When You Die Podcast with Penny Sartori
Throughout the course of my nursing career, I saw many deathbed experiences, end-of life-experiences. I witnessed people as they were dying, communicating with someone I couldn’t see. But clearly, they were having this conversation. And very often the patient, before they died, became very calm. When they were having these conversations, you might see smiles appearing on their faces. And they looked quite comfortable where they were. And I think I was exposed to that on my very first day as a student nurse. In fact, I can remember when I was on the morning shift, and the night nurse was handed over to us. And she casually remarked the man in bed six is going to be dead by the end of the morning. He’s been talking to his dead mother since three o’clock in the morning. And I thought they were trying to wind me up because it was my first day. But I went out to this man’s bedside. And, indeed, I did witness him communicating with someone I couldn’t see. And then he had this big smile on his face and his arms outstretched. He had such a lovely smile there. And then he just lay down, closed his eyes as if he’d gone to sleep, but he died at that point. – Penny Sartori
Johanna Lunn: This is the When You Die podcast. If it has to do with death and dying, we’re talking about it.
With me today is Dr. Penny Sartori, a highly skilled intensive care nurse, educator, and leading world-expert in near-death experiences. Dr. Sartori has been researching NDEs for over 25 years and has authored a number of books on the subject, including The Wisdom of Near-Death Experiences. It is through this work that she’s leading the way to improve end-of-life care.
Penny, thank you so much for being here today and talking with me, and for your participation in the When You Die Project and the trilogy of films. I’m so grateful to you as a person, and I’m grateful for the amazing work that you’re doing. So, thank you.
Penny Sartori
Thank you. It’s a real honor to be part of this. I think what you’re doing is amazing, as well. So, thank you.
JL
I’m wondering how long it has been that near-death experiences have been a such a big focus of your life.
PS
It’s been since about 1995 that I really got interested in them. I did the pilot study in 1997 so, a long time.
JL
It feels to me, and I’m curious what your thoughts are on this, that NDEs are becoming a little more broadly accepted than when you first started.
PS
I think so, because when I first started my research, I found it difficult to get people to share their experiences with me. A lot of people were very hesitant. They didn’t know if they could trust me, because it’s such a deeply personal experience. They didn’t know how it would be received, or if they would be perceived as going crazy. But I think over the years there’s been more in the media about near-death experiences. And I think that has encouraged the conversation, and more and more people are talking about them. And what I find interesting is that in the last 10 years or so, there are a lot of medical doctors who have had their own near-death experiences who are now talking about them publicly, as well. I think the fact that medical doctors are talking about their own experiences has opened up the playing field. I think people are less afraid to talk about their experiences, and more people are becoming curious about them. So, people are exploring them. When I first heard about near-death experiences, I dismissed them as some sort of hallucination. It was only when I started studying them, and really engaging with them, that I realized there was something very different. And I think there’re a lot of people out there now who are starting to explore these experiences in more depth. And I think it’s making people curious as well.
JL
I know that in the course of your work it’s not just near-death experiences that you’ve stumbled across, but end-of-life experiences and shared-death and spiritually transformative experiences. Is that so?
PS
Yes. Throughout the course of my nursing career, I saw many deathbed experiences, end-of life-experiences. I witnessed people as they were dying, communicating with someone I couldn’t see. But clearly, they were having this conversation. And very often the patient, before they died, became very calm. When they were having these conversations, you might see smiles appearing on their faces. And they looked quite comfortable where they were. And I think I was exposed to that on my very first day as a student nurse. In fact, I can remember when I was on the morning shift, and the night nurse was handed over to us. And she casually remarked the man in bed six is going to be dead by the end of the morning. He’s been talking to his dead mother since three o’clock in the morning. And I thought they were trying to wind me up because it was my first day. But I went out to this man’s bedside. And, indeed, I did witness him communicating with someone I couldn’t see. And then he had this big smile on his face and his arms outstretched. He had such a lovely smile there. And then he just lay down, closed his eyes as if he’d gone to sleep, but he died at that point. So, I think that stuck with me from early on in my nursing career. And then I observed it many times after that. I observed it in my own grandfather when he was dying, because we nursed him at home. At the time, I wasn’t really interested in end-of-life visions or near-death experiences, because I hadn’t started my research, yet. But I remember shortly before my grandfather died, he would be pointing at the bedroom door and saying, “Look who’s there! Look who’s there, come to see me!” And there was no one there. That was something that I witnessed within my own family, as well.
JL
What human benefit do you think these kinds of experiences have for us? What do you think it says about our humanity that these are increasingly common experiences?
PS
What I’ve observed through my nursing career is that these kinds of experiences are very common for the person as they transition towards death. And it might be that in the initial phases of having these visions, the patients might be a little bit resistant. And they might say, “Go away, I don’t want to come with you, I’m not ready yet.” So, there might be that sort of resistance. But as that process unfolds, and as they get closer to death, usually, within the space of about a week or so, they become more accepting of the visions. And then they actually enjoy these conversations. Some patients would talk more about them, but some would prefer to keep them private and not disclose what they were seeing. But some were very clearly communicating with deceased members of their family or friends. And I think they gained a lot of comfort from that. It was helping them to transition. I think it’s part of a natural process, isn’t it? You know, it’s going to happen to every one of us, but we tend not to think about what’s going to happen around death. So, if we push it aside, and we don’t explore it, it’s easy to dismiss these things. But sometimes what the patients see or the people they converse with, are people that they didn’t know to be dead at the time. I’ve got an example of someone in my research who was dying. We called his family members in during the night because we thought he was going to die in the middle of the night. But his condition settled, and the family had been back and forth several times. They returned home when his condition stabilized. After they left, my colleague called me and said, “Look at that man.” And there were a few of us. And we all watched him. He had this lovely smile on his face. And he was mouthing the words, “What are you doing here?” We could see him doing that for about 30 minutes; he was conversing with someone we couldn’t see. And then he kind of settled and then he went off to sleep, as it happens. In the morning, his family returned to visit him. I’d gone home at this point, because my nightshift had finished. He said to the family, “You’ll never guess who was there in the night visiting me.” And he described seeing his mother and his grandmother who had both died. But he also said, “My sister was with them; what was she doing with them?” And unbeknownst to him, his sister had died the week before, but no one had told him that, because they didn’t want it to set back his recovery. So, during that vision, he saw his sister, as well, without realizing that she was dead. A few days later his condition deteriorated again, and he died shortly afterwards.
JL
So, a lot of comfort there.
PS
Yes, absolutely. It’s very common to see. These patients are looking very, very peaceful, very comfortable and at peace with themselves. It’s like a healing process for them. So, in the days as they transition towards death, some tend to slip in and out of consciousness, as if they’re deeply unconscious at one point. Then we might be doing nursing care at the bedside, and the patient might speak out of the blue, if they’re lapsing in and out of consciousness. I think when they’re looking more unconscious, that’s more of when they perhaps have got a foot in both worlds. Perhaps they’re more in touch with their spiritual side at that point. So, they transition back and forth between it, as if they’re processing everything. There’s a lot of literature out there about reminiscence and how they reflect on their life. And if you think about it, in the near-death experience, which is an acute phase of the dying process, patients have a life review that’s commonly reported. During the life review they can see everything that they’ve done in their life. Sometimes, they will see very insignificant things. And they will remember everything, and they remember it all in minute detail. But there can be a reflective aspect of it, too, where they think, “Oh, I wish I’d behaved more appropriately in that situation.” They tend to return to life with some sort of moral changes. During the life review they might find themselves in the position of someone they’ve interacted with. For example, if they’ve been unpleasant to someone, and they can feel what it’s like to be on the receiving end of that unpleasantness. Or they’ve been nice to someone and not realized it, they can feel what it’s like to have those nice things done for them. Why is it that you think if we reflect on how we’ve lived, if death is the end, what would be the purpose of all that reflection? Because when we reflect on things, it’s to make improvements in the future. And so, I find that aspect quite interesting.
JL
Of course, not everyone who has an NDE dies afterwards; some live. So, they’re taking with them that experience of a life review, which might be a different kind of message than when someone is dying, and they’re in the act of the dying process. But before that, they are reflecting on their life, and somehow wanting to make their life have some value to tie up loose ends. “Did I do okay? Did my life have meaning?” All those kinds of things. And I wonder if the near-death review is different than the end-of-life review that can happen, or if you see them as the same?
PS
Yes, I think there are slight differences, because at the end of life, obviously, the person isn’t going to return; they are going to die. And it’s usually during the end-of-life experiences, during that period of a few days, when patients start to make amends and make peace. If there’s an estranged family member, it might be that they will request to see that family member. Or they might send a message to someone. It’s as if they are processing everything, processing their life and then making peace with their life.
JL
You get quite a bit of email, don’t you?
PS
Oh, gosh, I get so many I can’t respond to them anymore. I just get too many. It’s a full-time job responding to them. I get a lot of emails from people describing their experiences and from some people trying to make sense of what’s happened to them. They just don’t understand these experiences. They’ve sought help from, maybe, other health professionals who don’t understand the experience. So, they’re still trying to process what’s happened to them. And of course, I get emails from grieving family members, as well, because they’re trying to make sense of what’s happened to them. I tend to get quite a lot of emails.
JL
That makes me think about education. I think that’s something that is critical. While we are hearing more about NDEs, what are we doing right at the end of life with our healthcare, and what are we getting wrong?
PS
That’s such a good question because I think there’s not enough in our education for healthcare workers about these experiences. There is quite a bit of education on end of life. But when it comes to the subjective experiences that patients have, and indeed, with the shared death experience, maybe relatives at the bedside (my dogs will have this experience), there is such a lack of understanding and lack of attention given to these subjects. So, unfortunately, healthcare workers don’t know how to respond to a patient if they do report the near-death experience, or if they witness an end-of-life experience. So, I think it’s crucial that these experiences become part of the education of all healthcare professionals. I’ve been in Nurse Education Department at the University, and it’s always something that I try to bring into some of my lectures, and in training the nurses. The nurses and student nurses are all fascinated by these experiences, and they ask lots of questions to generate such good conversations. Very often some of the students will talk about their own experience, and they’ve never been able to understand it. So, I think it’s important that these experiences are in the education of all health professionals: the nurses and the doctors and other health professionals who are at the bedside when patients have these experiences.
JL
Validate, validate, validate, right?
PS
Absolutely. That’s the most important thing.
JL
I’m sure the UK is like this, as it is here in Canada (and certainly I know it’s true in the US), and it is probably a global thing right now, that our health care systems are strained beyond their limits. Doctors and nurses, all the health care workers, really, are handling caseloads that are overwhelming. And somehow, I think that the message of near-death experiences and the message of end-of-life experiences, can also be comforting to a health care worker.
PS
You’re quite right, all our health systems are overloaded. They’re constantly busy, and there are not enough nurses, and there are not enough resources to do the things needed to do, working as a nurse in the ICU. I got into doing research that gives me a completely different perspective on life. It gave me an insight about death and the dying process. But more than that, it gave me greater insight into the way I live my life, and I became grateful for the simple things that I had in life, instead of striving for things that I didn’t have. Suddenly, it made me aware of how blessed and lucky I am in my position, and by the simple things in life and the way I live my life. I was very competitive before. But since doing my research, it’s given me that different understanding of life. It’s drastically changed my values and everything that I perceive life to be, really. It’s made a big difference for me. I think that’s what allowed me to continue working in ICU for 17 years, because I think the research gave me that different perspective on life. So, when patients were dying, it was a privilege to be at the bedside. I had that slightly different perspective than I had when I started. When I first started there, it was very much about saving lives and doing all we could to stop patients from dying. But then I realized patients are going to die, inevitably, despite what we’ve done. So, it’s important to acknowledge the dying process. It gives me very different perspectives.
JL
There’s a woman, Ann Marie Chiasson, a medical doctor who’s been a palliative care and hospice worker for many years. She’s part of the When You Die Project and in the films, as well. And one of the things that she says to families is don’t expect the same thing out of the medical team at end of life. You need a different team. There are people that run away from death, and there are people that run towards death. And when that time for healing is up, you need a team that knows how to support the dying process. They’re the ones running towards death.
PS
Yes, that’s lovely. And you’re quite right, it is a different kind of team that’s needed in those circumstances. I’m used to working in the ICU, where it was always treat, treat, treat, treat. And it’s not just the patient; you’re looking after family members, as well. It’s such loss when a patient dies, and I saw that a lot in the ICU. I think it’s important that the family is cared for just as much as the patient.
JL
Oh, gosh, absolutely. End-of-life experiences and near-death experiences and shared-death experiences. In all of these are spiritually transformative experiences that are slowly becoming more public. I think there is a huge appetite for these stories, not just because there are people that have had experiences. But they don’t know what they are, and they’re afraid to talk about them. And so, it’s helping people who have had those experiences make meaning of them. But I also wonder if we’re not, as a broader public, really interested in these stories, because they’re telling us something about what it is to be a human being. And that we are so much more than just the three-dimensional flesh and bone being. We live in a very material world. And like you were saying, your research has really changed the way that you live. Most people don’t have the opportunity to do the research. But as the stories come out, I think it has another kind of transformative quality. I’m not sure about that. What do you think?
PS
Oh, definitely. It makes me think about my place in the world looking at these near-death experiences. We’re always busy doing something. We’re not human beings anymore. We’re human doings. We’re always doing something. We’re always busy. We’ve lost that part of ourselves, the most natural part of who we are: it’s to be still and it’s to notice the things around us. Sometimes, we’re so busy that we miss out on subtle things. It’s these subtleties that I think we’ve lost touch with. They are the essential parts of what it is to be human. And other people dismiss certain things. Like, for example, a good friend of mine, who’s retired now, was a university academic. And now that she’s slowed down and is coming towards the end of her career, she’s realized that she had this gift when she was younger, of having premonitions. And now she has developed a spiritual side of herself that has always been there, but she didn’t realize it because she was always busy doing other things. I think some of these things are there for all of us. We all have these different abilities. But I think we’ve been conditioned in the way that we think, by the way we’ve been brought up. We’re not really encouraged to acknowledge any spiritual aspects of ourselves. So, yes, I think doing my research has given me a different understanding of myself, and my place within the world. I became interested in the indigenous cultures and how respectful of nature they are, because they realize that we’re part of nature. Yet, look at what we’ve done to the planet, we’re destroying the planet, we’re polluting the planet, we’re cutting down all the trees. It’s because we’ve lost touch with real things that are meant to be a part of the human experience. We’ve lost touch with that. So, I think my research has made me think in ways that I never thought before. There are all kinds of things.
JL
I almost don’t know what to say. On the other hand, I have so many things to say. I’m struck by the idea that at the end of life a lot of this spiritual nature of ours does seem to be present. I know there can be a lot of suffering, and there can be a lot of difficulty. I never want to sugarcoat that, because there can be real hardship. But for the most part, it feels like a more tangibly spiritual connection, like the veil is thin. It seems to me that it’s in that space, that not only is someone coming to terms with the end of their life, but there’s also some kind of healing going on. And that’s an amazing thing, too, because, as humans, I think we can heal some of our emotional and relationship wounds. I think we can heal some health issues too. But I think more that, generally, at the end of life it seems like there’s an opportunity for families to do some healing that maybe they couldn’t do at any other time.
PS
Yes, absolutely. It’s like you read my mind, because that’s exactly what I was thinking. There is healing that happens as people die. And it’s more of an emotional healing. So, by healing I do not mean cure of the illness, but healing of who they are. I’ll give an example of a good friend of mine. She was dying of cancer. And I met up with her in the months before she died. She said, “It’s okay to talk about death. I’m quite comfortable with it. It’s okay, you can say the word, it’s fine.” So, we had these great conversations. She said, “I know I’m going to die, and I’m going to miss my family. But I feel healed.” She said, “This process has made me contemplate aspects of my life that I had not contemplated before. I’ve had experiences and been with my family in ways that I wouldn’t have if I didn’t know I was dying.” And she said, “I look at it as a gift, as well. I feel at peace with everything, and I feel healed.” And she did have a very peaceful transition into death. So yes, you’re right. People can be healed emotionally at the end of their life. Absolutely. It’s important that we allow them the space to have those conversations. They’re difficult conversations for everyone. But if the person wants to talk about it, it’s important that they do talk about it. And they are processing what they’re going through, as well, because it can be very healing.
JL
It’s an incredible gift, when you think about it.
PS
It is, because we go around life and we don’t think about our own death at all. I never did, never contemplated my own death until I started doing my research. It’s only then, when you start to learn about death, that you start to learn about life; so, I can give you so many opportunities.
JL
Now, I think you’ve read my mind, because I wanted to talk about that too. Sue Brayne’s book goes into this, as well, about living fully, and that oftentimes our fear of death is very closely related to our fear of really living. She says that we hold back out of fear that we’ll mess up, we’ll go broke, whatever’s in the nightmare closet, things will be flung wide open, and we’re not living fully. We’re avoiding death. There’s such an interesting relationship there.
PS
Absolutely. It’s all about living fully. Because when you can contemplate your own death, that’s when you start to think about your life as well. I haven’t been doing those things I wanted to do, and I’m afraid to do them, or I’m not good enough to do that. But so what! You could be dead! Go out and do them! Enjoy it! Live life to the fullest! So many people live their life in fear, instead of seizing the opportunities that are there for them. I think it’s important that you contemplate your own death, because it will give you a different perspective on your life.
JL
There’s a very old Christian monastic meditation. I think it goes back to the monastery, Cluny, in France. I don’t know what century that was, tenth, I think. It’s like a coin. One side is, “Remember, you must die.” And then the flip side of the coin is, “Remember, you must live.” It points to the indivisibility of that relationship. I love, “Remember, you must live.” It’s a slogan we have around the office here.
PS
That’s a great slogan. Yes, that’s so important. Absolutely.
JL
But sometimes, when I say that to friends, they are kind taken aback. As though they would say, “Well, of course, I’m living.” And I’m thinking, “But ARE you living?”
PS
Exactly. But it’s easy to get into a rut, where you go to work, where you have your time off, to go back to work. Some people are so much in that rut, because they’ve got bills to pay and things. It’s hard to see beyond that. Sometimes, it takes something like a big wake up call to make you think about these things. It’s best to do it of your own volition, rather than to wait and get to the point where you think, oh, gosh, you’re diagnosed with an illness or something like that. Because it can be a big wake up call.
JL
That’s the truth. And I think that’s also why there are best-selling books about the seven most common things dying people say: “I could have lived more fully. I should have spent more time with my family. I … whatever.” all those things. “I didn’t say I love you. I didn’t say I’m sorry.” And they are the most basic things. We’re so speedy and busy in our world. And the news is so overwhelming that it’s hard to think. Just taking a walk in the woods is really one of the best things I could do. Right?
PS
Yes, absolutely. Getting out there in nature. You know that’s so important. This conversation is taking me back to a man called Tibor Putnoki, who was from Hungary. He had a near-death experience. Sadly, he died a few years ago, but two years ago, now, I had the privilege of meeting him and attending some of his talks. What struck me about one of his talks was that during his near-death experience, he was asked three questions by a presence. The questions were, “Did you have a life before your death? Did you live a life which is worthy of a human being?” and, “Could you look into other people’s eyes with a pure heart and your head held high?” And I just thought, “Wow, there’s such wisdom in those questions. The first one, did you have a life before your death?”
JL
That is so beautiful, Penny. Really. Those are wonderful questions. I’m struck, too, by the loving nature of asking questions like that.
PS
Yes, that’s right. It wasn’t a judgement at all. And during his near-death experience he felt this overwhelming love. It was those questions that came up, and they were asked in a very loving way. I’m not certain. It’s something that I reflect on quite a lot. I often go back to those words and think, “Am I living a life before I die?” Sometimes I think, “No, I’m just working nonstop.” It’s important that we stop and take time to reflect on things like that.
JL
Absolutely. And it does feel like a big message of the near-death experiences. One of love.
PS
Oh, absolutely. That’s one of the key things that people say during their near-death experience: that they were just enveloped by this overwhelming love. This love was there constantly. They just felt at peace with this overwhelming, unconditional love. So, whatever they had done in their life, they were still loved, unconditionally.
JL
That’s amazing. And isn’t that really what we want to know?
PS
Yes, that we’re all loved.
JL
Yes. Well, it seems that the work that you’ve done, and the stories that you have brought forward, and are bringing forward, are so important for people to hear. Because it’s a different message than what we get in the news every day. Which is depressing.
PS
It is, yes. I try to avoid watching the news as much as possible, because it’s just bad news that’s reported, isn’t it? So, I try not to watch it because it can drag me down. I avoid it at all costs, to be honest with you. But I think a lot of people who have anxieties about death don’t want to talk about it, they don’t want to think about it. A few years ago, I was attending a conference in America. I went to an American hospice, and it was wonderful. It was fantastic. There was attention to detail, and everything was there for the family as well as the person who was at the end of their life. Shortly before I arrived, one of the patients there had requested, as a final wish, to spend time with her horse. And they’d actually arranged transport for her horse to be brought to the hospice. They wheeled her out in a wheelchair into the garden, and she spent the afternoon with her horse. I thought it was amazing that they went to the effort to do such wonderful things for the patients there. It can be such a lovely experience even though it’s death and dying. It’s something that we are all going to face at one point, and it’s not all doom and gloom. People can be healed as they’re dying.
JL
Oh, that is beautiful. Truly, what an incredible gift! I think hospices can be amazing. I think being home is also a very good place to be. It can be difficult for families to care for someone at home, so a hospice can come there. But that environment, where they went and got her horse, I mean, that is amazing. That is so amazing.
PS
And we’ve got the soul midwives as well. Do you get soul midwives [in North America] or death doulas, maybe?
JL
We have death doulas and death midwives. I think that there was a backlash against the term “death midwife” from the birth midwives. So, the term “death doulas” is really being embraced more.
PS
These people are companions at the end of life for people who are dying, and they’re there to facilitate and ease full transition into death. In the UK, we call them soul midwives. A friend of mine works as a soul midwife. And she takes her time to find out from her patients where they want to die. Some wanted to go and die at the beach; some wanted to die in their back garden. So, they facilitate the wishes of the patients. These things are so important. A lot of people have that very peaceful transition at the end of their life.
JL
And how fortunate are we for that?
PS
I know, it’s amazing. It really is. I believe there are also the ambulance people as well, who are trained in palliative care with facilitating end of life. There’re a lot of changes going on around death and dying. We’re seeing a lot more awareness. But we still need to raise more awareness. The work that you’re doing is working towards that. So that’s really important.
JL
We need educators like you, too, Penny, to be in there with the next generation of nurses. Sharing your knowledge of this is so important. And, of course, your books will go on for a long time. You never know whose hands they’ll be in and what lives they are changing. And that’s a wonderful thing too.
PS
Yes, I never thought of it like that. Yes. You never know who’s going to read it.
JL
It’s true. What do you feel most passionate about? I mean, is there another frontier for you?
PS
I think now I’m more passionate about getting this into the education of nurses. I educate nurses, so I would like to expand what we include with this. That would be something I’m working towards. Also, I’m about to undertake more research into it: near-death experiences and spiritually transformative experiences that occurred during COVID. There’re a lot of people who have these kinds of experiences, and we’re looking at that. I’m going to be collaborating with Professor Bettina Schmidt, who is a professor down at Lancaster University in Wales. I’m looking forward to doing some more research, because I have not done much in the last few years. Yes, my work with near-death experiences is where my passion lies.
JL
I’m so glad that it does. I truly am. I think it’s fascinating. The whole area of spiritual transformation and near-death experiences seems to be really instructive for people. I guess there’s always that risk that someone will hear about them and think, “Well, if I try to kill myself, I’ll have a near-death experience.” And that certainly is not the case. But I think it’s more what we can learn. The stories themselves generate a certain kind of beauty and awe in the people who hear them. I think it’s contagious. There’s something contagious there, in a good way.
PS
You’re quite right. Kenneth Ring and I did some research back in the 1980’s. He was one of the four pioneers in the field. He used to teach a course on near-death experiences, and what he found is that his students were also transformed in the way that people are through having a near-death experience, just by studying the experiences. So, they are contagious. Certainly, it’s had that knock-on effect with me as well. It’s transformed the way I live my life. If you can engage with these experiences, they can be life-transforming.
JL
That’s wonderful news for all of us. Well, Penny, I think I’ll leave it there. I’m so grateful for all that you’re doing. I think that your work has affected my life, and I am grateful for that too. Thank you.
PS
Thank you and thank you for your work. I look forward to watching the finished product.
JL
I can’t wait to show you. Thank you.
JL
This conversation is brought to you by the When You Die Project. From existential afterlife questions to palliative care and the nuts and bolts of green burial, if it has to do with death and dying, we’re talking about it.
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