Visions, Trips, and Crowded Rooms (2 page)

My mother battled health problems throughout much of my life. On New Year’s Eve 1972, I walked into her bedroom, where she was ailing. I gave her a kiss and said, “Mom, 1973 will be the year you get better.” Within days, as she endured severe kidney failure, she was transferred from our local VA hospital to one that was much larger and better equipped.

My father and I sometimes stayed at a hotel across the park from the hospital when we had the money. We mostly sat in the hospital’s lobby since my mother was in an intensive care unit, which only allowed visitors every two hours for ten minutes. One morning we were on our way to see Mom when there was sudden activity around our hotel. Everyone outside began running as shots were fired. Evidently, there was a sniper on top of the building. Within seconds, police were everywhere while people rushed into the adjoining buildings for cover. It was actually pretty exciting stuff for a child who had been so bored sitting in the hospital for days on end.

Dad and I eventually made our way over to see Mom and were told that she didn’t have long to live. She died alone that day, but that’s the way it happened back then. Families (especially children) were often not allowed to be present during a patient’s final moments; and when they were, it was at the mercy of the caretakers. My mother’s doctor reluctantly agreed to let my father see her, but said that I could not. When the nurse came to take Dad to Mom’s room, I went along, hoping I wouldn’t get caught.

The nurse led us to the bed where my mother’s lifeless body lay; and as difficult as it was, I was actually relieved to be face-to-face with her without all the machines and tubes. I felt little privacy, though, because there were 17 other patients in the ward. The nurse who brought us in also stood close by—never leaving us alone—ready to whisk us out when our brief time allotment was up.

Before the day was over, I took my first plane ride. Since my mother had just died, as a well-meaning gesture, the pilots invited me into the cockpit to “help” them fly the plane. Even though I appreciated the gesture, it was all but lost on me. I clearly remember looking out from the cockpit, feeling utterly overwhelmed, knowing that what I’d seen with my mother wasn’t how death was supposed to be.

When I take a look at my career choices—dealing with death in the medical world, becoming a reserve police officer, and learning to fly a plane—I see that they were all attempts to gain back the control I’d lost on the day my mother died. Once I found a healing process for myself, I felt that I’d gained a special insight and could help others. Today, I’m the one who could have helped that young boy who was in so much distress. My career is living proof that we teach what we need to learn.

I recently watched a peer of mine featured on
60 Minutes.
He’s a medical doctor and was on the show to discuss the idea that too much technology is used at the end of life. He presented his case so well, in fact, that I would have been hard-pressed to do better. As he spoke, I thought back to the numerous families I’ve worked with in the ICU who kept their loved ones alive with artificial equipment in a futile attempt to restore their health when it was no longer possible.

This universal struggle involves more than knowing to what extent one should use life-extending medical technology. It’s fear that I see in the eyes of my patients and their family members: the fear of saying good-bye, the fear that this life is all that there is, and the fear that they’ll never see each other again. At times, however, something extraordinary happens. This book is about those extraordinary times.

I
NTRODUCTION

I was recently talking with a colleague who teaches ethics at Loyola Marymount University. She was about to begin a class on death and dying, and we were discussing end-of-life issues, such as the controversy surrounding artificial nutrients and terminally ill and brain-dead patients. With our cutting-edge technology, how does one determine when life should end?

In that moment, I recalled a patient who had experienced a deathbed vision. Then I thought about all the patients, all the deathbed visions, and all the discussions I’ve had over the years with colleagues. At hospice, palliative-care, and other end-of-life conferences, it was the kind of thing that was never mentioned. The experts were far too focused and serious, and had only one point of view. But after a long day of lectures, people would eventually start opening up about the patients who were behind the studies and reports presented earlier. After a drink or two over dinner, someone would recount a patient’s deathbed vision, and another person would have a similar story. Suddenly, the whole group would fall into an animated discussion about who and what we see before we die.

I knew that when I brought up the phenomenon of deathbed visions, this highly respected, well-credentialed professor would have a strong reaction one way or another.Of course, my guess was that she would dismiss it, saying something like: “I’m not into all that—this is a
serious
program.” But her reaction was the opposite: “It’s so rarely written about, let alone discussed in a formal classroom setting. Everyone has these stories, although no one seems willing to put them down on paper.”

At that time, I had deadlines looming for two books that I hadn’t even started. It dawned on me that this subject would, and should, take center stage in one of them. Although that seed of an idea ultimately blossomed into the book you’re currently holding in your hands, I had no idea of the journey I’d be taking as I wrote it.

During my research, I became fascinated by the richness of the topic as well as the lack of practical, credible information available. But how would I present this subject matter? What purpose would it serve? I’ve always felt that a valuable book needs a great purpose. My thoughts were interrupted when the phone rang. My friend Barbara was on the line, and she sounded distraught. She’d just returned from visiting her 92-year-old mother, who was healthy enough but was experiencing the usual problems that come with old age. Barbara shared how hard it was to watch her mother slowly deteriorate, and then she told me that a close friend’s parent had recently died. “I don’t understand why I’m so depressed,” she said. “I’ve faced loss before.”

Barbara had been through a lot. She’d volunteered in hospice; she’d lived through the Vietnam era; and then during the AIDS crisis, she’d watched as so many of her friends had died all at once.

“The past is different,” I replied. “Vietnam was a war, and you were on the front lines when the AIDS epidemic broke out.”

She agreed. This
was
different for her—and for all of us. Just as our parents are older, we are older, too. The sudden death that we expected as young people was now transforming into a slow-motion deterioration of our own bodies. Instead of “live fast, die young,” many of us baby boomers are currently facing a natural progression in living and dying. Barbara was zeroing in on it when she asked, “Is there nothing to look forward to? Is this it? Just suffering and death?”

I told her that death was inevitable; suffering, however, was optional. Yet there was more to it than that. I listened to her words, but I also heard what was underneath. I asked, “Are you feeling hopeless?”

That was indeed the issue . . . and Barbara began to sob. If she had 500 tears to cry, I said, she shouldn’t stop at 300. When she called the next day to let me know she was feeling better, I realized why I wanted to write this book and what it’s truly about.

A Book about Hope

Although I lost my mother too soon, my father remained an incredible optimist his whole life, even when he was dying. I was busy trying to make sure he was comfortable and pain free, and at first didn’t notice that he had become very sad. He told me how much he was going to miss me once he was gone. And then he mentioned how much he was saying good-bye to: his loved ones, his favorite foods, the sky, the outdoors, and a million other things of this world. He was overcome by sadness I could not (and would not) take away from him.

My father was very down for the next few days. But then one morning he told me that my mother, his wife,
had come
to him the night before.
“I was looking at all I was losing, and I’d forgotten that I was going to be with her again. I’m going to see her soon,” he said. He looked at me as if he realized I would still remain here. Then he added, “We’ll be there waiting for you.” Over the next two days, his demeanor changed dramatically. He had gone from a hopeless dying man with only death in front of him to a hopeful man who was going to be reunited with the love of his life. My father lived with hope . . . and also died with it.

As someone who has spent most of my life writing, teaching, and working with the dying, I can’t prove to you that my father’s vision was real. I can only talk about my experience as a son and about countless other occurrences that take place every day. I used to believe that the only thing we needed to alleviate was the suffering of the dying by providing good pain management and symptom control. I know now that we have more than opiates for pain, and we have more than anti-anxiety medication to combat fear and distress. We have the “who” and “what” we see before we die, which is perhaps the greatest comfort to the dying.

My wish is that you’ll find the hope that my father did— the hope I felt after hearing his story. This is the same hope that so many patients and family members feel when they’ve experienced these visions.

So that is what this book is about:
hope.
Hope that there is more. Hope that we don’t watch each other slowly die and then simply wait for our own deaths. We want to hope that there is a heaven, that some part of us doesn’t die, so we can be reunited with those we love and maybe even with religious figures who’ve inspired us in our lives.

Throughout my years of working with the dying, their visions of visits from loved ones who have already died are only the first of three commonly shared experiences that remain beyond our ability to explain and fully understand. The second type is getting ready for a trip. The notion of the dying preparing for a journey isn’t new or unusual. Although, interestingly enough, it’s always referring to an earthly journey. People talk about packing their bags or looking for their tickets—they don’t mention chariots descending from heaven or traveling to eternity in some other manner. The archetype is about life and transitions, not endings. The saying “It’s not about the destination, but the journey” has never rung more true than here.

The third type is known as “crowded rooms.” The dying often talk about their room being filled with other people. The word I hear over and over again is
crowded.
It’s not unusual for the dying to recognize some but not all of these visitors. We will look into who these people are and the connections they have during both life and death. By doing so, the very idea that we die alone may be challenged. What if the journey at the end of life is not a lonely path into eternity, but rather, an incredible reunion with those we have loved and lost? Beyond that, what if the dying hold a connection to those who have been long forgotten? What could that offer to the living?

How This Book Is Set Up

The following chapters will bring about new insights and ideas on what the end of life looks like and the miraculous encounters that are put before us. This book follows my exploration into the deathbed phenomenon. Just like when I started researching, it begins by taking a look at the definition of the term
deathbed vision
and what it means. Since I have experience in the medical field, I was curious to see if this subject was acknowledged or touched on in other areas and professions. As I searched, I was pleasantly surprised to discover quite a bit of discourse in the legal world concerning the veracity of a dying person’s final words. I’ve also examined the role that deathbed visions play in the arts. All of my findings are included here.

Of course, the majority of this book is made up of the personal stories told by numerous health-care professionals, and I’ve divided them into several chapters. (Throughout many of these chapters, you’ll find my thoughts and commentary in italics in order to set them apart from the stories.) All of these witnesses have generously shared their personal experiences. I’ve done my best to retain their voices on these pages, and I’m excited to present their amazing accounts here.

In “Visions of the Dying: Part I,” I wanted to know if doctors and nurses had stories about deathbed visions from their patients and if they were willing to share them. They did, and they were! Encouraged by those powerful accounts, I checked in with many mental-health professionals (such as social workers, psychologists, and counselors) to see if
they
might want to discuss their experiences with the dying. The results were incredible, and their accounts are in the chapter titled “Visions of the Dying: Part II.” The accounts here are only a sampling of what these individuals see on a daily basis, and for each story included in these pages, there are countless more just like it.