When Dead Loved Ones Come to Visit the Dying

“Were you the butterflies?”

Are y’all confused?

What you’re feeling right now is exactly how I felt as I sat at the bedside of one of my hospice patients, Miss Cheryl, very early in my career.

It was a seemingly normal visit, as normal as it can be for a patient with terminal, untreated cancer. So I wasn’t really doing much other than sitting at her bedside and charting.

And as I was sitting there, I heard her ask that question out of the blue:

“Were you the butterflies?”

My eyes immediately jumped from my tablet to my patient, then to the doorway, trying to see if someone else had walked into the room.

But it was just us.

I leaned forward, touched her arm, and said, “I’m sorry?”

She turned ever so slightly in my direction and said, “I was asking my son if he was the butterflies.”

I stepped into the hallway to talk to her husband. His eyes filled with tears as he told me that their son had died in high school, and afterward, my patient started seeing butterflies everywhere.

Now, I wish I could say that I walked back into my patient’s room, sat at her bedside, and witnessed that beautiful conversation unfold between her and her deceased son.

But that’s not what happened.

Instead, I walked to my car, called our physician, and asked what medication I should give a patient who was hallucinating.

And I will always regret that decision.

Now, if you knew me as a child, my hesitation about the idea of an afterlife when I started working in hospice would really surprise you.

I was raised in a very strict religious household, and the idea of an afterlife was as plain a fact as the sky being blue.

Then, when I was 15, the world as I knew it ended.

I was at a high school football game. In front of me and hundreds of other people, my friend Taylor went up to catch a football. Two players from the opposing team hit him, and his liver ruptured, killing him almost instantly.

I became extremely confused and skeptical of everything.

I would sit in church and ask, “What kind of loving God would take my friend and allow certain other people to stay here?”

It really rocked my foundation. I began to question everything I was hearing.

As I continued on my hospice journey, Miss Cheryl was not the only patient who saw deceased loved ones.

There was Miss Sue, whose husband came to get her at the end, and her anxiety about death was wiped away.

There was Miss Edith, who had severe dementia and was somehow able to communicate with me near the end of her life, and even predict what would happen later.

As I had all of these experiences, I had one question:

What the heck is going on?

Because this just did not jibe with my atheism.

I felt like I should be able to piece everything together, put it into neat little boxes, and make it make sense.

And as so many of you in this room know, medicine wholeheartedly supports that way of thinking.

We take something as complex as depression and put it into neat little boxes. I know I’m not the only person here who can check the correct boxes on a PHQ-9 in five seconds flat.

Every symptom has a medication. Every disease has a treatment protocol.

So I thought I could take all of these experiences, make sense of them, and disprove all of it as hallucination.

And then I met Miss Margaret.

Miss Margaret was still in the hospital when I met her. This was not my first experience with someone seeing deceased loved ones or having a surge of energy.

Before I entered her room, I spoke with her nurse in the hallway. She told me that Miss Margaret’s heart had stopped the night before. Through the efforts of that nurse and many others, they had been able to bring her back with CPR.

As soon as Miss Margaret regained consciousness, she asked to go home on hospice.

So I admitted her.

The doctor warned me that her heart could give out at any minute and that she probably would not even survive the drive home.

But that is not what happened at all.

I got to spend many months with Miss Margaret, and I was always amazed by how happy she was despite her circumstances.

She was not the first patient to tell me to live life to the fullest. So many patients had told me that.

But before meeting her, I always thought that meant taking a big trip or going skydiving.

Miss Margaret had a different theory.

To her, living life to the fullest meant finding everyday joy.

It meant using the fine china on a Tuesday.

It meant laughing with a coworker.

It meant taking the scenic route.

And I always wanted to know what she had seen when she died.

I kept searching for the right time to ask her naturally, but it never came.

Instead, when she seemed satisfied that I finally understood what a life well lived looked like, she offered it to me.

“It’s beautiful, you know,” she said to me one day, completely out of the blue.

I asked, “What is?”

She said, “The afterlife. I can’t wait.”

Sorry. I miss her so much. She was wonderful.

Through Miss Margaret, Miss Cheryl, Miss Sue, and all of these other patients, I really started to rethink how I had been approaching these experiences.

I also began to scrutinize my own actions.

I had not simply been present with them. I was constantly analyzing, constantly searching for a reason why all of this was happening.

And as I looked back over my life, I realized that everything had been about trying to find an answer.

My Episcopalian beliefs had been an answer.

And so had my atheism.

I started to understand that a joyful life does not come from having everything figured out.

It comes from our ability to simply enjoy these unexpected moments.

As I began to accept that, I was able to truly sit with my patients as they saw their deceased loved ones.

I started looking forward to the next time one of those moments would happen.

I would wake up every morning excited for it.

Sometimes it took hours. Sometimes it took months.

But whenever the moment came, I was able to simply be there with them.

And gradually, that began to extend into every area of my life.

I started looking forward to a surprisingly good cup of coffee, or that song coming on the radio that you had completely forgotten existed.

You roll down the windows and listen, and suddenly you’re back inside that memory again for the first time.

I cannot wait for that moment to happen again.

Um, I’m no stranger to people saying that I smile too much for someone who works in hospice.

I always smile back and say, “It’s a gift my patients gave me.”

And it truly is.

I wake up so excited every single morning, and I want that for all of you too.

So, starting tomorrow, I invite you to ask yourself this question:

When is my next beautiful moment going to happen?

You may need to remind yourself. Put a sticky note beside your alarm clock or set a reminder on your phone.

But don’t be surprised when, just as regularly, you find yourself saying, “I knew my next beautiful moment would happen, and here it is.”

Many years after Miss Margaret, I cared for Mr. Al, or Big Al, as many people called him.

He had been a chef in New Orleans his entire life, and he was pretty indifferent toward me in the beginning.

I was desperately trying to find a way to connect with him, and I was falling short a lot.

Then one day, I walked in and saw him eating red beans and rice.

I said, “I tried to cook red beans and rice for my family recently, and it was not very good.”

He said, “Well, walk me through the steps, and I’ll give you some tips.”

I did not get very far before he asked, “How long did you soak the red beans?”

I looked at him, confused.

He looked very concerned.

I asked, “Are you supposed to soak the red beans?”

He said, “You served your family dry red beans?”

I said, “That makes so much more sense.”

Then he called out, “Honey, honey, come here.”

His wife walked in, looking confused.

He said, “You know how people are always telling us that they’re praying for me?”

She said, “Yeah.”

He said, “We need to start telling them to pray for whoever has to eat our nurse’s food.”

That really bonded us.

Every visit after that, we grew closer and closer.

Then one day, I got a call from his wife saying that he was out of bed, something that had not happened in probably a year.

That surprised me on its own.

But what surprised me even more was that when I walked in, he had a large kitchen knife in his hand.

I looked at his wife. She was very concerned.

At the beginning of my career, I would have walked over, taken the knife from him, and safely guided him back to bed.

Instead, I walked up to him, placed my hand on his free hand, and asked, “Am I finally going to get to learn from the master?”

He said, “More than you know. My mom is here, and she is the real master.”

So, as I cut vegetables under his direction, I got to witness him talking to his mother.

He spoke to her the way a schoolchild might talk to his mom about a field trip he was excited to take.

We put the red beans and rice on the stove to simmer, and I helped him back into bed.

I could still smell the red beans and rice in the air when I pronounced his time of death just a few hours later.

When I went to his funeral, it was clear that he had been deeply loved by so many people.

I did not expect any of his wife’s time. But to my surprise, she walked over to me carrying his top-secret red beans and rice recipe.

And as I held it in my hands, I realized that my next beautiful moment had happened.

In our industry, I see so many people trying to analyze and control experiences from that place.

But I want to invite all of you to meet your patients where they are.

And in that moment, behold your next beautiful moment as well.

Thank you