Finding Meaning in Life's Final Days, with Dr. Christopher Kerr

Dr. Christopher Kerr is an end life researcher, a hospice physician, CEO and Chief Medical Officer for Hospice and Palliative Care in Buffalo, NY, and the acclaimed author of Death is But a Dream. He provided hospice care for Matt Moran and his family in August, 2023. His extraordinary care and guidance was impactful and comforting for the family in the moment and in the grieving process that followed. As Matt would certainly would have wished and how he so often did with this podcast, we are passing along the lessons and spreading the good word about Dr. Kerr.

Dr. Kerr’s work, his research, book, and films are based on his experience and research working with hospice patients and seeing the extraordinary way the mind connects reality to the thoughts, visions and dreams of the dying. His work validates these powerful moments and brings comfort to family and to the emotions that come at the end of life. Dr Kerr defines End of Life Experiences or ELEs as significant, subjective experiences within the dying process that occur while asleep or awake. They can happen hours, weeks or even months before a person passes and may increase in frequency as patients approach death. These experiences are indeed gifts and impact the bereaved because “how people leave us matters,” says Dr. Kerr. His website provides many resources for learning more about his work, including:

·     View the award winning TED talk from 2015 titled  ‘I See Dead People, Dreams and Visions of the Dying” to learn more about Dr. Kerr’s perspective on End of Life Experiences.

·       Order the book, Death is But a Dream: Finding Hope and Meaning in the End of Life, by Dr. Christopher Kerr, available from numerous book outlets. 

·      His film, also titled Death is but a Dream, shares many patient stories. This is available for viewing on YouTube  or you can watch a short preview here.

·       End-of-Life Experience Research 

In this podcast, Bill Moran and Dr. Kerr talk though many of these topics and how Dr. Kerr helps brings perspective, purpose and meaning to the final days of a life. You will also hear how Bill was able to piece together what he was feeling as his brother was saying goodbye, the love and connection that was present, and the awareness of the power and incredible gift that came from this time that will last forever for him and the family. While the emotions don’t necessarily become less painful, talking through what is happening and what it all means shines light on the process. With that perspective comes much more joy, much more impact, and less focus on the loss and declining health of the individual. Tune in here to listen to the podcast (or connect to your favorite streaming service listed) or view the podcast on youtube. 

Transcript

0:09

Well, hello with gratitude Matt listeners, my name is Bill Moran and I'm Matt's older brother and today I will be your host for our show with gratitude. Matt With gratitude. Matt. As a place people can come to find the courage to be grateful. Regardless of how powerful this storm is. Matt started the blog with gratitude Matt dot com to track his cancer journey. Our goal with gratitude, Matt, is to reach and inspire more people and help them use gratitude on a regular basis. As many of you know, Matt passed away on August 20th. Matt's wife, Mary, and the entire family want to continue to help people through this podcast to find the courage to be grateful. Please know that Matt and the entire family appreciated all your love, prayers, support and generosity during his journey. His wife, Mary, and our entire family are so grateful and blessed to have your continued support. I am humbled and honored to be here today. Today, I'm super excited to introduce our guest, Dr. Chris Kerr. Dr. Kerr has earned both an M.D. and a Ph.D. in neurobiology. He is the chief executive officer and chief medical officer for hospice and Palliative Care in Buffalo, New York. Dr. Kerr realized that many of his patients in hospice had extraordinary experiences as death approached. As a result, he designed studies that would tabulate these experiences in a meaningful way. These experiences are enormous gifts to the dying and those of us left behind. They impact the bereaved because how people leave us matters. How we grieve is impacted by how we experienced their deaths. Dr. Kerr has shared his findings and the importance of these end of life experiences to the world. Most notably in an award winning TEDx talk titled I See Dead People Dreams and Visions of the Dying, he authored a book titled Death Is But a Dream Finding Hope and Meaning at Life's End, End and released a movie of the same name. In addition, in addition, Dr. Kerr continues his work, his research, and is helping his patients and their families realize a more meaningful and personal person, purposeful end of life experience. I first became aware of Dr. Kerr through Matt, his wife Mary, and Mary's brother, Dr. Ed Cosgrove. Matt spent his final days under the careful and loving care of Dr. Kerr in hospice of Buffalo. When I asked Dr. Curfew would be a guest on with Gratitude Matt, he jumped at the opportunity. Welcome, Dr. Kerr, and thank you for joining us today. Thank you. Thank you. Many years for the kind introduction. Okay. Well, it's I could have gone on and on, but we wanted to we wanted to get to the importance of your research and your findings. And we're I'm just so grateful to have you here today. So, Dr. Kerr, I'm going to kind of lead in. We'll start at the beginning. So you devoted your career, your energy and your research to end of life experiences. I know it's a it's a long answer, but how did that come about? Unintentionally and by accident. I was I had no interest in this area of medicine at all. I actually was a cardiology fellow and I worked in the ER with Ed Cosgrove for many years, and I was just moonlighting in, came to hospice, completely uneducated and uninformed on what it meant to be caring for people at the end of their life. Because in training we typically signed off on these people because there was nothing more to do to them. And I was just struck immediately that there was so much I didn't understand. There's the dying we obviously observe a physical decline and lessening. But the but that there was a subjective side, there was the experiential side that the patient was experiencing. And it was really paradoxical to the physical side. The they were actually a very rich, vibrant and very much alive in their and the work grew out of a frustration in trying to teach it to medical students because we live in an evidence based time that this that you know, there's nothing on this kind of thing. And of course, the irony is it's been always been written about through time and across cultures, but it wasn't in medical language, you know, nor our language. So that's why we did the studies. So so kind of to give our listeners a little bit of a glimpse to your you're a medical doctor, you have a Ph.D. in neurobiology, but then you, through your writings and your research, you came to the conclusion that dying is more of a human experience than a medical experience. Can you kind of expand on that? Yeah. So what's happened over time is medicine gets more advanced. We become ever more enamored by the science of medicine, but not it's art. And dying is really something that we were we're sort of death denied in death defying and somehow dying, which really is a closing of a life and inevitable has become this medical problem to solve. And that's why the majority of Americans don't want to die in the hospital but end up dying in the hospital because that's where they're recognized. There's this sense that we can always like we're consumers of health care and there's always something we can do to prevent dying. And we treat it as organ failure like failing parts. Not again, a holistic view of it, which is the closing of a life. So you were you in your writings and your research, you used the phrase end of life experiences. And in kind of for the listeners, what what does all that entail and what at hospice do you offer to help that journey? Yeah, So end of life experiences, it's really tricky known. Quite sure we use that to describe the subjective inner processes of dying each other. Words used to the closest. That language we have as kind of dreams or visions or that sort of thing. The reason why it's sticky for us is that if you talk to people about their adamant, this isn't a dream, right? That I don't they say I don't remember my dreams or this was very different. These aren't tend not to be fantastical or metaphorical or require analysis. They're based on real life events. And when we measure realism on a 1 to 10 scale, they tend to be a ten. So they see a lived experience. But that's the term we use is end of life experiences. And you kind of touched on this in a comment earlier, but in Western and the Western medical world, we don't really maybe talk about this as much. We talk more about the weather than maybe we do about end of life experiences. And maybe you can kind of explain a little bit of the why behind that. Yeah, I think it's you know, it's become easier to live longer, but higher. Higher to harder to die. Well, and, you know, we view it through this medical paradigm. And when you do that, you focus on body parts. And that wasn't true even a generation ago. I mean, we grew up and we would say, you know, how did grandma die? She was she died of old age, right? You were allowed to die of old age. Now you can you know, you're going to have ten diagnosis rate noses and more likely die in the hospital. So it's sad because dying is a reflective experience. It's a different vantage point you naturally look back on, but you you know, you stop caring about your taxes or your oil change and you start to focus on the things that matter. So it's not surprising then, that there are these inner experiences that are very, very, very different and that that that's what the patient the patient doesn't experience. Liver failure. They don't experience kidney failure. They experience life at its end. And there's a richness inside to that. You know, we did this really interesting study where we looked at dying as a as a as a as a traumatic experience. And this idea of post-traumatic growth, like the idea you could go to war and yes, it's a negative experience, but there are positive attributes like friendships, for example. And when we did that in dying, what we found was fascinating. It's actually measurable. Yes, they're physically declining, but paradoxically, they're emotionally, psychologically, spiritually, very much alive. And people don't stop learning and adapting right until the very last days of life. So the take home basically is the dying patient doesn't stop living because they're die. And there's actually a profound amount of living to do that's deeply meaningful. You think of your own situation, what it did to strength and draw the inner dynamics of your relationships right closer and more meaningful and very profound in important ways. And that's just part of this. And if we had one aim in this whole effort is to democratize the process and reclaim it as a humanizing process and one in which the patient should always have a say. That's a gift that you give the patient and that care that you're giving is is well, it's beautiful. It's so powerful. I'm going to shift a little bit over and we're going to get, you know, this is the 73rd podcast. Matt did 71 of these, and I'm kind of taking it over and carrying the torch here for for the family. But one of the things that Matt did in the a lot of his episodes was he he got real, he got vulnerable and he was able to kind of shed a little bit of light of his journey and how that might help others. But the one thing that that I and maybe you can help because you cared for and your team cared for Matt on his final days, but Matt owned his journey. He owned his health, he owned his diagnosis. And why is that important for both the patient and the family when they're going through these end of life experiences? Oh, yeah, it's wonderful. I think advanced illness in itself and I can speak from experience dying in particular is there is a loss, there's a surrendering of loss of ultimate control over the thing that matters most, which is the trajectory of your existence. Right. And there's a risk in that. In that one, you can be victimized to your circumstance. You can be totally defined. And we see this by illness. So I'm no longer a human right. I'm not seen in the totality and dementia quality of my existence. I'm seen as as a medical problem. So any time anyone takes the stage in their own story and give voice to something larger, and I think what's unbelievable is how often people change perspective. They they they don't lose hope. Hope changes. So hope changes from cure to hope for others. And it's a wonderful aspect in the human story that actually people do come to some understanding of where they are generally, but what they don't stop caring, they still care is just for other people. How are they going to be and how are they doing? And so there's this idea that they want to give and give and give of themselves. So this podcast series, for example, is an example of that. You got somebody struggling to get through a day experiencing physical symptoms that you and I can't really relate to or say we even come close to understanding yet what matters most. Perhaps is that he he was giving of himself to others. And that's the most redeeming quality in our struggle to remain humane. Is that is that we continue to to to bring meaning and love and value for for other people. And that sickness doesn't limit that, but actually can enhance it is powerful and is returns their control to you. Um so it makes sense to me. Well that that's beautiful. And I'm so happy that Matt was in your care and in your team's care. It was incredible. And I do have to confess, so you know, when Matt, he called me and he said he was he said he was going to hospice and we exchanged you know, we told each other we loved each other. And and I really struggled with whether with his mortality. I mean, you know, up until that point, you know, we knew the diagnosis was tough, but we also knew who Matt was. And I looked at you know, he's my younger brother, He's athletic, he's handsome, he's a devoted father, he's a loving husband, He's a faithful Catholic. And he's going to be called to heaven. And I was conflicted, honestly, on whether to drive from Cincinnati to Buffalo to be with him. I'd just been up there two weeks earlier and I tried to keep myself busy, but I knew I needed to be with Matt. I was I was there when Mom and Dad brought him home from the hospital, and I knew I had to be at his bedside when when, when I was going to walk him to heaven. And fortunately, my family told me that I needed to get up there and and to use Matt's word, I'm grateful I did. When I arrived at Matt's bedside, I gave him a kiss. I gave him a hug. I told him I loved him and and I gave him a few more kisses and I gave him a few more hugs. And I said, those are from each of his family members. And Matt responded with a beautiful smile. And it's really it's hard to describe how beautiful that smile was. But to use your words, that was a gift. And that's a gift that I get to carry and I get to share. I'm sharing it here today, and I know others have lost loved ones and they've experienced very similar experiences like this. But what how important is that experience at the bedside with a loved one who is, you know, at their end of life? Doctor, how I think what you said at the beginning, how people leave us matters. Right. And you can either it can be defined as empty without any redeeming qualities, dehumanizing, void of any spiritual reality of love. Or it can be this remarkable, incomparable experience where you feel something better. And that's what he you made sure you shared with him. You're it's interesting when you described the story, you didn't focus on the physicality of his appearance. You didn't focus on the sadness of seeing him transformed physically, what he may have been suffering with a roller cough trying to breathe. You focused about what was inside. You know, it's interesting that this is largely focused on gratitude. We did this large scale study that we haven't published for. We're just finishing to write up because caregiving so often described in negative terms. If you looked at the books on caregiving and you found out we were going to be when you'd go to a bridge and jump, you know, it's all measured in terms of, you know, the vernacular of our time, your life balance and all that other. It's just and that. And the funniest thing is, though, if you actually talk to caregivers, what they will tell you essentially is that that was the best, hardest thing I've ever done. And so we did this study and we used there's measures of gratitude. And what we found was enormous gratefulness that and the weird part was the harder the lifting during the caregiving, the more gratitude. So it's inversely proportional to struggle. So this was in the care team and the family members. Their family, the fear, the caregivers of the patient. The important thing is caregiving is such a more social, larger experience that's felt not at a transactional level of cleaning, feeding, but it's felt at a deep spiritual and psychological level. It's almost like it's a vocation, really. In adult. You said something when you touched on it in an odd way. So what Caribbean does is it's you've touched on a couple of ways. It stops you from running on the rat. We're all of your life, your attorney. You've got obligations and you said it. And oh, I stopped and I went to Buffalo, right? So you stop your life and then the next thing you said is you brought reverence and remembrance to your family members that you remember who we who, who at some level you're connected. It's defining. And you shared their gestures of love in a kiss and a hug to him. So a caregiving does is is not elective. It forces you to pause and find meaning and worth and redemption and love and what truly matters for being here. And it has to come to surface and be expressed. And you did those things so you're busy going along the day, boom, you hit the brakes, you turn your car, come up here, and you you went from being busy in life to focusing on what matters from your life. And, you know, I was beautiful. You described him from seeing him coming from the hospital to see him at the end. So you you you see it in its panoramic form and it's even richer. Well, that's gratitude. Well, thank you. In in in there. I was just the vessel. I was the lucky one to be there and and the family was to marry. And my sisters and everyone was. So it was like to use your words. It was life to affirming, not life denying. So that that was it was. It was. It was a beautiful. You said it more eloquently when you talked about your caregivers, but I you know, I described it as beautiful and sad all the same time. So, yeah. So one of the one of the things that I've noticed in your and noticed in your book and especially in the powerful, and I encourage and we in the show notes, we're going to provide links so that the listeners can really dive into your book, your, your, your TED talk and and really I think the interviews that you had with the patients were so powerful. One of the things that Matt always tried to remind his listeners was to be present. And I noticed that message In your research and in your studies, how was that important and what have you observed in that with being present? I it it's hard work in getting to the point where you can work through the grief, whether experiencing or anticipated, the sense of loss, the injustices, saying goodbye. The only way that happens is if you're open to seeing something that has more value. And as you said, affirms rather than denies life. And that only happens by being present. That's and I think it's so easy to distract ourselves. I do it every day with with the truly irrelevant and and be unpleasant and unmindful. But I think, you know, it really that's what brought me here was that when I was removed from the hospital and the allure of all the technology and the acts of doing and a full team and you're just compelled, it's just you patient and you're at the bedside and the at no tricks and you can't role play. That's so you're forced to brain, you're forced to being present and all you have is presence. And sometimes that doesn't even require language. It's just being present, has it learning how to be a comforter and that what you have to give is just which God and your shared past like you did with his brother. So it's all that. Yeah. So that in that's that's beautiful and and and so powerful and I hope the listeners get the impact of that because that that they're that that is that is amazing the findings that you made and you have you know you've you've lived it you were real you did it you were present for those patients. And and one of the things that you know, we've talked about this end of life experience and and the effect on on the dying and then also on the family members. But how does that carry over to the grieving process and what, you know, kind of getting back again, we've mentioned it twice already. You know, how you leave us matters in how can that help what you're doing? How can in what you've observed, how can that help those that are grieving? Oh, it helps immensely. And we've we've published studies on this with about 750 bereaved family or loved ones. And as you said, how people leave matters. And you can view death in terms its finality and the end point or you can see in it the opportunity to connect with something larger. So, you know, the clearest example that we've seen many times and you've got a couple who may have lost a child at or shortly after birth, and they've been together for 60 plus years. And at the end of the life, the one person is actually feels the presence or talking to this lost child. And that's the best example of converting, dying to empty and without redeeming qualities to something that actually again validates having lived and mattered. And what it also does is it connects usually it connects the person to the bedside, to the experience, so that what you end up feeling is there, that there isn't. There's this connectivity across lives, whether they're living or not. And so it gives a version of a better story. And when we looked at bereavement and there's tools to measure bereavement, know how do you remember, how do you get through? How do you have a still the relationship? How do you cope? People who experience these things absolutely changes how you process loss and also how you have reverence. It's the other videos of the family I think are as compelled knowing as they are the the the patient. I know if you saw the one I can I am bringing this up to you. I was just looking at it with somebody else named Sue, whose mum was very demented. But as she's getting closer to death, she's waking up and she's sharing these wonderful stories because every time she's closed her eyes, she's with her deceased husband. And so she's actually living a better, richer, happier existence, a kind of present in and connected in love. And at the end of her life, she tries to escape the facility. And what she's doing is she's reliving her wedding day. So she's got to get to Niagara Falls. So when you'd expect escalating psychogenic distress as one's life's closing, she's actually reclaiming lost love and it's just amazing. So when you hear the daughter talk and she talked about because you ask this question about the caregiver in the breed, she actually talked about how nice it was to go visit her mom towards the end of her life, because spiritually, psychologically, she was just in this wonderful place and she had these great stories to share about her husband. So well, that that certainly will help us all as we experience this in our own lives. So, you know, I don't want to take too much more of your time in it, because I know you're you've got some great work that you're working on. But if you could kind of share to the listeners some of the most the exciting ventures that you're working on and kind of where they can learn more about, you know, what you're doing and just kind of get. But give us a glimpse into the exciting news that you might have coming down. The I think the most important thing for your listeners is to look at I can't remember the exact linkage, but if you look at hospice, buffalo, end of life dreams or visions or hospice buffalo patients on YouTube, there is a bundle of videos because I can't do this justice. You really have to hear from the patients and families themselves because they're really quite moving. Yeah, we're doing a lot of interesting things. We're working with an Emmy, an Academy Award winner on a film that they're we're working with indigenous people in Brazil and Australia and who have had all these cultural beliefs all along. And they're coupling that with our research. And kind of the take home is this has always been part of the human experience. It's not something newly discovered but lost. And that's really cool that we're working on. And then we have a lot of just a number of really interesting studies we're. Doing as well. Well, we'll encourage the listeners in, like I said earlier in our show notes to to refer to that and be sure that they get that information and and and again, words don't do it justice. The power of those video interviews with the family and with the patients it's it's it's it's it's very impactful. So Dr. Kerr, I'm so grateful that we met through met Mary and the Cosgrove family. I want to thank you for your team's care of Matt and of his family. That's most appreciated. I want to thank you for bringing peace, compassion and grace and love to all those that you care for in their final chapter of their earthly life. Is there anything that you would like to add as kind of a closing remark here? Because, you know, I just. I just think it's fun talking to you, not only because you've obviously given this a great depth of thought, but I I think it's part of this story of gratitude and reverence for your brother that is that helps you give give a death and the loss of very different experience, meaning. So I really congratulations It's it's a heavy obligation and but you're doing it well so congrats to you. It's it's my it's my privilege to do it And and again I'm just the the voice behind it. I have the whole entire Cosgrove and Marian families behind me, you know, encouraging and, and supporting us. But so one of the things that Matt would always close with and and kind of remind his listeners of, you know, he met roadblocks and his dedication, work ethic, ethic and willingness to help others on his journey was his gift to us. And we want to continue that. Doctor, I see that work. Excuse me. I see that in your life and in your work. And thank you for that. And thank you for all those you've cared for. We're so inspired by what you've said here today and the work that you've done. I'll remind our listeners to put into practice Dr. Kerr's message and and learn how they can apply some of his lessons to their daily lives. Matt reminded us there are three things that we can do find the courage to be grateful regardless of how powerful this storm is, be present with those that we are around. Pay attention to what we are feeding our mind, our body and our soul. Again, again, a tremendous thank you to our today's guest, Dr. Chris Kerr. Remember to subscribe to this show, share it with friends and comment on the show with gratitude. Matt Listeners, until next time, find the courage to be grateful. Godspeed, my friends.