00:47:56.135 --> 00:47:56.575
No, but—

777
00:47:57.075 --> 00:48:05.723
Again, there's something in us that's innate that can heal these kind of broken pieces of us at the end that make us whole.

778
00:48:06.124 --> 00:48:17.294
So a lot of, again, I come back to it, the most inspiring people are the people who have been harmed and often from nothing of their own doing, but that find peace in the end.

779
00:48:17.895 --> 00:48:20.137
Do you think there is life after death?

780
00:48:22.025 --> 00:48:30.993
because one train of thought is that, you know, our bodies go into the ground or we're commated and then we become dust and then the trees, you know, we become part of the trees and the bees and the birds and that's it.

781
00:48:32.001 --> 00:48:39.767
Yeah, I don't think we go on in a physical form, but I go back to this idea that there's the shared, seems to be the shared consciousness.

782
00:48:40.327 --> 00:48:50.295
That the love that we've experienced early in life, and it's very interesting, it tends to be those who love to son conditionally and the other ones kind of go by the wayside.

783
00:48:51.075 --> 00:48:53.917
They're inseparable from us.

784
00:48:54.838 --> 00:48:59.341
and they become more present to us as we're leaving our physical form.

785
00:49:00.122 --> 00:49:04.385
So it does suggest that there's some sort of collective consciousness that goes on.

786
00:49:04.605 --> 00:49:13.812
And back to your survey on the bereaved, the fact that that many people feel that they're accessed by those who have passed is interesting.

787
00:49:14.533 --> 00:49:15.273
How do you see that?

788
00:49:15.794 --> 00:49:17.975
I think that consciousness is a really fascinating thing.

789
00:49:17.995 --> 00:49:23.179
You know, I've interviewed lots of people on this subject, and I never really thought of consciousness as a thing before.

790
00:49:23.199 --> 00:49:23.540
Yeah.

791
00:49:24.120 --> 00:49:26.822
But I've got a couple of hypotheses around what consciousness might be.

792
00:49:28.963 --> 00:49:39.428
None of them I can say I necessarily believe, but I remember one particular, I think it was a physicist, telling me that he thinks maybe consciousness is the way that the universe understands itself.

793
00:49:40.089 --> 00:49:49.194
And he hypothesized to me that consciousness breaks itself into lots of little pieces, into fish at the bottom of the ocean and human beings that walk the land and

794
00:49:51.495 --> 00:49:55.556
And it's consciousness's way of learning about itself and understanding itself.

795
00:49:55.576 --> 00:49:57.356
It breaks itself into these living organisms.

796
00:49:57.397 --> 00:50:01.538
They send some of them to the bottom of the oceans and some of them to the top of the mountains and they all explore.

797
00:50:01.558 --> 00:50:05.839
And it maybe explains why humans, but all animals, are so fascinated by novelty.

798
00:50:06.079 --> 00:50:09.560
The reason we go on holidays is because we want to have new experiences.

799
00:50:09.580 --> 00:50:13.521
We go and look up in awe at things we've never seen before, like mountains.

800
00:50:13.581 --> 00:50:15.281
And it's interesting.

801
00:50:15.341 --> 00:50:18.442
I was telling the story about being in, I think, Gibraltar or Malta or whatever it was.

802
00:50:18.522 --> 00:50:18.582
And

803
00:50:19.322 --> 00:50:26.452
driving down the street after I'd had this conversation with this physicist, and looking at tourists in a completely new light, because tourists are stood there...

804
00:50:27.378 --> 00:50:30.581
for 10 minutes or an hour, staring at something they've never seen before.

805
00:50:31.161 --> 00:50:37.807
And it's interesting to me that that's part of the animal experience, is this fascination with things we haven't seen.

806
00:50:37.827 --> 00:50:52.819
So maybe this hypothesis that consciousness is this central source that breaks into lots of pieces and goes off into existence to understand itself is a plausible, not completely indefensible, but plausible idea.

807
00:50:52.959 --> 00:50:55.161
And then maybe when I die, I return back to...

808
00:50:56.203 --> 00:50:57.265
source of consciousness.

809
00:50:57.846 --> 00:50:59.910
I like my version better.

810
00:51:00.290 --> 00:51:06.262
And you know what's interesting is that you should look at is the work that's done with psychedelics and dying patients.

811
00:51:07.125 --> 00:51:07.685
Tell me about that.

812
00:51:07.885 --> 00:51:17.527
Basically, when they give psychedelic drugs, which indigenous people have been doing for thousands of years, they come back structurally altered.

813
00:51:17.567 --> 00:51:20.188
First of all, their fear of dying dissipates.

814
00:51:21.308 --> 00:51:31.931
And they tend to see themselves as something larger, immersed within and connected to life at large, but they're at peace.

815
00:51:32.731 --> 00:51:33.711
in a beautiful way.

816
00:51:33.771 --> 00:51:37.913
So they have this heightened awareness and they come back differently and they die differently.

817
00:51:38.733 --> 00:51:41.214
And that's like with this work, they die differently.

818
00:51:42.834 --> 00:51:44.935
So back to our board here, what was the 10th thing?

819
00:51:45.235 --> 00:51:47.416
What matters most to people at the end of their life?

820
00:51:48.856 --> 00:51:50.417
Having finances in order.

821
00:51:50.757 --> 00:51:51.477
Hmm, interesting.

822
00:51:52.137 --> 00:51:54.098
And the last one is resolving conflicts.

823
00:51:54.794 --> 00:51:57.235
And that's where I have trouble with the idea of regret.

824
00:51:57.595 --> 00:51:59.956
Yeah, because it's not that important to people.

825
00:52:00.236 --> 00:52:01.296
So now, invert this.

826
00:52:01.316 --> 00:52:03.557
So if you went to people and said, do you have conflicts?

827
00:52:03.577 --> 00:52:04.778
They go, yeah, I have conflicts.

828
00:52:04.818 --> 00:52:05.438
Or do you have regrets?

829
00:52:05.478 --> 00:52:06.038
Yeah, I have them.

830
00:52:06.238 --> 00:52:09.579
But when you actually rank one of them as priorities, it's not relevant.

831
00:52:10.000 --> 00:52:10.140
Hmm.

832
00:52:11.260 --> 00:52:11.960
Very interesting.

833
00:52:12.701 --> 00:52:13.381
Very, very interesting.

834
00:52:13.401 --> 00:52:14.522
It's definitely changed my mind.

835
00:52:14.542 --> 00:52:28.030
Because you're right, because we go and talk about regrets at the end of your life and regret generally so often, we end up misunderstanding that to mean that regrets are the most important thing, and that you need to live your life in a way where you don't have regrets.

836
00:52:28.070 --> 00:52:30.892
But actually, you're saying that having spoken to those that are dying,

837
00:52:31.692 --> 00:52:35.893
living their life free from regret seems to be quite low in their priorities.

838
00:52:35.914 --> 00:52:38.354
Well, I think it's a symptom of our times, right?

839
00:52:38.374 --> 00:52:41.876
Which we become introspective and self-analytical.

840
00:52:41.956 --> 00:52:46.617
So if you ask these questions, they're going to come up.

841
00:52:47.297 --> 00:52:50.519
But in the lived experiences, are they actually relevant?

842
00:52:51.519 --> 00:52:54.220
So we have these six handwritten cards.

843
00:52:55.223 --> 00:52:59.425
So these are the lessons I've learned from actually caring for dying patients.

844
00:52:59.486 --> 00:53:04.969
And probably the one that stands out the most is that love endures after physical loss.

845
00:53:05.329 --> 00:53:06.990
Love endures after physical loss.

846
00:53:07.590 --> 00:53:18.536
So the idea that, and this is really what our research bears out, which is that people who have been lost often decades earlier are there for us at the end.

847
00:53:19.196 --> 00:53:23.579
And that part of that dying process is this reunion with and to them.

848
00:53:24.639 --> 00:53:25.821
so that that survives.

849
00:53:26.561 --> 00:53:34.770
And on that point, it's probably a good time to touch on the subject of grief and how the dying process impacts the grief that those left behind experience.

850
00:53:35.329 --> 00:53:38.372
Yeah, and we've done a lot of work on this.

851
00:53:38.392 --> 00:53:44.959
And a long story short is that how people die absolutely affects our bereavement.

852
00:53:45.940 --> 00:53:50.745
How we witness that changes our bereavement, and it's measurable.

853
00:53:51.165 --> 00:53:57.091
So people who have had these experiences, who have watched their loved one reconnect, grieve very differently.

854
00:53:57.692 --> 00:53:59.452
And it's measurable, actually, in grief.

855
00:53:59.732 --> 00:54:04.953
How they remember, how they recall, how they get through obstacles, how they heal.

856
00:54:05.174 --> 00:54:11.295
So if I want to grieve in the most healthy way, what dying experience is most conducive with that?

857
00:54:12.055 --> 00:54:19.176
Oh, seeing that loved one as rich in love rather than empty and defined by their physical dimensions.

858
00:54:19.736 --> 00:54:20.777
And I don't know if it would help.

859
00:54:20.797 --> 00:54:22.677
Do you want to show the video of Jennifer?

860
00:54:23.017 --> 00:54:23.237
Sure.

861
00:54:23.757 --> 00:54:26.058
This is an interesting video for a couple of reasons.

862
00:54:27.878 --> 00:54:31.299
events are not these great epiphanies or revelations.

863
00:54:31.319 --> 00:54:37.241
They're just about very real moments that are symbolic, usually, of a relationship.

864
00:54:37.261 --> 00:54:43.363
And she's describing her partner, Patrick, who's at the end of his life, and he has these experiences.

865
00:54:43.423 --> 00:54:45.123
But she describes what it means to her.

866
00:54:45.804 --> 00:54:50.185
Patrick was the only member of his family that knows how to make the sauce.

867
00:54:51.205 --> 00:54:56.367
And for all the years I knew him, he insisted something was missing.

868
00:54:56.938 --> 00:54:58.279
After his grandmother had passed.

869
00:54:58.419 --> 00:54:59.319
After she had passed.

870
00:54:59.679 --> 00:55:02.140
This would be the Sunday before he passed.

871
00:55:03.301 --> 00:55:08.423
He woke up in the morning, and I couldn't get him to eat.

872
00:55:08.764 --> 00:55:11.505
He wasn't hungry, total loss of appetite.

873
00:55:12.325 --> 00:55:15.047
And I'm like, baby, we got to make you something for breakfast.

874
00:55:15.067 --> 00:55:15.527
What do you want?

875
00:55:15.547 --> 00:55:16.187
He goes, I'm full.

876
00:55:17.808 --> 00:55:21.149
I said, Pat, you had a snack pack pudding yesterday.

877
00:55:21.469 --> 00:55:22.050
You're not full.

878
00:55:22.917 --> 00:55:26.843
And he's like, oh, no, I ate with Nana Dolores last night.

879
00:55:27.764 --> 00:55:39.540
He believed he made sauce with his grandmother the night before, said he could smell it, he could still taste it, he was full from it,

880
00:55:40.841 --> 00:55:52.224
And she showed him after all these years what he had done wrong, which is the very last step before you take it off the burner was to add a teaspoon of sugar.

881
00:55:52.344 --> 00:56:00.847
We spent the next seven and a half hours, because that's how long it takes, making his grandmother's sauce.

882
00:56:01.347 --> 00:56:02.247
He added the sugar.

883
00:56:03.747 --> 00:56:04.848
Last time Patrick ever ate.

884
00:56:05.328 --> 00:56:09.589
Every morning he woke up saying, this is the day I'm going to die.

885
00:56:11.243 --> 00:56:12.564
And I said, you'll go when you're ready.

886
00:56:14.604 --> 00:56:15.385
And he was ready.

887
00:56:16.545 --> 00:56:21.007
Did that dream help you exact that reality further?

888
00:56:21.527 --> 00:56:22.127
Absolutely.

889
00:56:22.447 --> 00:56:22.648
Yeah?

890
00:56:22.868 --> 00:56:23.468
Absolutely.

891
00:56:24.228 --> 00:56:33.612
And not only the reality that he is gone, it's made me think of maybe there is something out there after we go.

892
00:56:34.393 --> 00:56:40.935
So how she remembers him in death was that he was put back together by being with those he loved.

893
00:56:41.215 --> 00:56:55.819
So if I know that one of my relatives is going to pass away, what should I be doing to, because, you know, my first instinct in that scenario is to protect my family from the grief of it, to make sure that the grief process is as healthy as it can possibly be.

894
00:56:55.899 --> 00:57:00.341
And I'm not trying to deny grief in any way, because I know that it's kind of unavoidable from everything I've read.

895
00:57:00.381 --> 00:57:00.501
But

896
00:57:01.361 --> 00:57:07.624
Is there things we can do as a family to insulate us from having a really negative grieving process?

897
00:57:08.084 --> 00:57:15.127
Yeah, I think one is obviously communicating and being open with each other and with what's happening.

898
00:57:15.267 --> 00:57:19.829
I think one of the worst outcomes we see in when death is denied.

899
00:57:20.409 --> 00:57:27.873
So if you see it, if it's forecastable and it's obvious and you're proximate to us, it's less of an injury than if

900
00:57:31.234 --> 00:57:32.776
And we see so much of that in medicine.

901
00:57:32.977 --> 00:57:34.579
So this is a rule for life, which is acceptance.

902
00:57:34.639 --> 00:57:35.300
Oh, gosh, yeah.

903
00:57:35.580 --> 00:57:38.344
A third of our patients that come into hospice are dead in seven days.

904
00:57:38.945 --> 00:57:40.848
They just didn't start dying seven days.

905
00:57:40.868 --> 00:57:42.069
They became aware of it.

906
00:57:42.710 --> 00:57:46.275
So what we do is we refer to this as medical harm.

907
00:57:46.776 --> 00:57:50.038
We deny them and separate them and deny their reality.

908
00:57:50.478 --> 00:57:53.380
So they're left to figure it out suddenly and acutely.

909
00:57:53.760 --> 00:58:01.645
And that injury is, you're robbing people of their agency, their time to spend the way they want to have the conversations they need to have.

910
00:58:02.105 --> 00:58:04.325
And the impact to the bereaved is enormous.

911
00:58:04.745 --> 00:58:05.846
So acceptance, number one.

912
00:58:05.906 --> 00:58:06.366
Anything else?

913
00:58:06.706 --> 00:58:07.766
Yeah, presence.

914
00:58:08.146 --> 00:58:08.486
Presence.

915
00:58:08.706 --> 00:58:10.146
And it used to be this way.

916
00:58:10.206 --> 00:58:11.887
It used to be death was in the home.

917
00:58:11.907 --> 00:58:12.907
It was in the community.

918
00:58:12.927 --> 00:58:13.767
It was shared.

919
00:58:14.207 --> 00:58:18.768
And that shared grief is wonderful because we're meant to be mutually supportive.

920
00:58:19.368 --> 00:58:21.308
The opposite is a sterilized death.

921
00:58:21.669 --> 00:58:29.390
So in an intensive care unit, in a gown, you know, anything that dehumanizes the process of dying is injurious.

922
00:58:30.030 --> 00:58:32.051
So acceptance, physical presence.

923
00:58:32.412 --> 00:58:32.772
Yeah.

924
00:58:33.152 --> 00:58:35.213
Anything else that helps the grief process?

925
00:58:35.794 --> 00:58:36.514
Loving each other.

926
00:58:38.095 --> 00:58:41.017
Talking, sharing, acknowledging.

927
00:58:42.678 --> 00:58:51.264
Anything that's repressive or denying about it, whether it's your own feelings, whether it's what's happening to the patient, is harmful, period.

928
00:58:52.685 --> 00:58:54.326
That's why death in the home is so different.

929
00:58:55.799 --> 00:58:58.860
You know, the person seen as a person, not a patient, right?

930
00:59:00.581 --> 00:59:02.322
And the patients know this instinctively.

931
00:59:03.042 --> 00:59:04.483
That's why they want to get back home.

932
00:59:05.983 --> 00:59:06.704
This was your father?

933
00:59:07.044 --> 00:59:08.704
Passed away when you were... Yeah, I was 12.

934
00:59:09.045 --> 00:59:10.525
You were 12 and he was 41?

935
00:59:10.585 --> 00:59:11.786
42, I think, yeah.

936
00:59:11.806 --> 00:59:12.366
42, yeah.

937
00:59:13.406 --> 00:59:14.887
He passed away of... Cancer.

938
00:59:14.987 --> 00:59:15.427
Cancer.

939
00:59:17.188 --> 00:59:18.629
In what way was this formative?

940
00:59:20.569 --> 00:59:20.930
Well, I...

941
00:59:22.140 --> 00:59:31.406
I think it shaped life in certainly ways that I wouldn't have chosen and that I don't understand.

942
00:59:34.081 --> 00:59:41.984
The one thing was that, you know, that sort of loss at that point in your life changed the trajectory of your life.

943
00:59:43.405 --> 00:59:48.207
You don't just lose the person, you lose the world the way it's supposed to be.

944
00:59:49.028 --> 00:59:54.810
And for me, my world went off the tracks pretty badly.

945
00:59:54.830 --> 00:59:56.531
It was a pretty bumpy road.

946
00:59:57.430 --> 01:00:05.297
But, you know, and it's so unusual because the last time I saw him, he was having one of these end-of-life experiences.

947
01:00:06.078 --> 01:00:11.263
I still can't make sense of it all because then after he died for many years, I could never speak his name.

948
01:00:11.343 --> 01:00:14.666
I certainly couldn't talk about the last time I saw him.

949
01:00:15.307 --> 01:00:16.207
So the irony...

950
01:00:17.038 --> 01:00:23.302
that the thing I could never talk about is the thing that I now share with millions of people.

951
01:00:23.343 --> 01:00:24.403
I feel like I'm getting punked.

952
01:00:25.024 --> 01:00:28.987
Like, I didn't mean for this to happen.

953
01:00:29.747 --> 01:00:33.390
And you wonder, though, you know, that sort of loss does change you, right?

954
01:00:33.510 --> 01:00:40.835
It changes what you're sensitive to in others, what you see in others, what you feel from others, how you want to help.

955
01:00:41.896 --> 01:00:43.117
Does grief ever go away?

956
01:00:43.137 --> 01:00:43.597
Yeah.

957
01:00:44.881 --> 01:00:45.221
It doesn't.

958
01:00:45.661 --> 01:00:50.485
I think grief, there's a period where grief is unbearable.

959
01:00:51.345 --> 01:00:54.408
And it's like having this rock in your pocket.

960
01:00:54.468 --> 01:00:56.869
You know it's there, and other times you forget it.

961
01:00:57.690 --> 01:01:03.775
You lose the person in the physical form, but they still relate to you in other ways.

962
01:01:03.875 --> 01:01:07.477
It changes how you see the world for having known them.

963
01:01:08.198 --> 01:01:10.439
So they continue on in some way.

964
01:01:10.460 --> 01:01:10.560
Yeah.

965
01:01:11.240 --> 01:01:16.628
We talk about grief in terms of what we lose, but not necessarily what remains.

966
01:01:17.590 --> 01:01:19.853
And a lot of that person remains.

967
01:01:20.834 --> 01:01:23.498
And that's remembered.

968
01:01:23.999 --> 01:01:24.580
And I think...

969
01:01:25.895 --> 01:01:30.661
Grief is probably one of the most illuminating things that can happen in your life.

970
01:01:31.461 --> 01:01:34.304
It changes your life, the circumstances.

971
01:01:34.505 --> 01:01:38.289
I wouldn't be talking to you if I hadn't lost my father as a boy, for example.

972
01:01:38.649 --> 01:01:39.170
Wouldn't happen.

973
01:01:39.991 --> 01:01:43.254
Because a chain of events took place.

974
01:01:43.495 --> 01:01:45.777
And you've interviewed 750 grieving families.

975
01:01:46.478 --> 01:01:46.638
Mm-hmm.

976
01:01:48.584 --> 01:01:56.967
I think there's a great expression that, you know, the trick is, the art is, is to carry grief in one hand, gratitude in the other, and be stretched by both.

977
01:01:57.627 --> 01:02:00.588
You know, you don't deny the grief, but you learn how to be grateful.

978
01:02:00.948 --> 01:02:04.329
And somewhere there's peace there.

979
01:02:04.969 --> 01:02:07.650
When you interviewed those 750 grieving families...

980
01:02:08.650 --> 01:02:19.658
Did you notice a difference between those that really carried the grief well versus those that didn't carry it so well?

981
01:02:19.718 --> 01:02:22.200
Yeah, but we were looking at a very specific question.

982
01:02:22.240 --> 01:02:26.283
We were looking at families who had seen these end-of-life experiences.

983
01:02:27.344 --> 01:02:30.927
And the best example I can give you is, so you have a couple of.

984
01:02:31.970 --> 01:02:34.452
and they've been married for six decades.

985
01:02:35.232 --> 01:02:38.614
And part of their shared life was losing a child, an infant.

986
01:02:39.695 --> 01:02:44.337
And the spouse is looking down at his loved one in the bed, the woman in the bed.

987
01:02:45.658 --> 01:02:50.281
And she, in her inner experiences, is holding this deceased child.

988
01:02:51.782 --> 01:02:52.902
And she's at peace.

989
01:02:53.743 --> 01:02:53.863
And

990
01:02:56.529 --> 01:03:12.721
Well, one, it connects all lives, right, living and dead, but it reframes dying from something that could be empty and only defined by its physical dementia, what you're seeing, and it shows that it can be rich in meaning and love.

991
01:03:13.672 --> 01:03:25.697
Because the question always is, when you care for these families, is when that patient becomes nonverbal, when you become disconnected from them, is the question is where are they and how are they?

992
01:03:26.377 --> 01:03:34.441
And if you're seeing that, that changes how you experience their loss and informs how you bereave.

993
01:03:35.561 --> 01:03:36.622
You view it very differently.

994
01:03:37.708 --> 01:03:41.610
I've done almost 700 interviews with some of the most interesting people in the world.

995
01:03:41.690 --> 01:03:47.132
And one of the things you learn, which is unexpected, is that vulnerability is the doorway to connection.

996
01:03:47.152 --> 01:03:52.055
And after sitting here for two, three hours with a guest, I feel a deep sense of connection to them.

997
01:03:52.175 --> 01:03:58.418
And as they leave, what I get them to do is to write a question in the diary of a CEO.

998
01:03:58.498 --> 01:04:01.019
We've taken all of the questions from the diary of a CEO.

999
01:04:01.159 --> 01:04:03.020
We have put the question...

1000
01:04:03.860 --> 01:04:06.941
here on this card with the name of the person that wrote it.

1001
01:04:07.081 --> 01:04:11.623
So you can sit at home as I do with my fiance and my colleagues at work and other people in my life.

1002
01:04:11.944 --> 01:04:16.005
Whenever we get a minute, we play the Diary of a CEO conversation cards.

1003
01:04:16.185 --> 01:04:18.607
And it is incredible what happens.

1004
01:04:18.667 --> 01:04:22.268
These are great if you're in a romantic relationship and you want to connect your partner more.

1005
01:04:22.288 --> 01:04:25.670
These are also great if you're in a team and you want to bond your team together.

1006
01:04:25.910 --> 01:04:33.033
And I have to say they're also great for families that want to learn more about each other and that need a good excuse to spend some time in a digital world

1007
01:04:33.613 --> 01:04:36.514
in the analog environment, connecting human to human.

1008
01:04:36.754 --> 01:04:40.875
It is remarkable what the right question at the right time can do.

1009
01:04:41.035 --> 01:04:45.776
Go to thediary.com and you can get these conversation cards right now.

1010
01:04:47.497 --> 01:04:48.537
So that was the first point.

1011
01:04:49.257 --> 01:04:51.518
Love endures after physical loss.

1012
01:04:51.758 --> 01:04:51.978
Yes.

1013
01:04:53.539 --> 01:04:53.979
Number two.

1014
01:04:56.219 --> 01:04:58.080
Hope never fades, it changes.

1015
01:04:59.947 --> 01:05:01.368
And it's a very interesting thing.

1016
01:05:01.628 --> 01:05:02.489
What does that mean, sorry?

1017
01:05:02.809 --> 01:05:07.152
Well, when you're diagnosed with illness, you hope for cure.

1018
01:05:08.313 --> 01:05:14.698
And then, you know, it's unbelievable how acceptance comes into play.

1019
01:05:15.398 --> 01:05:19.541
And they kind of get through that, and then they hope for other things.

1020
01:05:19.621 --> 01:05:22.543
But the hope doesn't change, it just evolves.

1021
01:05:22.563 --> 01:05:23.384
Yeah.

1022
01:05:23.984 --> 01:05:24.845
It's fundamental.

1023
01:05:25.425 --> 01:05:26.405
And it becomes hope.

1024
01:05:26.445 --> 01:05:27.566
I want to be comfortable.

1025
01:05:27.906 --> 01:05:28.126
Hope.

1026
01:05:28.186 --> 01:05:29.707
I want to have time with my family.

1027
01:05:29.727 --> 01:05:31.627
It becomes all those things that they become.

1028
01:05:31.967 --> 01:05:33.348
That's all based in hope.

1029
01:05:33.848 --> 01:05:36.749
So hope didn't go away when they find out they're dying.

1030
01:05:36.869 --> 01:05:37.990
It just changed shape.

1031
01:05:38.430 --> 01:05:39.350
They just hope for something else.

1032
01:05:39.410 --> 01:05:44.893
And then at the end, it's the most beautiful part is it becomes hope for others.

1033
01:05:45.993 --> 01:05:49.875
And that's what you hear again and again, and it's just this wonderful story.

1034
01:05:50.595 --> 01:05:53.316
Somehow we become less selfish.

1035
01:05:53.796 --> 01:05:58.218
I found this when I tried to get the study approved, many studies approved.

1036
01:05:58.238 --> 01:06:01.539
The university would say, you know, we want to sterilize the dying.

1037
01:06:01.559 --> 01:06:03.180
They're never going to participate.

1038
01:06:03.220 --> 01:06:03.780
They're dying.

1039
01:06:04.040 --> 01:06:06.461
Why do they want to waste your time with you?

1040
01:06:06.841 --> 01:06:10.503
And actually, they all did, and they even want to be filmed.

1041
01:06:11.203 --> 01:06:13.464
And if you think about it, there's no secondary gain.

1042
01:06:13.885 --> 01:06:19.348
They're never going to see, it's like the old man that plants the trees, never going to live under the shade, but somebody else is, right?

1043
01:06:19.868 --> 01:06:22.170
And that's what we get from that.

1044
01:06:22.650 --> 01:06:24.491
It mattered that they contributed.

1045
01:06:24.951 --> 01:06:26.532
It mattered that they connected.

1046
01:06:27.053 --> 01:06:29.914
It mattered that they were heard, that their words mattered.

1047
01:06:30.395 --> 01:06:32.056
And that's a form of hope.

1048
01:06:32.816 --> 01:06:36.737
So they've gone from cure when they were diagnosed and they let go of that.

1049
01:06:37.217 --> 01:06:40.677
And then they think about things like comfort and having time with family.

1050
01:06:40.977 --> 01:06:43.838
But then at the end, what they always hope for is other people.

1051
01:06:44.858 --> 01:06:46.058
Maybe that's the essence of us.

1052
01:06:46.958 --> 01:06:51.319
Yeah, it's a better version of thinking.

1053
01:06:51.419 --> 01:06:53.239
I think we live in a selfish space.

1054
01:06:54.020 --> 01:06:56.680
I think we're robbed of that when you become a parent and whatnot.

1055
01:06:56.980 --> 01:07:01.981
But I think in the end, I think it's wonderful that hope doesn't extinguish because cure has.

1056
01:07:05.818 --> 01:07:10.139
The next is people don't stop living because they're dying.

1057
01:07:10.779 --> 01:07:21.941
And when we did this study looking at dying analogous to post-traumatic growth, the idea that within a negative adverse event like war, there's positive things like camaraderie.

1058
01:07:22.401 --> 01:07:23.942
That's what we found with this.

1059
01:07:24.862 --> 01:07:33.486
is that people were growing and adapting, and this was measurable and significant according to post-traumatic growth scales, right up into the last days of life.

1060
01:07:34.187 --> 01:07:36.848
And it's paradoxical to the physical state.

1061
01:07:37.248 --> 01:07:43.231
So physically they're declining, but psychologically and spiritually they're very much alive.

1062
01:07:43.251 --> 01:07:48.054
Number four, the dying leave us connected.

1063
01:07:49.514 --> 01:07:56.963
This became very important, and I wrote about this during COVID, because so many people were removed from their loved ones, which was an unbelievable tragedy.

1064
01:07:57.864 --> 01:08:05.192
And what I wrote about was, you know, when they're having these inner experiences, actually they're immersed and very much connected.

1065
01:08:05.572 --> 01:08:08.796
We don't see people who have these experiences in solitary.

1066
01:08:09.337 --> 01:08:10.037
We tend to think of

1067
01:08:10.698 --> 01:08:13.801
dying as lonely in a solitary event.

1068
01:08:14.581 --> 01:08:18.504
And what happens is in our inner world, we're bringing people into us.

1069
01:08:18.564 --> 01:08:19.845
We're reflecting on life.

1070
01:08:19.905 --> 01:08:24.769
And in these end-of-life dreams and visions, we're just immersed with people who we love.

1071
01:08:25.150 --> 01:08:31.815
So even though it looks like they may be isolated in an intensive care unit, when their eyes are closed, they're also surrounded in love.

1072
01:08:32.235 --> 01:08:36.118
But then externally, the dying process brings people together.

1073
01:08:36.138 --> 01:08:36.839
Yeah.

1074
01:08:36.999 --> 01:08:37.840
Lives stop.

1075
01:08:38.280 --> 01:08:43.344
You know, that son who has a roaring job in California has to fly home to New York.

1076
01:08:43.864 --> 01:08:50.249
It tends to stop the world and we focus on what really matters, which is each other.

1077
01:08:50.749 --> 01:08:51.610
And that's very clear.

1078
01:08:54.486 --> 01:08:57.009
The dying can heal with harmed or broken.

1079
01:08:58.070 --> 01:08:59.871
And this happens in a multitude of ways.

1080
01:09:00.732 --> 01:09:06.838
There's that external peace, whether it's making peace with their God, making peace with their family.

1081
01:09:06.898 --> 01:09:10.802
It's amazing how many families come together together

1082
01:09:11.122 --> 01:09:17.349
And what seemed like an issue of contention goes away and dissipates.

1083
01:09:17.929 --> 01:09:20.052
And they're able to see beyond that.

1084
01:09:20.152 --> 01:09:23.896
It reshuffles your priorities in ways that you can't imagine.

1085
01:09:23.916 --> 01:09:26.879
The grudge that was held on to is let go.

1086
01:09:26.979 --> 01:09:30.322
So there's this healing process that's innate to dying.

1087
01:09:31.023 --> 01:09:41.769
And I think internally, what we see again and again and again, people who are having negative or distrust in dreams and visions, they're often centered around harmful things.

1088
01:09:42.570 --> 01:09:45.752
But they're often addressed within that process.

1089
01:09:46.272 --> 01:09:54.617
So that somehow, and this is probably the most remarkable thing of all, they've lived this life with this injury and it gets addressed in the end.

1090
01:09:54.637 --> 01:09:56.558
There's almost like this final justice.

1091
01:09:56.818 --> 01:09:57.599
People like Dwayne.

1092
01:09:57.959 --> 01:10:01.102
you know, who has wrestled with these demons his whole life.

1093
01:10:01.843 --> 01:10:04.486
And then at the end, he's kind of made whole.

1094
01:10:07.558 --> 01:10:11.540
Lesson number six is there's a better story than the one we fear.

1095
01:10:12.440 --> 01:10:19.703
And the best analogy I can give you is that famous Dylan Thomas, the famous poet.

1096
01:10:20.063 --> 01:10:25.926
It's a message to his father who was becoming blind and dying, I believe, but he was healthy.

1097
01:10:26.506 --> 01:10:30.688
And it says, you know, basically, don't surrender, don't fight the dying of the light.

1098
01:10:32.008 --> 01:10:44.999
And most of us in health can relate to this idea of the resistance of death, you know, that you're going to—this is the enemy to be fought, and you're going to muster all your strength and will, and you're going to overcome and survive.

1099
01:10:45.739 --> 01:10:48.241
And that's not what happens to the dying.

1100
01:10:48.762 --> 01:10:51.464
The dying aren't fighting against anything anymore.

1101
01:10:52.027 --> 01:10:58.109
if anything, they're fighting towards and what they're fighting towards to get back to those that they've loved and they've lost.

1102
01:10:58.889 --> 01:11:00.250
Horace is a great example.

1103
01:11:00.770 --> 01:11:05.652
So Horace is, I believe, close to 90 years old, and he's very near the end of his life.

1104
01:11:06.812 --> 01:11:20.617
And I think what's beautiful about Horace is that his inner world experiences are so overwhelming that he actually struggles to find language for what the beauty that he's experienced is, the colors that are richer,

1105
01:11:21.957 --> 01:11:24.018
the relief he feels in seeing her.

1106
01:11:24.338 --> 01:11:29.360
And it really highlights this notion that they actually aren't struggling against anything.

1107
01:11:29.620 --> 01:11:34.622
If anything, Horace wants to go to this experience that he's having with his eyes closed.

1108
01:11:34.982 --> 01:11:36.763
So if we could watch Horace, that would be great.

1109
01:11:37.303 --> 01:11:38.664
Well, she looked always beautiful.

1110
01:11:38.824 --> 01:11:42.625
I mean, she was feeling pretty.

1111
01:11:42.965 --> 01:11:46.747
She looked...

1112
01:11:51.045 --> 01:11:54.028
She knew me inside out.

1113
01:11:55.389 --> 01:11:55.869
You know?

1114
01:11:57.451 --> 01:11:57.731
Yeah.

1115
01:11:59.212 --> 01:11:59.572
Mm-hmm.

1116
01:12:00.613 --> 01:12:01.254
And maybe that...

1117
01:12:02.695 --> 01:12:05.878
I guess maybe words weren't necessary.

1118
01:12:05.918 --> 01:12:11.923
We just look at each other and it was exactly what one was thinking.

1119
01:12:15.576 --> 01:12:17.236
And he's describing a vision he's had there.

1120
01:12:17.436 --> 01:12:18.457
Oh, it's beautiful.

1121
01:12:18.717 --> 01:12:22.458
And he describes this relief like paying a bill, like it's over.

1122
01:12:23.018 --> 01:12:24.998
And the greens of the grass are greener.

1123
01:12:25.078 --> 01:12:28.459
And he's so emoted by it that he starts to get very tearful.

1124
01:12:29.980 --> 01:12:37.942
How has interviewing these people as they're leaving this world changed how you live your life on a day-to-day, week-to-week, month-to-month basis?

1125
01:12:37.962 --> 01:12:39.222
Oh, absolutely.

1126
01:12:41.477 --> 01:12:42.177
I think a lot.

1127
01:12:42.277 --> 01:12:47.699
I think cancer did more to change how I live on a daily basis, probably.

1128
01:12:47.999 --> 01:12:48.920
You had stage four?

1129
01:12:49.180 --> 01:12:49.340
Mm-hmm.

1130
01:12:49.940 --> 01:12:50.820
Stage four cancer?

1131
01:12:50.980 --> 01:12:51.181
Mm-hmm.

1132
01:12:51.561 --> 01:12:54.722
Has it changed your perspective of you dying yourself?

1133
01:12:55.822 --> 01:13:01.144
I can tell you that I'm certainly not fearful of the actual process of dying anymore.

1134
01:13:01.984 --> 01:13:02.104
No.

1135
01:13:02.845 --> 01:13:03.265
Yeah, I'm not.

1136
01:13:03.585 --> 01:13:04.145
Were you before?

1137
01:13:04.805 --> 01:13:05.466
Yeah, I think so.

1138
01:13:05.666 --> 01:13:05.866
Yeah.

1139
01:13:06.326 --> 01:13:06.526
Yeah.

1140
01:13:06.862 --> 01:13:08.045
I mean, it's innate to us, right?

1141
01:13:08.065 --> 01:13:12.114
It's why we survive, is we're meant to resist.

1142
01:13:12.414 --> 01:13:15.120
And what in particular has alleviated that fear?

1143
01:13:16.808 --> 01:13:25.495
Oh, I think seeing so many patients, I think having to face it myself, that possibility, myself, I had to wrestle that demon.

1144
01:13:26.136 --> 01:13:27.317
And where does the comfort come from?

1145
01:13:28.317 --> 01:13:29.879
Because it becomes less about self.

1146
01:13:30.179 --> 01:13:31.180
It's very interesting.

1147
01:13:31.740 --> 01:13:43.009
When you have a diagnosis like I had, first you're confronted with this enormous responsibility, this reckoning with the lives that you're responsible to.

1148
01:13:43.049 --> 01:13:43.149
Okay.

1149
01:13:44.270 --> 01:13:50.294
And you worry about their wounds and how they're going to be, particularly if you have people who are dependent on you.

1150
01:13:51.014 --> 01:13:54.736
So I went through, that's what you first are confronted with.

1151
01:13:55.257 --> 01:13:57.498
And then it changes you in a lot of ways.

1152
01:13:58.358 --> 01:13:59.939
What specifically has changed?

1153
01:14:01.200 --> 01:14:03.561
I'm always restless.

1154
01:14:04.622 --> 01:14:06.203
I can never sit.

1155
01:14:06.663 --> 01:14:08.945
But cancer brought that to a stop.

1156
01:14:09.957 --> 01:14:10.377
Suddenly.

1157
01:14:11.638 --> 01:14:15.639
And it's a very weird thing because there's no period of adaption.

1158
01:14:15.779 --> 01:14:17.500
All of a sudden, you can't do.

1159
01:14:17.860 --> 01:14:23.763
You're used to going into the world, and now the world has to come to you.

1160
01:14:24.783 --> 01:14:31.466
And it forces you to do what I really could never do, which is kind of be more present.

1161
01:14:31.846 --> 01:14:36.568
I rehabbed basically over many, many months on my farm.

1162
01:14:37.528 --> 01:14:41.312
And I would gradually walk a little farther down the driveway than in the barn.

1163
01:14:42.373 --> 01:14:44.394
Animals walk in field and woods.

1164
01:14:45.275 --> 01:14:54.604
And I can't quite describe this, but there's one day I was there and I'm looking at these willow trees that I had planted decades earlier.

1165
01:14:55.705 --> 01:14:58.327
And they were the most beautiful things I'd ever seen.

1166
01:14:58.347 --> 01:14:59.428
And...

1167
01:15:00.829 --> 01:15:02.611
You know, the trees hadn't changed.

1168
01:15:04.213 --> 01:15:04.813
I changed.

1169
01:15:05.554 --> 01:15:09.938
Viktor Frankl talks about this in the book, Man's Search for Meaning, right?

1170
01:15:10.359 --> 01:15:11.320
He was a Holocaust survivor.

1171
01:15:11.340 --> 01:15:11.580
Yeah.

1172
01:15:11.920 --> 01:15:12.681
Yeah.

1173
01:15:12.701 --> 01:15:19.468
And somehow he came out of that experience and was able to put a lot of definition around finding meaning.

1174
01:15:19.908 --> 01:15:21.329
And he describes a day when...

1175
01:15:21.970 --> 01:15:24.491
One of the prisoners runs out and says, look at this sunset.

1176
01:15:24.551 --> 01:15:28.892
And they all come out and they're all admiring it despite their despair and destitute.

1177
01:15:29.352 --> 01:15:31.392
And the one says, look at what the world could be.

1178
01:15:31.912 --> 01:15:39.094
And the point is, is that beauty isn't about doing or accomplishing, but it's internalized.

1179
01:15:39.334 --> 01:15:41.315
It's the finding meaning in the experience.

1180
01:15:41.495 --> 01:15:44.776
And I never got it, but I got it then when I got sick.

1181
01:15:45.256 --> 01:15:50.217
And on that point of meaning, which is the word on the front of your book here, what is the meaning of life?

1182
01:15:51.278 --> 01:15:57.063
from everything you've experienced and all the death, loss, grief you've seen, what is the meaning of life?

1183
01:15:58.295 --> 01:16:02.477
I don't know about meaning, but I know the destination is always love.

1184
01:16:03.317 --> 01:16:10.740
And I think that we're meant to get there together, and we're meant to endure struggle together.

1185
01:16:11.620 --> 01:16:14.361
I think that that's just fundamental.

1186
01:16:14.761 --> 01:16:19.063
Again, we're fundamentally interdependent and reliant on one another.

1187
01:16:19.083 --> 01:16:25.545
If you think of the best parts of yourself, it's always in the context of love.

1188
01:16:26.794 --> 01:16:32.117
You wrote this wonderful book, Death is But a Dream, Finding Hope and Meaning at Life's End.

1189
01:16:33.478 --> 01:16:35.179
Who is this for?

1190
01:16:36.460 --> 01:16:42.083
Well, again, it was meant for a medical audience, but I think it's anybody who's caring for somebody.

1191
01:16:42.123 --> 01:16:45.105
I think it's anybody who's wondering about their own mortality.

1192
01:16:45.665 --> 01:16:52.029
I think what I find a lot of people are benefiting, it's people who have witnessed this experience, but it's never been explained.

1193
01:16:52.049 --> 01:16:52.269
Right.

1194
01:16:52.903 --> 01:16:56.405
And I think it's nice because it includes different types of patients.

1195
01:16:56.425 --> 01:16:59.947
So it includes patients who are cognitively different, includes children.

1196
01:16:59.967 --> 01:17:02.488
And each one of those is very unique.

1197
01:17:03.529 --> 01:17:08.752
Dr. Christopher, we have a closing tradition on this podcast where the last guest leaves a question for the next guest, not knowing who they're leaving it for.

1198
01:17:09.592 --> 01:17:16.176
The question that has been left for you, it's a question I often ask, what is one thing we haven't talked about that we should have talked about?

1199
01:17:16.796 --> 01:17:17.236
The children.

1200
01:17:18.457 --> 01:17:18.717
Explain.

1201
01:17:20.277 --> 01:17:21.458
children die very differently.

1202
01:17:22.339 --> 01:17:31.007
I think that it's not so much lessons, but there's certainly inspiration, and I think it talks about what's innate in us.

1203
01:17:31.467 --> 01:17:33.169
How do children die differently from adults?

1204
01:17:33.810 --> 01:17:33.890
Oh.

1205
01:17:35.939 --> 01:17:41.285
For one, they don't struggle to find acceptance that they're already accepting.

1206
01:17:42.146 --> 01:17:44.849
They don't think in terms of finality of mortality.

1207
01:17:45.490 --> 01:17:47.332
They just accept the state that is.

1208
01:17:48.053 --> 01:17:50.776
So they don't talk in terms of regrets and what-ifs.

1209
01:17:51.357 --> 01:17:52.958
Children have this amazing ability to...

1210
01:17:53.740 --> 01:17:59.044
to make themselves whole, to take care of themselves, to reassure themselves.

1211
01:17:59.464 --> 01:18:06.970
So one of the ways they do that is they may not know somebody who's died, so who comes back for them, and often it's an animal.

1212
01:18:08.071 --> 01:18:13.715
And children don't have the same distinctions, obviously, between the human and the animal world.

1213
01:18:14.356 --> 01:18:18.138
And they come with the same message, which is that they're loved and that they're not alone.

1214
01:18:18.158 --> 01:18:18.258
Yeah.

1215
01:18:19.119 --> 01:18:24.423
The other thing that's just fascinating is they become very self-informed by these inner experiences.

1216
01:18:24.963 --> 01:18:28.106
By that I mean they end up understanding where they are.

1217
01:18:28.566 --> 01:18:30.327
You don't have to tell them they're dying.

1218
01:18:30.808 --> 01:18:33.770
They seem to put this together in remarkable ways.

1219
01:18:35.031 --> 01:18:39.914
And far and away, the most remarkable thing about children—

1220
01:18:41.411 --> 01:18:50.395
is that they have this quiet courage and how they care for those around them so they become so utterly selfless.

1221
01:18:50.595 --> 01:18:52.096
It's almost hard to describe.

1222
01:18:52.116 --> 01:18:56.257
I saw a young lady who was taking her pain medicine.

1223
01:18:56.778 --> 01:19:08.583
She didn't want to take her pain medicine because she was enjoying being a weight and plugged in, but she was sensitive to what other people were observing, and she didn't want her mother to see her grimace.

1224
01:19:09.543 --> 01:19:11.165
another one who was from Syria.

1225
01:19:11.645 --> 01:19:12.726
She knew she was dying.

1226
01:19:13.047 --> 01:19:19.353
Her parents couldn't talk to her about it, but she had already gone ahead on Facebook and said goodbye and given life lessons.

1227
01:19:19.834 --> 01:19:21.375
Do they have the same visions and dreams?

1228
01:19:21.675 --> 01:19:22.636
Oh yeah, they do it better.

1229
01:19:24.255 --> 01:19:26.216
And we could show that with Jessica.

1230
01:19:26.796 --> 01:19:27.676
So tell me about Jessica.

1231
01:19:28.397 --> 01:19:32.278
Jessica's 13 years old, and she's raised by a single mother.

1232
01:19:33.358 --> 01:19:37.980
And she sees this deceased friend of her mother's playing with her curtains.

1233
01:19:39.220 --> 01:19:42.321
And she doesn't want to tell her mom because she didn't want to scare her.

1234
01:19:42.822 --> 01:19:45.923
But it made her feel good because she was a good person.

1235
01:19:46.003 --> 01:19:47.603
And again, she's not going to be alone.

1236
01:19:48.264 --> 01:19:51.765
So they tend to look after, despite being children,

1237
01:19:52.705 --> 01:19:57.486
and being robbed of life, they somehow tend to worry about others and try to protect others.

1238
01:19:57.586 --> 01:19:58.487
And that's what she does.

1239
01:19:59.247 --> 01:20:06.949
I had a feeling that she was just coming and telling me that you're going to be okay, everything's fine, but she didn't look at me.

1240
01:20:07.809 --> 01:20:08.569
She was just looking.

1241
01:20:08.869 --> 01:20:14.891
But I had a feeling if I called out her name, she would look at me, but I didn't want to scare my mom.

1242
01:20:15.251 --> 01:20:17.072
I felt a sign of relief.

1243
01:20:17.712 --> 01:20:17.992
Yeah.

1244
01:20:19.294 --> 01:20:24.155
And happiness because she was a very strong person.

1245
01:20:24.815 --> 01:20:26.316
And I know that I'm strong.

1246
01:20:26.416 --> 01:20:30.577
And my mom tells me all the time that I'm like her.

1247
01:20:30.597 --> 01:20:31.417
Wow.

1248
01:20:32.077 --> 01:20:35.158
And you told me that you thought that, oh, mom, I saw an angel.

1249
01:20:35.178 --> 01:20:38.099
That's how you said you felt and you felt peace.

1250
01:20:38.179 --> 01:20:39.619
And then you were able to go to sleep?

1251
01:20:39.919 --> 01:20:41.800
And that I was able to go to sleep.

1252
01:20:42.220 --> 01:20:43.620
So it was really comforting.

1253
01:20:43.800 --> 01:20:44.880
It was comforting, yes.

1254
01:20:44.900 --> 01:20:45.540
You weren't afraid.

1255
01:20:45.560 --> 01:20:47.761
I wasn't afraid of it at all.

1256
01:20:48.245 --> 01:20:52.747
So children have this way of self-healing.

1257
01:20:52.807 --> 01:20:53.648
It's remarkable.

1258
01:20:53.668 --> 01:21:03.412
We have another child on video who she creates this castle and she can feel the warmth of light coming through the window and all the animals are well and plain.

1259
01:21:03.872 --> 01:21:07.394
And when asked what the castle meant, she said it meant that there's a safe place.

1260
01:21:12.677 --> 01:21:16.418
Dr. Christopher Kerr, what a wonderful reminder of what actually matters.

1261
01:21:17.199 --> 01:21:17.439
Good.

1262
01:21:18.735 --> 01:21:25.177
And also, when we think about how many of us, ourselves, fear our own death, it's quite high.

1263
01:21:25.217 --> 01:21:28.558
It's about half of people, men and women, fear their own death.

1264
01:21:29.298 --> 01:21:36.560
But actually, I think through your research, through the book that you've written and through the studies that I have here in front of me, it certainly made me think a lot less about the fear of my own death.

1265
01:21:36.580 --> 01:21:42.041
Because you're right, people think of it as being this sort of painful, prolonged process, but that's not what you report.

1266
01:21:42.221 --> 01:21:43.662
No, and actually, we've looked at that.

1267
01:21:43.782 --> 01:21:46.643
And what they actually fear is isolation.

1268
01:21:47.043 --> 01:21:47.223
Yeah.

1269
01:21:47.923 --> 01:21:48.905
and being disconnected.

1270
01:21:49.846 --> 01:21:53.831
And more so than fearing our own death, we fear losing someone else.

1271
01:21:54.232 --> 01:21:54.452
Right.

1272
01:21:54.592 --> 01:21:56.896
I've never come with the right way to frame it.

1273
01:21:57.316 --> 01:22:02.804
But all of this comes back to this better idea that the concern is for others lends that more than self.

1274
01:22:03.625 --> 01:22:04.466
And that's a beautiful thing.

1275
01:22:04.766 --> 01:22:04.967
Yeah.

1276
01:22:05.407 --> 01:22:09.949
Death is But a Dream, Finding Hope and Meaning at Life's End by Dr. Christopher Kerr.

1277
01:22:10.169 --> 01:22:13.611
I'll link this book below for anyone that would like to read it and dive deeper into these subjects.

1278
01:22:13.631 --> 01:22:21.715
They are illuminating subjects, again, because people in those moments of their life have such a wonderful retrospective clarity, but maybe it's just clarity.

1279
01:22:22.835 --> 01:22:25.316
Maybe it's just clarity on what actually mattered the whole time, as you say.

1280
01:22:25.857 --> 01:22:39.322
Thank you so much for doing this work, because again, it's destigmatized a bunch of prevailing myths and ideas about the last stages of our life that probably cause us undue harm, both to those that are left behind, but also to those that pass on.

1281
01:22:39.602 --> 01:22:50.527
And it does, it raises more questions about the nature of consciousness and spirituality and religion and the afterlife and all these things, which I guess are...

1282
01:22:53.325 --> 01:22:54.551
our individual questions to answer.

1283
01:22:55.696 --> 01:22:56.017
Thank you.

1284
01:22:56.198 --> 01:22:56.620
Thank you.