Dr. John Lerma Answers Questions from Readers

What was the impetus for entering the field of Hospice and Palliative Medicine?

All in all, it was to carry out the oath I took to DO NO HARM OR SINE QUA NON (LATIN) when caring for patients. It was clearly obvious to me during my medical school years and residency (1980’s) that many patients that were terminally-ill with cancer, AIDS (1980s was the advent of HIV), very debilitated elderly patients and vegetative patients with no chance for quality of life, were being kept alive without treatment of their emotional, spiritual, interpersonal and many times there physical pain. Health care professionals had not been trained in this field because the field of Hospice and palliative medicine did not exist. The hospice Medicare benefit did not begin until 1983. I knew there had to be some way to help these suffering patients die comfortably and with dignity. It would not be for over 20 years, the fall of 2006, which the American board of medical specialties, agreed to formally announce that humans end-of-life required special training. Currently, MD Anderson Cancer Institute is the leader in that training.

Was there any specific incident that lead you into the research of NDE’s (Neardeath experiences) and PDE’s (Pre death experiences)?

Yes, during my internship year I was working in the emergency room when a multiple casualties of a collision entered as well as an elderly gentleman having a heart attack. Since all doctors were busy with patients, I cared for the elderly gentleman who had a better chance of survival. He eventually had a cardiac arrest which I was able to bring him out of and during that time he began to speak of the light, God, his life review and so forth. I felt it was hallucinatory but days later after his admission, he said he saw a coin on the monitor in the ER room he was in, He asked me to find out if it truly was there, so checked and was amazed to find it. It was as he said, a 1985 nickel on the lower right hand corner. This began a career where stories like this one were a rule and notan exception. This is an example of an NDE.

When did you first hear or learn about PDE’s?

Essentially, when I was caring for terminally ill AIDS and cancer patients in the hospital. Weeks prior to their death, most that could speak began to tell me of light entities that were at the doorway that were telling them they would be back. I explained this off as hallucinations as my professors told me that’s what they were. Just chemical and gaseous changes in the brain at the end of life. Deceased families would appear after the spiritual beings and usually with a few days of their death. At the end, most would rally with incredible energy and would tell their family and friends goodbye and at times describe their visions. They would say they had to leave on the train, plane, bus……within 24 hours they would be dead. After seeing hundred of patients dying, including murderers, Christians, Muslims, Atheists, Jews, and most claiming to see the same apparitions at similar times before their death, I knew there had to be more to the experiences that modern medicine had not been willing to research.

When I began my research on PDEs, I found that the quest for facts to support the idea of post-mortem survival w over 2,000 years ago. The most well-known example being the pre-death experience of Jesus of Nazareth. He foresaw His death and resurrection and told of seeing and speaking to angels and deceased prophets, all which appeared to Him so as to help with His transition. Prior to His death and while on nailed to the cross, He left us with knowledge of hoe to live our life’s and how to die and what awaited us. What He explains is similar to the descriptions and messages that many of my patients leave with me. In the book, more is described.

What other noted civilizations and people described the pre-death experience?

The Egyptians, Sumerians and Plato describe pre-death experiences in their writings. The Romans, a second century Rabbi Yochar wrote about death bed visions in his book entitled The Book of Splendor. Abraham Lincoln told his best friend a dream of his death just days before he was assassinated.

A twentieth-century well-known physicist named Sir William Barrett, who worked with the famous physicist Dr. Tindell studied this phenomenon and wrote a book in 1926 entitled Death Bed Visions – 1926. He described visions the dying described just days to hours before their death. These visions included deceased loved one and spiritual beings coming to guide them to the other-side.

What is the difference between a hallucination and a dying vision?

HALLUCINATIONS are a truly confused period of brain function usually related to certain factors like fever, strokes, heart attacks, low oxygen……most of these experiences are of living individuals, our environment, and the patient cannot recall them after the episode resolves.

VISIONS OR WHAT I CALL NON-LINEAR CONSCIOUS AWARENESS are totally opposite to hallucinations. Like hallucinations they occur during times of extreme stress, usually prior to death, but the patient is quite lucid and oriented and describes visitations by spiritual beings and their loved ones that have passed on. They are given much information with regards to their life, and close family members so they can make the transition to the next life or heaven as some patients call it. It is for all practical purposes the same for all terminally-ill patients which can communicate. They can recall the experiences and describe them to a tee at any time, unlike hallucinations. Can you describe the timing of these visions or non-linear conscious awareness?

Around 4 weeks before death, the patient sees there first spiritual being. They do not communicate until the patient initiates it.The vision usually last a few seconds. Enough time to allow the patient to see remember elements of the entity.They reappear within one or 2 days and move closer to the patient. By this time the patient usually has initiated the conversation and the beings purpose is revealed and the life review begins. By this time most patients are beginning to feel quite excited bout the process.Less than 2 weeks before death, deceased loved ones appear to comfort the patient and negotiate.Less than 3 days before death literally 30 to 40 or more angels, deceased loved ones and others are in the room 24 hours a day to comfort and guide the loved one to the heavenly realm. At times, patients claim to see God at the foot of the bed. Can you tell us about a story that stands out in your mind?

They are all beautiful stories however the story of Matthew is dear to my heart. It is a story of a nine year old boy who died of retinal cancer and had his eyes removed to help stop the spread of cancer. Obviously, this did not work. He was an inspiration to all, including his classmates, teachers, nurses and myself. He was so unselfish and spoke of his three angels he called Gabby, Raphy and Noe. He said they were quite large angels that were there to keep him from feeling pain and to fulfill his purpose for being born. That was to help redirect his mom’s soul as well as his sisters back to God. He gave several prophecies about our world and my life. He told me about two weeks before his death the day he would go back to God. He died on that day and almost to the exact time.

Did patients ever see hell or talk about the devil?

Only a few, and most explained it as a self separation from God that comes from not being able to forgive oneself or love oneself as we are ready to transition.

How do you help these patients find peace?

I have made it my mission to sit down with all patients especially those who have deep darkness in their life, on how to find that forgiveness and self love. It takes dedication and group effort…nurses, chaplains, social workers and volunteers and nurses aides that are part of that dedicated hospice team. Stories of other patients truly help them find hope. This is one of the main reasons I wrote this book… a book full of hope and love by telling story after story of my patient’s experiences with the angels and how loving and understanding God truly is! I have to say of the thousands of patients I have cared for, I do not know one who has moved on to a dark place.

How do you propose to improve this lack of knowledge with regards to the process of dying?

EDUCATE, EDUCATE AND EDUCATE! I hope to start my foundation, once I have enough donations, to lobby congress and the educational department to mandate that the process of death and dying be incorporated into health studies beginning in 7th grade and continuing through college. Moreover, all health professional schools absolutely must understand the process of dying and that these patients, which we will all be one day, need not just medicines, but time to listen to their needs, especially with regards to the four types of pain which healthcare professionals do not even know exist: physical, emotional, spiritual and social or interpersonal. What kind of research is being done to understand the dying process as well as the non-linear conscious awareness or death-bed visions?

Well, there are prominent physicians and scientists who are currently being funded to look into these experiences. Dr. Bruce Grayson who is the director of the perceptual studies at the University of Virginia Medical School as well as Dr. Gary Schwartz out of The University of Arizona School of medicine. They are looking at biological markers, as well as EEG’s, pet scans, immunological markers and other brain Neurotransmitters, like dopamine, serotonin, Nor epinephrine and the latest being Dimethyltryptamine (DMT) located in the pineal gland and possibly related directly to the visions. Some call the DMT chemical the God molecule because of its ability to invokespiritual experiences which is believed to be carried out in the temporal lobes of the brain. It has long been know now that these lobes are responsible for telekinesis, remote viewing, spiritual experiences, and psychic.

Many of the family members including spouses and mothers of young children dying have also asked me that question. Yet, the nurses as well as I and other physicians somehow are able to get the patients to tell us their visions. One of the reasons maybe that we actually ask the patients specific questions about potential visions they will or may be having. We educate the patient. Many of the patients tell me they think they are hallucinating and would rather not tell their family as this may make them more concerned. Now if they are too sick to talk and close to dying, then they will not be able to communicate their experiences. Also, if one is on hard narcotics like morphine, which I believe to be necessary for comfort, their minds maybe to relaxed to communicate. Remember, most people begin to see the first spirits at about four weeks, but many do not see them until days to hours before their death. By that time, they are usually asleep, abilities and so forth. In fact the government is so well aware of the brains abilities in certain individuals that a remote viewing program was started and some believe is still alive and well. My patients have related to me that all humans have the latent ability but not all brains are fully evolved or have the right amount and balance of chemicals to initiate this ability. DMT is one of the molecules that are absolutely necessary.

What do you feel will be the impact of the book’s message five years from now?

We are already seeing the impact of the patient’s message now. I have received feedback from many whose lives have been forever changed by the book. The core essence of the book is one of Hope and enduring Love for All. Surprisingly, judgment does not play a big role in this message. You can speak of dying patients who have done ill will in their lives that they would be the ones judging themselves as told by many of my patients. So, self forgiveness and self love is so important. The question is how do we learn to do this? Family, churches, media–needs to be more positive, improvement in politics….new programs. If we all do not try to help in some way, evolution and direct affects of mans actions on each other and our earth will take care of it sooner or later. Why YOU? Why NOW? Why the urgency of your patient’s messages?

I believe that humanity as a whole has reached the “fork in the road”, if you will. The patient’s messages are in essence, as they put it, a direct revelation from Heaven to guide us in these challenging and troubling times, to nudge us to the Higher Path. No matter how dire our circumstances might be, there is always hope and opportunity. I believe that is why the book has been embraced by so many. I am just a simple witness to their testament. I believe there is a much Higher Purpose than I can ever imagine to these messages. What would you tell someone who is thinking of ending their life prematurely?

This is such a tough question but maybe one we can discuss. I have had a few patients which have survived suicide and eventually changed their lives as a result of the spiritual visions they had. Howbeit, there is so many that go the other way. How would you answer skeptics who might think these stories are just a figment of your imagination?

I too was skeptical and to this day have to remain quite objective and impassive, yet with a human caring heart, as patient’s lives hinge on my diagnosis and palliative treatment.

Why do you feel the book has been embraced by so many?

I have to admit I have not experienced a book and its message which has touched so many people at such a deep level whether they are religious or non-religious regardless of their race and creed. It has to be the unconditional love and non-judgment that awaits us as we exit this tough life. Powerful indeed! If one of your imminent terminally-ill patients were with you right now, and they could talk, what would they say?

So many things pop into my head, but the most common statement I hear is to tell others about what awaits us and that starting to love oneself and forgive oneself is truly the answer to a beautiful, peaceful life on earth as well as a more gentle transition from this world to the next.

I had a relative commit suicide, what have you learned about suicides?

Well, as far as your relative’s suicide, I am so sorry for the pain you have felt and the sorrow.But, please know that of the many suicide patients I have cared for, All told me that they saw the angels and that God accepted them into the happiest place they had ever seen. God knew that they were extremely depressed and that their brain chemistry was such that it felt leaving this world was the only option. They said that the angels told them that humans were wrong to condemnthem as the pain they were suffering was horrific. The lesson of their suicide was not just for them but for those that survived and to forgive themselves and their loved one that died and to know that God was with all. I know its tough, but for someone to kill themselves is the least selfish thing one can do. No one wants to kill themselves…no one! and God is aware of that. Do deceased relatives communicate with us while we are still healthy?

As far as what a few patients have told me is that some of us have the ability at this time and that as our brain evolves and we open our minds to this possibility thru meditation and prayer and so on….. we all will be able to have the ability. They told me this is beginning to happen as we speak and will occur with intensified frequency after 4 more years. So yes, it is happen and we all have the potential. I will let you know more soon. I am writing about his very question in my 2nd book.

I have attended 4 deaths. My 82 yr old aunt, my 45yr old husband, my 2 sisters, age 56 and 51. My 2 sisters were on morphine but my husband and aunt were not on anything. None of them acknowledged any of the entities that you suggest. Why do they see them for you and not for me?

One of the reasons maybe that medical personnel, who develop incredibly trusting relationships with their patients, provide a medium of non-judgment and understanding, thus allowing patients to express a multitude of thoughts and concerns. Another reason is the mere time we end up being around the patient. Most visions last 3 to 4 seconds and discussion of those experiences usually ensues immediately after. Nurses and other medical workers are usually in the room during these periods facilitating the conversation. Fear of being ridiculed is a frequently cited response by patients as to why they do not share their experiences with their family or friends.

Moreover, many of the patients tell me they think they are hallucinating and would rather not tell their family as this may make them more concerned. Now if they are too sick to talk and close to dying, then they will not be able to communicate their experiences. Also, if one is on hard narcotics like morphine, which I believe to be necessary for comfort, their minds maybe to relaxed to communicate. Remember, most people begin to see the first spirits at about 4 weeks, but many do not see them until days to hours before their death. By that time, they are usually asleep. I always wondered about forgiveness because thebible says to forgive and also because mediums say spirits have difficulties inthe afterlife when there is unfinished business.

I have seen several people die who could not find it within themselves to find self forgiveness or self love as they had lived a life full of deceit, lies, hatred, vengeance, abuse, drug use….much of it ,if not all, stemming from family genetics. They call this generational sin. They would claim to see dark figures that would frighten them and remind them of all the darkness they had not only brought to themselves but to the world. The light angels would come as well as deceased loved ones to aid the patient in obtaining self-forgiveness and self-love. Most of those patients did not listen to the angels as they did not feel worthy to forgive themselves and thus they chose to be separated 20from God. Many described going into an abyss or a cave that was full of other people who were murderers, abusers, leaders of countries that massacred people i.e., the Romans, Germans. I witnessed many screaming and shouting telling the dark angels to leave them alone. It was horrifying to watch.I learned the only way to help these souls was to pray for them and to witness to them about Gods unconditional love and forgiveness. Over a period of time, many would find their way out and move towards the light at which point they would learn how to forgive and love.That is why it is so important to pray for those souls who have died and not close to God. They need our help. I was told in order to move up the ladder of knowledge, if you will, is to learn to pray for others hat may have hurt you deeply. In the end, it is all about self forgiveness, self love and then forgiveness with accompanied love of everything and everyone. Is it common for patients to die without claiming to see spiritual entities?

It is quite common as well for many of my patients to deny seeing any entities at either other four weeks before or even hours…. One example was a lawyer who had lost his son a year earlier and was quite worried because he had not seen angels or any other kind of spiritual being just one day before he died. At one hour before he died he finally saw his son and smiled and died. The weeks before he died he was really ill, with fevers, blood loss, with resultant delirium.The people that did see spirits were not in distress, confused from fever or anemia secondary to blood loss or low oxygen. They were awake, without pain and talkative. I truly believe that the brain needs to be functioning somewhat well in order to have visions with our physical eyes. So the opposite is true. He definitelydid not have enough blood moving towards his brains and thus eyes therefore, he saw blackness.

How does one go about forgiving oneself before dying?

I do not have the exact recipe, but I can tell you what my patients tell me: In their opinion, to forgive oneself, one must LIKE oneself….. And for the most part, most people do not like themselves. That is why they seek to always be connected to someone…because they cannot stand to live with the one person they don’t like themselves. Now, if you are living alone, then you are greater than 50% there. Since you are already asking and desiring to forgive yourself you are definitely greater than half-way there. In the end, that is really what God wants from us… just to admit and attempt. Spending time alone and taking care of ones body, mind, and spirit. Therefore, exercise, eat fairly well, go have fun, and make time to talk to God and help others, i.e. volunteering…or just praying for others.

For more information, please visit www.warwickassociates.net or www.drjohnlerma.com

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