Tuesday, July 20, 2010

'Visions, Trips and Crowded Rooms' David Kessler's latest book chronicles what we experience before we die.

By R. W. Dellinger 
David Kessler had to author three books on grief, the needs of the dying and death, meet Mother Teresa and work with acclaimed thanatologist Elisabeth Kübler-Ross before he could develop the maturity and muster the courage to write "Visions, Trips and Crowded Rooms - Who and What You See Before You Die."

"When you're starting out in your professional life, you want to make sure that you're doing credible work," says the vice president of patient support care services, which includes overseeing end-of-life care, pastoral care and social work, at Citrus Valley Health Partners. "If I would have said to anyone early on, 'You know, I've been noticing there's some visions going on here with our dying patients,' they would have thought I was crazy.

"After writing three books and being around people like Kübler-Ross and Mother Teresa, I hope that people will realize I'm just always reporting from what's happening at the end of life. I mean, if anything, I see myself as an end-of-life reporter because I know everybody's not going to be around the bedsides of the dying.

"I think there's a part of me that's become more courageous and more mature to say: 'You know what? Not only should I find the courage to share these stories, but it's actually a disservice by letting you believe your grandfather or grandmother, who was a very sane person, became crazy in his or her last moments of life,'" he points out. "I actually have a responsibility to say: 'Nope. This is a common phenomenon. I can't explain it. Don't have any interest in arguing about it. Accept it or don't.'"

The 51-year-old modern-day student of death, who runs the Citrus Valley Hospice program for the group of three hospitals in the San Gabriel Valley, conducted in-depth interviews with healthcare professionals, members of the clergy as well as individuals who had lost loved ones. They told him what it was like being at the deathbed of a patient, relative or close friend.

Eyes fixed on mom

The first shared experience reportedly was deathbed visions, most often of the dying person's mother or mother figure. Their eyes became fixed on something no one else in the room could see as they reached out their hands passionately, according to many witnesses of deathbed scenes.

A hospital supervisor who Kessler calls Nina in the 168-page book said her dying husband suddenly started talking to someone in his hospital room, although no one else was present. She clearly heard him say, "Mom, I can't believe you're here." Then he told his dead mother all about his living family. But the supervisor said the "most amazing part" was how her husband kept his eyes focused upward on a particular spot, like his mother was hovering there.

An oncologist was at the bedside of his brother, who had terminal cancer, with their mother. The patient began talking as if there was somebody right in front of him. And it soon became apparent that he was speaking to his father's parents, whom he'd been particularly close to. The conversation lasted for a couple of hours, with the patient smiling and calling both of his grandparents by name.

"As a doctor, it's very easy to dismiss this sort of thing until you see it firsthand," the oncologist told Kessler, adding, "Before the episode, there was a sense of struggle and tension in the air, but now there seemed to be only peace surrounding my brother. I truly believe that it was a result of my grandparents' visit as he died."

Kessler found that deathbed vision happenings shared a number of things. First, death had to be imminent, within at least a week and sometimes the same day. Only really dying people, in short, had visions. And these end-of-life visions were remarkably similar, with mothers or mother-like figures being the most likely apparitions.

"The more I thought about it, I wasn't as surprised as I might have been, because our mother ushers us through this threshold into life - and wouldn't she be there at the end?" he muses.

The healthcare administrator and former nurse stresses that the visions were more than hallucinations or the result of oxygen deprivation. He explains that hallucinations feel unsafe and don't make a lot of sense. The same can be said for the ramblings of people who are oxygen deprived. But the deathbed witnesses he talked to reported that the dying patient carried on a coherent conversation with the unseen visitor and then had no trouble switching back to people in the room.

Standing room only

Dying people spoke a lot about getting ready for a trip, which was the second commonly shared deathbed experience, Kessler found. And he emphasizes that the journey was a real concrete trip versus an abstract notion of heading into eternity. People asked "Where's my ticket?" or "What happened to my passport?" not "I'm about to go into the abyss of death."

A social worker at a major hospital shared a story about a woman in her 80s dying of congestive heart failure. After not talking for days, she sat up, waving at her daughter to look where she was pointing. "Don't you see them?" she declared in a steady voice.

"See who?" the daughter asked.

"I see a dock; and there are your dad, grandmother, grandfather and uncle."

When the daughter said she still didn't see anybody, her mother exclaimed, "Well, they're all there! They're standing on the dock, waiting for me to come across." After a pause, her gaze fixed again on the wall, she directly addressed the people in her vision. "There's no boat at the dock," she said. "How can I get to you?"
The next day, the elderly frail woman uttered her last words with an expression of complete contentment: "The boat is finally at the pier."

The final kind of deathbed experience reported to Kessler was crowds and crowded rooms, or what he likes to call the "standing-room-only experience." The dying often reported being in a room - or about to enter one - full of people, some of whom they didn't even recognize.

"We may think we only have a handful of friends, but what about all the people we've interacted with or shared a kindness with during our life?" he notes. "What if there's a lineage that we do gather with once again in the afterlife, in heaven? There was an awe of how many people were present for many of the dying."

Like the account a hospital chaplain told him of a middle-age woman who was losing her battle with ovarian cancer. Focusing her eyes upward at a corner of her bedroom, she said, "Oh, it's a door. A lovely golden door."

Then she told her mother, who was present, there were more and more people trying to push the door open. "Mom, look how many are here for me," she said. "They're going to help me."

The chaplain, who was also at her bedside, remarked at how happy she looked, especially when her mother said, "Dorothy, you can go with these folks if it's time."

Placing her hand on the dying woman, the chaplain assured her, "It's all right to go. I'll take care of your mom."

Shortly after, Dorothy died peacefully.

'It changes everything'

"You hear people say, 'we're born alone, we die alone,' but from the deathbed it doesn't seem like a lonely experience," observes David Kessler. "It feels like we're not going into the emptiness but arriving into a fullness."

After a moment, he confides, "One of the most starling things for me in hearing these stories is what if death isn't that lonely experience that we should all fear? What if we are comforted and loved and cared for - and there is standing room only? It changes everything. I mean, it reaffirms our faith."

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