Kerr, a hospice physician, begins by pointing out that as a young doctor, he typically thought the most important thing was to keep people alive - at a minimum, conscious and breathing. He gave little thought to the way that individuals might wish to die. As he worked with terminally ill patients, he became aware, though, that in the face of death, individuals seek meaning in their lives, even as it comes to an end. Through dreams, that meaning often emerges and is comforting and insightful
Kerr write that doctors “owe it to their patients to incorporate this awareness into their practice. End-of-life experiences ought to be recognized as evidence of the life-affirming and inspiring resilience of the human spirit that drives. They assist in reclaiming dying in which patients have a say. They also benefit those left behind.” Most of the book is made up of anecdotal accounts of the types of dreams that patients have had and the effect that the dreams have on them. It’s made clear, though, that these are not hallucinatory drug-caused dreams.
Often, these dreams involve the reconstruction of memories so that concerns bothering patients as they are dying can be altered to give some kind of peace. In one instance, a dying man who had suffered from insecurity all of life dreams that he is holding a bat and calling to his childhood friend to come and play. He was no longer frail but youthful and discovering a sense of adventure and purpose. There are more details to the dream, of course, but it indicates a reworking of the man’s life.
Another interesting instance was that of an aged woman who commented that she often felt that her children didn’t know her, and that was too late to change that. Her mother had died when she was nine years old and so she never really knew her own mother. In her dream, she sees her mother again, this time with a full dialogue taking place between them. She died peacefully.
Of course, not all dreams of the dying are pleasant ones, nor do individuals universally have dreams that influence them, but Kerr’s emphasis is on the healing dreams. Most of us, he points out, have clear boundaries between what we perceive as reality and the dream state of our unconscious inner lives. It is the act of dying, though, that merge and reconcile the two. And bring about a good death.
To summarize, he quotes from the physician Atui Gawande’s book, BEING MORTAL to emphasize that modern medical science “has rendered obsolete centuries of experience, tradition, and language about our mortality and created a new difficulty for mankind: how to die.” Malfunctioning body parts get treated one at a time, while the patient is his entirety of both physical and mental aspects. is often ignored. What Kerr does is to emphasize that humanity and to consider late life dreams as one aspect of recognizing that wholeness of the human being.