A hospice doctor shares what dying patients actually experience in their final weeks
Steven Bartlett interviews Dr Christopher Kerr, a hospice physician who has spent three decades caring for the dying and interviewing over 1,500 patients about their end-of-life experiences.
Summary
Christopher Kerr, a hospice doctor and PhD neurobiologist, has spent thirty years caring for dying patients and conducting peer-reviewed research into what people actually experience as they approach death. He describes how nearly 90% of dying patients report vivid dreams and visions — predominantly of deceased loved ones — that are consistently rated a 10 out of 10 for realism and are distinct from delirium. His research challenges widespread myths about dying, including that it is painful, that patients are consumed by regret, and that it is a lonely or frightening process. He presents empirical data showing that what dying patients actually care about most differs sharply from what medical students predict, with relationships and presence far outweighing legacy, meaning, or conflict resolution. He also shares his own experience with stage four cancer, which he says transformed his relationship with fear, presence, and what matters in life.
Key Takeaways
FULL TRANSCRIPT
What a hospice doctor does
Steven Bartlett: Dr Dr Christopher Kerr, you've spent three decades of your life experiencing something that most of us probably spend our lives trying to avoid. What is it you've done for the last three decades?
Dr Dr Christopher Kerr: I was trying to avoid it too, but more by accident. I ended up becoming a hospice doctor.
Steven Bartlett: What does that mean?
Dr Dr Christopher Kerr: A hospice doctor cares for that individual who is no longer deemed treatable.
Steven Bartlett: So you've spent 30 years caring for people that are going to die shortly. And you started interviewing them.
Dr Dr Christopher Kerr: Probably 1,500 at this point.
Steven Bartlett: Why did you start interviewing people that were about to die?
Dr Dr Christopher Kerr: Because their perspectives matter. I arrived at that hospice completely unprepared to be a doctor of the dying. Medical school prepares you really to defeat death, not to care for those who are dying. But my colleagues, particularly in nursing, were much more tuned to what the actual patient was experiencing. What I've come to understand is that the patient perspective is the one that matters. And when you start to see patients as people, you start to understand that they have these rich emotional and personal lives, and that's what matters at the end of life.
Steven Bartlett: How much research have you done? I've got about 15 research papers here that you've published.
Dr Dr Christopher Kerr: We've done a lot. And we do very important things. We rule out confusion states. We've done studies on post-traumatic growth to see whether within the negative experience of dying there was actually positive gain. We've looked at the effect on children.
Steven Bartlett: When children die?
Dr Dr Christopher Kerr: Yes. And we've looked at the effect of these things on bereavement — those left behind, and how that influenced their grieving.
Steven Bartlett: And you've also done a lot of research on the visions people see as they're dying and the dreams they have in the days leading up to their dying.
Dr Dr Christopher Kerr: Yes, that's the focus. The vast majority of people — nearly 90% — start to have very intense dreams or visions, and the overriding theme is that they're seeing people who they've loved and who they've lost. Very specifically, it's those that have loved them unconditionally and purely. And those that didn't aren't there.
Dying is progressive sleep. Your sleep architecture changes, your sleep cycles change. And evermore you start to have these inner experiences. It makes sense that as you're dying, you're going to be reflective, introspective. They usually become more prevalent towards the last week or two of life. The frequency of these events increases as people approach death. So it's all been an attempt to really humanize the dying process — to take it from a medical model, which looks at organ failure and management of disease, and instead look at what the patient is actually experiencing towards the end of their life. And what's fascinating is that when you measure what themes bring them the most comfort, it's seeing the deceased.
Steven Bartlett: So if I'm passing away, the thing that brings me the most comfort is seeing my deceased relatives?
Dr Dr Christopher Kerr: Yes.
The visions of the dying — and what they mean
Steven Bartlett: I've got a graph here which shows the dreams of the dead that were most comforting. Would it help to see a video?
Dr Dr Christopher Kerr: Yes. What happened was we filmed patients early because we knew that our audience, particularly a medical audience, would have a view of what a dying patient was — that they were either compromised or feeble-minded. So it became very important to capture them on film. This is Paul. This is actually three weeks before his death, and he kind of covers all the bases. These dreams are very vivid. Very little is said between the dreamer and the person in the dream. What you'll notice in all these videos — and it's so striking — is the absolute absence of fear. These dreams never deny the fact that they're dying. They almost transcend it. And they really sometimes have trouble finding language for what they're seeing, but they know how their loved one felt, which is that they're kind of put back together.
Paul: I've probably had 15 dreams about her — maybe somewhere in there. She always wears — I dream of color mostly — and she always wears a beautiful light blue. It could be a suit, it could be a gown, it could be a dress. It's always light blue. And a couple of times she's given me the little beauty pageant wave. And a couple of times she sort of — always greets me with a smile. Only one or twice have I ever heard her voice. But she only kind of lets me know that she's fine.
Steven Bartlett: So he's in the lead-up to his death and he's having what, 15 dreams about his deceased wife. What do you make of that? What does that mean?
Dr Dr Christopher Kerr: Honestly, my view of this is changing. I would have told you before, when I started doing this, that it was a rekindled memory.
Steven Bartlett: So it was just a memory — like looking at a picture?
Dr Dr Christopher Kerr: Yeah. And there are a couple of features that stand out suggesting there's a lot more to it than that — that there's almost this continued consciousness. One is that the detail that's rekindled is remarkable. A 95-year-old man who lost his mother when he was five talks about smelling her perfume and hearing her voice. The other is that often these interactions — and you're going to see this in other videos — there's communication. They're not in still form. Again, not like looking at a picture.
Steven Bartlett: Do you believe his wife is still truly accessible? Or are you saying that the memory of her is accessible through his dreams? Because they're very different propositions.
Dr Dr Christopher Kerr: I don't know what this means. I wouldn't be so bold as to say this speaks to an afterlife. What I am more convinced of is that those who have loved us are never gone. They're accessible to us. And what is fascinating to me is that at the end of life, when people are neurologically compromised, fading, can't move, the remnant of function is still this core sense of being connected to love. And that remains.
It's like we enter the world and leave the world with remarkable symmetry. You come into the world and the infant doesn't know language, has an undeveloped brain, but it knows its mother's love. It knows it feels connected and secure. And at the very end of life, it's kind of the same thing. They're diminished, they're less capable, but what they're feeling and sensing, even without language, is the same thing.
Steven Bartlett: Was there one particular video you got with a patient approaching their death that was most persuasive to you as it relates to believing that consciousness continues, or that our loved ones are never really gone?
Dr Dr Christopher Kerr: Definitely the ones where people have injury or harm from having lived, and they've struggled with that — often for decades. No matter how much therapy, talk therapy, or medication, they've never found peace. And they find it in the end in these experiences. An old veteran who suffers with survivor's guilt and PTSD — in the last days of his life, he's brought back to those who died overseas, and he's comforted.
And some of the most remarkable ones, of course, are the children, who do this so differently. But just the fact that there's so much innate ability within us to heal these harmed and broken pieces. For children who do this, it's done in ways that are absolutely inspiring. They're often not dramatic. There's no great epiphany, no great reveal. These are moments of just having lived and mattered. They're sitting around a kitchen table.
If you want, we can show Florence. She's lost her husband and her daughter. This is five days before her passing.
Florence: The other night I saw — right into a sleep — they were like sitting at a kitchen table, laughing. I could see their faces. I could tell them from photos. We were laughing, we were talking, we were eating. And then it felt like they walked away. And never existed.
Jennifer: Because it was so real — he was there in the present.
Florence: And seven years since my daughter was gone. It was like we were always together, never separated.
Steven Bartlett: When you see something like that — people are aware they're going to pass away at some point. They've been given that diagnosis, that prognosis. The end of their life, their family — these are the things that would be on their mind. And if they're on their minds, they'd be in their dreams. So is it the process of death that's provoking these kinds of dreams or visions? Or is it just the case that you dream about what you think about, and obviously these people are thinking about the end of their lives?
Dr Dr Christopher Kerr: The only rebuttal to that is when you ask them these sorts of questions, the thing that gets them most distressed is when you refer to them as dreams. Because these are unlike anything they've ever experienced. They're not dreams in the sense of being metaphorical or fantastical. They don't require interpretation. I've never had a patient say, "Hey, what do you think this means?" They're given a sense of knowing. They'll often say, "I don't normally dream," or "I don't recall my dreams," or "No, this was virtual. This was a happening." They have no doubt. When we ask them to scale it zero to ten on the degree of realism, it's always a ten. It feels like this actually happened.
And those who are having these experiences in the waking state — you can watch them. They're looking right through you. They're looking at the room. They're petting the dog that isn't there.
Steven Bartlett: So some of them have these visions while they're awake?
Dr Dr Christopher Kerr: 50% are occurring when they're awake. Yes.
Steven Bartlett: Even quite some time before they pass away?
Dr Dr Christopher Kerr: No, it's usually measurable within weeks — a couple of weeks. And it picks up as you get closer to death.
Steven Bartlett: And when it gets closer to death, how do these visions change or evolve?
Dr Dr Christopher Kerr: They become more immersive. Again, dying is progressive sleep. They're living more in this other state — deeper and deeper sleep. They spend more time there. And they'll often wake up and wish they were going back into that other state. Often they're just warmed by the reunion they were experiencing. Time and distance go away. Decades have moved, and they're recalling very vivid memories — a dog they lost in childhood, for example.
Steven Bartlett: So do you think this is a biological, physiological thing — a bunch of chemicals sloshing around in the brain — or do you think it is spiritual?
Dr Dr Christopher Kerr: I'm also a PhD neurobiologist — spent five or six years studying the brain. So I'm drawn to that. But no one knows, and I'm good with that. You can point to parts of the brain and say love lives in certain areas, certain neurotransmitters are correlated with happiness. You can take all the pieces and you can't make the whole. I can't show you where love is. I can't recreate love in a dish. And I can't create this. I see it really goes beyond brain function into something else.
Steven Bartlett: So you think it is spiritual?
Dr Dr Christopher Kerr: I do, very much. Yes.
Steven Bartlett: Do you believe there is a soul?
Dr Dr Christopher Kerr: Yes.
Steven Bartlett: And you would posit that it lives beyond the physiology of the human body and brain?
Dr Dr Christopher Kerr: Yes.
What the data shows about connection to the deceased
Steven Bartlett: Half of Americans say a dead relative has visited them. The answer that got 53% of votes to the question "Have you ever felt a dead family member visit you in a dream or in any other form?" is yes. 34% say in the past year they felt the presence of a dead family member. And 28% say in the past year they've told dead family members about events in their life.
Dr Dr Christopher Kerr: We remain connected.
Steven Bartlett: 15% say in the past year they've had a dead family member communicate with them.
Dr Dr Christopher Kerr: All the data has always suggested that at least in this country there's a higher degree of spiritual orientation than you would expect. But that's always been the case.
Steven Bartlett: When people are in their last days, do they become more religious and more spiritual?
Dr Dr Christopher Kerr: Yes. We know it because of what they focus on. They tend to think about these big things, and again, they tend to be about relationships. They ask better questions. We've looked at the question of religion and we have not found that having a religious belief changes how you experience these end-of-life events. It just doesn't seem to matter.
Steven Bartlett: And most dying patients report end-of-life dreams and visions. The stats here show that 80% of healthcare professionals have witnessed or been told of one. I didn't realize it was so many. And people might think this is because of delirium, because of their illness.
Dr Dr Christopher Kerr: That's a good question, and that's what our studies did smartly — we sorted out the patients who were delirious. We screened them every day before they did a questionnaire. These studies are approved by a university, so you have to be witnessed, you have to have consent, you have to be cognitively intact. Before they did our questionnaire every day, they had to be screened for delirium. And these events don't resemble delirium. Delirium is very disorganized, and the biggest difference is most people are left frightened or distressed by delirium. These events are recalled with acuity — there's sharpness — they're based on real happenings, and they leave people with a feeling of comfort, not distress or fear.
The biggest myths about dying
Steven Bartlett: What are the other fundamental misunderstandings people have about death that you've spent your career trying to confront and reverse?
Dr Dr Christopher Kerr: Oh, there are many. Dying is a process; death is a moment. It changes over time. The big myths are that pain is expected or anticipated — and that's actually not true. Pain isn't inevitable, and the pain that is there can be resolved. The other misconceptions are around eating and drinking. People stop eating and drinking. It doesn't hurt. They're not eating and drinking because they're dying. Something happens in nature so that we don't die in want. It just kind of dwindles.
Dying is really like a dimming of the shades. It's gradual. You start to lose function, do less. If you have the flu, you know to go to bed. Sleep is preferred, and most people die in sleep. The key is that to die, you have to be able to sleep well. But to sleep well, you have to be comfortable. And what people tend to think is that comfortable means physically comfortable — but you also need to be psychologically at peace, existentially at peace. The vital sign that matters for us is comfortable sleep, because you can't sleep if you're in discomfort, and you can't die if you can't sleep.
Steven Bartlett: There's that famous study by Bronnie Ware, who I think was a palliative nurse in Australia, who interviewed people in their last days and asked them about their regrets. Have you ever done any research like that?
Dr Dr Christopher Kerr: I really have trouble with that study. First of all, it wasn't empirical — it was based off of conversations. And that's not my experience. I don't see people bringing up regret towards the end of their life. Now, if you ask people whether they have regrets, I'm sure they would give you an answer. It's like if I asked you, "What's your favorite color?" You have an answer, but you don't go around thinking about it. Regrets, and this shows in our quantifiable study, don't actually come to the surface. A lot of that gets let go of. I can honestly say, having done this for nearly 30 years, that's what I hear.
What actually matters to dying patients — versus what we assume
Steven Bartlett: Let's take a look at this, because I think it's quite important. We have eleven things that medical students say they think will matter to a dying patient at the end of their life. And then you're going to tell me what actually mattered when you did an empirical peer-reviewed study asking patients with days to live what actually mattered to them.
Dr Dr Christopher Kerr: The first thing the hospice patient cares about is not being a burden. They become selfless. They don't want to tax their family. They don't want their illness to compromise their family's life. They want to spend time with them, but they don't want to interfere with their living. You would think that as people are nearing the end of their life, they would become more and more self-focused — and they become other-focused. And what's really interesting is this aligns well with the science of happiness work, which says that happier people derive meaning from doing for others rather than doing for self. These better features kind of come to life at the end.
Steven Bartlett: If I've got a relative who's passing away and this is the thing they care about most — not being a burden — is there something I can do as the loved one to ease this concern for them?
Dr Dr Christopher Kerr: I think it's aligning your wishes with their hope, which is that your wish is to actually be a presence — and you're letting them know they're not a burden.
Steven Bartlett: Okay. Number two — they want time with friends and family. That's what they care about second.
Dr Dr Christopher Kerr: Fundamental here is relationships. That's what it's about.
Steven Bartlett: And the medical students thought it would be feeling that life was meaningful. This is one that fascinates me the most.
Dr Dr Christopher Kerr: So you're in your 20s and you're on this journey of development and you've had this impact of some sort. That door has shut. And they're not living in the rearview mirror and they're not wondering whether they had meaning or not.
Steven Bartlett: This is very relevant because me and my fiancée were in the car the other day and we were talking about this, and she turned to me and said, "What's your why?" And having sat here on this podcast with a guest a couple of weeks ago who asked me to close my eyes and imagine it was the last day of my life — the only thing that mattered in that moment was who was around my bed, what they thought of me, and whether they were safe and secure. It didn't dawn on me in that moment, when I visualized being on my deathbed, to think about my legacy or the impact I'd had or the achievements I'd accomplished. It's made me really reconsider what my why is. Because really, if in the last moments of my life what I'm concerned about is who's standing there and what they think of me — and when I say what they think of me, it's things like do my kids think dad was a good man, did he leave us with lessons and principles so we can live a good life too — that seems to be most important. We go through life and we read Instagram and LinkedIn and it tells us: what's your why, what's your legacy, what impact do you want to have on the world, what's your purpose, what's your passion? And these are all very self-focused. But actually it appears that in those moments, it's about others.
Dr Dr Christopher Kerr: And there's good work on this — the brain's ability to predict what makes us happy is horribly wrong. What we predict will make us happy is never sustainable. And then what's important is to de-want what matters.
Steven Bartlett: De-want what matters?
Dr Dr Christopher Kerr: Yeah, because we're on this treadmill of things we think are going to make us happy — job promotions, and so on — and they're not sustainable. That's proven over and over again. Belonging, connection, meaning — those are the things. We're fundamentally meant to belong to one another. If you think of the best version of yourself, it was never achieving something. It was being a son, it was being a brother, it was being a friend, it was being a fiancé or boyfriend. It's those things that make us important. And ultimately, what you find out of this research is the enormous value of interdependency. That's the whole deal — whether it's in the physical world, the natural world, the ecosystems — but as humans, we're meant to be interdependent, and that's most clear in moments of vulnerability. So you pose yourself the question about the last day, and you're immediately vulnerable. And what you did is you pulled in all these other people that matter to you. Because we're defined only by our relationships. That's the only surviving thing — not by these other things that seem, in a transient sense, important. And that bears this out. What's beautiful is their concern shifts from self. Hope changes in that way — it's hope for cure, then just hope for others. It's just this really wonderful story about who we are.
Steven Bartlett: It's interesting because a lot of people will intellectually understand and believe that it's about the relationships in these last moments — and therefore it's about relationships throughout our life. But then when you look at how we allocate our time on a weekly and monthly basis, there's a disconnect. Because we're allocating our time towards accomplishment, achievement, money, promotions, cars — but then in the final hour, it's all about something else. And if I even reviewed the allocation of my time this week, I'd be like, wow.
Dr Dr Christopher Kerr: Dying is this unbelievably truthful place. Pretense goes away. All the superficiality goes away. You're stripped to the bare bones of who you are. And what you end up finding is that we're more alike than unlike, and there's a universality to being human. It involves being connected to one another. Our struggle is to remain humane, and we go through this together, not alone. There's a symmetry — you see it at the beginning of life and you see it at the end of life. Politics falls away.
Steven Bartlett: And this is interesting because so many people spend their lives getting agitated. You said we're more alike than we believe. And so when you're bare bones, you're not really thinking about the left, the right, this political issue.
Dr Dr Christopher Kerr: When people are most vulnerable, you see beauty. You see love. You see tenderness. You see vulnerability. There are some awful humans who have lived a bad life, but in the end, when you see them in a more vulnerable state, I think you see their better nature. You see tenderness. You see expressions of love. There's a lot of pretense that people have to work through — personas that they present — and illness kind of strips you of that. It's this great leveling effect to be sick. What mattered to you two weeks earlier doesn't matter to you now.
Steven Bartlett: Okay, so medical students thought the third thing would be pain and symptom management, and according to your hospice patients, they agree. And what does that mean — their concern is not being in pain?
Dr Dr Christopher Kerr: Unfortunately, there's not a lot of conversation about what to expect. We just completed a study on this. If you were told you had a terminal disease, I guarantee one of your first overwhelming thoughts would be suffering. And unfortunately, it's damning how little conversation there is to address that issue — in terms of what to expect, when to expect it, what you're going to feel — and to reassure people. These honest conversations actually don't take away hope; they restore agency.
Steven Bartlett: So what is the misunderstanding?
Dr Dr Christopher Kerr: That it's far worse than people think — that there's rarely a pain we can't manage.
Steven Bartlett: It's less painful than people think?
Dr Dr Christopher Kerr: By a mile. That's probably the biggest myth about death and dying. And honestly, it's compounded by the fact that doctors don't have these discussions.
Steven Bartlett: Okay. Number four in terms of what hospice patients say matters most to them?
Dr Dr Christopher Kerr: Peace with God.
Steven Bartlett: Being at peace with God. And presumably just the religious ones?
Dr Dr Christopher Kerr: I know — it's peace with a belief in something larger. I've asked patients this, and they'll say what I would say is that they don't know. It's an existential feeling that doesn't necessarily have to be attributed to a belief or a god.
Steven Bartlett: Is it because they're concerned they're going to go to hell, or that they don't know?
Dr Dr Christopher Kerr: I don't hear that. I'm sure there was a time when judgment played a role, but it's just about being at peace — existentially.
Steven Bartlett: And is there a way to become at peace that patients will ask for?
Dr Dr Christopher Kerr: I don't hear it, but I imagine it's to ask for forgiveness in part.
Steven Bartlett: And the medical students thought number four would be being mentally aware. That's actually number five. And then the next is dying at home. And this is tragic because 80% of Americans want to die at home, and about 30% do.
Dr Dr Christopher Kerr: It's really reflective of our medicalization of dying. As a country we under-invest in care at home, so people end up having to go into the hospital, and the death they fear is the one they get. The more advanced a hospital is, the more aggressive treatment there is. It's part of the death-defying approach of medicine — there's always something you can do. They die in units, and the irony is the more aggressive care they get when they're dying hasn't been shown to enhance life. Medicine does its best to defy death, and unfortunately it often denies it even when it's obvious, when things have become futile. And if medicine can't appreciate death when it's objectively there, they're certainly not going to pay attention to the experience of the dying.
We've lost our way with dying. Dying used to be in the home and in the community, connected to our church. In the last 100 years it's become institutionalized. Death is now like a rumor — something that happens somewhere down the line, probably to somebody else, but it's not proximate to us like it used to be. Medicine has become technically focused and no longer artful. People can't die of old age anymore — you've got to have about five diagnoses. It's lost its grace. It's lost its humanity.
Steven Bartlett: So if someone knows they're going to die, you would recommend they get into a hospice so they can die at home?
Dr Dr Christopher Kerr: Yes. Hospice is more likely to align your wish to an outcome. Hospice developed out of our communities as an answer, a rebuttal to the way dying was traditionally treated in a hospital. What matters to the dying patient is familiarity — to be connected, to be where they live, the things that make them comfortable, the people they love. They don't want to be woken in the night, they don't want to be poked, they don't want IVs, they don't want another scan. It comes down to what will make you comfortable. What matters to you in the end? And being at home with your people is what matters.
Steven Bartlett: Makes sense. So number seven — having care directives followed. What does that mean?
Dr Dr Christopher Kerr: Making sure that what you want to happen is going to happen.
And then the next is resolving conflicts. The medical students ranked that seventh. And what's interesting is the dying patients kind of say, all good. They're not a problem to be solved.
Steven Bartlett: That is the most interesting takeaway so far — living people think the dying will be really concerned with legacy and what they accomplished and whether they had any beef with anybody. But dying patients don't?
Dr Dr Christopher Kerr: That's why I have trouble with the regret literature. Because that's not what they're saying. They're not focused on the negative aspects of having lived. They're trying to preserve what makes them them, and what makes them them is their family. Being in their home and being at peace with their God.
Steven Bartlett: That speaks to what we should be thinking about in our lives day-to-day to some degree.
Dr Dr Christopher Kerr: And the idea that this changes in death actually isn't all that true. I think we're aware of it in dying. Dr. Laurie Santos does this wonderful work on happiness. If you go upstream and do that work on happiness, you reveal a lot of these same truths.
Steven Bartlett: We also live in a commercialized world where we're exposed to marketing and told what matters every day when we turn on the TV or open our phones. We're told the Louis Vuitton bag matters. We clap when someone gets the promotion. So there is an element of socialization that orientates our values towards being more materialistic and, I guess, shallow to some degree.
Dr Dr Christopher Kerr: Those things are transient and non-sustaining. One of the things that comes out of the happiness work is the importance of savoring — savoring things of worth, like our relationships.
When dying patients have lived badly
Steven Bartlett: Are there any people who were days from their own passing who were truly unhappy because of the way they'd lived their lives?
Dr Dr Christopher Kerr: Yeah, you die how you live. You can't reinvent it. It's not rainbows and flowers. I've certainly seen that, and I've written about them. They're people who had done wrong and were fearful of dying.
Steven Bartlett: Fearful of what?
Dr Dr Christopher Kerr: In several cases, they'd been raised Catholic and were worried about judgment. One case was actually a police officer. He thought that because he'd been raised with confession, he had to tell everybody all the horrible things he'd done wrong. We had a reporter from the New York Times and she got an earful. He just had to be cathartic and say everything. He was trying to unleash his sins. But it's very rare.
Steven Bartlett: In that case, you've got a police officer unleashing their sins. Could that not result in legal consequences if they say things that —
Dr Dr Christopher Kerr: Yeah, you'd think so, because he talked about beating up witnesses and things like that. I never thought of that, but it's certainly true.
Steven Bartlett: And nothing was done about that?
Dr Dr Christopher Kerr: No. And what was interesting is we had a criminal — a guy who'd spent more time in prison than out — at the same time. He's actually on film. He had regrets, true, but they got addressed at the end.
Steven Bartlett: What do you mean?
Dr Dr Christopher Kerr: About 12% of our patients report dreams that are distressing or uncomfortable. They're not all comfortable. Again, it's not surprising — you're going to die the way you lived. And what we got wrong was that those are sometimes the most transformational. Those are the ones where they find healing.
Steven Bartlett: He had a dream about some of the bad things he'd done?
Dr Dr Christopher Kerr: Oh, yes. And it caused the transformation. Dwayne had committed crimes in his life — two murders, both self-defense on the street. Someone was trying to rob him, that sort of thing. He lived on the streets most of his life. But he never reckoned with the things he had done wrong. And this was his reckoning.
Steven Bartlett: And how many days was this before he passed away?
Dr Dr Christopher Kerr: Twelve.
Dwayne: My dreams, man. My nightmares. I don't like them. I think it's because my past is coming back to me — from doing wrong. Because I'm not going to say I'm a perfect guy when I was out there. Because I was living right in the streets, doing wrong to individuals. And now they know my symptoms. They know I'm sick. So now they want to try to hurt me. It was like they were jerking a knife, trying to cut out my neck where my cancer was at. Stop. Stop trying to fight. I'm sorry. I'm sorry. Trying to fight this guy off from hurting him. It scared me. I'm not a bad individual, man. I've crossed a lot of people in my life. And I need help. I need help. I don't want to live my life — I don't want to be walking in society having to look over my back, man. I just want people to forgive me. And please know that I was sick at the time when I was doing certain things that I was hurting them and their families. That's all I want. I don't want them to look at me as a bad individual, because I'm not. I need help.
Dr Dr Christopher Kerr: What ends up happening is he can't sleep. And again, going back to this idea that it's very hard to die if you can't sleep. He ends up waking up and he asks to see his daughter. And she comes on the film. And what she describes is that for the first time in her life, he holds her for minutes and says how much he loves her and that he's sorry for what he had done. So this negative experience that was happening when his eyes closed brought this reckoning and this ask for forgiveness — which, of course, she gave.
Steven Bartlett: And what do you make of that? What do you think is happening there? Is that a spiritual thing? Is that just him approaching the end of his life and feeling remorseful?
Dr Dr Christopher Kerr: He didn't have conscious control of this. I don't believe that for a second. This was happening when his eyes were closed. I think that he was carrying at a very deep level the knowledge of the wrongs that he had done. And something was forcing him to find peace. And it did.
Steven Bartlett: Something.
Dr Dr Christopher Kerr: Something. Yeah. I think truth. I think somewhere in him he couldn't joke and contrive around it. Dying brought this to the surface and he needed to find peace. And it was wonderful for her. It changed her completely. And what ends up happening was she spends every night with him, and he ends up passing comfortably.
What dying patients actually care about — the full list
Steven Bartlett: So, back to our board of things that actually mattered. Number eight?
Dr Dr Christopher Kerr: Feeling that life was meaningful. And this is particularly low relative to the others.
Steven Bartlett: And number nine?
Dr Dr Christopher Kerr: Living as long as possible. And I've never heard a dying patient say, "I want to live as long as possible." What they want is to live as well as they can for as long as they can. But unless you've been sick, that's not the goal. Which is antithetical to the way the medical world looks at patients — that we keep going at all costs.
Steven Bartlett: There are stats here about how many years people spend sick on average. In the United States, up to around eleven years of our lives are lived in poor health. So although our health span in the Western Pacific is 68 years or in Europe 66 years, we spend about a decade in poor health. And what you were saying to me is that people care more about their health span — how many years of good health they have — versus their lifespan, which is just how many years they're alive.
Dr Dr Christopher Kerr: I think that's a perspective that's very hard to understand in health. But it's hard work being sick, and it's hard on those you love, so it makes sense to me.
Steven Bartlett: What about the longevity movement — people wanting to extend life and live forever? What is your perspective, having interviewed thousands of people who are dying?
Dr Dr Christopher Kerr: I think there's a risk of some illusion. There was an article in Science recently — 55% of lifespan is determined by genetics. And it doesn't leave you immune from circumstances of disease and whatnot. I worry a lot about the lack of evidence around some of the efforts. And I think the focus really needs to be on living well. If you look at the blue zone folks, that little lady in Japan or Italy isn't waking up from a cold plunge and measuring out creatine. She's just living well. They move, they eat more plants, they're highly social, they take time to downshift through prayer, meditation, music, whatever.
Steven Bartlett: When you think about all the people you've met who were days from their death, are there some who were more at peace with it because they had accomplished more? What is the correlation in terms of those who were most at peace with leaving this planet?
Dr Dr Christopher Kerr: The love given and received. That's the only thing that matters. I've seen people who have led remarkably simple lives, but they were pure in the love that they were able to experience.
Steven Bartlett: And so they were happier to leave?
Dr Dr Christopher Kerr: Oh, yes. You want to live in a way that you can die well, and that means loving well.
Steven Bartlett: And have you experienced the opposite — where someone had nobody there?
Dr Dr Christopher Kerr: I've had some very bad experiences. One of them I've written about — a woman who was taken as a child into a home situation that was really for kids with a lot of complexity, and had never seen or experienced love. The emptiness she felt. I'll never forget what she said to me. She was watching somebody kiss on a screen and she said, "You know, I look at that. I've never understood that." And her dying was empty and regretful.
Steven Bartlett: What do you mean? Take me into the nothingness.
Dr Dr Christopher Kerr: Just that she never was loved. She was denied love by parents. She was misused by men. So what she knew of love hurt her. And she was aware enough to know that.
Steven Bartlett: And there was no one there when she passed away?
Dr Dr Christopher Kerr: No. It's interesting though — she had one very interesting dream. There had been a man who wanted to marry her, but she had been so taken advantage of that she was doubtful, and as soon as he asked her, she moved out of their apartment to self-protect. At the end of her life, he came to her and told her that he really did love her. So she was shown some version of it that was soothing to her.
Steven Bartlett: A lot of people, because of early traumas, are somewhat avoidant of love. You explained that she moved out of the apartment when someone tried to propose to her. I could almost relate to some degree. I remember in my early teens I was extremely avoidant of commitment or relationships. And I remember this particular person turning around to me after I'd pursued them for four years, telling me they would now want to be in a relationship with me, and I remember immediately dissuading them.
Dr Dr Christopher Kerr: After pursuing them for four years?
Steven Bartlett: For four years, for sure. But a lot of it reads back to our early models of love and connection and relationships — where we modeled it in a healthy way. And this brings me to the point around overcoming trauma and wounds. How does the process of dying help us confront our earliest traumas or the traumas that have held us back in our lives? Have you seen evidence of that?
Dr Dr Christopher Kerr: Oh, lots. I've seen it in this end-of-life process. And again, I think these are the most meaningful ones that I witness personally. I've seen a man who had lost his arm at the age of eight. He was from an impoverished family, and developmentally his whole identity was about how he was going to be independent and be able to be a provider. And at the end of his life, he sees himself lying in a bed and everyone he had worked with came by him and told him he was the best worker they had known. A mother whose child was in prison for drug offenses — her identity as a mother was being questioned. And at the end of her life, her parents came to her and told her she was loved and she was a good parent.
Steven Bartlett: In a vision?
Dr Dr Christopher Kerr: Yes. There's something in us that's innate that can heal these broken pieces at the end and make us whole. The most inspiring people are those who have been harmed — often through nothing of their own doing — but who find peace in the end.
Is there life after death?
Steven Bartlett: Do you think there is life after death? Because one train of thought is that our body goes into the ground or we're cremated, we become dust, we become part of the trees and the bees and the birds, and that's it.
Dr Dr Christopher Kerr: I don't think we go on in a physical form, but I go back to this idea of a shared consciousness. The love that we've experienced early in life — and it's very interesting, it tends to be those who loved us unconditionally, and the others kind of go by the wayside — they're inseparable from us and they become more present to us as we're leaving our physical form. So it does suggest that there's some sort of collective consciousness that goes on. And back to your survey on the bereaved — the fact that that many people feel they're accessed by those who have passed is interesting.
Steven Bartlett: I think consciousness is a really fascinating thing. I've interviewed lots of people on this subject and I never really thought of consciousness as a thing before. But I've got a couple of hypotheses around what consciousness might be. None of them I can say I necessarily believe, but I remember one in particular — I think it was a physicist telling me that he thinks maybe consciousness is the way that the universe understands itself. He hypothesized that consciousness breaks itself into lots of little pieces — into fish at the bottom of the ocean, human beings that walk the land, birds that see from the sky — and it's consciousness's way of learning about itself and understanding itself as it breaks itself into these living organisms. He sends some of them to the bottom of the oceans and some to the top of the mountains and they all explore it. Maybe it explains why humans, and all animals, are so fascinated by novelty. The reason we go on holidays is because we want to have new experiences. We go and look up in awe at things we've never seen before, like mountains. And it's interesting — I was telling the story about being in Gibraltar or Malta or wherever it was, driving down the street after I'd had this conversation with this physicist, and looking at tourists in a completely new light. Because tourists are standing there for ten minutes or an hour staring at something they've never seen before. And it's interesting to me that that's part of the animal experience — this fascination with things we haven't seen. So maybe this hypothesis that consciousness is this central source that breaks into lots of pieces and goes off into existence to understand itself is a plausible, not completely indefensible idea. And then maybe when I die, I return back to the source of consciousness.
Dr Dr Christopher Kerr: I like my version better.
And you know what's interesting — you should look at the work that's been done with psychedelics and dying patients.
Steven Bartlett: Tell me about that.
Dr Dr Christopher Kerr: Basically, when they give psychedelic drugs — which indigenous people have been doing for thousands of years — patients come back structurally altered. First of all, their fear of dying dissipates. And they tend to see themselves as something larger — immersed within and connected to life at large. They're at peace in a beautiful way. They have this heightened awareness and they come back differently, and they die differently. And that's like with this work — they die differently.
Steven Bartlett: So back to our board. What was the tenth thing that matters most to people at the end of their life?
Dr Dr Christopher Kerr: Having finances in order.
Steven Bartlett: And the last one?
Dr Dr Christopher Kerr: Resolving conflicts. And that's where I have trouble with the idea of regret. Because if you went to people and said, "Do you have conflicts?" they'd say, "Yeah, I have conflicts." Or "Do you have regrets?" "Yeah, I have them." But when you actually rank-order them as priorities, it's not relevant.
Steven Bartlett: Very interesting. It's definitely changed my mind. Because we talk about regrets at the end of your life so often, and we end up misunderstanding that to mean that regrets are the most important thing and that you need to live your life in a way where you don't have regrets. But actually, you're saying that having spoken to those that are dying, living free from regret seems to be quite low in the priorities.
Dr Dr Christopher Kerr: I think it's a symptom of our times. We've become introspective and self-analytical. So if you ask these questions, they're going to come up. But in the lived experience, are they actually relevant?
Six lessons from caring for the dying
Steven Bartlett: So we have these six handwritten cards.
Dr Dr Christopher Kerr: These are the lessons I've learned from actually caring for dying patients. And probably the one that stands out the most is that love endures after physical loss.
Steven Bartlett: Love endures after physical loss.
Dr Dr Christopher Kerr: The idea that people who have been lost — often decades earlier — are there for us at the end. And that part of that dying process is this reunion with them. That survives.
Steven Bartlett: And on that point, it's probably a good time to touch on the subject of grief and how the dying process impacts the grief that those left behind experience.
Dr Dr Christopher Kerr: We've done a lot of work on this. A long story short is that how people die absolutely affects our bereavement. How we witness that changes our bereavement, and it's measurable. People who have had these experiences, who have watched their loved one reconnect, grieve very differently. It's measurable in grief — how they remember, how they recall, how they get through obstacles, how they heal.
Steven Bartlett: So if I want to grieve in the most healthy way, what dying experience is most conducive to that?
Dr Dr Christopher Kerr: Seeing that loved one as rich in love rather than empty and defined by their physical dimensions. And I don't know if it would help — do you want to show the video of Jennifer?
This is an interesting video for a couple of reasons, because these end-of-life events are not great epiphanies or revelations. They're just about very real moments that are symbolic, usually of a relationship. She's describing her partner Patrick, who's at the end of his life and has these experiences. But she describes what it means to her.
Jennifer: Patrick was the only member of his family that knew how to make the sauce. And for all the years I knew him, he insisted something was missing — after his grandmother had passed. This would be the Sunday before he passed. He woke up in the morning and I couldn't get him to eat. He wasn't hungry — total loss of appetite. And I'm like, "Baby, we've got to make you something for breakfast. What do you want?" He goes, "I'm full." I said, "Pat, you had a snack pack pudding yesterday. You're not full." And he's like, "Oh, no. I ate with Nana Dolores last night." He believed he had made sauce with his grandmother the night before. Said he could smell it. He could still taste it. He was full from it. And she showed him, after all these years, what he had done wrong — which is that the very last step before you take it off the burner was to add a teaspoon of sugar. We spent the next seven and a half hours — because that's how long it takes — making his grandmother's sauce. He added the sugar. Last time Patrick ever ate. Every morning he woke up saying, "Is today the day I'm going to die?" And I said, "Go when you're ready." And he was ready.
Interviewer: Did that dream help you accept that reality further?
Jennifer: Absolutely. And not only the reality that he is gone — it's made me think that maybe there is something out there after we go.
Dr Dr Christopher Kerr: How she remembers him in death was that he was put back together by being with those he loved.
Steven Bartlett: If I know that one of my relatives is going to pass away, what should I be doing? My first instinct in that scenario is to protect my family from the grief of it, to make sure that the grief process is as healthy as it can possibly be. Are there things we can do as a family to insulate us from having a really negative grieving process?
Dr Dr Christopher Kerr: One is obviously communicating and being open with each other and with what's happening. One of the worst outcomes we see is when death is denied. If it's forecastable and it's obvious and you're proximate to it, it's less of an injury than if it's denied, denied, denied and then suddenly it happens. We see so much of that in medicine. This is a rule for life — acceptance. A third of our patients who come to hospice are dead in seven days. They didn't just start dying seven days before. They became aware of it. What we do is we refer to this as medical harm. We deny them and separate them and deny their reality. They're left to figure it out suddenly and acutely. And that injury robs people of their agency, their time to spend the way they want, the conversations they need to have. And the impact to the bereaved is enormous.
Steven Bartlett: So acceptance, number one. Anything else?
Dr Dr Christopher Kerr: Presence. It used to be this way. Death was in the home and in the community. It was shared. And that shared grief is wonderful because we're meant to be mutually supportive. The opposite is a sterilized death — in an intensive care unit, in a gown. Anything that dehumanizes the process of dying is injurious.
Steven Bartlett: So acceptance, physical presence. Anything else that helps the grief process?
Dr Dr Christopher Kerr: Loving each other. Talking, sharing, acknowledging. Anything that's repressive or denying — whether it's your own feelings or what's happening to the patient — is harmful. Period. That's why death in the home is so different. The person is seen as a person, not a patient. And patients know this instinctively. That's why they want to get back home.
Dr. Kerr's personal losses and his own cancer diagnosis
Steven Bartlett: Your father passed away when you were twelve?
Dr Dr Christopher Kerr: Yes. He was 42, I think.
Steven Bartlett: He passed away of cancer. In what way was this formative?
Dr Dr Christopher Kerr: I think it shaped life in certain ways that I wouldn't have chosen and that I don't understand. The one thing was that that sort of loss at that point in your life changed the trajectory of your life. You don't just lose the person — you lose the world the way it's supposed to be. And for me, my world went off the tracks pretty badly. It was a pretty bumpy road.
And it's so unusual because the last time I saw him, he was having one of these end-of-life experiences. I still can't make sense of it all, because after he died, for many years I could never speak his name. I certainly couldn't talk about the last time I saw him. So the irony is that the thing I could never talk about is the thing I now share with millions of people. I feel like I'm getting pumped — I didn't mean for this to happen. And you wonder — that sort of loss does change you. It changes what you're sensitive to in others, what you see in others, what you feel from others, how you want to help.
Does grief ever go away?
Steven Bartlett: I don't think grief goes away.
Dr Dr Christopher Kerr: There's a period where grief is unbearable. It's like having this rock in your pocket — you know it's there, and other times you forget it. You lose the person in the physical form, but they still relate to you in other ways. It changes how you see the world for having known them. So they continue on in some way. We talk about grief in terms of what we lose, but not necessarily what remains. And a lot of that person remains. And grief is probably one of the most illuminating things that can happen in your life. It changes your life and the circumstances. I wouldn't be talking to you if I hadn't lost my father as a boy. Because a chain of events took place.
Steven Bartlett: And you interviewed 750 grieving families.
Dr Dr Christopher Kerr: I think there's a great expression that the trick, the art, is to carry grief in one hand and gratitude in the other, and be struck by both. You don't deny the grief, but you learn how to be grateful. And somewhere there's peace there.
Steven Bartlett: When you interviewed those 750 grieving families, did you notice a difference between those who carried the grief well versus those who didn't?
Dr Dr Christopher Kerr: We were looking at a very specific question — families who had seen these end-of-life experiences. The best example I can give you is a couple who had been married for six decades. Part of their shared life was losing a child, an infant. And the spouse is looking down at his loved one in the bed, and she in her inner experiences is holding this deceased child. And she's at peace. That connects all lives — living and dead. But it reframes dying from something that could be empty and only defined by its physical dimensionality into something rich in meaning and love. Because the question always is, when that patient becomes non-verbal, when you become disconnected from them — where are they and how are they? And if you're seeing that, it changes how you experience their loss and informs how you grieve. You view it very differently.
The six lessons — continued
Steven Bartlett: That was the first point — love endures after physical loss. Number two?
Dr Dr Christopher Kerr: Hope never fades. It changes. When you're diagnosed with illness, you hope for cure. And then — it's unbelievable how acceptance comes into play. They kind of get through that, and then they hope for other things. The hope doesn't change; it just evolves. It becomes hope to be comfortable, hope to have time with family. And then at the end, the most beautiful part is it becomes hope for others. And that's what you hear again and again.
Somehow we become less selfish. I found this when I tried to get the study approved. The university would say, "You can't — we want to sterilize the dying. They're never going to participate. They're dying. Why would they want to waste their time with you?" And actually, they all did. And they even wanted to be filmed. And if you think about it, there's no secondary gain — they're never going to see it. It's like the old man who plants trees he'll never live under the shade of, but somebody else does. It mattered that they contributed. It mattered that they connected. It mattered that they were heard, that their words mattered. And that's a form of hope. They've gone from hoping for cure when they were diagnosed, they let go of that, they think about comfort and having time with family, and then at the end, what they always hope for is other people.
Steven Bartlett: Maybe that's the essence of us.
Dr Dr Christopher Kerr: It's a better version of thinking. I think we live in a selfish space. I think we're robbed of that when you become a parent and whatnot, but I think in the end it's wonderful that hope doesn't extinguish because cure has.
The next is: people don't stop living because they're dying. When we did this study looking at dying analogous to post-traumatic growth — the idea that within a negative adverse event like war there are positive things like camaraderie — that's what we found. People were growing and adapting, and this was measurable and significant according to post-traumatic growth scales right up until the last days of life. And it's paradoxical to the physical state. Physically they're declining, but psychologically and spiritually they're very much alive.
Number four: the dying leave us connected. This became very important, and I wrote about this during COVID because so many people were removed from their loved ones, which was an unbelievable tragedy. When they're having these inner experiences, they're immersed and very much connected. We don't see people have these experiences in solitary. We tend to think of dying as lonely and a solitary event. But in their inner world, they're bringing people in. They're reflecting on life, and in these end-of-life dreams and visions they're immersed with people they love. So even though it looks like they may be isolated in an intensive care unit, when their eyes are closed they're also surrounded in love.
But then externally, the dying process brings people together. Lives stop. That son who has a roaring job in California has to fly home to New York. It tends to stop the world and we focus on what really matters, which is each other.
The dying can heal when harmed or broken. This happens in a multitude of ways — external peace, whether it's making peace with their God, making peace with their family. It's amazing how many families come together. What seemed like an issue of contention goes away and dissipates. They're able to see beyond that. It reshuffles your priorities in ways you can't imagine. The grudge that was held onto is let go. And internally, people who are having negative or distressing dreams and visions — they're often centered around harmful things, but they're often addressed within that process. Somehow, people who have lived with this injury their whole life get it addressed in the end. There's almost this final justice. People like Dwayne, who wrestled with these demons his whole life, and then at the end he's made whole.
Lesson number six: there's a better story than the one we fear. The best analogy I can give you is that famous Dylan Thomas poem — a message to his father who was becoming blind and dying. It says, essentially, don't surrender, don't fight the dying of the light. And most of us in health can relate to this idea of the resistance of death — that this is the enemy to be fought, and you're going to muster all your strength and will and overcome and survive. And that's how it appears to the healthy. The dying aren't fighting against anything. If anything, they're fighting towards — and what they're fighting towards is to get back to those they've loved and lost.
Horace is a great example. He's close to 90 years old and very near the end of his life. What's beautiful about Horace is that his inner world experiences are so overwhelming that he actually struggles to find language for the beauty he's experiencing — the colors that are richer, his wife, the relief he feels in seeing her. It really highlights this notion that they actually aren't struggling against anything. If anything, Horace wants to go to this experience he's having with his eyes closed.
Horace: I should look at all this beautiful. She was even feeling pretty. She was looking at me inside out. Yeah. And maybe the — I'm just — maybe words weren't necessary. Just looking at each other and knew exactly what I was always thinking.
Dr Dr Christopher Kerr: He's describing a vision he's had. He describes his relief like paying a bill — like it's over. And the greens of the grass are greener. He's so moved by it that he starts to get very tearful.
How this work changed Dr. Kerr — and his own cancer
Steven Bartlett: How has interviewing these people as they're leaving this world changed how you live your life on a day-to-day, week-to-week, month-to-month basis?
Dr Dr Christopher Kerr: I think a lot. I think cancer did more to change how I live on a daily basis, probably.
Steven Bartlett: You had stage four?
Dr Dr Christopher Kerr: Yes.
Steven Bartlett: Stage four cancer. Has it changed your perspective on your own dying?
Dr Dr Christopher Kerr: I can tell you that I'm certainly not fearful of the actual process of dying.
Steven Bartlett: Anymore?
Dr Dr Christopher Kerr: No. Yeah, I'm not.
Steven Bartlett: Were you before?
Dr Dr Christopher Kerr: Yeah, I think so. It's innate to us — it's why we survive. We're meant to resist.
Steven Bartlett: And what in particular has alleviated that fear?
Dr Dr Christopher Kerr: Seeing so many patients. And having to face that possibility myself. I had to wrestle that demon.
Steven Bartlett: And where does the comfort come from?
Dr Dr Christopher Kerr: It becomes less about self. When you have a diagnosis like I had, first you're confronted with this enormous responsibility — this reckoning with the lives that you're responsible to. You worry about their wounds and how they're going to be, particularly if you have people who are dependent on you. So that's what you're first confronted with. And then it changes you in a lot of ways.
Steven Bartlett: What specifically has changed?
Dr Dr Christopher Kerr: I was always restless. I could never sit. But cancer brought that to a stop. Suddenly. And it's a very weird thing because there's no period of adaptation. All of a sudden, you can't do. You're used to going into the world and now the world has to come to you. And it forces you to do what I really could never do, which is be more present.
I rehabbed basically over many, many months on my farm. I would gradually walk a little farther down the driveway, then into the barn, the animals, walking in the field, then the woods. And I can't quite describe this, but one day I was there and I'm looking at these willow trees that I had planted decades earlier. And they were the most beautiful things I'd ever seen. The trees hadn't changed. I had changed.
Victor Frankl talks about this in Man's Search for Meaning. He was a Holocaust survivor. And somehow he came out of that experience and was able to put a lot of definition around finding meaning. He describes a day when one of the prisoners runs out and says, "Look at the sunset." And they all come out and they're all admiring it despite their despair and destitution. And one says, "Look at what the world could be." The point is that beauty isn't about doing or accomplishing — it's internalized. It's finding meaning in the experience. I never got it, but I got it when I got sick.
Steven Bartlett: And on that point of meaning — which is the word on the front of your book — what is the meaning of life? From everything you've experienced, all the death, loss, and grief you've seen, what is the meaning of life?
Dr Dr Christopher Kerr: I don't know about meaning, but I know the destination is always love. And I think we're meant to get there together. We're meant to endure struggle together. We're fundamentally interdependent and reliant on one another. If you think of the best parts of yourself, it's always in the context of love.
Steven Bartlett: You wrote this wonderful book, Death is but a Dream: Finding Hope and Meaning at Life's End. Who is this for?
Dr Dr Christopher Kerr: It was meant for a medical audience, but I think it's for anybody who's caring for somebody. I think it's for anybody who's wondering about their own mortality. And I think a lot of people are benefiting from it who have witnessed these experiences but have never had them explained. And it includes different types of patients — patients who are cognitively different, children. Each one of those is very unique.
Children and dying — a closing reflection
Steven Bartlett: Dr. Christopher, we have a closing tradition on this podcast where the last guest leaves a question for the next guest, not knowing who they're leaving it for. The question that has been left for you is: what is one thing we haven't talked about that we should have talked about?
Dr Dr Christopher Kerr: The children.
Steven Bartlett: Explain.
Dr Dr Christopher Kerr: Children die very differently. It's not so much lessons, but they're certainly inspiration, and I think it speaks to what's innate in us.
Steven Bartlett: How do children die differently from adults?
Dr Dr Christopher Kerr: Well, for one, they don't struggle to find acceptance. They're already accepting. They don't think in terms of the finality of mortality. They just accept the state that is. They don't talk in terms of regrets and what-ifs. Children have this amazing ability to make themselves whole, to take care of themselves, to reassure themselves. One of the ways they do that is — they may not have known somebody who's died, so who comes back for them? Often it's an animal. And children don't have the same distinctions between the human and the animal world. And they come with the same message, which is that they're loved and that they're not alone.
The other thing that's just fascinating is they become very self-informed by these inner experiences. By that I mean they end up understanding where they are. You don't have to tell them they're dying. They seem to put this together in remarkable ways. And far and away the most remarkable thing about children is this quiet courage and how they care for those around them. They become so utterly selfless. It's almost hard to describe. There's a young lady who was taking her pain medicine — she didn't want to take it because she was enjoying being awake and plugged in. But she was sensitive to what other people were observing and she didn't want her mother to see her grimace. Another one who was from Syria — she knew she was dying. Her parents couldn't talk to her about it, but she had already gone ahead on Facebook and said goodbye and given life lessons.
Steven Bartlett: Do they have the same visions and dreams?
Dr Dr Christopher Kerr: Oh yes, they do it better. And we could show that with Jessica. Jessica is 13 years old and she's raised by a single mother. She sees this deceased friend of her mother's playing with her curtains. And she doesn't want to tell her mom because she didn't want to scare her, but it made her feel good because this was a good person and again she's not going to be alone. They tend to look after others — despite being children and being robbed of life, they somehow tend to worry about others and try to protect others. And that's what she does.
Jessica: I had a feeling that she was just coming and telling me that you're going to be okay. Everything's fine. But she didn't look at me. She was just looking. But I had a feeling if I called out her name, she would look at me. But I didn't want to scare my mom. I felt a sign of relief and happiness because she was a very strong person, and I know that I'm strong, and my mom tells me all the time that I'm like her.
Jennifer: And you told me that you thought — oh, Mom, I saw an angel. That's how you said you felt. And you said you felt peace and then you were able to go to sleep.
Jessica: And then I was able to go to sleep.
Jennifer: So it was really comforting.
Jessica: It was comforting, yeah.
Jennifer: You weren't afraid?
Jessica: I wasn't afraid of it at all.
Dr Dr Christopher Kerr: Children have this way of self-healing that's remarkable. We have another child on video who creates this castle and she can feel the warmth of light coming through the window and all the animals are well and playing. And when asked what the castle meant, she said it meant that there's a safe place.
What we actually fear about death
Steven Bartlett: Dr Dr Christopher Kerr, what a wonderful reminder of what actually matters. And also, when we think about how many of us fear our own death — it's about half of people, men and women. But actually, through your research, through the book you've written, and through the studies I have here in front of me, it's certainly made me think a lot less about the fear of my own death. Because you're right — people think of it as this sort of painful, prolonged process. But that's not what you report.
Dr Dr Christopher Kerr: No. And actually we've looked at that, and what they actually fear is isolation and being disconnected.
Steven Bartlett: And more so than fearing our own death, we fear losing someone else.
Dr Dr Christopher Kerr: Right. I haven't ever come up with the right way to frame it, but all of this comes back to this better idea that the concern is for others more than for self.
Steven Bartlett: And that's a beautiful thing.
Dr Dr Christopher Kerr: Yeah.
Steven Bartlett: Death is but a Dream: Finding Hope and Meaning at Life's End by Dr Dr Christopher Kerr. I'll link this book below for anyone who would like to read it and dive deeper into these subjects. They are illuminating subjects — because people in those moments of their life have such wonderful retrospective clarity. But maybe it's just clarity. Maybe it's just clarity on what actually mattered the whole time, as you say. Thank you so much for doing this work, because again it has destigmatized a bunch of prevailing myths and ideas about the last stages of our life that probably cause us undue harm — both to those that are left behind and to those that pass on. And it raises more questions about the nature of consciousness and spirituality and religion and the afterlife, which I guess are individual questions to answer.
Dr Dr Christopher Kerr: Thank you.