Frank T. Pool

It’s conventionally said that only two things are truly unavoidable, and I’m not writing today about taxes.

Hadley Vlahos is a registered nurse who does hospice work near New Orleans. She also has a couple million followers on social media and has written a book, “The In-Between: Unforgettable Encounters in Life’s Final Moments,” that has been deservedly well received. I listened to the audiobook with great pleasure and satisfaction.

The book is structured around the dying experiences of a dozen people Vlahos has known. These range from a decidedly grumpy man who becomes a grandfatherly mentor to the young nurse, a wealthy and attractive woman who gives a life lesson that Hadley never forgets, a homeless man, an atheist, her own mother-in-law, and a young mother dying of cancer who wants her children to see her look good one more time.

In the book, Vlahos also traces the outline of her own life and the wisdom she acquires through the experiences of hospice nursing.

Hadley, brought up in a strict religious family, became a single mother at 20. She chose nursing as the quickest path to self-sufficiency and support for her son. She is smart, vivacious, and pretty, as her many YouTube spots make clear. Besides that, she is devoted and kind and committed to family, patients, and to her own personal growth. Her own life story is intertwined with her patients’ lives and deaths. It’s a well-told narrative.

She has learned several important things from her experiences. First, it is quite common for dying people to encounter deceased loved ones shortly before the end. Sometimes they can talk about it, and those who are most lucid say it’s not like a hallucination.

Second, many dying people exhibit a burst of energy in their last days. They may get out of bed and start walking, or become clear-headed and articulate, or joke and laugh with visitors. Some family believe they have miraculously recovered, but experienced nurses know the end is near.

Third, dying people often have some control over the time of their departure. They may wait around until the last of their children calls on them, or they may wait until their loved ones leave the room, apparently not wanting to die with them present.

Finally are some really inexplicable events that might be coincidence, or not. The author says that all the hospice nurses she knows believe that there is something after death, but that emergency room nurses, who deal with trauma and accident and violence, often do not.

I have been doing hospice volunteering for some time, though my own limited contact with patients keeps me from knowing them as well as Vlahos does. I asked someone who has been working with patients for years at Hospice Austin’s Christopher House about some of these assertions.

He said, yes, indeed, people often report meeting their deceased loved ones. Sometimes they are so close to death that their words don’t make sense, but occasionally they can say, “my mother is over there.”

He also confirmed the burst of energy as a frequent occurrence, how the patients seem to perk up right before the end.

And he said that not everybody has control over the moment of their death, but some people apparently do.

I didn’t ask him about the stranger phenomena. Stories have abounded for centuries about clocks stopping when their owner dies, vases shattering, birds hovering near the window, and other events. Hadley Vlahos recounts some of those, including a chandelier burning out right as a woman died, and a bluebird she associated with the patient’s deceased daughter repeatedly flying and staying close.

There’s more. A woman deep in Alzheimer’s dementia was in panic because she thought the room was on fire. A veteran nurse told Hadley to move the bed into a different room, which she did. After the woman died, there was an electrical fire in that room, but the husband had been sleeping in the other bedroom where they had moved the bed.

Vlahos also felt a presence after a patient’s passing and forgot to take her name tag to work with her. Her return made her late, avoiding a terrible traffic wreck. Later, the best friend of the homeless man who had passed said that his last words had to do with Hadley avoiding a wreck.

A dear friend of mine once had a total stranger in another country come up to him and say, “I have a message for you.” He thought the man was mentally ill until he said, “It’s from your father. He didn’t realize what was happening until it was too late to do anything, and he is sorry.” This was an allusion to a profound experience my friend had had.

My mother told me that when her younger brother died, she was over 100 miles away. She said she suddenly thought of him, and felt very close to him. She believed that he was saying goodbye to his beloved sister.

Another relative of mine was combing his mother’s hair when she died. Shortly afterward, he said he saw stars. He said aloud, “I’ve just seen something I’ve never seen before.”

My brother said he was in the hospital room with his best friend and his friend’s mother, who had just died. He said he sensed a presence in the room, and though he saw nothing, he said that he and she “made eye contact.”

All these stories I would have brushed off some years back as coincidence or wishful, emotional thinking. I asked a hospice chaplain once if she had experienced anything like this, and she said she had not. These events are recurrent but not predictable or subject to scientific scrutiny.

I’m not sure what I think, though I am more open than I used to be to the possibility of some kind of overlapping reality beyond life. The fancy word for it is “liminal,” but Vlahos calls it simply, “the in-between.”

As Shakespeare famously wrote in his greatest play, “There are more things in heaven and earth, Horatio,/Than are dreamt of in your philosophy.” Maybe so, and it’s surely true that not everybody is able to compose themselves and prepare for death. Sudden violent death is all around us.

Yet for some, the final hours find surprising gifts for them and those they love. There can be grace and tenderness at the end. This is a lovely and loving book. It might relieve some fears and anxieties when the inevitable happens.

We the living also need to rest. Peace, y’all.