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Doctor Explores the Dreams of Hospice Patients

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Pre-death dreams and visions “have been reported throughout history and across cultures. They are mentioned in the Bible, Plato’s Republic, Shakespeare,” says Dr. Christopher Kerr in a TedTalk about his research of the dreams of hospice patients, viewed more than 5 million times.

In his talk, Dr. Kerr remembers at age 12, having a conversation with his own dying father who reached out to him, touching his buttons and talking about needing to hurry to catch a plane to go fishing up north.

“I didn’t choose this topic of dying, I feel it has chosen or followed me throughout my life,” Kerr says.

Despite this childhood encounter, Kerr first learned of the phenomenon as an adult from a nurse who told him she knew a patient was dying soon because he’d dreamed about his mother.

Kerr says found dying patients often describe their end of life in ways that are “life-affirming and rich with meaning, love and even grace.”

He spoke with us about what he’s found while studying these dreams and visions of patients in hospice.

How are the dreams of dying patients different from everyday dreams?

“One is the depth of realism. We had a scale to measure realism of zero to ten, with ten being the most realistic, and ten is the most common number (we received). In listening to our patients, what they are emphatic about is that these don’t feel like dreams because of the virtualness of it.

The disclaimer we commonly hear from our patients is ‘I don’t normally dream’ or ‘I don’t recall my dreams,’ so there’s that qualitative aspect of it that just feels very different.

The other thing is the content. The predominant theme is seeing deceased loved ones. They’re not random. They are the ones who loved you right, unconditionally, secured you, nurtured you … and excluded are people who didn’t. So it might be one parent and not another.

There’s very little said. It’s not a dialogue. The dreamer is left with a feeling, intuited something. There doesn’t seem to be a need to analyze or decipher a metaphor. It is just understood. I’ve yet to meet a patient that wakes up and says ‘Hey, what do you think this means?,’ which makes sense to me, because the time for analysis is over.

The frequency is striking, particularly as you get closer to death. There’s a dramatic increase. And the comfort level. These people are not confused by what it was. It triggers a variety of senses, so it feels profoundly real.”

Can you describe a memorable dream you studied?

“It’s tough, there are thousands. There’s one I discuss in the TedTalk, a woman named Mary, who toward the end of her life was cradling a baby that she named, cooing and kissing. Her children didn’t recognize the reference. When her out-of-town sister arrived, it turned out (the sister knew) it was Mary’s first child that she’d lost. I think that was monumental for me because it was something I had zero interest in, but it was so obviously therapeutic for her, this idea that we all have wounds for having lived, and she had hers, and here it was being addressed.”

How does your work inform the bigger picture of the needs of hospice patients?

“I think the larger story is that dying isn’t a medical equation. Dying is when nature takes its rightful place and becomes a human experience. What we’ve done is sterilize it and define it in terms of organ failure rather than life closure. What’s lost in that is that we only experience what we see, which is physical lessening, and what we anticipate, which is loss. And there’s something else going on which is the patient’s experience. What you see is that so many people do this with grace, comfort and meaning. Dying is lonely and there is always something you can do which is to be a presence. There’s human value in being there in front of somebody.”

You mention that it was a nurse who helped you recognize this phenomenon. What is special about the relationship nurses have with these patients?

“I think what happens is that they’re closer to the bedside. It is not transactional for them. They have to be visible, accessible and present in a way that doctors don’t. They understand things about families, whereas a doctor can have a level of detachment.”

What advice do you have for hospice or health care doctors, nurses and staff who work with patients experiencing these dreams or visions?

“I think the most important thing is to take off the diagnostic hat and just have reverence for the experience. Regardless of source, it doesn’t change the validity or the potency for the person who is in the bed. It is not our responsibility or right to decipher or invalidate it, it’s just to honor it as belonging to them. In so much as it has meaning for them, it needs to be respected. Dying changes your vantage point. It changes your perception. It changes your perspective. So, it is not surprising that they are having inner experiences that are unique and should be honored in that way.”

Your research avoids interpretation of the source or meaning of the dreams. Why?

“The sinkhole of studying anything pre-death is that it is viewed as a conduit into something beyond death.

So, dying isn’t looked at as a mystery unto itself, but as a keyhole you get to look through. It’s unfortunate, because then it becomes this blank palette that anybody can paint, whether it is religiosity, afterlife, paranormal, reincarnation, it’s just fodder.

I believe that we should just honor their words and translate them purely, without adding our editorial or interpretation. It is one of the reasons we did the work.”

Dr. Kerr is a hospice physician, end-of-life researcher and author. His research has been published in his book “Death is but a Dream,” his documentary airs this spring on public television (check local listings). You can find more information on his website, and stream the documentary on Vimeo.