How Virtual Reality Can Help You Face Your Own Mortality

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[I] was in elementary school when I first became aware of my own mortality. It was early in the morning. My mom was in the bathroom getting ready for work, and I was on her bed covered in tears, thrashing around and yelling “I don’t want to die!” over and over.

Like a lot of people, dying terrifies me, the finality of it so unthinkable that I try not to acknowledge it in my day-to-day life. So when an opportunity came to go to “Second Chance” — an interactive experience that uses theater and virtual reality to help people come to terms with their demise — I was both scared and intrigued. It was one of 175 activities that took place during Reimagine End of Life week in San Francisco, an event that consisted of panels, film screenings, and other experiences that encourage people to talk openly about death and how it affects us.

SF-based art collective Lava Saga spent three months creating “Second Chance,” transforming a two-story gallery in the city’s Mission district into an ethereal environment.

“We believe that immersion is a way to experience things, and when we have those lived and bodied experiences, we can start to answer some of those big questions around death or around life itself or any other big topic we’d like to explore,” said co-producer Scott Shigeoka in an interview.

“Second Chance” only allowed 10 people in at a time, and they all had to be strangers (one of Lava Saga’s few hard rules). It unfolded across four different rooms, with VR serving as a key piece of the production. My group entered the first space — a darkened room lit only by blue and purple lights — and found black futons on the floor, all of which had pillows and neatly folded white sheets. Next to them were Samsung Gear VR headsets and wired headphones that attendants asked us to put on after we sat on the beds.

The nearly four-minute VR sequence pulled me through a monochrome landscape filled with massive planets, intricate caverns, and pulsating tendrils that pierced the sky. An otherworldly hip-hop track from electronic artist Shigeto made the 360-degree journey feel lonely and isolating.

When the experience was over, I took the headset off and laid on the bed; another person came to pull the white sheet up to my neck. A cellist at the corner of the room began playing a peaceful but melancholic tune. I closed my eyes as our end-of-life doula (who had spoken to the group beforehand to address any concerns) read a poem from Buddhist monk Thich Nhat Hanh.

As far as the “Second Chance” narrative was concerned, we were dead.

Simulating Death
Surprisingly, the VR music video wasn’t made for “Second Chance.” It’s a pre-existing project (known as “Hovering”) from creative studio 79 Ancestors. Lava Saga worked with VR and augmented reality curator Dream Logic to determine what kind of piece would best represent the transition between life and death.

It wasn’t easy. For awhile, they wondered whether they should even have a symbolic representation of death. After all, how do you visualize an experience that, by definition, is impossible to come back from?

“We picked [‘Hovering’] because it feels like going through a portal. And with VR in ‘Second Chance,’ we wanted it to serve that function, to be a transporting mechanism that people could go inside, be transported, and come out into a shifted reality,” said Dream Logic producer Kelly Vicars.

Though “Hovering” wasn’t created with “Second Chance” in mind, its abstract graphics made it a fitting choice for the production. During the design process, Lava Saga interviewed people who had near-death experiences, with many of them saying they were moving through a tunnel or seeing black-and-white images before being resuscitated. “Hovering” also worked well because it wasn’t scary and didn’t adhere to any specific religious beliefs.

“It was important for us to honor the diversity of cultures, traditions, and wisdom around death. … We wanted to make sure that whatever experience we used was really inclusive,” said Shigeoka.

Lava Saga and Dream Logic knew that for a lot of people, “Second Chance” would be their first opportunity to be in VR. So they tried to make the experience as seamless as possible, with attendants giving clear instructions on how to use the equipment. And Gear VR offered the least amount of friction due to its portability and ease of use (when compared to PC-based gaming headsets like Oculus Rift and HTC Vive). Participants just had to put it on and wait for “Hovering” to begin.

“My team’s goal is to use immersive technology to elevate art, to have the technology disappear,” said Vicars.

Breaking through taboo topics
After dying in VR, my group entered a series of rooms that represented a kind of liminal purgatory state. One had thin sheets of white fabric hanging from the walls and ceiling, with actors and dancers (Lava Saga refers to them as spirits) talking to each other about their previous lives.

From there, “Second Chance” starts to pull back on its mystical interpretations of an afterlife and morphs into something a little more grounded: group therapy.

In the third room, we broke into two smaller groups with trained facilitators who asked us questions about our own lives. Shigeoka said this was often an “emotionally charged” space because of the stories people would share — about their hardships, mourning for loved ones who died, or anything else they just needed to talk about. This vulnerability is why it was so vital to go through “Second Chance” with strangers instead of friends or family members.

I didn’t let my guard down completely. I couldn’t quite squash the skeptic voice in my head, which was too loud and too stubborn to go away. But I still felt comfortable in those discussions, as well as in the 1-on-1 meetings that followed in the last room, where we were randomly paired with another person from our group. That I was able to share personal details about my life at all was remarkable given that we had only met an hour before.

“Second Chance” wasn’t a perfect experience; at times, I was bored or confused about what was going on. But the core conceit — getting people to express their feelings about a sensitive topic — was sound. It reminded me that sometimes, it feels good to have someone just listen to you.

“I hope that people emerge [from ‘Second Chance’] with a new perspective and a new relationship with what it means to die. And that’s [to] live,” said Vicars.

Lava Saga and Dream Logic consider this first run as a prototype. If the show ever returns (whether in San Francisco or elsewhere), they want to keep refining it based on the feedback they receive. One day, they might make their own VR experience to replace “Hovering,” or maybe even depict that life and death transition in a totally different way.

But the idea of using theater and immersive technology to break through cultural taboos is something both teams want to keep exploring.

“It’s so important for us to open up about [death] and it’s so important for us to change the narrative around it, to make it something that should be discussed and talked about. … We need to have a conversation that goes beyond the medical world around the end of life,” said Shigeoka.

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How virtual reality is improving end-of-life care

In the UK, terminally ill patients are being transported from the hospice to other worlds.

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[V]irtual reality is not just for showing off the latest games and inventions. The technology has found a purpose in the healthcare industry as part of improving hospice and end-of-life care.

When someone is terminally ill, it may be inevitable that the individual will, at some point, go to a hospice or treatment center for end-of-life care or, at the least, to a respite center to give home caregivers a break.

However, in the UK under a creaking, strained, and underfunded National Health Service (NHS), sometimes these facilities may be suffering themselves from a lack of budget to make these stays as comfortable as they could otherwise be.

In addition, and perhaps most importantly, taking someone away from their home at such a stage can be a difficult transition.

To make this process a little less heartbreaking, local charity hospice Loros, which provides hospice and home care to roughly 2,500 terminally ill individuals across Leicester, Leicestershire, and Rutland, UK, has launched a new project which uses virtual reality to enhance end-of-life care.

The idea is to help those who have limited mobility to experience life outside of treatment and give them the chance to go back to places in their past which hold fond memories, as well as experience new areas beyond the hospice and home.

As shown in the video below, 70-year-old John, who is diagnosed with motor neuron disease (MND), is trying out the headset equipped with a video of Bradgate Park. This kind of technology can give patients a little more joy in their lives when perhaps it matters most.

Since being diagnosed with MND, we can get out but I can’t spend a lot of time out of the wheelchair, so being able to have these experiences through the glasses is really good,” said John. “It’s almost as good as the real thing.”

It’s a reminder that while many of us obsess over whether or not the latest mobile device will have a headphone jack or an impossibly thin shell or not, advances in technology can also provide far more important experiences.

Loros is currently working with a VR company to produce more films and hopes to commission new films that other hospice providers will be able to use in their own virtual reality services.

“Research suggests that the brain accepts the virtual world within 20 seconds after which the experience becomes all-absorbing,” Loros CEO John Knight commented. “We recognize that some of our patients are often restricted to where they can go due to their illness, so we wanted to help give them the opportunity to still enjoy life wider than their restrictions allow, through virtual reality.”

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Exploring death through the isolation of VR

Confronting your own mortality is tough but helpful.

By Mona Lalwani

[I]’m sitting on a field of tall, red grass staring straight ahead at a lone tree. Its leaves match the crimson landscape that stretches out before me. In the distance, a rusty orange forest fades into the background. There’s a gentle rustling of leaves, occasionally interrupted by the faint chirping of a bird, that forces me to breathe slower.

“Thank you for being here and being willing to consider moving towards the idea of dying and death,” a calm, male voice prepares me for the virtual meditative journey.

A hazy white light source rises in the distance as the voice walks me through the process of focusing on my breathing. I watch the blades of the grass swish to the left with the wind. The tree slowly starts to lose its leaves. “Feel the air around you,” the voice continues. “Feel yourself letting go as if you’re a tree dropping your leaves. The breeze takes the leaves away. Everything that you know and everything you cherish will be taken by the wind.”

As I let the weight of those words sink in, the blue sky slowly takes on a deep green hue, ushering in darker skies. Within moments, the field beneath me turns into a deep red lake that starts to rise around me. I gasp for air before I quickly remind myself that I have an Oculus Rift headset on my face.

When We Die is a virtual reality experience for perhaps the most difficult kind of contemplation: the end of life. The first half, with the metaphorical tree, presents the ephemerality of nature as a symbol of the finiteness of your own life. But the next chapter addresses the wider perception of death as a tragedy through real-life experiences.

In the second half, serene views of the cosmos shift the narrative from considering your own mortality to thinking about the process of dying as an inescapable reality for all. Celestial objects that dot the night sky reveal audio clips from a hospice worker, who shares her observations of death, and a neurologist, who grounds the experience in a physician’s approach to it.

“We wanted to create a safe space for people to have difficult conversations,” said Paula Ceballos, an NYU student who is a part of a trio that created When We Die for the school’s Interactive Telecommunications Program. “We find that in the Western culture death and dying and aging get put behind closed doors, and we wanted to bring it up and make you think about it.”

The fear of death, your own or a loved one’s, is deeply ingrained in the human psyche. It can drive the choices we make, yet it continues to be shrouded in mystery. Over the years, hundreds of research studies have probed the process of dying, the fear of confronting death and how the awareness of one’s own mortality has impacted religious, cultural and spiritual world views.

When We Die makes room for that spiritual contemplation with its abstract worlds: There are no physical bodies, only metaphors for the process of aging and dying. But the idea is rooted in a more practical understanding of the ways in which neglecting end-of-life processes can hamper the process of dying, especially for the elderly and the terminally ill.

“It leads to systemic challenges,” said Leslie Ruckman, an NYU student whose background in health care informed her work on When We Die. “There’s all this money that gets spent on treating patients in ICUs, and people [often] end up dying in hospitals even though advance directives might say they’d rather die at home. These are bigger issues that arise out of the inability to look at the end of life and not being able to define what a good death might look like.”

The VR experience relies on surreal visuals to make that happen. According to co-creator Dana Abrassart, when the group first started working on the project, they envisioned a James Turrell-style liminal space. But they quickly realized that a virtual take on the light and space movement would trigger motion sickness.

Nausea in a death-related experience would defeat the purpose of their work. So instead, the group found inspiration in Richard Mosse’s infrared imagery. “It’s this idea that there’s a light spectrum around us but the human eye can’t see it,” Ruckman told me. “We liked that as a parallel to this natural process that is always present and yet, we choose not to see it.”

Death is a constant. Yet its prevalence is hidden behind hospital doors. “In the US, there’s a sanitization of death,” Dr. Gayatri Devi, the neurologist whose voice floats through the cosmos in the second half of the VR experience, told me at her clinic in Manhattan. “Our current view of death might be a victim of industrialization and development. There’s less contact with ill people who are dying so they get sequestered and put in a different place. Whereas in India, for example, there is a philosophy of maintaining contact with family and contact with death is not uncommon.”

More than 80 percent of Americans with chronic illnesses would prefer to forego hospitalization, but according to the CDC, 70 percent of that population dies in a hospital or nursing home. Even in cases where patients have advance directives to avoid aggressive measures, a widespread study revealed that only 25 percent of the physicians were aware of their patients’ end-of-life choices. The discrepancies are jarring. Even though the rise of palliative care and hospice work in the past few years is starting to close that gap, the inability to talk about death continues to get in the way of making better choices.

“Death is not a contagious illness,” said Dr. Devi. “But in some ways, we treat it like one. We need to talk about it and get comfortable around it and maybe use VR to experience it. The better the conversation about death, the more likely we’ll be to allow more of us to die at home so we’re not scared of it.”

Conquering those fears has been the focus of recent psychological explorations in VR. While When We Die uses a light meditative touch to approach conversations around death, a Spanish research group recently simulated an out-of-body experience to tackle the full spectrum of thanatophobia (or the fear of dying) in an attempt to reduce anxiety.

“Death is not a contagious illness. But in some ways, we treat it like one. We need to talk about it and get comfortable around it and maybe use VR to experience it.” — Dr. Gayatri Devi

The idea of one’s own nonexistence has always been a tough one to conquer. “But it’s a reality and we can’t opt out of it,” said Dr. Devi. “When you allow yourself into that space of thinking you’re dead, where you lose agency over yourself — that can be a powerful experience. Allowing yourself to sit with that makes you vulnerable and to be able to think about death. You have to allow that to happen.”

While some might consider this exploration of death terrifying or even futile, in many cases the practical rewards offer the required motivation. Preparing beforehand, for instance, allows people to get their affairs in order, which unburdens families from making end-of-life decisions.

“When people are faced with death, if they haven’t done any preparation, there’s too much fear and anxiety to let anything else in,” Stephanie Hope, the hospice nurse who shares her experiences in When We Die told me. “It makes it important to talk to people who aren’t faced with that yet.”

Hope, who has been a hospice worker for about four years, points out that when people think about having limited time, they start to withdraw and often show an inclination to spend time with people they’re close to. She likens that purposeful shrinking of the world to a kind of intimacy and peace that can be felt in the aloneness of VR.

The isolation, which tends to be one of the biggest criticisms of the medium, lends itself to the deeply personal experience of contemplating death. “You’re in your own world and this is your moment,” said Hope. “So to think that that’s what it might be like at the end for you can be powerful thing.”

While the immersive possibilities of VR feel contemporary, tools that address the human predisposition to death have been around for centuries. John Troyer, director of the center for death and society at the University of Bath, traces the lineage of the visual format all the way back to mediumship. “For me, a lot of it, although a different kind of technology, has a relationship to this idea of connecting with the dead in some way,” he said. “To understand any kind of new tool that is supposed to help people think about death, we have to place it in context of the long history of tools that were created by humans to help other humans make sense of their mortality.”

Troyer pointed to theatrical experiences like phantasmagoria of the 19th century, which played with themes of monsters and death long before VR. The use of projection systems like magic lanterns turned those imaginative ideas into visual experiences for audiences, which in a way is comparable to the current applications of the immersive technology.

The visual trickery of present-day VR, however, is far more profound than its predecessors, both in terms of the visual display as well as its potential for real-world impact. Death-related VR experiences can help prepare people for the inevitable but can also be used to train hospice nurses. Hope believes that bringing VR headsets into nursing school simulation labs, where trainees already work with dummies to stage scenarios, could provide crucial insight into hospice work from a patient’s perspective.

While hospice workers are trained to care for the dying, physicians are primed to prevent death. “In medicine we’re taught to keep that heart beating,” said Dr. Devi. “There’s an attitude of ‘let’s do whatever we can to keep this person’s heart beating, even if that doesn’t improve their quality of life.’ But why are we putting our elderly or very ill patients through these aggressive ways when the outcome is not going to be a good-quality life?”

When We Die doesn’t address those questions directly. Instead, it gets at them with an acknowledgement of death as a potentially positive experience. There’s an inherent belief that dying is depressing. It continues to be a terrifying unknown because we lack experience in it. But as the VR experience reveals, the tragedy of death isn’t true for all.

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