Here's Where It Gets Interesting - The In-Between with Hadley Vlahos

Episode Date: August 9, 2023

Sharon is joined by Hadley Vlahos, RN, who has written a bestselling book about her experiences working as a hospice nurse. Hadley walks us through the discomfort of death with great compassion and empathy while considering what it means to live well, and to die well. She explores commonalities in death spanning across a variety of faith backgrounds, many of which have no definitive scientific explanation. We’re encouraged to embrace the dignity in dying by allowing our loved ones to share their experiences in death. And while there is no one right way to die, we can gently hold space for our loved ones in the in-between. Host/Executive Producer: Sharon McMahon Guest: Hadley Vlahos Audio Producer: Jenny Snyder Hosted on Acast. See acast.com/privacy for more information. To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices

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Available now until November 24th in Ontario only. Woo-hoo! small latte. Available now until November 24th in Ontario only. Hello friends, welcome. So excited to have you with me today. My guest is Hadley Vlahos, who has written a bestselling book called The Inbetween. And it is all about her experiences as a hospice nurse and what she has learned from caring for dying patients. This is not a depressing episode. It is not a gory episode. I really think you're going to get a lot out of this, so let's dive in. I'm Sharon McMahon, and here's where it gets interesting. I am really excited to be chatting with New York Times bestselling author Hadley Vlahos. Thank you for being here today. Thank you so much for having me.

I'm so excited to talk. First of all, I've been following you on TikTok for a long time. I've seen so much of your content on TikTok, and it is very, very good. And it is really compelling. And I have absolutely loved all of your content. And so when I saw your book coming out, I immediately pre-ordered it. I read it. I loved it. I'm so excited to be talking with you about it. So first of all, congrats on all of your success of being a bestseller for multiple weeks. Thank you so much. I so appreciate it.

It's actually a very big deal. People don't realize what a big deal it is to make it multiple weeks on the bestseller list. It's a huge accomplishment and it's a testament to how good the book actually is. And just congratulations, Hadley. Congrats. Thank you so much. Well, your book is called The Inbetween, so much. Well, your book is called The Inbetween. And it is sort of like part memoir about your experiences working as a hospice nurse, and some of what you have learned as a hospice nurse about the process of dying and things that dying people in hospice experience. So it's part memoir of your own story of being, you know, like a 19 year old pregnant mom going to nursing school and what it has meant to you to spend all of these years as a nurse caring for patients who are dying and some very,

very interesting stories about some of the things you have experienced and learned. So let's start with, first of all, people are always curious, how did you even get to become a hospice nurse? As you well know, you don't see a lot of like 23-year-olds, 24-year-old hospice nurses. What about this field made you want to pursue it? Yes. And I think that's because in nursing school, we do not get much education on hospice. We learn about dying, but it's more in the hospital setting. So I think you see a lot of older nurses because they spend time in the hospital usually.

And they're like, okay, well, I think I understand what hospice is now. And I think that's what I want to do. But for me, I, of course, like you said, went through nursing school as a single mom. And then I did work in the hospital for about a year. And then from there, I went to a nursing home because they offered me a management position. And you know, you're just kind of trying to figure things out. And I was very burnt out in both of those roles because you have so many patients at one time and you're just trying to keep your head above water doing tasks. There's no time to sit down with patients. There's no time to do anything other than keep people alive, truly. And when I

was in the nursing home, that's when I saw hospice because we had hospice patients within the nursing home. So I would watch while I am running around like crazy. These hospice nurses come in, go sit with the patient. I remember I'd run past this room with the door open and they just be sitting there talking and occasionally, you know, taking a blood pressure and I'd hear them talk about their life and growing up and then they'd come out 30 minutes to an hour later and they just be like, okay, this is what we're going to do. And it's always just so calm and peaceful. And I'm like, okay, well, do you need me to call the doctor? Do you need me to call family? Nope, I've got it. I'll do that in a minute. And I was like, what is this career where you can just sit down with one patient at a time? Because that is what I want to do. And then as you know,

through the book, I went into it just being like, all right, I'm just going to do this. And I was like, maybe it'll be a little bit calmer. And I learned just a totally different side of medicine. And it's not necessarily easier. It's just very different, but I really like it. I have a friend and she's now been working in hospice for a long time. And she specifically works in a monastery caring for dying nuns. And she loves it. One of the things she says about hospice is that there are no emergencies in hospice. Somebody is there because they're in the process of dying. And so if somebody dies, that's not an emergency. But it really, you have to be the kind of nurse that wants to develop

relationships with your individual patients. And that's not the right nursing environment for everybody. But it can be incredible if that is the type of position you're attracted to. Yeah, absolutely. And I totally agree that every person, every nurse I think has what is their perfect fit. And I think I always tell new nurses, just find what's perfect for you. It's okay to try out a few different things. I have watched so much of your content and again, have read your book. I have watched so much of your content and again, have read your book. And you said that when you began working in hospice, you were of the opinion that what happened after we died was essentially like, I don't remember exactly how you phrase it,

but like eternal unconsciousness. Like you just ceased to exist. Yeah. And your position on that has changed based on your experiences working with dying patients. And I would love to hear more about that process. I would love to hear more about what you've learned working in hospice. So whenever these things first started to happen, which one of the biggest things is that patients see their deceased loved ones. And when it first started happening, I thought they were just hallucinating. There was a very clear explanation for it in my mind. They just were hallucinating. And whatever their religious

views were, that's what they were going to see. And then as I moved through my career and I realized that everyone was seeing the exact same thing, which is very different than hallucinations. Hallucinations can be anything. It can be seeing a bird in your room. It can be a spider. It can be the walls moving. And it's usually pretty scary for the patient. And this always brought extreme peace. It did not matter if they were atheist, if they were Jewish, Christian, Buddhist, whatever their background was, they were seeing the same things. And so to me, there was not really a logical explanation anymore for that. So I had to get a little bit uncomfortable with like, something else is happening here that we don't have explanations for. And then all of

these things, like the coincidences you read about in the book start happening. At one point, I just said, it's not really logical for me to say that there is not something beyond here. And patients can tell you correctly when they're going to die, their deceased loved ones will tell them when they're going to die. And I've never had a patient be wrong about that. And then all these coincidences, like in my book, I have a patient with Alzheimer's who I thought was having hallucinations of a fire on her bed and I could not get her calm. And so finally an older hospice nurse who had had tons of experience instructed me that for her, whatever's happening feels real to her. So if there's a fire on her

bed, move her bed, which was so funny to me at the time, because now I have experience. I'm like, yeah, that's such an easy solution instead of stop giving her all these medications. And so I moved her bed. And then many, many, many months later, she had died. many, many, many months later, she had died. Her husband told me that there was a fire in that room. And the only reason he survived is because he had never moved the bed back that I had moved. And to me, at some point, it was like, it's not logical anymore to think that coincidences with dying people happening every day is just coincidences. That doesn't make sense. There are so many commonalities is what I'm hearing you saying. It doesn't matter what kind of religious background they had or no religious background whatsoever. It doesn't even

seem to matter what they actually believe about the dying process, that they have so many things that happen that almost seem like universal experiences to people who are experiencing the dying process, like seeing deceased loved ones. And you talk in the first chapter of your book even about a woman who is having absolutely normal conversations with her deceased sister, where she's just speaking like this of like, oh, yeah, that's right. That's what we're going to do this afternoon. Just having a very normal conversation. Her sister was absolutely real to her. But I thought it was so interesting that the longer you worked at this, and you talk about this in the book, too, like you went through her chart, there was nothing in her chart that would indicate hallucinations or that level of confusion or anything medically that could

explain why she's having completely rational conversations with her sister. But that was very upsetting to her daughter in the book. It was upsetting to her daughter that she was having conversations with her dead sister. Her daughter felt like she's going crazy. You got to fix it. But the fact that when her daughter had a nap and came back in, your patient was lucid enough to know that her daughter was uncomfortable with her talking to her dead sister. And she actually lies to her daughter and said like, oh, guess I must've been tired. She's not here anymore.

Meanwhile is like wink, wink at you of like, yeah, she is, she's right over there, which indicates again, the lucidity that it's not just a hallucination. She can distinguish between who's comfortable with this information and who isn't. And I'll share with one person, but not the other. Absolutely.

And then me sharing that with my manager who was like, Oh, yeah, yeah, that's interesting. I was like, it was entertaining to her that I was like, Yeah, here we go. Another new one, you know, learning all of this. And every single I've now worked in multiple different states, multiple different companies, every single coworker, manager, doctor, everyone I've worked with completely just accepts and believes that no matter what their own religious beliefs are, that these are people's actual loved ones coming to get them. And I also think it was so interesting that you said that this is universally a positive experience for people, that they are happy to see their deceased loved ones. It's not scary. They're not like, my dead sister is haunting me. It's not a haunting.

They are excited to see them. What kind of things do they talk about with their deceased loved ones? A lot of times they'll say that they're going on a trip or they're going on a journey. And whenever I ask, it almost feels like they don't have the words to explain to me what's going on. So they will use words to try to make it make sense to me. But you know, it's one of the reasons why I call it the in between because I feel like they're in between the next world and our world. So I've had a patient tell me, well, I'm going on a very long trip. And I'm like, where are you going? It was like, if you can imagine getting on a train and you don't know where it's going, but you're excited.

And so it's almost like they're starting to see what's going on and they feel happy and calm about it, but they don't really have the words to express that I would understand what's going on, but they try to. And they'll usually say, I'm just going on a trip. I'm going on a journey. And they'll usually say that. And then sometimes they'll just talk to them. And I don't even understand it. I actually recently had a patient who was speaking in code to his old

war buddies. He was in Vietnam and he just started speaking in code. And then I'm taking his blood pressure. And then a minute later, he's like, is it okay? Like the blood pressure. And then he's talking in code again. It was very neat. So they talk to people just like you and I talk. And it's like, almost like they don't understand that I don't see them. Did it take a while for you to feel comfortable working with dying people? Because it's obviously a topic that makes a lot of people uncomfortable. We associate death with very negative feelings because it brings grief. And often we don't want that person to pass away. And so it's understandable why many people would feel very uncomfortable being around people that we know are dying. Did you have that experience or was it always comfortable for you?

So as far as the physical part goes, I was raised with grandparents who worked in the funeral industry. So death was pretty normal for me the way we discussed it. So that part didn't really bother me. And then as far as physically like me taking care of people who are dead, I still do see them as my patients. I still talk to them. To me, it's no different than when they were talking to me a few minutes beforehand. What I've gotten much more comfortable with is now having this sense of peace that I will see them again. So it's not necessarily as sad for me as it was in the beginning, because hopefully it'll be a while, but I feel like I will see them again. What kind of advice would you offer to people who are going through this experience?

Let's say somebody has gotten a terminal diagnosis, or let's say somebody has a loved one or a parent who is dying. Maybe it's not today, but it'll be someday in the future. What would you say to them? If it's a family member, one of the biggest things that I hear from patients, like whenever family members are not in the room and it's just the two of us, is that they try to bring up discussing death and family members will stop the conversation and say like, oh, no, no, you're okay. We don't need to talk about that. And that is not out of malice at all from the family members.

I know it's out of love that they want them to not think that they're like giving up on them, but the patients feel like they have no one to talk to about what they know is going to happen. So if you're a family member, I always say, please don't stop those conversations. I know they can be very uncomfortable, but please allow the dying person to talk about dying. I see that very frequently. So that is one piece of advice that I have. And then as far as for patients, I will tell you, I am on a daily basis amazed at the strength of my patients and just the peace that they have with it.

I always wonder, you know, would I be at peace with this as they are? And so many patients, in my opinion, they have some sort of spiritual energy with them because so many of them just have this sense of peace and calmness about it that just amazes me every day. So what you're saying is that for many people, based on your experience, it doesn't feel traumatic and terrifying to the patient. It feels peaceful and like they are ready to go or they accept whatever it is versus what we picture it being this like horribly traumatic of like, no, please, I'm not ready yet. And of course, I'm sure that has happened, but you know what I'm saying? Like that's not your typical experience

with patients. Yes. My typical experience is that they're usually pretty at peace with things. They'll usually go through what we call a life review stage. And they just start talking about their life. And they'll just kind of look back on their life. That's usually when I'll get advice and regrets from people. And I'm just always open to hearing those. And that is usually the only time that I'll see where people maybe have some regrets. But after that, people do seem to make peace with it, which amazes me. What kind of advice do dying people give you? They give me a lot. I would say

most of it would be centered around not caring about material things. They say, can't take it with you when you go. I hear that a lot. I hear that it goes by very quickly and to really treasure those moments. One of my favorite ones that I have really been practicing for many years now is understanding that it's not those big moments in life that make a life. It's not that trip to Hawaii or it's not that wedding day. It's what you're doing on an everyday basis that make a life and you've got to really find joy in the everyday. What kind of things do you find that people regret about their lives? People regret caring too much what other people think and that being a reason that they don't do

something like pursue a goal, like a different career. Or I've even heard of people saying that they didn't have more children because they felt like, oh, two is enough, but they wanted more. Really, it's very external. They regret caring too much about what other people think instead of what they really want. It's such an interesting thing to think about, they really want. It's such an interesting thing to think about too. Will I care about this when I'm 94 and in hospice? Chances are real good you are not going to care about the mean DM when you're 94 and dying. You're probably not going to care about a lot of things you think are really, really big deals like today in this moment. Yeah. And I have taken care of a therapist before and that was incredibly interesting because they were very open with me about their regrets, which I found very interesting,

of course, because they had heard a lot throughout the years. And I remember, I don't even know how it came up, but it was along the lines of the mean DMs, the mean comments, and I remember her telling me that you should really examine when something upsets you, why it upsets you. Basically, the analogy she used, she said, if someone tells you the sky is green, you're not going to get upset because you know that they're wrong and the sky is blue, and so she said, whenever someone tells you the sky is green, you're not going to get upset because you know that they're wrong and the sky is blue. And so she said, whenever someone tells you something about yourself, you need to think, why is this bothering me? Is there some truth to it? And I have really taken

that to heart. And I tried to practice that and taking a step back and saying, you know, why is this bothering me? Interior Chinatown is an all-new series based on the best-selling novel by Charles Yu about a struggling Asian actor who gets a bigger part than he expected when he witnesses a crime in Chinatown. Streaming November 19th only on Disney+. This episode is brought to you by Dyson OnTrack. Dyson OnTrack headphones offer best-in-class noise cancellation on Disney+. Colors and finishes. Dyson on track. Headphones remastered. Buy from DysonCanada.ca. With ANC on, performance may vary based on environmental conditions and usage.

Accessories sold separately. As a Fizz member, you can look forward to free data, big savings on plans, and having your unused data roll over to the following month. Every month. At Fizz, you always get more for your money. Terms and conditions for our different programs and policies apply. Details at fizz.ca. You also mentioned that you really believe that patients can choose their time of death.

I would love to hear your experiences with people who choose their time of death, and how do you know that that's true? The way I know it's true is that it is down to the second. And every time I say choose time of death, I always want people to know it is not necessarily people wait until people get there. I have seen multiple times people wait for people to leave. And I found that that really correlates with personalities. Whereas the more introverted people, the more stoic men, I will see a lot older men will like to be alone whenever they die. But one in my book, Miss Sandra, I mean, she, in my opinion, waited. Her daughter walked in, her only daughter, walked in the house and she came and kissed her mom and she died immediately. And I 100% believe

that she waited for her daughter to get there. But you also see where people are like, they've been there all day and you're like, it could be any minute. And then they say that the minute they walked to the bathroom, just to the bathroom. I mean, think about how quick that is. They will die. And it is incredibly interesting to me because you can't choose what time you go to sleep at night, but you seem to be able to choose when you die. That is so interesting. And of course, again, this is not universal and I definitely don't want this to come off as like all people can choose it. People die in terrible accidents, die at the hands of violence. Of course, that's true. We're talking specifically about people with terminal illnesses on hospice, but that's really fascinating. And it makes me wonder, and I know we probably maybe

don't have an answer to this, but it makes me wonder what is it that they think they are waiting for? When they decide in their own mind, I'm going to go as soon as she gets here. I'm going to go as soon as they're gone, or I'm going to wait until January 2nd or whatever it is. What is it that they think that they're waiting for? They obviously view that other moment as more opportune. Yes. I personally think from getting to know patients and then seeing them choose, I think that they are protecting people from regrets. I think that, for example, in my book, the daughter who had just gotten there from out of town, I think her mother was protecting her from saying, why did I pause and get gas? Or why didn't I get off of that plane quicker?

Just those regrets. And I think that people do, they're protecting people. Or the opposite, whenever they're alone, I think that they have the sense that some people can't necessarily handle it. And they would do better with their last memories being them alive, not taking their last breath. And I do think that we're incredibly in tune with each other, whether we are aware of it or not. So your experience has been that it's really about the relationship they have with other people and making sure that that is optimized in their own mind, whether they can handle it, can't handle it, whatever it is, they're trying to optimize it for the loved ones they're leaving behind.

I absolutely think so. And even personally, just very recently, I'm sure you saw on my TikTok that we just lost one of my husband's best friends and he was on life support and he was only 38 and his parents had to make the difficult decision to stop life support. And interestingly enough, so they let everyone into the room because you know how the ICU is. They let all the family and friends into the room because they were about to stop the life support. And the minute before they were about to turn off the machine, he actually died on his own. He actually died on his own. And to me, that was his way of hanging on and then saying, I'm not going to make you feel like you decided to do this because it was incredibly difficult for his parents.

Yeah. He wanted to control the decision for himself so that other people didn't have to feel guilty about it. Mm-hmm. You also mentioned another common feature that people who are dying have, that many of them have, which cannot be explained by anything medically. Science has no explanation for why so many people shortly before they pass away get this surge of energy and their loved ones sometimes are even like, do they even need

hospice? Like they're eating, they're sitting up, they're eating all the food, they're like chatting away, like, are they better? And then, you know, a few days later, or whatever, they have passed away. That surge of energy, first of all, is there a term for it? That is what we call it, as far as I know. That's what I put in my chart. No one's told me not to. Energy surge. Patient is experiencing energy surge. Does it usually happen in your experience within a week of their death? What's the timing? It can be within a week. I've seen up to maybe a month. And usually nine times out of 10, I would say that you don't really realize it was a surge of energy until after they've died. People will look back and they'll be like, oh, okay. They got up and they wanted some ice cream and then they quickly declined

afterwards. And that was nice. They sat up in the living room and visited with family whenever they've just been really sleeping, you know, all the time for many months. So it's not always as extreme as some of the cases that I've seen, whereas like in my book, the patient who was pretty much bed bound got up and was playing hide and go seek with his deceased daughter. That's very extreme example where you can chart it and say, this is a surge of energy. I know what's happening. It's so interesting. Like, why does that happen? I wonder if it's their body being like, we got to burn off all this stuff before we're ready to go. You know, like, we got to burn off all of these extra chemicals, all these things that have been started your tissues and whatever, like they got to go, got to dump them. Essentially.

This is me as a non-medical person being like, what's the explanation? Do you have a hypothesis about what that actually is? So Barbara Carnes is her name that wrote what we call the little blue book in my book that explains all of these process phenomenon that we give to family members. And it's a very, this is what you might experience. This is the timeline. It's very straightforward book. And her thought process as to why it happens is that she believes that our spirits get this energy that will prepare them for the journey into the next life. And it will show up physically here for a little bit.

And then as we see them go into more of a sleeping all the time, almost comatose state, they're then using that energy to prepare for the journey. And we just can't see it anymore. That's her theory. I like it. I know that people have long believed that people who are in comas can hear you and that people encourage people to continue to talk to them even if they can't respond. And I wonder if you have experienced any evidence of that. Yeah, I absolutely think just from the studies that there have been shows that you can hear

people when you're in a coma. Personally, from what I've heard and experienced, we actually had as an example, there's a patient who was a surfer. He was very into surfing, and his wife played music that was like waves and birds and just like that atmospheric music and we would watch his toes curl like they were on a surfboard that's what she said she said that's what his toes would do when he was on a surfboard and you're like wow but I mean he couldn't talk. He couldn't do anything. Didn't even really respond in any other way except like he was surfing, which was super cool.

That's neat. One of the things that I'm interested in or fascinated by is the concept of a good death or a happy death. Not that it's happy to your relatives that you're dying. At least you hope it's not. You don't want to be somebody who's like, thank God they're dead. Hopefully you have not lived that life. Hopefully your relatives will miss you and are sad that you're gone. But do you believe there is such a thing as a good death or a happy death? Yes, but I think it is patient to patient specific. Yes, but I think it is patient to patient specific. So for a while, I thought that I knew what a good death looked like.

To me, it was being at home. It was having the doors open so you could hear the waves and the candles and the low lighting. That was a good death to me. But my mother-in-law, it was having her son, my husband there. That is all that mattered to her. And that I think is important to consider that what we think is a good death might not be to the person who's experiencing it. And it's just so important that they get what they want. Yeah, totally. This is not the time to make it about you. This is not the time to do what you want. It's to consider what would make them happy. And often it seems like there might be signs that even if they have trouble communicating,

that they like having the door open or they like hearing the wind chimes or whatever it is, and to cater to their needs instead of what your vision of what it would look like. Yeah, absolutely. And for some people that is, like you said, you can kind of know the person, you know, personally, I would want anyone who wants to come, they can come. But for a lot of people, it is important for it to just be them and their main caregiver, like them and their spouse. They don't want every single person there. That's too much for them. You can kind of see where they get a little bit restless, even if they can't talk anymore, whenever there's just

so many people. So yeah, it is, like you said, very important for us to know what would matter to them. Do you feel like as a hospice nurse, you have gotten really good at knowing how much time someone has left? Yes and no. There's always those people that really surprise you where you will get on the morning call and they're like, oh, so-and-so died last night. And you're like, what? And then I tell people that and they're like, well, I mean, is it really surprising? And you're like, yes, I know. I know it shouldn't be surprising that anyone dies on hospice, but it can be. But I will say now, since I've been doing it for over six years, I'd say about 75% of the time I can get it within a day or two correctly.

And sometimes that's just my own mental thought process. And other times families do ask and I will tell them. But about 25% of the time, it's just they follow their own kind of plan. They're going to do what they want and they're going to have control over the process because that's what they want. Yeah. And of course, there's physical process where somebody is actively dying that I'm sure as a nurse, you're very familiar with.

And one of the things that I know sometimes people who have a loved one on hospice feel like they're getting so dehydrated. Why aren't we giving them IV fluids? They have to be so thirsty or why don't we have a feeding tube? They can't eat. And there are good medical reasons for those things. But I would love to hear you talk about why do patients go through this process of like, I'm not going to eat a drink anymore when they're dying.

I always say, and a lot of people don't think of it this way, but just like how our bodies know most of the time how to go into labor. And just, it's been 40 weeks, which always just fascinates me. Like, okay, 40 weeks. All right, let's go. Let's go into labor. Our bodies know how to die too, without us having to do anything. And our bodies naturally say, okay, I don't need food or fluids anymore. And when we force that on them, it can be very, very, very uncomfortable. So food, when their body, all it's doing is just keeping your heart beating and your lungs breathing. Whenever you give it food, it now has to focus on digesting that food and excreting that food. And that can be very tiresome to someone and they don't need it anymore. With the issue

with fluids, especially IV, is that you can get something called third spacing, which is where the fluids go outside of where they're intended and it goes underneath your skin, which is where the fluids go outside of where they're intended. And it goes underneath your skin, which is extremely uncomfortable for patients. I know people just want to help their loved one. They just want to love them. It's never out of a place of anything but love. But it is so important for people to understand that you can harm people by doing that. And you can speed up the process, unfortunately. Yeah. The last thing you want to do is make your dying loved one more uncomfortable.

And creating lots of swelling in their extremities and stomach pain. That's actually not helping them in this moment. It's not keeping them alive. In some cases, it can have the opposite effect. It can hasten their death because you're interrupting the natural process and forcing their body to expend energy doing other things. Yeah, exactly. What, if any, differences in your mind or your experience are there between people who are dying, who have no religious faith or a very minimal religious association? They go to their house of worship twice a year or whatever, versus somebody who is very actively practicing a religion.

Are there differences or do you not notice any? So the biggest difference I see is people's own comfort with what they believe. And so I would have originally thought that it meant that anyone who is religious are comfortable and so they will have a comfortable death and that anyone who's atheist might be scared but what i've found is that no matter how much you go to church there are certain people who are religious who are still scared at the end and they still question what's going to happen and then there's religious people who are like i am so excited like. Like I am ready. Let's do this. And they are happy and comfortable. And then there are also atheists or agnostic people or whatever they believe that are also have come to a big sense

of comfort about what they believe. And they are not scared that they think nothing is going to happen. And so what I found to be most important is just feeling comfortable in whatever your beliefs are and really living a life that you feel happy with and that you feel like if you have to meet any maker that you're like, okay, I think I lived my life well. I think I was kind to others. I think that I did my best to be a good human. Those are the people that I see having the best deaths. So it's less about the level of religious adherence and more about how comfortable or confident are you in your own beliefs, whatever they may be? Yeah, exactly.

What do you wish people understood about the in-between, this time sort of between your normal life and the time that you pass away? You know, what I am excited about getting out there with this book and with these stories is people's understanding that this is normal so that they can embrace it and say, okay, like they are possibly actually seeing a deceased loved one. Like let's embrace this. Whereas since it's such an unknown concept that many people don't talk about, instead of embracing it, people are concerned. They think that something is wrong with their loved one. And so they're not really enjoying that moment. So I want people to understand that no matter

what you believe, this experience is very common and it does not mean that anything is wrong with the person. And if you feel up to it, I think that you should just meet them in that in-between space and enjoy it while it lasts. Hadley, thank you so much. This was such an interesting conversation. Your book was so easy to read. The stories were so compelling. I just really loved hearing more about your experiences, especially because most of us will only, if at all, we may only have one or two experiences with a loved one in hospice. So it is so interesting to hear more about somebody that has hundreds and hundreds of experiences under their belt and can see sort of from a bird's eye view, like what some of the commonalities are, what a happy death or a good death looks like for an individual, and what that journey can be like if you are willing to embrace it and feel comfortable and confident in your beliefs. I just loved it. I loved reading In Between and

I love following you on social media. So thank you so much for being here today. Thank you so much for having me. You can find Hadley Vlahos' book, The In Between, wherever you buy your books. Hadley Vlahos' book, The Inbetween, wherever you buy your books. I always have to plug bookshop.org. It supports independent bookstores, but you can also visit nursehadley.com and that will get you all of her social media links. I love following her. And thanks so much for being here today. This show is researched and hosted by me, Sharon McMahon. Our executive producer is Heather Jackson. Our audio producer is Jenny Snyder. And if you enjoyed this episode, would you consider leaving us a rating or review on

your favorite podcast platform? That helps us so much. And we always love to see your shares and tags on social media. We'll see you again soon.