Alex Ferrari 0:00
Tell me what your life was like before you died.

Julie McFadden 0:08
Being an ICU nurse, being that nurse, being in that environment where we are trying to keep people alive at all costs, helped me see that that is not the way we need to go in healthcare, we have made leaps and bounds in western medicine to keep us living a lot, much longer of a time, which is amazing most of the time. And then I think we get to a place because we're in we are such a death denying culture that it slips into like suffering more than like surviving like they're not like survive, surviving at all costs. You know, life at all cost, and that's been my experience as an as a hospice nurse. So those are the things that I learned as a new hospice nurse. You know, watching the body not need much at the end of life, meaning, like, we didn't have to do a lot as as nurses. Now, sometimes we do right? But there were certain circumstances where, like, I saw how our bodies are built to die, and the less we do, and the more we allow that to happen, the better the person usually does, and the more peaceful the death usually is. That was mind blowing to me. I truly didn't know that. I didn't know that our body had built in mechanisms to shut off hunger and thirst, to have our calcium levels rise so we sleep a lot. I didn't know that allowing the body to do that naturally, helps the body shut down and helps the person die more peacefully. I didn't know that as a healthcare worker, I haven't been to medical school, but from what I've heard, yeah, from when they didn't teach at nursing school, well, so that is one of the phenomenons that I would say. It's like a phenomena of end of life, where people can kind of choose how and when they die, and I think it's really based on people's personalities. So I think sometimes people will wait until everyone's there, everyone's in town. I had a woman who was like the matriarch of the family, where she had a bunch of kids, a bunch of grandkids, great grandkids, she was in her late 90s, right? Kept the family together so super close with her family. Family was huge to her. She actively died, which means, like the last phase of life where you're unconscious, changes in breathing, no food and water. And she was in her 90s, mind you, she was like that for three weeks, because she was literally waiting for everyone to come into town, and everyone came into town, and then she died. So I think it depends on the person's personality. Now, I think people who are independent, not shy, but, like, introverted or prideful, or, you know, don't want to be taken care of things like that, like my mom would. My mom is still alive, but she would be like that, like she would want people to all be gone so she could die alone, basically, because she doesn't want them to see her like that. She wouldn't want us to see her like that. So I think it depends on the personality. There is a syndrome called, like, the broken heart syndrome, where, I don't know if they've actually done studies on it, but they do think there's, like, stress hormones that happen when someone dies that could technically affect the heart, and that's why people say people die of a broken heart. You know, some a couple who's been, you know, married for 60 years, the wife dies and the husband dies soon after. So there could actually be some biological things to the dying from a broken heart, you know. But also, I had a patient once tell her caregiver like, I'm dying tonight. Please take care of my son, because she had a disabled son. Please take care of my son. Promise me, you will the caregivers like, What are you talking about?

Julie McFadden 3:20
You're gonna be like, I know you're on hospice, but you're not dying right now, tonight, I'll take care of your son. Don't worry. And she said, No, I'm tired. I'm going home. She called her son in said, you know, said her goodbyes to him, and then she died. That's the kind of stuff that, like, is, it happens a lot. I see it a lot on hospice, but those are, like, unexplainable things. My favorite patient, yes, I have a favorite. I feel bad saying that, but like, I can't help it. This guy, I still think of him all the time. So he came onto our service. He was young, dying of a terminal illness. Obviously, he had a lot of mental health issues. So when we showed up at his house as a hospice team, you know, he had a hoarding issue. He didn't have friends and family, per what he said, very anxious demeanor, and clearly, like, in unsafe living conditions. And luckily, I feel like, because he had this terminal diagnosis, he almost had this, like, this new ability to, kind of like, want to let things go. I mean, hence, he was a hoarder, hoarders, you know, that's a whole that's a mental illness. That's, you can't just get rid of the stuff. They'll get more stuff, right? So luckily, though, when we met him, I think because he knew he was dying, he sort of, like, turned over a new leaf, and he allowed us to, like, reach out to people that might know him, distant relatives, cousins, things like that, to help come in town and, like, basically clean out, clean out his apartment so he's a safe place to live, and kind of get this journey started for him. And he allowed us to do that. So within one weekend, we got in touch of, like, distant cousins who came in town helped get rid of all of his stuff in the house so he could have, like a nice living, nice apartment to live in. And I remember coming back after all of that happened, and he was like a new man. He was like, so happy that he had this apartment again and that he saw his cousins who stayed for a while and ended up leaving and because. Of that I feel like, end up living on hospice for much longer than we thought he would have. The type of cancer he had was very advanced, and he usually died pretty quickly, but he ended up being with us, probably for nine months, maybe more, and he was like, pretty well, like he like his pain was controlled, but he could still, like, walk around and do things, right? So I say all this because for nine months, my visits were not that complicated. And really, all I did was, like, sit around and talk with him, maybe change meds once in a while with his pain increase, but for the most part, we just talked. And he was so interesting, and we talked about life and death and what he thought and his hopes and fears, and, like, all these existential questions. And of course, I didn't really have answers for him, so it was just sort of like him, and I just talking about what we thought. Or, you know, it was never me giving him like answers, because I don't know what happens. I was just listening to what he had to say. And slowly he did get to the point where he was in the actively dying phase, which is like the last phase of life. And we did have a continuous care nurse in his home, meaning a nurse that was there 24/7 to care for him, because he was having, like, intermittent agitation and things like that, but he was mostly unconscious. And the last day I visited, because I had to visit every day while the continuous care nurse was there just to make sure everything was okay, I could tell he would die that day. Just from being a hospice nurse for a while, I could tell the way he was breathing, how he looked like I think he would die that day. So I said my goodbyes to him in my head, because he was unconscious. And I just said, like, Thank you for everything. Like, I hope you have a beautiful journey. And I told the continuous care nurse, hey, when he dies, text me, because I knew he would die, like, pretty soon. And I left. And as a hospice nurse, it's so weird you, like, leave your most favorite patient and then go who's dying, and then go to your next patient, right? So I had a weird feeling leaving, but like, you got to do what you got to do. And I got in my car, and before I left, I was like, No, I sat there and, like, basically, kind of started talking to him in my head again, just saying, like, Thank you for your friendship. Like, you're so wonderful. Blah, blah, blah, hope everything works out. Like, thank you for only care for you all that stuff. And then all of a sudden, in the car, I could hear his voice in my head, and I could feel like, feelings of like, excitement. Well, I can't help but like smile when I talk about it like, and he his voice goes, oh my gosh, Julie, oh my gosh. And he was smiling. I could, like, see him and hear him and feel what he was feeling. Best way I could describe it. It's kind of like I was transported somewhere else, you know, and he was going, oh my gosh, Julie, oh my gosh, if I only would have known. And this feeling of like peace and joy and kind of like soaring, like exuberance, like just came over me, and he wasn't saying much, except for, oh my gosh, Julie, oh my gosh, Julie, if I only would have known. But the essence of what he gave me was like, if I only would have known how amazing this is, I would not have feared this, because we had many conversations of him saying he was a little afraid. You know, he's a little scared. And I knew in his life he felt very restricted and tons of anxiety, and he had mental health issues. And he was showing me how free he was, like the immense feeling of freedom and release and joy and excitement and peace that I felt in that moment when he was going, oh my gosh, Julie. He was almost like whispering to me, I can't believe it. I was like weeping in my car, weeping, weeping, weeping, tears of joy. Because I couldn't the feeling was so overwhelming.

Julie McFadden 8:09
If I could, really, if I can get into it, I can almost relive it again and again. And almost as soon as it started, it ended, probably, you know, maybe 30 seconds. But once it ended, it was like, whew. I was kind of like back in my car again, like back to this reality, which made me realize I wasn't in this reality, if that makes sense. And my phone beep, and I looked at it, and it was the nurse saying so and so just died. And I thought, I know, because I feel like he just showed me, like what it was like that moment he had when he was, if you want to say crossing over or something, right? And I just said, Thank you, and we started planning things. I didn't tell her what just happened, because I didn't know what just happened. I was kind of like, God smacked. I was like, wiping my tears in my car, being like, the heck just happened, you know? And that's never happened to me before. Did that really happen? You know? That's where I go, like, Did that really happen? What's going on? And I think, like, years later, I finally decided to tell people, because I didn't tell anybody, because people always ask me why I didn't really fear death. And there's many reasons why I don't fear death, but this reason is one of the main reasons why this like feeling and experience I had. So finally, I just told people, because I thought, You know what? This is why. And I've been like, kind of like hiding one of the reasons, right? And then that's when I found out it was called a shared death experience. What was amazing, a shared death experience happens to everybody, but visioning, which we can get into, is something that happens on hospice, you know, all the time, like you can't really deny it happens all the time. Visioning is when a dying person, and it usually happens a few weeks before they die, we'll see loved ones who have already died, or friends who have already died, pets who have already died. Sometimes they see deities, depending on what they believe. You know, if they're Christians, sometimes they say Jesus or like an archangel. And I've seen other religions, see other things, so that doesn't really have to be Christian, but sometimes they'll see deities, sometimes they'll see angels, but it's usually like loved ones who they love and care for, who have already died. Died, I make visitations, and that happens in probably, like 80% of people. It's not always reported. It's hard to get, like, a real number, but, and it usually happens around three weeks, three to four weeks before they die. So they're not really, like on death's door. They there's a while there people think and talk. I mean, this is, like, my number one thing. People are always like, oh, you know, we don't know why it happens. We don't, and it might not be anything spiritual. Who knows it could be a biological thing, but we do know that it's not happening because of lack of oxygen and medication, because those things we rule out. And the person who has low oxygen, usually that's the very, very, very, very end of life. And people who are visioning are not at the very, very, very end of life. They're, you know, three weeks out or something, and their oxygen is fine. So there's a huge difference between, you know, delirium psych, like ICU psychosis, where people are seeing like scary things and bugs and things like that, then visioning, visioning is very clear. They're not confused most of the time, and they know who they are, and they're almost as surprised as anybody else. But I wouldn't say I'm like into this, like spiritual things, right? I'm not seeking it. Hence why I can have these experiences and not tell anyone for years, because I don't want people to know, because I don't know what it is, and I can't explain it, and so I keep it to myself. I think I've tried to define God because it was easier, and then the closer I got to this, like defined God that I have had experiences with, the more and more I realized, like it's not defined. So it's like a feeling of love and peace, and like a divinely guided higher power that deeply loves me personally would never be condemned, condemning or judgmental. So it's a lot of things. It's like, hard to define because it's so vast now, but I still, I still try to have it be like a personal God who, like, knows me personally. Because, like, the the more general and vast it is, it's hard for me to, like, think that it would know me personally. Well, I think God is love. It's like, if I'm gonna, like, bring it back to, like, hospice, I always say like, watching someone care for someone on hospice is like love in action. So like giving freely, sitting with someone, even though you're really uncomfortable because you love them. So it's hard for me to, I guess, to define it, but a lot of times, like, I see it in action through other people's actions. Like I see the love, and it's overwhelming. It's really overwhelming. It can overwhelm me sometimes where, like, I leave the house and cry, like, I'll leave my patient's house and, like, go in my car and cry because I'm so overwhelmed by the feeling of love. Be present with God at all times and see how your life unfolds.