Chris Kerr was 12 when he first observed a deathbed vision. His memory of that summer in 1974 is blurred, but not the sense of mystery he felt at the bedside of his dying father. Throughout Kerr’s childhood in Toronto, his father, a surgeon, was too busy to spend much time with his son, except for an annual fishing trip they took, just the two of them, to the Canadian wilderness. Gaunt and weakened by cancer at 42, his father reached for the buttons on Kerr’s shirt, fiddled with them and said something about getting ready to catch the plane to their cabin in the woods. “I knew intuitively, I knew wherever he was, must be a good place because we were going fishing,” Kerr told me.
12岁时，克里斯·科尔第一次看到了临终前的异象。他对1974年那个夏天的记忆已经模糊，但在垂死的父亲床边感受到的那种神秘感却依旧清晰。科尔的整个童年在多伦多度过，父亲是一名忙碌的外科医生，没有太多时间陪伴儿子，除了每年两人一起到加拿大荒野的钓鱼之旅。那一年，42岁的父亲因癌症而憔悴虚弱，他伸手去摸科尔衬衫上的纽扣，摆弄着它们，说了几句要收拾东西赶飞机回到林中小屋之类的话。“我凭直觉知道，不管他在哪里，那一定是一个好地方，因为我们要去钓鱼，”科尔告诉我。
As he moved to touch his father, Kerr felt a hand on his shoulder. A priest had followed him into the hospital room and was now leading him away, telling him his father was delusional. Kerr’s father died early the next morning. Kerr now calls what he witnessed an end-of-life vision. His father wasn’t delusional, he believes. His mind was taking him to a time and place where he and his son could be together, in the wilds of northern Canada. And the priest, he feels, made a mistake, one that many other caregivers make, of dismissing the moment as a break with reality, as something from which the boy required protection.
伸手去触摸父亲时，科尔感觉到一只手搭在他的肩膀上。跟着他走进病房的牧师告诉他，他的父亲出现了妄想症状，把他带走了。第二天一大早，科尔的父亲就去世了。如今，科尔把他目睹的一切称为临终幻象。他相信父亲没有妄想。他的思绪把他带到了加拿大北部的荒野，那是一个他和儿子可以相聚的时空。他觉得，牧师犯了一个和许多其他看护人一样的错误，认为那一刻是和现实无关的，认为这个男孩需要保护，不应该目睹那个时刻。
It would be more than 40 years before Kerr felt compelled to speak about that evening in the hospital room. He had followed his father, and three generations before him, into medicine and was working at Hospice & Palliative Care Buffalo, where he was the chief medical officer and conducted research on end-of-life visions. It wasn’t until he gave a TEDx Talk in 2015 that he shared the story of his father’s death. Pacing the stage in the sport coat he always wears, he told the audience: “My point here is, I didn’t choose this topic of dying. I feel it has chosen or followed me.” He went on: “When I was present at the bedside of the dying, I was confronted by what I had seen and tried so hard to forget from my childhood. I saw dying patients reaching and calling out to mothers, and to fathers, and to children, many of whom hadn’t been seen for many years. But what was remarkable was so many of them looked at peace.”
直到40多年后，科尔才不得不谈起那天晚上在病房里的情景。他已经追随父亲和祖上三代人的脚步，成为一名医学工作者，在布法罗的安宁疗护中心工作担任首席医疗官，负责对临终幻象的研究。直到2015年在TEDx演讲上，他才分享了父亲去世时的故事。他穿着休闲外套在台上踱来踱去，告诉观众：“我想说的是，并不是我选择了死亡这个课题。我觉得是它选择了我，或者说跟随着我。”他接着说：“当我站在临终者的床边时，我看到了我童年时所看到的、我努力想要忘记的东西。我看到垂死的病人向母亲、父亲和孩子伸出手，呼唤他们，他们当中许多人已经很多年没有见过面了。然而值得注意的是，相当一部分人看上去是很平静的。”
The talk received millions of views and thousands of comments, many from nurses grateful that someone in the medical field validated what they have long understood. Others, too, posted personal stories of having witnessed loved ones’ visions in their final days. For them, Kerr’s message was a kind of confirmation of something they instinctively knew — that deathbed visions are real, can provide comfort, even heal past trauma. That they can, in some cases, feel transcendent. That our minds are capable of conjuring images that help us, at the end, make sense of our lives.
这次演讲获得了数以百万计的观看量和数以千计的评论，许多来自护士，对于医学界有人验证了他们长期以来的认识表示感激。也有一些人在评论中讲述了自己亲眼目睹亲人在弥留之际出现幻象的故事。对他们来说，科尔的信息确认了一种对他们凭本能知道的东西——临终前的幻象是真实存在的，可以提供安慰，甚至治愈过去的创伤。在某些情况下，它可以让人感到超然。我们的大脑能够创造出各种图像，帮助我们在弥留之际理解自己的生活。
Nothing in Kerr’s medical training prepared him for his first shift at Hospice Buffalo one Saturday morning in the spring of 1999. He had earned a degree from the Medical College of Ohio while working on a Ph.D. in neurobiology. After a residency in internal medicine, Kerr started a fellowship in cardiology in Buffalo. To earn extra money to support his wife and two young daughters, he took a part-time job with Hospice Buffalo. Until then, Kerr had worked in the conventional medical system, focused on patients who were often tethered to machines or heavily medicated. If they recounted visions, he had no time to listen. But in the quiet of Hospice, Kerr found himself in the presence of something he hadn’t seen since his father’s death: patients who spoke of people and places visible only to them. “So just like with my father, there’s just this feeling of reverence, of something that wasn’t understood but certainly felt,” he says.
1999年春天的一个周六早上，科尔在布法罗安宁疗护中心第一次当班，此前他在俄亥俄医学院拿到一个学位，他在那里攻读神经生物学博士，然而他所接受的医学培训对这份工作毫无帮助。在内科实习结束后，科尔在布法罗开始了心脏病学的研究。为了多赚点钱养活妻子和两个年幼的女儿，他在布法罗安宁疗护中心做了一份兼职。在此之前，克尔一直在传统医疗系统中工作，专注于那些经常被捆绑在机器上或服用大量药物的病人。就算他们讲述幻象，他也没有时间去听。但在静悄悄的安宁疗护中心里，科尔发现，自己遇到了自父亲去世后从未见过的情况：病人们谈论着只有他们才能看到的人和地方。“所以，就像和父亲在一起的时候一样，我感受到一种崇敬，感受到一种不被理解但肯定能够感觉到的东西，”他说。
During one of his shifts, Kerr was checking on a 70-year-old woman named Mary, whose grown children had gathered in her room, drinking wine to lighten the mood. Without warning, Kerr remembers, Mary sat up in her bed and crossed her arms at her chest. “Danny,” she cooed, kissing and cuddling a baby only she could see. At first, her children were confused. There was no Danny in the family, no baby in their mother’s arms. But they could sense that whatever their mother was experiencing brought her a sense of calm. Kerr later learned that long before her four children were born, Mary lost a baby in childbirth. She never spoke of it with her children, but now she was, through a vision, seemingly addressing that loss.
在一次轮班中，科尔检查一位名叫玛丽的70岁老妇人，她的成年子女聚集在她的房间里，喝葡萄酒缓解情绪。科尔记得，玛丽毫无征兆地从床上坐起来，双臂交叉放在胸前。“丹尼，”她低声说，亲吻并拥抱着一个只有她能看见的婴儿。起初，她的孩子们很困惑。家里没有人叫丹尼，妈妈怀里也没有婴儿。但他们能感觉到，无论母亲正在经历什么，都会给她带来一种平静感。科尔后来得知，早在她的四个孩子出生之前，玛丽曾因难产失去了一个孩子。她从来没有和孩子们谈起过这件事，但现在，她似乎在通过一种幻象来解决这种损失。
In observing Mary’s final days at Hospice, Kerr found his calling. “I was disillusioned by the assembly-line nature of medicine,” Kerr told me. “This felt like a more humane and dignified model of care.” He quit cardiology to work full time at the bedsides of dying patients. Many of them described visions that drew from their lives and seemed to hold meaning, unlike hallucinations resulting from medication, or delusional, incoherent thinking, which can also occur at the end of life. But Kerr couldn’t persuade other doctors, even young residents making the rounds with him at Hospice, of their value. They wanted scientific proof.
通过观察玛丽在安宁疗护下的最后时光，科尔找到了自己的使命。“我对医学流水线的本质感到失望，”科尔告诉我。“（安宁疗护）感觉像是一种更人道、更有尊严的护理模式。”他放弃了心脏病学，全职在临终病人的床边工作。这些病人当中，许多人描述的幻象都来自他们自己的生活，似乎有意义，这与药物导致的幻觉或妄想，乃至不连贯思维是不同的——这些也可能在生命尽头出现。但科尔无法说服其他医生相信这些幻象的价值，甚至那些在安宁疗护中心陪他巡视的年轻住院医生也不例外。他们需要科学证据。
At the time, only a handful of published medical studies had documented deathbed visions, and they largely relied on secondhand reports from doctors and other caregivers rather than accounts from patients themselves. On a flight home from a conference, Kerr outlined a study of his own, and in 2010, a research fellow, Anne Banas, signed on to conduct it with him. Like Kerr, Banas had a family member who, before his death, experienced visions — a grandfather who imagined himself in a train station with his brothers.
当时，只有少数已发表的医学研究记录了临终前的幻象，而且这些研究主要依赖于医生和其他护理人员的二手报告，而不是患者自己的描述。在参加完一个会议回家的飞机上，科尔概述了他自己的一项研究，2010年，研究员安·巴纳斯加入了他的研究队伍。和科尔一样，巴纳斯的一位家族成员在去世前也经历过幻象——她的祖父想象自己和兄弟们一起在火车站。
The study wasn’t designed to answer how these visions differ neurologically from hallucinations or delusions. Rather, Kerr saw his role as chronicler of his patients’ experiences. Borrowing from social-science research methods, Kerr, Banas and their colleagues based their study on daily interviews with patients in the 22-bed inpatient unit at the Hospice campus in the hope of capturing the frequency and varied subject matter of their visions. Patients were screened to ensure that they were lucid and not in a confused or delirious state. The research, published in 2014 in The Journal of Palliative Medicine, found that visions are far more common and frequent than other researchers had found, with an astonishing 88 percent of patients reporting at least one vision. (Later studies in Japan, India, Sweden and Australia confirm that visions are common. The percentages range from about 20 to 80 percent, though a majority of these studies rely on interviews with caregivers and not patients.)
这项研究并不是为了回答这些临终幻象在神经学上与幻觉或妄想有何不同。科尔认为自己的角色是病人经历的记录者。科尔、巴纳斯和他们的同事借鉴了社会科学研究方法，对有22张病床的安宁疗护中心住院部的病人进行每日访谈，以此进行研究，希望捕捉到病人看到幻象的频率和不同主题。他们对患者进行了筛查，以确保他们神志清醒，没有处于混乱或谵妄状态。发表在2014年的《姑息医学杂志》(The Journal of Palliative Medicine)上的研究结果提出，临终幻象比其他研究人员发现的要普遍和频繁得多，而且令人吃惊的是，有88%的患者报告至少出现过一次幻象。(后来在日本、印度、瑞典和澳大利亚进行的研究也证实了幻象的普遍性。比例从20%到80%不等，不过其中大部分研究依靠的是对护理人员，而非对病人的访谈）。
In the last 10 years, Kerr has hired a permanent research team who expanded the studies to include interviews with patients receiving hospice care at home and with their families, deepening the researchers’ understanding of the variety and profundity of these visions. They can occur while patients are asleep or fully conscious. Dead family members figure most prominently, and by contrast, visions involving religious themes are exceedingly rare. Patients often relive seminal moments from their lives, including joyful experiences of falling in love and painful ones of rejection. Some dream of the unresolved tasks of daily life, like paying bills or raising children. Visions also entail past or imagined journeys — whether long car trips or short walks to school. Regardless of the subject matter, the visions, patients say, feel real and entirely unique compared with anything else they’ve ever experienced. They can begin days, even weeks, before death. Most significant, as people near the end of their lives, the frequency of visions increases, further centering on deceased people or pets. It is these final visions that provide patients, and their loved ones, with profound meaning and solace.
过去10年里，科尔聘请了一个长期研究团队，扩大了研究范围，把对在家接受安宁疗护的病人及其家属的访谈包括进去，加深了研究人员对这些临终幻象的多样性和深刻性的理解。这些临终幻象可能在病人睡着的时候出现，也可能出现在病人完全清醒的时候。幻象里最常出现的是去世的家庭成员，相比之下，涉及宗教主题的幻象则极为罕见。患者经常会重温他们生命中的重要时刻，包括坠入爱河的快乐和被拒绝的痛苦感受。有些人会梦见日常生活中尚未完成的事项，如支付账单或照顾孩子。幻象中还会出现过去或想象中的旅程——无论是长途汽车旅行还是短途步行上学。患者们说，无论主题是什么，这些幻象都感觉像是真实的，迥异于他们以往经历过的任何东西。这些幻象可能在死亡前几天甚至几周开始出现。最重要的是，当人们接近生命的终点时，幻象出现的频率会增加，并进一步主要围绕已故的人或宠物展开。正是这些幻象给病人及其亲人带来了深刻的意义和慰藉。
Kerr’s latest research is focused on the emotional transformation he has often observed in patients who experience such visions. The first in this series of studies, published in 2019, measured psychological and spiritual growth among two groups of hospice patients: those who had visions and a control group of those who did not. Patients rated their agreement with statements including, “I changed my priorities about what is important in life,” or “I have a better understanding of spiritual matters.” Those who experienced end-of-life visions agreed more strongly with those statements, suggesting that the visions sparked inner change even at the end of life. “It’s the most remarkable of our studies,” Kerr told me. “It highlights the paradox of dying, that while there is physical deterioration, they are growing and finding meaning. It highlights what patients are telling us, that they are being put back together.”
科尔的最新研究侧重于他经常观察到的有这种幻象的病人的情感转变。在2019年发表的这一系列研究中的第一项里，他们测量了两组安宁疗护患者的心理和精神成长情况：一组是出现过幻象的患者，对照组则没有出现过幻象。患者对他们有多同意一些陈述进行打分，这些陈述包括“我改变了对生命中什么最重要的想法”或“我对灵魂之类的问题有了更好的理解”。那些经历过临终幻象的人对这些陈述的认同度更高，这表明即使在生命的最后阶段，幻象也能引发内心的改变。“这是我们的研究里最引人注目的一项，”科尔告诉我。“它凸显了死亡的悖论，即在肉身衰败的同时，人也在成长，找到意义。这也强调了病人告诉我们的，他们正在重新振作起来。”
In the many conversations Kerr and I have had over the past year, the contradiction between medicine’s demand for evidence and the ineffable quality of his patients’ experiences came up repeatedly. He was first struck by this tension about a year before the publication of his first study, during a visit with a World War II veteran named John who was tormented throughout his life by nightmares that took him back to the beaches of Normandy on D-Day. John had been part of a rescue mission to bring wounded soldiers to England by ship and leave those too far gone to die. The nightmares continued through his dying days, until he dreamed of being discharged from the Army. In a second dream, a fallen soldier appeared to John to tell him that his comrades would soon come to “get” him. The nightmares ended after that.
过去一年里，我和科尔进行了多次交谈，医学对实证的需要与他的患者那些难以言喻的经历之间的矛盾反复出现。大约在他的首个研究发表的前一年，他第一次感受到这种矛盾。当时他去拜访一位名叫约翰的“二战”老兵，约翰一生都被噩梦所折磨，在梦境中，他回到诺曼底登陆日那天的海滩。约翰曾经参加过一项营救任务，用船将受伤的士兵运往英国，而把那些距离过远的士兵留下来等死。在他临终前的日子里，噩梦一直萦绕着他，直到他梦见自己从军队退伍。在另一场梦中，一名已经阵亡的士兵出现在约翰面前，对他说，他的战友很快就会来“找”他。之后噩梦就结束了。
Kerr has been nagged ever since by the inadequacy of science, and of language, to fully capture the mysteries of the mind. “We were so caught up in trying to quantify and give structure to something so deeply spiritual, and really, we were just bystanders, witnesses to this,” he says. “It feels a little small to be filling in forms when you’re looking at a 90-something-year-old veteran who is back in time 70 years having an experience you can’t even understand.” When Kerr talks about his research at conferences, nurses tend to nod their heads in approval; doctors roll their eyes in disbelief. He finds that skeptics often understand the research best when they watch taped interviews with patients.
从那时起，科尔就一直被科学和语言无法充分捕捉思想的奥秘所困扰。“我们如此着迷于量化如此深奥的精神世界，并为其赋予结构，但实际上，我们只是这一切的旁观者和见证者，”他说。“当你看到一位90多岁的老兵回到70年前，经历着你根本无法理解的事时，照本宣科让人感觉很渺小。”当科尔在会议上陈述他的研究时，护士们往往会点头表示赞同，而医生们则会翻白眼表示不相信。他发现，怀疑论者在观看患者采访录像时往往能更好地理解这项研究。
What’s striking about this footage, which dates back to Kerr’s early work in 2008, is not so much the content of the visions but rather the patients’ demeanor. “There’s an absence of fear,” Kerr says. A teenage girl’s face lights up as she describes a dream in which she and her deceased aunt were in a castle playing with Barbie dolls. A man dying of cancer talks about his wife, who died several years earlier and who comes to him in his dreams, always in blue. She waves. She smiles. That’s it. But in the moment, he seems to be transported to another time or place.
这段视频记录了科尔在2008年时的早期研究，其中最令人震惊的部分并不是幻象的内容，而是患者的行为。“没有丝毫恐惧，”科尔说。一名十几岁的女孩在描述自己与已故阿姨在城堡里玩芭比娃娃的梦时，脸上露出明朗的笑容。一名濒死的患癌男性谈到了他几年前去世的妻子，她在梦中来到他的身边，总是穿着蓝色的衣服。她向他挥手，微笑。仅此而已。但在那一刻，他似乎被“穿越”到了另一个时空。
Kerr has often observed that in the very end, dying people lose interest in the activities that preoccupied them in life and turn toward those they love. As to why, Kerr can only speculate. In his 2020 book, “Death Is but a Dream,” he concludes that the love his patients find in dying often brings them to a place that some call enlightenment and others call God. “Time seems to vanish,” he told me. “The people who loved you well, secured you and contributed to who you are are still accessible at a spiritual and psychological level.”
科尔经常观察到，临终者在生命的最后时刻往往会对生前痴迷的活动失去兴趣，转而投向他们所爱的人。至于原因，科尔只能推测。在他2020年出版的《死亡不过是一场梦》(Death Is but a Dream)中，他总结道，病人在濒死时刻寻得的爱意常常将他们带到一个有人称之为启蒙、有人称之为上帝的地方。“时间似乎消失了，”他告诉我。“那些深爱你、保护你、帮助你成长的人在精神和心理层面上仍然在那里。”
That was the case with Connor O’Neil, who died at the age of 10 in 2022 and whose parents Kerr and I visited in their home. They told us that just two days before his death, their son called out the name of a family friend who, without the boy’s knowledge, had just died. “Do you know where you are?” Connor’s mother asked. “Heaven,” the boy replied. Connor had barely spoken in days or moved without help, but in that moment, he sat up under his own strength and threw his arms around her neck. “Mommy, I love you,” he said.
2022年在年仅10岁时去世的康纳·奥尼尔就是这种情况。我和科尔前往他家，拜访了他的父母。他们告诉我们，就在他去世前两天，他们的儿子喊出了一位家庭朋友的名字，而他当时并不知道这个朋友刚刚去世。“你知道自己在哪里吗？”康纳的母亲问道。“天堂，”男孩回答道。当时康纳已经好几天没有说话，也没有在无人帮助的情况下移动过，但在那一刻，他凭借自己的力量坐了起来，用双臂搂住了她的脖子。“妈妈，我爱你，”他说。
Kerr’s research finds that such moments, which transcend the often-painful physical decline in the last days of life, help parents like the O’Neils and other relatives grieve even unfathomable loss. “I don’t know where I would be without that closure, or that gift that was given to us,” Connor’s father told us. “It’s hard enough with it.” As Kerr explains, “It’s the difference between being wounded and soothed.”
科尔的研究发现，在生命的最后时日，这些时刻超越了往往令人痛苦的身体衰退，帮助像奥尼尔夫妇和其他亲戚这样的父母承受难以承受的丧亲之痛。“如果没有这个宽慰，或者那个上天给予我们的礼物，我都不知道我会怎么办，”康纳的父亲告诉我们。“这已经够难的了。”正如科尔所解释的，“这就是受到伤害和得到宽慰之间的区别。”
In June, I visited the adult daughter of a patient who died at home just days earlier. We sat in her mother’s living room, looking out on the patio and bird feeders that had given the mother so much joy. Three days before her mother’s death, the daughter was straightening up the room when her mother began to speak more lucidly than she had in days. The daughter crawled into her mother’s bed, held her hand and listened. Her mother first spoke to the daughter’s father, whom she could see in the far corner of the room, handsome as ever. She then started speaking with her second husband, visible only to her, yet real enough for the daughter to ask whether he was smoking his pipe. “Can’t you smell it?” her mother replied. Even in the retelling, the moment felt sacred. “I will never, ever forget it,” the daughter told me. “It was so beautiful.”
6月，我拜访了一位几天前在家中去世的患者的成年女儿。我们坐在她母亲的客厅里，看着外面的露台和喂鸟器，它们给她的母亲带来了很多欢乐。在她母亲去世三天前，女儿正在整理房间，就在这时，母亲说话开始比之前清晰多了。女儿爬到母亲的床上，握住她的手，聆听着。她的母亲一开始先是对着女儿的父亲说话，她可以看到他在房间的远处角落，还是那么英俊。然后，她开始对着自己的第二任丈夫说话，虽然只有她自己看得见，但真实得让女儿问道他是否在抽烟斗。“你闻不到吗？”她母亲回答道。即使在重述中，这一刻也让人感到神圣。“我永远不会忘记它，”女儿告诉我。“真是太美了。”
I also met one of Banas’s patients, Peggy Haloski, who had enrolled in hospice for home care services just days earlier, after doctors at the cancer hospital in Buffalo found blood clots throughout her body, a sign that the yearlong treatment had stopped working. It was time for her husband, Stephen, to keep her comfortable at home, with their two greyhounds.
我还见到了巴纳斯的一位患者佩吉·哈洛斯基，就在几天前，她刚刚开始接受安宁疗护中心居家护理服务。在那之前，布法罗的癌症医院发现她全身出现血栓，这表明长达一年的治疗已经不再起效。是时候让她在丈夫斯蒂芬和两只灵缇犬的陪伴下，舒舒服服地待在家里了。
Stephen led Banas and me to the family room, where Peggy lay on the couch. Banas knelt on the floor, checked her patient’s catheter, reduced her prescriptions so there were fewer pills for her to swallow every day and ordered a numbing cream for pain in her tailbone. She also asked about her visions.
斯蒂芬带着巴纳斯和我来到家庭娱乐室，佩吉躺在沙发上。巴纳斯跪在地板上，检查病人的导管，她的处方药量减少了，这样每天吞服的药片就少了，并为她的尾椎骨疼痛开了一种麻醉膏。她还询问了她的幻象。
The nurse on call that weekend witnessed Peggy speaking with her dead mother.
那个周末的值班护士目睹了佩吉和她去世的母亲说话。
“She was standing over here,” Peggy told Banas, gesturing toward the corner of the room.
“她就站在那里，”佩吉指了指房间的一个角落对巴纳斯说。
“Was that the only time you saw her?” Banas asked.
“那是你唯一一次见到她吗？”巴纳斯问。
“So far.”
“目前是的。”
“Do you think you’ll be seeing her more?”
“你觉得还会见到她吗？”
“I will. I will, considering what’s going on.”
“按照现在这个样子，会的，我会的。”
Peggy sank deeper into the couch and closed her eyes, recounting another visit from the dead, this time by the first greyhound she and Stephen adopted. “I’m at peace with everybody. I’m happy,” she said. “It’s not time yet. I know it’s not time, but it’s coming.”
佩吉深深地坐进沙发里，闭上眼睛，回忆起另一次见到逝者，那是她和斯蒂芬收养的第一只灵缇。“我和所有人都很好。我很快乐，”她说。“现在还不是时候。我知道还不是时候，但已经快到了。”
When my mother, Chloe Zerwick, was dying in 2018, I had never heard of end-of-life visions. I was acting on intuition when her caregivers started telling me about what we were then calling hallucinations. Mom was 95 and living in her Hudson Valley home under hospice care, with lung disease and congestive heart failure, barely able to leave her bed. The hospice doctor prescribed an opioid for pain and put her on antipsychotic and anti-anxiety medicines to tame the so-called hallucinations he worried were preventing her from sleeping. It is possible that some of these medications caused Mom’s visions, but as Kerr has explained, drug-induced hallucinations do not rule out naturally occurring visions. They can coexist.
2018年，在我的母亲克洛伊·泽维克弥留之际，我还从未听说过临终幻象。当她的护理师告诉我她出现了我们当时称为幻觉的现象时，我只是凭直觉行事。妈妈95岁了，在哈德逊河谷的家中接受安宁疗护，她患有肺病和充血性心力衰竭，几乎无法离开病床。安宁疗护医生给她开了阿片类止痛药，并让她服用抗精神病和抗焦虑药物，以控制所谓的幻觉，他担心这些幻觉会妨碍她入睡。妈妈的幻象有可能就是其中一些药物导致的，但正如克尔所解释的，药物引起的幻觉中不排除有自然产生的幻象。它们可以并存。
In my mother’s case, I inherently understood that her imaginary life was something to honor. I knew what medicine-induced hallucinations looked and felt like. About 10 years before her death, Mom fell and injured her spine. Doctors in the local hospital put her on an opioid to control the pain, which left her acting like a different person. There were spiders crawling on the hospital wall, she said. She mistook her roommate’s bed for a train platform. Worse, she denied that I loved her or ever did. Once we took her off the medicine, the hallucinations vanished.
对于我的母亲，我本来就明白她的想象世界是值得尊敬的。我知道药物引起的幻觉是什么样子和感觉。大约在她去世前10年，妈妈不慎摔伤了脊椎。当地医院的医生让她服用阿片类药物来控制疼痛，这让她像变了一个人。她说，医院的墙上爬满了蜘蛛。她把病友的床当成了火车月台。更糟糕的是，她否认我爱她，说我从没爱过她。我们给她停药后，这些幻觉就消失了。
The visions she was having at the end of her life were entirely different; they were connected to the long life she had led and brought a deep sense of comfort and delight. “You know, for the first time in my life I have no worries,” she told me. I remember feeling a weight lift. After more than a decade of failing health, she seemed to have found a sense of peace.
她在生命尽头的幻象则完全不同；这些幻象与她漫长的一生密切相关，给她带来了深深的慰藉和喜悦。她对我说：“你知道吗，这是我有生以来第一次没有烦恼。”我记得当时我感到如释重负。在经历了十多年的健康衰退之后，她似乎终于找到了平静。
The day before her death, as her breathing became more labored, Mom made an announcement: “I have a new leader,” she said.
在她去世的前一天，当她的呼吸变得越来越困难时，妈妈说出了一个消息，她说：“我有一个新领路人。”
“Who is that?” I asked.
“是谁？”我问。
“Mark. He’s going to take me to the other side.”
“马克。他会带我去对岸。”
She was speaking of my husband, alive and well back home in North Carolina.
她说的是我的丈夫，他在北卡罗莱纳州的家中活得好好的。
“That’s great, Mom, except that I need him here with me,” I replied. “Do you think he can do both?”
“这太好了，妈妈，但我也需要他陪着我，”我说。“你觉得他两件事都能做到吗？”
“Oh, yes. He’s very capable.”
“啊没问题，他很能干。”
That evening, Mom was struggling again to breathe. “I’m thinking of the next world,” she said, and of my husband, who would lead her there. The caregiver on duty for the night and I sat at her bedside as Mom’s oxygen level fell from 68 to 63 to 52 and kept dropping until she died the next morning. My mother was not a brave person in the traditional sense of the word. She was afraid of snakes, the subway platform and any hint of pain. But she faced her death, confident that a man who loves her daughter would guide her to whatever lay ahead.
那天晚上，妈妈再次呼吸困难。“我在想来世，”她说，她在想我的丈夫，他将带领她到达那里。当晚值班的护理师和我坐在她的床边，看着妈妈的血氧量从68降到63，再降到52，一直降到第二天早上她去世。我母亲并不是传统意义上的勇者。她害怕蛇、地铁站台和任何疼痛。但她直面死亡，坚信一个深爱她女儿的男人会指引她前方的路。
“Do you think it will happen to you?” she asked me at one point about her dreaming life.
“你觉得这会发生在你身上吗？”有一次提到她的幻象时，她这样问我。
“Maybe it’s genetic,” I replied, not knowing, as I do now, that these experiences are part of what may await us all.
“可能这是基因里的，”我说，那时我还不知道，这些体验是我们所有人都可能遇到的。
Phoebe Zerwick是《Beyond Innocence: The Life Sentence of Darryl Hunt》一书的作者。她是一名常驻北卡罗来纳的记者。她是维克森林大学新闻项目主任，教授新闻与写作。
Amy Friend是一名加拿大艺术家，她的作品主要关注历史、时空、土地记忆、尘埃、海洋以及我们与宇宙的联系。
翻译：纽约时报中文网
