Christopher Kerr, MD, PhD, is the Chief Medical Officer and Chief Executive Officer for Hospice & Palliative Care Buffalo. Alongside direct patient care, Dr. Kerr’s focus is in the areas of leadership and patient advocacy. He has overseen the integration and expansion of palliative care into hospitals and developed a large home-based program for both adults and children and has published on innovative program models that are designed to better align patient/family services to the complexity of needs inherent to advanced illness.
Dr. Kerr’s background in research has evolved from bench science toward the human experience of illness as witnessed from the bedside, specifically patients’ dreams and visions at the end of life. Although medically ignored, these near-universal experiences often provide comfort and meaning, as well as insight into the life led and the death anticipated. To date, the research team at Hospice & Palliative Care Buffalo has published multiple studies on this topic and documented over 1,500 end-of-life events, many of which are videotaped.
Dr. Kerr’s work was published in a recent book called Death Is but a Dream: Finding Hope and Meaning at Life’s End.
Christopher Kerr is a hospice doctor. All of his patients die. Yet, he has cared for thousands of patients who, in the face of death, speak of love and grace. Beyond the physical realities of dying are unseen processes that are remarkably life-affirming. These include dreams that are unlike any regular dream. Described as “more real than real”, these end-of-life experiences resurrect past relationships, meaningful events, and themes of love and forgiveness; they restore life’s meaning and mark the transition from distress to comfort and acceptance.
Drawing on interviews with over 1,400 patients and more than a decade of quantified data, Dr. Kerr reveals that pre-death dreams and visions are extraordinary occurrences that humanize the dying process. He shares how his patients’ stories point to death as not solely about the end of life, but as the final chapter of humanity’s transcendence. Kerr’s audiobook also illuminates the benefits of these phenomena for the bereaved, who find solace in seeing their loved ones pass with a sense of calm closure.
Beautifully written, with astonishing real-life characters and stories, this audiobook is at its heart a celebration of our power to reclaim the dying process as a deeply meaningful one. Death Is but a Dream is an important contribution to our understanding of medicine’s and humanity’s greatest mystery.
Please enjoy my conversation with Dr. Christopher Kerr.
Listen to more great episodes at Next Level Soul Podcast
Follow Along with the Transcript – Episode 112
Dr. Christopher Kerr 0:00
I think there's a value in not knowing. Because what you see patients go through is this journey of discovery.
Alex Ferrari 0:19
I've been able to partner with Mindvalley. To present you guys free. masterclass is between 60 and 90 minutes, covering Mind Body Soul Relationships, and Conscious Entrepreneurship, taught by spiritual masters, yogi's spiritual thought leaders and best selling authors. Just head over to nextlevelsoul.com/free. I like to welcome to the show, Dr. Christopher Kerr, how you doing Dr. Chris?
Dr. Christopher Kerr 0:52
I'm good doing well. Thank you very much for having me.
Alex Ferrari 0:55
Thank you so much for coming on the show. You know, we're going to talk today about something that's pretty, I think something that we're all gonna have to go through at one point or another. Yeah. Exactly. And I've had a lot of people on the show, who have had near death experiences. I've had doctors who had shared death experiences. But your research is really interesting, and really wanted to kind of touch upon that in the show. But my first question is, how did you become a Why did you want to become a hospice doctor?
Dr. Christopher Kerr 1:23
I didn't. I wish I could tell you there was some great inspiration or aspiration, but it was a simple. I was here to do a fellowship in cardiology, after I'd done residency, and I was needing to moonlight. And I saw that in the paper, asking for a doctor to work weekends. And I needed money. And I, I started working here part time. And I was into this work very short period of time, I realized this was the most meaningful stuff I'd ever done. Yeah. And I went back to my cardiology department and said, You know, I want to leave cardiology and pursue this. And they actually, they actually asked me if I needed to see psychiatrists, cardiology, then it is pretty lucrative, and a medicine. And hospice at that time was largely populated by volunteer doctors at the end of their career. So
Alex Ferrari 2:27
Interesting it's fun it's funny how the universe works.
Dr. Christopher Kerr 2:31
Yeah. And I've never looked back. Periodically, my daughter will find one of those solicitation postcards that says, come make a million dollars and work three days a week and show pulled out of the garbage and say it's not too late.
Alex Ferrari 2:47
So can you discuss a little bit about the research you've been doing over the years, being hospice doctor?
Dr. Christopher Kerr 2:52
Sure, I, you know, I came here to this work pretty unprepared for my training. And I wasn't here very long. And I was learning from my non physician colleagues, nurses, social work pastoral care, folks, that patients at the end of life, there was a very subjective side to it. There's the experiential side. So there's this kind of what we see, which is physical lessening, and it's often suffering in what we feel, which is sadness, but the patient is having their own experiences. Dying is a singular, unique vantage point that inherently changes your perspective. And your perceptions. So I, when you look beyond the veil of the obvious, which is, again, this physical disability, and symptomology and started asking people what they were experienced, as you find out there's another, there's another thing happening. And what I learned from my non physician colleagues was that it was very common for people at the end of their life to have very intense Dream Vision experiences. Dying is essentially progressive sleep. So you're in and out of sleep states, kind of got a foot in two worlds, and people who even don't normally dream, were reporting these very vivid experiences. And what impressed me was how profoundly comfrey they were. And they gave such meaning. And kind of what happened was, I was trying to teach this to medical residents and, and students, and the response I got was, well, there's no real evidence for this, and they kind of put it in a bucket of confusion and whatever. And it really frustrated me because it clearly had mean to the patient their loved ones. So originally, I did the research. Just to give it validity. So we there's a university monitor research project, we had to rule out confusion, made sure people were cognitively intact aware all those things. I'd signed consents, and we started interviewing them and knowing that scene is bleeding, we also started filming them, you know, shoot ahead 20 years. And you know, we published I don't know, seven, eight papers on it a book, PBS documentary and we're part of a Netflix Docu series. And what's fascinating is there was very little response in the medical world, but the non medical world, it's gone around and around the world.
Alex Ferrari 5:29
Can I ask you, why is it that the medical establishment just doesn't want to listen to anything that's outside their box, then that goes for so many different things, whether it could be, you know, natural remedies that might have some help, like, you know, just even Chinese medicine from 3000 years ago? Or are other things that are outside of their box? And this is another obviously box that's outside of what they're normally why is this establishment so wretched?
Dr. Christopher Kerr 5:56
There are a couple of reasons. One is this wasn't true 100 years ago, but the more medicine has been able to do it, the scientific revolution, essentially, from antibiotics, to imaging to interventions, has self amused the physician to really become death defying and death denying.
Alex Ferrari 6:21
They feel that they feel they can do anything there. It's almost it's almost like god complex. And
Dr. Christopher Kerr 6:26
Well we know where anyone challenges. So the oath in medicine is to cure where possible, but to comfort always. And I think we've hung clung to the one and not the other. And it's how we educate and how we train. And then you add to it that we become spot welders, so you get sick, and you can see a buffet of six doctors, so everyone's there, it's very organ system based, or even our economics of healthcare ordered system base. So we do things to parts, and lose sight of the whole. So it's not uncommon for us to have patients who by multiple by every measure constitutionally are dying, I'll give you an example. person with cancer hasn't eaten in three weeks, they're dying. They do the imaging, and the imaging might show disease progression, but it's really the burden of the disease over the time and frailty that come into play. So it's not uncommon to see physicians prognosticate or have a scan that doesn't consider that looking at an organ but doesn't consider the body that the organs end or the patient's wishes.
Alex Ferrari 7:42
It's almost irrelevant.
Dr. Christopher Kerr 7:43
Yeah, it becomes irrelevant. So we lost our ability to look at the totality, not only the person, what's happening, how happened to them in the fullest sense. But what considerations, some people are just tired, it's a lot of energy to be to fight LS, and your ADA, you can't get up anymore, you know, it's easier not to do than to do. So if we treat numbers and treat pictures and treat parts, you can miss the forest for the trees.
Alex Ferrari 8:14
There that makes sense, that makes absolute sense that you discuss visions and dreams. Is there a distinction? You know, in between the two?
Dr. Christopher Kerr 8:23
Yeah, and both are inaccurate? Actually, it's the only nomenclature we have. So when we when we so we've done a trip now 1500 patients and families and in our first study, we did interviews of them daily surveys of their daily until death. So this is several weeks and months before. And not the last moments when people are clearly often confused, or deoxygenated? And what they will tell you is Yeah, I don't normally drink. This was different. When we asked we get asked them to scale the realism of it's usually 10 out of 10. They're virtual, like they've been lived. They come out with a sense that they were it happened. And of course, then thematically the content is a random, you know, overwhelmingly, it's about people who they have loved and lost. So we looked at this as people what changes occurred as people got closer to death. And what happened is they stopped dreaming of everyday events, and started experiencing people who were most important to them. And time didn't seem to matter. So they could have lost a parent a decades ago, but they were tangible to them. Very little said there's a lot of difference between what I understand about near death experiences in these events. This isn't a trial run. These people are actually dying. Very little is said they don't need a lot of interpretation. They're not looking for a metaphor. They're just given an understanding and predominant themes are themes of love. The people who condition their love are often removed. So could be one parent present in the anon another. Whatever injury you had, that could be lost a child. That comes back to you, we've had many veterans who have survivor's guilt that gets addressed. We've all been harmed in one way or other for having lived. And we seem to get put back together through these experiences. And so the life you lead gets kind of validated. And inversely, the fear of death seems to lessen. And when we asked them to measure comfort, from these experiences, where their comfort and discomfort in you, the actual comfort level goes up, so as the as approached death, so there's an increase in the frequency, intensity, and the comfort given.
Alex Ferrari 10:58
Now you say most, are there any negative experiences like nightmares, or, you know, just horror, but like, not good?
Dr. Christopher Kerr 11:07
Yeah. We're pretty naive, because we measured, comforting, not need, or whatever. And about 16% of people have a noncompete experience. But it's really interesting, as those are often the most transformational or meaningful. And some of this is captured on film, which is really wonderful to see. So I'll give you an example. We had a guy who is in his 40s, who has spent most of his life in and out in prison, more in prison than out he had drug addictions. And he had had neck cancer, and he was dreaming. And we caught this on film, by accident, really, we're just interviewing from another topic. He's joking, he was very jovial. He's one of these guys who couldn't afford to live with regret or look backwards. And then he starts crying, because he's having these horrible dreams. He's been stabbed by all the people he's heard out of sight of his cancer, and he breaks down. But then when he comes out of it, he asked to see a doctor that he wants to express his love towards and apologize. And after that he slept. So there are these dreams don't deny life. We had a mother whose worth was questioned, because two of her kids were in prison for drug related offenses. And in her end of life, she's back in her home in Puerto Rico. And her parents come to her and tell her what a good mother and what a good person she was. So that, again, they're not denying the bad things and painful things transpire. But they address them and sue them in a way that's very interesting.
Alex Ferrari 12:47
So it's not like if you have a negative experience, quote, unquote, negative experience, it's not there to punish you. It's there to guide you into a positive scenario like that example you gave with the the 40 year old who had that horrible dream, but then that prompted him to make amends, make amends in a positive thing. And once he was able to release that, he, then he slugged it? Yeah, yeah. So there wasn't you haven't had any? In your research, you haven't found any, like punishing, like, I'm just getting beaten with these bad dreams for no reason?
Dr. Christopher Kerr 13:25
No. We have. I talked about the most powerful one in my TED Talk. They were a guy. He had been involved in the invasion of Normandy at the age of 16, or 17. Jesus, and His whole life had been, he'd been suffered with PTSD, he never got help. And he kept it all to himself that his wife knew because he'd scream in the night. And so he came into our unit, the end of his life, because he was having such horrific experiences where he's seen body parts and bloody water and screams and he couldn't rest. You can't die really, unless you can sleep. It's pretty hard to do, because you just pass in sleep. So he couldn't sleep. And then one day going to see him and he's, he slept. So what's your dream about? He was in our study goes? Well, I had a great dream, he said, where I relived the best day of my life, which was the day he got his discharge papers. And he said, and I had a really good dream. He said, I was on a beach, presumably Normandy, and a soldier who he didn't know, came up to him and said, No, we're going to come get you. So that sense that he abandoned people had kind of gone full circle. And he slept peacefully after that, and he died peacefully.
Alex Ferrari 14:57
So it seems it seems that these dreams And or visions are, are helping the process along and in many ways a blessing for people who can go through this process because it's kind of like a, it's a longer, longer runway to the end of of life as opposed to someone who just gets shocked or gets killed instantly or something along those lines or has a heart attack or something like that. They're kind of preparing and they're like working out business, if you will, that they've had life.
Dr. Christopher Kerr 15:29
Yeah, exactly. And we actually did a really interesting study where we just whole notion, first of all, that, that there, you're passive to the process, or that there's nothing to be learned from a negative experience. This isn't true. So we talk dying. And there's actually an inventory to measure something called post post traumatic growth. So the idea, for example, you go into war, and we all the negatives are obvious. But is there is there a positive elements to it. And that's what we found in dying. So people who are who are dying, who are having these experiences when compared to people who weren't, we're, we're adapting, we're learning, we're gaining insight and was measurable, right up until the very end. So yeah, there's this other side to it. Basically, because you're dying doesn't mean you've stopped living. And you do intense living in the latter period. That kind of makes sense. And you go, you knew you were dying, your worries, and focusing concerns are on affairs and other people and go over your own mortality. But as you actually get close to it, you're looking back on the life you've left, and you're abstracting from it, the things that come to surface are actually overwhelmingly positive and affirm life. Rather than denial. They don't deny death. That's what's really interesting, nobody, they don't come out of these experiences. And so you're not dying. You're you're dying, but you're doing so with a better sense of meaning.
Alex Ferrari 17:03
Did you did you find that most, if not all, of the patients that you you researched? Or studied? Had a less fear of death?
Dr. Christopher Kerr 17:15
Alex Ferrari 17:17
Nobody, nobody became more fearful or or went in?
Dr. Christopher Kerr 17:21
No, no, we didn't measure fear, per se. That's actually interesting. You're asking that's what we're in a study doing now. How's it changed their kind of existential view? What was expressed to us and it was quite the opposite. And this is what's so powerful about the patient videos for your audience to see them because the, what comes out in abundance is they're not fighting the dying of the light stuff they're actually trying to get towards not away from so there's a great lady in the video who had lost her daughter and her husband and you know, days before death, she's just sitting around the kitchen table, nobody's talking but she feels them. And it gave her a sense of warmth that was beyond description. And you know, that's what she wanted to return to.
Alex Ferrari 18:14
Now with that said, I mean like I said, at the beginning of our conversation, I've spoken to a lot of near death experiencers and doctors and and loved ones who have gone through shared death experiences did you in your studies and research find any any of these dreams were aligned with what is considered a near death experience? Or like those kinds of story elements or tropes of near death experiences you know, the tunnel fly, seeing your relatives there? I'm coming to take you are these kinds of things did you see any of this in your research?
Dr. Christopher Kerr 18:49
Not a single one I'm doing this for 23 years right 24 years
Alex Ferrari 18:56
So it's a different phase is different
Dr. Christopher Kerr 18:58
Yeah. It just makes sense. I mean, people who have near death experiences again I just have a laypersons understanding of it right it they seem to almost be structurally changed the way they come back with a different view they see the world through a different lens they're often feel compelled to change often compelled to write about it you know, they become prophets and then they're really powerfully moved by whatever it is they had. I never had that. Never saw it.
Alex Ferrari 19:36
It's a different it's just a different way
Dr. Christopher Kerr 19:39
That you think about it. The time for therapy is over the time for adaptive changes over the they don't I've never seen the patient come up week from these experiences say hey, what do you think this means? They just are left with a sense of knowing a sense of love of being put back Gather of reacquainted with their loved one, what have you they don't they don't come back with regret, I gotta change this, what is my therapist going to think? None of that ever seen it?
Alex Ferrari 20:13
Right! Because it's just a different thing because a near death experience is something that happens suddenly and you know, according to near death as they go somewhere, and then they come back, where as what you're going to end of life, it's the road is set
Dr. Christopher Kerr 20:28
There's no dry, there's no dry run, there's no rehearsal, the trajectory is completely different. They've gone through a period of, of accepting their mortality, the finality of their life. Were you know, you hear from a lot of near death that was sudden, you know, they didn't have time to process. So it makes sense to me at some level, that they're different. I just always bothersome when they're coupled, because they're different. And as for shared experiences, you know, I surely know, people who document these things. As somebody who actually takes care of dying people. I don't, I don't see it.
Alex Ferrari 21:09
Have you been? Have you been in the room with many of your patients that passed?
Dr. Christopher Kerr 21:14
Literally 1000s? Really? I mean, it's all I do. Right? Since 1999?
Alex Ferrari 21:20
I'm a layman as well. So I don't know what you in the room? Are you the family?
Dr. Christopher Kerr 21:26
Oh, yeah, very, we have an inpatient unit here. So we take care of about 1200 people a day. But we've got an inpatient unit where there's 22 beds literally across the hall from me. And I've worked there for decades. So I'm rounding on patients every day. And of course, the patients are always changing. So it's a lot of patients over a lot of years.
Alex Ferrari 21:50
Let me ask you, how do you handle this psychologically? You keep seeing death, day in day out over two decades? I mean, you know, I've been around, you know, when my grandparents passed, and relatives have passed, and it hits. I mean, obviously, I have, obviously more emotional connection to them, because they're my relatives. But how do you handle it psychologically to see, I'm assuming you connect as you are even more connected than most hospice? Doctors, because you're asking questions, you're documenting, you're really getting deep in connections with these people? How do you handle the loss day in and day out?
Dr. Christopher Kerr 22:28
You know, it, it's not what you'd think. If you were on, if I was hearing this on the outside, we must be the most depressed people in the world, or best depressing. It's actually the opposite. It's, you'd find the place oddly uplifted, full of humor. And there's undeniable sadness, particularly in unfinished lives, you know, a young parent leaving shows that we care for 135 kids a day. What you know, we're also enormously privileged to witness participate in the care of patients along with their loved ones. And what we see on the caregiving side is the best of our nature, we see people finding courage to care for their loved one in ways they couldn't imagine. Express kindness. It's heroic. What we see people, you know, we, we think of caregiving in terms of burden, but we actually see is is remarkable people's lives who are stopped and overwhelmed by responsibility. It's not easy. And what we hear and see, it's the best, hardest thing they've ever done. It can be both those things. So we see grace, we see remarkable love in the face of loss. So you come out of these experiences. The sadness is undeniable, but it's also inspiring. And to be a part of it in any way is a privilege. So and we are fortunate in hospice, because we're not a volume based fee for service business. Like, you know, so much of healthcare is demoralizing, because you take people with good impulse and instinct to go into medicine. And then you put them on assembly line where you get 15 minutes with a patient kind of thing.
Alex Ferrari 24:35
15 That's a lot.
Dr. Christopher Kerr 24:36
Yeah, right. The expectation for us is we sit and we get to know the patients as people and the mandate and hospice, the unit of care and hospice is the patient and their loved ones. That's why the framers of the benefit give 13 months of bereavement for we may have the patient for a week we get to care for their family for 13 months. So we, we, and we joined in most of our work in their home. So you're seeing them in the context of their lives, how they live, you see pictures of them when they were 50 years ago when they were young and vibrant. So you get to know them differently, you know, their pets. So it's just, if you were to do this in a typical medical environment, it would rip you apart. But when you actually get to know them as humans, it becomes more human to you. And it's a special in a very unique ways. It's a privilege to do this in medicine.
Alex Ferrari 25:39
Now, you mentioned children, is the experience. The first of all, did you have any children in your research? And if you did, how did the experiences differ from adult to children? If they do?
Dr. Christopher Kerr 25:51
Oh, enormously? Yeah, so we have one of the largest pediatric programs. And it's a chapter in the book, we published a paper on it, it's in both a PBS documentary, and it's in the Netflix series, they're in them. And so yeah, we've done a lot of work with kids and kids who this entirely differently. They don't have, they may not necessarily have a concept of finality or even mortality. They, they live in the day. But they may not have known someone who's died. So who comes for them kind of thing, right. And then what often happens is, I mean, in our, in our knees, the cases we wrote about is they didn't know a person, but they knew animals, pets. And it may not be their pet. But it might be your neighbors or grandparents. And children make little distinction between animal qualities that are ascribed to humans and animals. So it all kind of blurs, right, and but they come back to them with same message that they're loved and not alone. And that's verbatim, the language they used in, in two of the features on the film, and the other young lady. Because children are creative and imaginative and can access that part of them. She created a castle for herself. So there was a castle around her there was a swimming pool, the animals were returned, there's a piano, there was a window with warm light coming through. So she gave it sensory feel, you know, and when asked, What does the castle represent, she said, a safe place. So it was like she used the they use their creative and imaginative world to to, to, to give them some some sort of solace. Another woman, another child, you know, was a child of a single mum. So who was she? How does she exist without her parent. And then she dreams of seeing her mom's deceased friend in her mother's room, adjusting the curtains. Again, she's not alone, and she's reassured. So these experiences for children become very self informing. They seem to understand intuitively that something's happening to them. But they're secure. And they're loved.
Alex Ferrari 28:22
It seems that the theme, one of the themes that I keep hearing, from your, from what you're saying is that you're loved, and that you're going to a safe place. And that seems to be a recurring theme in many of the people that you've researched.
Dr. Christopher Kerr 28:41
Very much. So yeah.
Alex Ferrari 28:45
So let me I have to ask you now as a physician, you know, you look at life. I mean, as physicians are trained to look at life very scientifically. But yet, I've spoken to other hospice workers. And there is a spiritual aspect to this. It's just such a. I mean, I'm interested to hear your perspective on the spirituality of what's going on. How, you know, what do you think is going on? In this esoteric kind of place where you can't really put it in a box like the medical establishment wants? What is your feeling? Because it just seems, I mean, hearing the story. I mean, I've, obviously I have a spiritual show, and a personal growth show. So I understand a lot of the concepts that you're talking about, for many people, like your colleagues, maybe in the medical establishment, I have a lot of trouble dealing with this. Over the years did you did how have you processed this and what are your thoughts on the spirituality of this? Because it just seems, you know, is it something I can't believe it would be something that's physiologic like it's in our mind that every one is programmed with this exit strategy of having dreams, visions, Is that make us feel better? As we're dying? There has to be something bigger than that, in my opinion, what's yours?
Dr. Christopher Kerr 30:06
Yeah, I mean, first of all, it's it's unique to our human experience, not our culture. So some of the interesting work I've been talking about with a three time Emmy award winning producer who was working with the indigenous people of the Outback. And she called me and she goes, You know, I, somebody gave me your book, and you know, everything you're talking about, they have language for. So it's unique to our human experience. I'm kind of a good messenger on this, because I have a general aversion to these sorts of things, right? Like, I don't gravitate to it at all. A couple things are really, really important. We didn't come at this at all, from any other angle than to translate what the patients were saying to so dying is a keyhole. Right. And you can look through it and project on paranormal afterlife religious, we didn't interpret, we just kind of deliberately translated. I'm also I have a PhD in neurobiology. So I'm very, I understand neurobiology. Well, and where I'm at is, I don't care whether there's a center of the brain
Alex Ferrari 31:17
That releases these visions and dreams. How can that even make sense? Like, how
Dr. Christopher Kerr 31:23
Well you know it's like show me love.
Alex Ferrari 31:26
Right exactly. Where show me in the brain where love is what is.
Dr. Christopher Kerr 31:31
And I think that whole need to make this concrete, organic, and quantifiable, measurable, is, is insane, and really misses the point, which is that there are things that we should just have reverence for.
Alex Ferrari 31:52
And, and admit, and admit, we don't understand
Dr. Christopher Kerr 31:55
You understanding etiology source. What the next is absolutely irrelevant and really obscures the meaning. It is what it is. And where I'm at in question is what has this done to me, is, it's left me with a clearer understanding, there's a better story. The Dying is really a closing of a life not about broken pieces of you. And we are more than the sum total of our exit. And the story is a better one. And what leaves me wondering is, you know, the things you think are gone, are they gone? Because they're tangible to us. You know, when you see somebody who's in their ninth decade of life, and they lost a parent when they were a child, and that parent comes to them, and they can hear the voice or smell the perfume. That's, that's, that's proximate to who they are still, their essence is there for and it makes you feel, oddly hopeful. Certainly, you should be respectful to you don't know all that's going on. And, and again, I just think it goes back to reverence.
Alex Ferrari 33:18
I think you're coming at it from a humble place where you just go, Look, I just don't understand everything in the world and how the world works. And I'm just going to just some things are what they are. And you should have just revenants like, you and I both don't understand the inner workings. Maybe you have a better understanding the inner workings of the sun, and the life the energy that it gives the our planet but we have reverence for what it does for us every single day. Without it, we would all perish.
Dr. Christopher Kerr 33:47
Yeah, and I'm not sure we're meant to. And I think there's a value in not knowing. Because what you see patients go through is this journey of discovery. You know, they're at the end of their life, and they're rediscovering who they were and who they loved. And I think if that came with an owner's manual, it would kind of miss the ball. I don't you know, I? Yeah, and I just think it's more hopeful. And, you know, you touched on a really important idea you asked, you know, are they experiencing evil, you know, and living in that sphere? And honestly, they're not and it gives you this odd faith that something else that's better prevails, even to people who may have been themselves evil like it's, you know, there's an L there seems to be the spinal justice that the you know, you don't get harmed somehow. And I don't think these are inconsistent or swith. A tense of faith of love and forgiveness, not the symbolism, so faith but The tenants belief. So yeah.
Alex Ferrari 35:03
Well, I want to ask you another question, because this is the slightly controversial question regards to near near death, end of life, which is the prolonging of life through technology through the metal, you know, through, you know, you know, plugging the pulling the plug in question. In your studies, did you ever study somebody who hadn't made maybe made the choice prior to prolong their life artificially? And did that change? Anything in regards to your studies?
Dr. Christopher Kerr 35:36
No, I can't say and I, you know, I guess there's not an inherent bias in our workers or in our hospice program. So they've already, you know, they've acknowledged, yeah. I've certainly seen people who were fearful of death, horribly fearful, throughout life, and traumatized by the idea. And they get to a better place. But I don't see I haven't seen that.
Alex Ferrari 36:07
Now, how did you get these people to sign on to this process?
Dr. Christopher Kerr 36:11
That's the cool part of the story. It's unbelievable. It's a story within the story. So originally went to the University. And they said, No, you can't do this to people because we sterilize dying, right? We put them on a shelf, and we make sure it's quiet. And you know, if somebody is the worst thing you can do, some of the dust dust I've seen are when they're having a birthday party, because they don't want to be disconnected from what made them them. Right. So some people are more comfortable with the, you know, their kitchen family, and everybody's around, they people like to be reminded that they're more than sec. And so there's that and we finally got them to approve. What's fascinating is there was nobody who we approached. And I talked about this in my book, who didn't say yes. And what was shocking was the number of them the vast majority who agreed to be filmed. Because if you think about how you appear as, and there are a couple of takeaways. One is that people want, even though there's no secondary gain, so not going to be around to get the attention does no dividend for participation, what tells us they first they want to connect, they have something to say they want to matter. They want to be heard. And they again, they don't stop living because they're actively dying. Their voices are there. And you know, it's, it's this idea of, of putting a bubble around them and sterilizing them and removing them from what it means to be human, is completely absurd. So I just was, there's only interesting. In the book, there was only one person who didn't use whose name isn't the real name. Everybody wanted. Yeah, go ahead. And they were airing really the real stuff of having lived right. Because that's part of their stories was we were introducing them as people. The exception was a person who turns out wasn't abused by a family member. And the children didn't want that out there. Because there were other family, there was an an aunt, a relative of the abuser, and they weren't trying to protect her, she comes in and says, you know, we probably shouldn't use because they want to protect his children. So they were both they're both they're both holding a secret not knowing that the other side knew. So that's the only person who's whose name isn't real in the entire book, they who they were, and I can't believe the number of people we have who've just filmed really, before death.
Alex Ferrari 39:04
So in all these years, you've been doing this are there any stories or any lives that really stand out to you that that the the experience of their end of life just sticks to you in a way that
Dr. Christopher Kerr 39:20
Yeah, that the most moving ones for me? Were the ones who had what I for me is unimaginable loss, you know, loss of a baby, you know, a wound from which you don't recover from and you're caring for somebody like that the end of their life, and you you can treat things but you can't treat that's those spiritual worlds. And, you know, I talked about this in the book and that is, this is the case of actually got me really motivated, was we had a woman who was sharing all these experiences she was having at the end of her life with her children, her children were really interesting, all very artistic, all very open minded. And then she starts holding a baby and who she called Danny, and none of the four kids understood the reference. And she's cooing the baby and talking to and kissing. And the next day, her sister came in from out of state, and the children relayed a story. And the sister says, Wow, she, that's her first baby who she lost. And the pain was so deep, she could never really talk about it and life. Yet, here it is. Full circle, and she's at the end of her life. And she's, again, kind of put back together with with, with the presence of her child. And again, it just felt just and unfair, that, you know, and we see this, they live their life, and they have these wounds. And before they leave us, they're they're given some kind of peace.
Alex Ferrari 41:08
It's about it's about cleaning up the business of life. Yeah, in many ways, it's like just closing all the chapters that are open. All the books are open different things, and just kind of like, okay, it's like you've you've, you've packed away everything. Everything's good. Everything's clean. Now. It's time. You're good. You can you can move forward.
Dr. Christopher Kerr 41:28
Yes. Yeah. And you know, the effect for the family just completely redefines death, right? It goes from being something empty. And without any redeeming value to well, it doesn't feel like nothing's death, mum is okay in there. Because we all worry, be somewhere in a bad what are they actually experiencing? And we've done studies on the bereavement and people who witnessed this. It has enormous measurable benefits to grief and grief processing, which just makes sense.
Alex Ferrari 42:01
So with all the with all the research you've done over the years, how does the end of life experience especially the the ones that you've documented? How do the families benefit from seeing this? Or do they benefit? How do they react? How does it move forward? Because you're like you said, you you go on with them for the next 13 months trying to help them along with the process? How is, you know, those experiences? Watching the video? You know, the filming of it? I'm not sure I'm assuming they don't if they see it, or they don't see it, but how does that whole experience that they've gone through that you've studied, help the family if that,
Dr. Christopher Kerr 42:38
Yeah it was surveyed and interviewed, combined some 150 bereaved family members. And the best way to say is what's good for the patients good for the family. So it redefines loss from something empty and final, to something that that again, was more life affirming. When we measure the process of grieving, they're able to remember and recall better they're less harmed by so Dying isn't seen as a horror and, and suffering. It's seen in another context, or at least there's another dimension to it. And that's often the thing they recall, they'll go back to that and their remembrance frequently. So yeah, and again, that's quantifiable.
Alex Ferrari 43:29
There's a term called terminal lucidity. Can you explain what that is?
Dr. Christopher Kerr 43:33
Yeah, terminal lucidity.
Alex Ferrari 43:34
Lucidity. Thank you. Sorry.
Dr. Christopher Kerr 43:36
Yeah, it's fascinating and is very real. You know, it's been studied by the NIH, etc. Now, and basically, it's people, the best example of somebody who's demented, who may not have remembered their family members names for years. And, and they're very use either on a dying trajectory, and they're very quiet and sleepy and may be confused. And then they go through this period where they're more wakeful, engaged, alert, and they're able to access memories that they didn't otherwise have access to. So they'll often use that daughter's name. And it's fascinating. We see this with music, for example. So you can take somebody who's nonverbal who was in the army, and you play that old Delta, and then all of a sudden, they can speak, you know, so, we retrieve what you remember. I'll give you an example. You know, a song will come on from when you grew up, maybe in the 80s, or whatever the 70s and it'll Kindle all of these. Oh, yeah. Yeah, I remember being in the field and partying that night, whatever, same idea. So something happens that triggers recall in a way that they haven't had, you know, one theory I have is that these inner experiences they're having. If they're going backwards and they're remembering things in a different time, it resets the tone of the context in a sparks memory. Because there's something to it. Terminal lucidity is fascinate.
Alex Ferrari 45:18
It's so it's so there's moments where, you know, they've been, they had dementia. And at the end of their life, there's a moment when they're like, able to recognize, yeah, people in the room have conversations about things where maybe it didn't years, since something like that happens. That's fascinating. Because from my understanding of of these dementia and Alzheimer's, it's the brain is degrading, it's literally the connections are our
Dr. Christopher Kerr 45:49
Progressive neurodegeneration, right? So then there is an origin. Imagine a circuit board, and you got a light bulb over here, there's one wire that we typically use to fire up the light bulb, but there's all these other pathways. And again, these there's a music pathway. So you play the right old tune in that triggers the memory of the light bulb, you know, it might be you're having a dream, and that triggers a memory or a light bulb to fire. So something happens in the dyeing process, that response works on an excess previously unaccessible memory. So it's not that the memory vanish so much is that our access access to it changes,
Alex Ferrari 46:38
Right. In other words, the filing cabinets still there, but we just forgot where it is.
Dr. Christopher Kerr 46:41
Yeah, we're finding a different drawer.
Alex Ferrari 46:44
Exactly. The information that doesn't go away. It's the pathways to the doors, the rooms, whatever analogy you want to use to get to that information. Now, of course, I have to ask you, after all of these years, do you fear death anymore?
Dr. Christopher Kerr 47:00
Oh, yeah. Just as much as the next guy.
Alex Ferrari 47:06
But you have a different perspective on it, though. I mean, all
Dr. Christopher Kerr 47:09
I on I fear death. It's not less personally, more, because when I think of death, I think of the people who depend on me not being here. So I guess there's two ways to answer the question. Personally less fearful. That's, in actuality, very fearful, because I can't be separated from my responsibilities. And so you know, yeah,
Alex Ferrari 47:44
That makes that I, as a as a father, I understand what you're talking about now.
Dr. Christopher Kerr 47:48
Yeah. Do I fear the processes of dying as much, no.
Alex Ferrari 47:52
Right. But you fear of like, Oh, God, if I've gone, what's going to happen to my family? How are they going to continue all these responsibilities that you have? Because it's not your time yet, sir. You've got you've got it's, you know, let's we got work to do here, sir. Yeah. We all open. Like they say everybody wants to go to heaven, but just not right now.
Dr. Christopher Kerr 48:13
Alex Ferrari 48:15
Now, tell me about the work that you're doing at the hospice palliative care of Buffalo?
Dr. Christopher Kerr 48:21
Well, I'm the CEO here, but I'm also a doctor, and we do a lot of research. And so one of the areas we're three research is, is is this area, we actually published and study a lot of things, but this is the one that's gotten so much attention. And the area we're looking at now is what question you asked about is what are these experience doing changes people's existential position or views. What you know, how does it change how they view about dying, hopeful, fearful, what have you.
Alex Ferrari 48:55
What has there been in your research? Has religion played a part in any of this? The It doesn't sound like it doesn't.
Dr. Christopher Kerr 49:04
Very rarely, and you know, we wrestled with, as other people have found, so people who did kind of survey work on this in India and in the United States. Lee was in the 60s and 70s found the same thing. And there's a wonderful person named Terry Egan, who wrote a piece that ended up on CNN, the wire, she's a hospice chaplain. And, and she's, you know, title was what people talked about when they're dying. And they talk about life. They don't talk about the symbolic or the structural pieces of life. But the her argument is, this is entirely consistent with faith. So they talked about love, they talked about forgiveness. Those are the things that actually matter from our beliefs. So they're not incongruent,
Alex Ferrari 49:55
Dr. Christopher Kerr 49:56
Report, we said there are some large groups Do we first or first and last classroom? Is our family. And that's where we learn. So that's where we return to.
Alex Ferrari 50:11
Without question now where can people find out more about you the work that you're doing and you're and where they can get your book?
Dr. Christopher Kerr 50:17
Sure. My Books Online is published by Penguin, it's called death is but a dream. It's in 10 languages now. There's a website called drchristopherkerr.com. drchristopherkerr.com. And I encourage people to go there because you're going to access patient videos, or they're on YouTube. If you look under Hospice Buffalo
Alex Ferrari 50:43
And, and I'll ask you three questions. I asked all of my guests, what is your definition of living a good life?
Dr. Christopher Kerr 50:51
For me It's find, some earthly use it to find purpose. I think that's how you become actualized.
Alex Ferrari 51:05
What is your mission in this life?
Dr. Christopher Kerr 51:10
To find a purpose for which I'm suited. I, I believe strongly that if you're going to work well for working hard, but it better be something you're going to get behind passionately.
Alex Ferrari 51:27
And what is the ultimate purpose of life?
Dr. Christopher Kerr 51:31
Alex Ferrari 51:32
Chris, it has been a pleasure talking to you, thank you so much for coming on the show and sharing your your research and your studies over the years and thank you for doing the work that you're doing. I mean, you are as they say, doing God's work in many, many ways. You're helping people along the path. I know you just doc that you know a lot of people out these documenting like Yeah, but just I love the idea that you say like that people want to be heard. They want to be seen. They want to they want to matter, and you're giving them that gift at the end of life through your research. So I appreciate you my friend.
Dr. Christopher Kerr 52:05
Thank you very much. Appreciate you having me on.
Links and Resources
- Dr. Christopher Kerr – Official Site
- Death Is but a Dream: Finding Hope and Meaning at Life’s End
- Hospice and Palliative Care Buffalo
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