By Pam Kircher
In this essay, hospice physician Pam Kircher addresses the topic of how near death experiences (NDEs) and the hospice movement are transforming American values. Dr. Kircher is the author of Love is the Link: A Hospice Doctor Shares her Experience of Near-death and Dying, and she speaks nationally on integrating complementary medicine into conventional medical settings.
This essay is not about butterflies and sunshine — it is about the difficult time we live in and the ray of hope we have been given through Near Death Experiences (NDEs) and hospice experiences. The outcome is not certain. The hope is. There is a definite chance of redemption even at this late date, but attention must be paid to the values of NDEs and hospice.
If the world in general and America in particular continue to follow the path of materialism with people's values, passion, and power being directed toward acquisition of material possessions, there is no hope of salvation of the planet.
If, however, people turn toward simplicity and compassion and connectedness, there is much hope for a sustainable future that has greater peace and safety than the world has ever known.
Although we don't like to dwell on it, we all know the extreme dangers that we face: the wars that persist throughout the world, the AIDS epidemic, famines, terrorism, depletion of resources, enormous disparity between the haves and have-nots, the nuclear dangers, etc.
One response to these hazards is to simply focus on the moment and make it as pleasant as possible. When making it as pleasant as possible contributes to the problems, much is lost. If it means using up resources in acquisition of superfluous things, we have contributed to the dissolution of resources. When making it as pleasant as possible means leading lives of quiet simplicity with intimate connections with individuals and groups, it can add much to the resolution of current problems. It not only saves the environment, but also contributes to understanding among people and helps to bring more peace in relationships.
This is where the wisdom of NDEs and the hospice experience come in. An in-depth psychological study of people who had undergone NDEs was reported by Dr. Kenneth Ring in Heading Toward Omega (1) in 1984. In addition to a lack of fear of death, these NDErs tend to be less interested in material possessions, more interested in universal love and being of service, more interested in nature, and more interested in spiritual (not necessarily theological) matters. These people tend to leave the business world and enter the world of social services. If they stay in the business world, they consider the well being of clients and employees as much as they do the financial bottom line. These are the people who tend to volunteer both formally and informally to assist others who need help in the moment. People who have had NDEs understand that we are all part of the great Oneness and that when they help a neighbor or a person halfway around the world, they are helping themselves as well.
These values are seen in hospice patients as well. As people are dying, they commonly do a life review where they look at the details of their lives and seek to make meaning of their lives. People in the last days of life typically come to realize that it was the relationships in their lives that were important to them, not their accomplishments, and certainly not their financial acquisitions. The last work of a lifetime is frequently seeking and giving forgiveness for old transgressions. People who are caring for their loved ones in those last days of life learn a great deal about the meaning of life. These people frequently begin to do a life review themselves and contemplate the values from which they are living their lives. It is not uncommon for the caregiver to make big changes in their lives as a result of what they learned from the dying person. These changes are always in the direction of greater balance in life, more spaciousness of time, and a greater emphasis on peaceful loving relationships.
These changes in values do not only occur in the people with NDEs and those who are dying or caring for dying people. These changes in values are beginning to permeate our society. Thirty years ago when Raymond Moody first published his book, Life after Life (2), the concept of NDEs was a novel one. While NDEs had been anecdotally mentioned throughout time, never before had a whole book been devoted to the concept. Prior to that time, people who had NDEs usually kept them to themselves because they didn't want to be considered crazy. If they told anyone, it was usually just one or two people that they were especially close to. That book gave people the courage to talk about their experience and it gave doctors the impetus to ask patients about the experience. Until then, it was rare for patients to tell their doctors about NDEs and, if they did, they were often referred to a psychiatrist and possibly put on medications and labeled a psychiatric patient.
Attitudes toward NDEs did not change over night, but they have changed dramatically over the past 30 years. The change began with people being willing to share their experiences. Initial stories usually found their way to "The Enquirer." As more and more stories came out, people were interviewed on daytime television shows like "Oprah." NDEs came to be featured in movies like "Resurrection" and even on television series. Currently, NDEs are such an accepted part of our culture that when a movie star has a NDE, that will simply be mentioned as a part of his/her life rather than as the main part of the story. In a Spring, 2003 AARP (3) journal article, Tony Bennett's life-changing NDE was referred to, but not dwelled upon. The thrust of the article was about how he had changed his life, not the details of the NDE that had led to the changes. This is a far cry from the NDEs in the 1970's that were featured in the "Enquirer." Some of the best selling books in the past few years have been about NDEs.
At the same time that the public was becoming increasingly curious about NDEs, research was done on NDEs and it was determined that they occur in 20-50% of cardiac arrests. A Gallup Poll (4) in 1982 showed that 8 million Americans had undergone a NDE. With improving technology for cardiac resuscitation (including the automatic external defibrillator device — AED), more people are surviving cardiac arrests and, hence, the absolute number of people with NDEs is rapidly rising. These people feel freer to talk about their NDE than at any other time in the history of the world, so it is now common to hear an acquaintance talk about a NDE. In fact, it is quite common for people to simply ask someone after a cardiac resuscitation if they had a NDE. Hence, the influence of NDEs on values is even more powerful than the number of people having the experience.
At the same time that interest in NDEs was on the rise, the hospice movement began in the United States. From the first hospice that was founded in 1976 in Connecticut, the hospice movement has increased at such a rate that currently nearly every town in the United States has at least one hospice. Most people now have either cared for a loved one on hospice or have at least known someone who died while on hospice service. Until the hospice movement began, most people died in ICUs in isolation with daily 15-minute visits from loved ones. Those brief visits gave little time for life reviews and intimate conversations. In fact, in those days prior to Dr. Elisabeth Kubler Ross' work to change medical professionals' attitudes toward death and dying, the standard practice was to not tell people that they were dying. There was certainly no invitation by the medical community for dying people to talk about their feelings and concerns. Families were encouraged not to talk about dying with their loved ones. The rationale for that is that a frank discussion might hasten death.
Much has changed since the 1960s. Mitch Albom's book, Tuesdays with Morrie (5), was on the bestseller list for over a year. That book was composed of conversations that he had over several months with his dying mentor. This new eagerness for conversations about the meaning of life (or, at least, reading about such conversations) bodes well for a change in values in this country.
Along with the rise of interest in NDEs and the concerns of the dying, there has been an increase in interest in spiritual matters in general. Neale Donald Walsh's book series, Conversations with God (6), has been another bestseller. There seems a genuine shift in attitudes toward looking at the deeper side of life.
In contrast, there has been an upswing in "reality" shows on television that generally portray the baser aspects of human kind. This is a time of great contrasts and the outcome is not certain.
How can we harness this interest in NDEs, hospice values, and spiritual values to positively affect our culture? Let's look at what is already happening. Media tends to focus on the negative aspects of our daily news, but there have been some very positive recent changes as well.
There has been an interest in introducing "Spirituality and Medicine" into medical schools, largely due to the support of the Templeton Foundation. Most medical schools now have such a course that recognizes the influence that spirituality plays on an individual's level of wellness. The emphasis in medical school is moving away from the idea that the patient is simply a machine that needs to be fixed and the physician is the mechanic to do the job. The paradigm of healing is moving toward a more holistic model that recognizes that the patient's body is constantly interacting not only with his/her mind and spirit, but that it is constantly interacting with the environment as well. The physician is beginning to see themselves as a part of the therapeutic team that includes the patient as well as other health care providers that are contributing to the patient's sense of wellness. To be sure, the medical profession is not entirely invested in this paradigm, but there is definitely a move in that direction.
Hospitals are also bringing in more complementary therapies into the in-patient setting. Since the study by Eisenberg in 1997 (7) showed that 1/3 of healthcare out-of-pocket money was spent on complementary therapies; hospitals and clinics have begun to offer these services. In the best of settings, these are integrated into conventional medicine and are not seen as separate but as integral to successful outcomes for the patient who seeks optimal wellness. The March/April 2004 issue of "Spirituality and Health" featured several of these medical settings. Small towns such as Great Bend, Kansas and large medical centers such as California Pacific Medical Center in San Francisco have programs like this.
The next front toward adopting the values of the NDE is to educate the public about the positive benefits of those values to them. There are several excellent studies that support that.
Dr. Dean Ornish reported on the power of volunteerism in his book, Love and Survival (8). A study of volunteerism showed that people who worked as volunteers were healthier than matched controls. When people become volunteers, they begin to feel themselves connected more to other people. Their compassion grows. They spend their time helping other people rather than consuming resources. The world benefits from their activities.
Dr. Randolph Byrd in the cardiac care unit of the San Francisco General Hospital found that prayer positively affected the outcome of patients, even when they didn't know that they were being prayed for. Dr. Larry Dossey reported on many other studies illustrating the power of prayer in his book, Healing Words (9).
Stress is one of the biggest factors in illness. Living a life that requires less money allows one to work at a more leisurely pace most of the time. Having fewer belongings allows a person more spaciousness in time since they are not busy acquiring and maintaining a lot of "stuff."
Dr. Paul Lam reported that tai chi improves health and reduce stress (Journal of Rheumatology, 2003 (10). It costs nothing, uses no resources, and can be done anywhere anytime in a life that has some time in it.
Food that is raised organically and cooked with love has higher nutrient value than prepared foods that are not organically grown. Community gardens are a great way to produce organic food while deepening relationships with friends. What about cooking some great meals together as well?
Studies have shown that if people feel connected to other people, their overall health is better through the years. Being connected takes time. (11)
As more and more people adopt these values, what will the new America look like?
Recognizing that the health and well being of our neighbors (near and far) impacts our own health and well being, we will look for ways to contribute to the happiness of others. Recognizing that excess material possessions require undesired expenditures of time and effort, purchases will be kept to a minimum. Recognizing that time is needed to develop deep relationships with ourselves and others, excess distractions such as most television, will be kept to a minimum. Recognizing that nature enhances our sense of well being, we will spend more time in quiet in nature appreciating the beauty and balance of nature. That appreciation of nature will allow us to make wise decisions at the polls and the market place as to how we want to preserve that precious aspect of our lives. Recognizing that our relationship with Spirit is fundamental to our happiness, we will spend more time in meditation and prayer. Recognizing that our bodies are intimately connected with our minds and spirits, we will eat only those things that contribute to a sense of radiant health. Having developed a greater awareness of our bodies, minds, and spirits, we will create balance in our daily lives that give us time for movement as well as quietude. We will create balance between our time with other people and time in solitude. With less frantic input from outside sources, we will come to know ourselves at a deeper level and make friends with our bodies and our needs. We will be aware of the difference between a need and a want. Americans will move slower, but each move will be purposeful and in balance with other people. We will honor the great gift that we have been given to live in a democratic land of plenty. We will be grateful and we will share with the rest of the world, recognizing that we are all a part of the great Oneness that is humanity.
How do we begin to create this new America?
First, we must recognize that the change is already in process. Each of the aspects that I discussed earlier in this essay shows that a quiet revolution is already in place. The next question is merely to recognize how each of us is already contributing to that revolution and how we would like to contribute at an even deeper level. I invite each of us to write down what we are doing to bring about a simpler, gentler world for others and ourselves. So often, we slip immediately into what we aren't doing. Let's first honor ourselves for what we are doing. As you write down the positive changes, just gently review for yourself when that change occurred — no judgment, just a gentle asking to increase your own awareness of your decision processes. Then consider the next two or three things that you would like to change to move your own life toward more balance and connectedness. Not big things, just little ones that you can actually accomplish. Then, simply do those things. Review back in a couple of weeks or a month and honor yourself for any small positive changes that you made. Share those changes with a friend. It will give you support and allow them to consider changes that they might be ready to make. Perhaps you might want to develop a support group of friends who are working toward making similar changes. Know that you are part of a growing revolution.
All of the concerns listed at the beginning of this essay — the famine, the wars, the nuclear dangers, etc. — could be resolved if we each seriously began to live our lives from the perspective of a person who expected to die next week or from the perspective of a person who just had a NDE. We have just enough time to do just that. This is the time. We are the people. What greater purpose could there be for our lives? Together, we have the power to address the concerns of our world today. And, we have the love.
1. Ring, Kenneth. Heading Toward Omega. New York: Morrow, 1984.
2. Moody, Raymond. Life after Life. Covington, GA: Mockingbird Books, 1975.
3. AARP Magazine, 601 E. Street NW, Washington, DC 20049.
4. Gallup, P. and Proctor, W. Adventures in Immortality: A Look Beyond the Threshold of Death. New York: McGraw-Hill, 1982.
5. Albom, Mitch. Tuesdays with Morrie. New York: Random House, 2002.
6. Walsh, Neale Donald. Conversations with God. New York: Putnam, 1994., 1999.
7. Eisenberg, David. "J. Altern. Complement. Med.," 2001. 7 Suppl 1:S19-21.
8. Ornish, Dean. Love and Survival: The Scientific Basis for the Healing Power of Intimacy. New York: Harper Collins, 1998.
9. Dossey, Larry. Healing Words: The Power of Prayer and the Practice of Medicine. San Francisco: Harper, 1993.
10. Lam. Paul. "Journal of Rheumatology" Sept., 2003.
11. Ornish, Dean. Love and Survival: The Scientific Basis for the Healing Power of Intimacy. New York: Harper Collins, 1998.