One of the things that surprised me most during the writing of my book Stop Worrying! There Probably is an Afterlife was the topic of end-of-life experiences (ELEs), and in particular death-bed visions (DBVs). I devoted an entire chapter to this fascinating topic – phenomena that occur in the final days and hours of someone’s life, covering everything from DBVs to coincidences at the time of death, the room of the dying suddenly becoming illuminated, and sudden recoveries from coma.
And yet, while near-death experiences are often covered by the media, and have had many best-selling books written about them, ELEs are very much the poorer cousin, with very little coverage in books and media. And yet, once I dug into the topic, it was every bit as fascinating as the NDE literature. When I spoke to palliative care physician Michael Barbato about this strange disconnect, he suggested that the fundamental difference might be that with NDEs, we have a returned ‘hero’ (that is, as the subject of the archetypal “hero’s journey”), while with end-of-life experiences the subject actually does pass away, unable to continue talking about what happened to them. From my book:
In a small study he carried out in the 1990s, Barbato found that about 20 to 30 percent of patients reported a death-bed vision. But he points out that this is “almost certainly an underestimation” of the number of experiences, as his study only included reports from the patient or next-of-kin. “I, like many, suspect the incidence of death-bed visions increases as death approaches, but loss of consciousness or sheer fatigue get in the way of these visions being shared”, Barbato notes. “This number may therefore be the tip of an iceberg, with many, and possibly the majority, of death-bed visions going unnoticed”.
Those who report a near-death experience, Barbato points out, live to tell their story. Those who have a death-bed vision though may not get the opportunity to report their experience, being too sick or unconscious in the lead-up to their death. But even if they do, Barbato says, many in the caring profession label it as delirium and the experience goes unrecognised. “The medical profession (including palliative care) has contributed to the ‘poorer-brother’ status of death-bed visions [relative to the NDE] by not acknowledging their occurrence,” he opines. “When I first submitted an article to an International Palliative Care Journal some 15 years ago on death-bed visions, their reply was ‘this is not for us’ – code for ‘it’s too fringy’.”
It is rather sad that ELEs have not had the same coverage as NDEs, because when you look at the literature, and listen to experiencer accounts, it is obvious that these are profound and deeply moving experiences. “For those who have a death-bed vision, the experience is very real, personally significant and almost always helps them as they transit from life to death,” Michael Barbato told me. These experiences also have a significant impact on family and carers attending the dying, as this wonderful, moving selection of interviews with hospice nurses shows:
Those who have read my book will notice many of the factors discussed in the chapter on end-of-life experiences: how patients seem to straddle the boundary between the realms of the living and the dead, how patients’ experiences are often embedded within symbolism of traveling or being assisted on their way, and the appearance of previously-deceased family members as guides to the next world.
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