Finding Hope and Meaning at Life's End

End of life experiences like redemption, reconciliation and transcendence, are rarely considered by doctors.  To them, death is a failure, and the clinical aspects of treatment leave little room for anything but last-ditch attempts to prolong life and manage pain.


Christopher Kerr, MD, PhD, a researcher and hospice physician, paused to consider the dreams and visions encountered by his patients as death lurked about them.  He documents a number of their stories and looks deeply into the “resolution of what was once a crippling affliction into healing and redress” in his book Death is But a Dream, Finding Hope and Meaning at Life’s End.

Kerr noticed that his patients experienced deep reprieve with significant people in their lives who passed before them.  He also discovered that most of the research done on pre-death experiences included interviews with family members, caregivers and medical professionals, but not the dying themselves.

He began to document what his patients encountered as death came for them and found that, “grieving patients who face death do not fear or adulate it; they just wait for it.”
The reason for this equanimity about dying came from profound dreams and visions that his patients had during their last days.

Patients told Kerr that their end of life experiences “differ from any dreams they ever had.  They are more sensorial.  They are deeply felt and lived.  They feel more real than real.”  And they help the patients come to terms with their own mortality.  Through them patients resolve trying experiences that weighed on their minds as they face the journey into the unknown.

Kerr presents stories of patients that range from elderly couples to a bad cop; from children to criminals; to people who lived exemplary lives but were still troubled by something on their deathbeds.  Although he states that 18% of all end of life dreams are distressing in nature, every one of the cases he presents ends in positive, redemptive resolution.  By the time each of the patients he follows dies, they are at ease and without regrets.

This recitation of universal positive experience stretches credulity as the seemingly endless presentation of cases grinds on.  The book is light on data and research, and after a time I tired of the stories and put the book down.

But the stories were compelling and the idea of coming to a good death intrigued me.  I soon picked the book back up and finished it.

I then realized that the lack of hard data and clinical insight was exactly the point of the book.  Instead of emphasizing the science behind treatment, perhaps we should just be with the dying - allow them their visions without labeling them delusional and sit with them and listen as they meet people who populated their past.  People who beckon them into peace.

Most of the family members in the stories in the book who practiced this compassionate, attentive caring as their loved ones died found that witnessing death could be a positive experience as loose ends are wrapped up in dreams and closure arrives.

The book spoke to me because, as the older father of a young daughter, I have an inordinate fear of death.  A fear of missing out on key events.  My struggles with mental illness have also led to behavior I regret, and relationships I have damaged.  The idea that a positive end is possible makes me a little less reluctant to consider my own mortality.

In Death is But a Dream Kerr brings that idea to life.  It’s a handy guide for physicians who must be more present and understanding instead of seeing death as a failure, and it’s a call to hope for those who care for, and love, the dying.

Maybe death is not so scary after all.  Maybe Rilke’s lament that, “I don’t want a doctor’s death.  I want my own freedom,” so heartfelt by all, is the end our loved ones, and one day we, will face.  That freedom, that blessing, that fearlessness is, according to Kerr, not only possible, but likely.