UNTOLD TREASURES

I, like so many others whose career eventually led them into palliative care, discovered that caring for the dying is one of the most rewarding niches in healthcare. The reasons for this are many and varied, but perhaps the most profound has to do with the practical or natural spirituality that one encounters when in the presence of dying people.

Clinical nurses spending time with the dying (and that is the key; i.e. spending time) become aware of, and eventually accustomed to, phenomena that most would consider paranormal. For those intimately involved with the dying, paranormal eventually becomes normal.

For clinical (as opposed to managerial or administrative) hospice nurses, dying people seeing and interacting with deceased relatives, friends or other unseen entities prior to their own death is not the least bit unusual. It may seem odd to the novice , but given sufficient time and experience it begins to take on a natural-ness that not only ceases to excite suspicion or disbelief, it helps to explain the clinical picture.

For example, a terminally ill woman whose course has been rather unremarkable suddenly reports having had an interaction with her deceased husband, and shortly thereafter she dies. Why?

An inexperienced hospice nurse might conclude that this patient has been hallucinating, then contemplate the possible causes and what interventions might be employed to put a stop to it. An experienced hospice nurse, on the other hand, would be more likely to conclude that the patient’s husband has indeed come to assist her in crossing, which will likely allay some of the patient’s trepidation about the so-called “end” of her life. Rather than supposing there is something wrong with this patient, the experienced nurse assumes a key issue has been resolved (whether or not death ends life) and death (moving on) will probably follow sooner rather than later.

But experienced hospice nurses seldom talk about these things, except perhaps among themselves. Why?

Because it is not "scientific," and of course there is always the very real possibility of being labeled "crazy."

Hospice nurses are leery of talking about their experiences for the same reasons as dying people; i.e., they are afraid of having their sanity questioned.

Why am I talking about it then? Well, first of all I am now legally blind and retired from active nursing. Second, I am getting older and age has its perquisites; such as saying whatever one darned well pleases. As far as that goes, I have long been afflicted by an inclination to say whatever I please anyway. If you think I am nuts, frankly my dear, I don’t give a damn. And finally, practical experience has taught me that this information is extremely valuable to those who will die… which happens to include every person on the planet, so the information has rather broad application.

Dying people see the world differently. I have long felt that there are basically two perspectives of the world; 1- that of the living, and 2- that of the dying. Hospice nurses eventually begin to adopt the perspective of the dying. Why? Because it makes more sense.

The following is another practical example of what I am talking about.

A man who has been in the active phase of dying for several days is growing progressively weaker and more somnolent. He is no longer eating or drinking and his urine output is virtually zero. Suddenly he perks up and gathers just enough energy to whisper, “I am not going to die.” Shortly thereafter, he dies.

An inexperienced hospice nurse would have been perplexed and felt rather unsettled about this patient’s remark. The rational inference would have been that the poor man had a remarkable talent for practicing the fine art of denial. She would have concluded he was deluded and obviously not getting enough oxygen to his brain.

But an experienced hospice nurse would likely have reached a very different conclusion; namely, the patient had seen where he was going (after death) and was greatly relieved to learn that death does not end life after all. Rather than doubting his sanity, an experienced nurse might have smiled broadly and replied, “You are correct, you will not die.” Neither would she have been at all surprised when he "died" shortly thereafter. The nurse realized her client had seen where he was going, was greatly relieved if not captivated by the prospect, and then moved on.

Can you imagine this sort of perspective being taught in nursing or medical schools? Don’t hold your breath. Clinical hospice nursing is one of the most profoundly inspiring careers extant, yet it is all kept mum. And you do not have to think about it very long or hard to figure out why.

The living (or the not-yet-dying) view death as purposeless tragedy which brings about the “end of life.” Dying process is seen as some bad stuff that occurs shortly before a person ceases to exist. That is the scientific point of view... the default, consensus definition of death and dying process.

Dying people, on the other hand, come to see the world as logical, purposeful and continuous. Dying process comes to be seen as a series of events preparing a person for continued life, not as an augur of life's "end." It is quite impossible to understand death until one learns to view it through the eyes of the dying.

When hospice nurses accumulate sufficient experience and insight to begin viewing the world as the dying view the world, words like "death" and "life" take on entirely different meanings. The way the general public uses those terms seems, to an experienced hospice nurse, strange and misguided. Misconceptions are so prevalent that they are literally embedded into our language. It is difficult, if not impossible, to carry on an intelligent conversation about "life" and "death" when personal definitions vary so markedly. To most, "death" means the "end of life." To experienced hospice nurses, "death" means something altogether different... but certainly NOT the "end of life."

It is fascinating to reflect that, while the "living" and the "dying" view the world very differently, it is the "living" who become the "dying." What happens to effect such a dramatic change in perspective?

Dying process itself is what brings about this major alteration in perspective. The profound nature of the experience opens the eyes of those going through it to realities and realizations beyond our mundane world. We cannot see and hear what they (the dying) see and hear, but we can, over time, notice sufficient consistencies in the stories they tell to begin connecting the dots.

The goals of living and dying are the same... they both teach us who we are. The biggest difference between the two is that "living" allows us to meander about more-or-less aimlessly in the haphazard and unfocused manner we seem to favor, while "dying" forces the issue by insisting that we pay attention and get down to serious business.

Studying dying people as they move through dying process is an untapped gold mine of insight... insight into what it means to be human. It offers the rarest of opportunities. Along the ragged borders of human experience are loose and tattered edges that can be gently lifted and ever-so-delicately peeled back... revealing perspectives that cannot be gained in any other way. Dying process has potential beyond all description for learning about who we are... but we squander that opportunity shamelessly... stupidly. We say the dying are "confused" and "hallucinating" and we feel sorry that their lives "ended." By so doing we completely miss the point and the opportunity to learn something truly profound.

One of the most mundane misinterpretations of a statement uttered by a dying person that I have heard recently (perhaps ever) occurred during the dying process of Pope John Paul II. While drifting in and out of consciousness an attending Cardinal reported the Pope to have muttered, "I have been waiting for you. You have come, and I thank you." That is a typical statement made by someone in the late stages of dying process and usually indicates they have perceived and are communicating with someone beyond the mundane realm. But the journalist making the report confidently announced that the Pope must surely have been referring to the crowd in St. Peter's Square!

Now think about that for a minute. Here is a man who has devoted his life to spiritual matters. He has lived long, worked hard, accomplished much and is now sitting on the fence between the mundane and spiritual realms. His parents died when he was young and he would most certainly love to see them again. His brother died many, many years before and he would certainly love to see him as well. He is a devout Christian and would, without question, be "waiting" to see Jesus. He is a man of God and would unquestionably "wait" to see Him. But those in the mundane world naively suppose the Pope just wanted to see them?!?! It would be challenging to imagine a more absurd and pathetically egotistic misinterpretation of a profound event.

We live in the mundane world and see little else. We fall into the habit of assuming this is all there is. Dying process opens our eyes to that which lies beyond. Because they hang out with dying people, hospice nurses are exposed to this perspective repeatedly... one that sees beyond the mundane world. For them, the perspective of the dying becomes the norm.

The average person looks up into the heavens, counts a few million stars and calls that "infinity." Dying people and hospice nurses look up and see more.

Michael Holmes, R.N.

Author's Note

When I use the terms "science" or "scientists" in general (as I have in the essay above) I am definitely NOT referring to those great thinkers and cutting-edge scientists whose work supports and confirms what hospice nurses see in the field every day. Relatively recent advances in the study of quantum physics and consciousness have closed the gap between science and spirituality. While advances in these fields are little known or understood by the general public at present, these scientific advances will have profound consequences for humanity in the not-too-distant future.

For a good general overview of the depth and breadth of this new research see the movie (or rent the DVD):

"What The Bleep Do We Know."