Zibby speaks to hospice nurse, passionate end-of-life care advocate, TikTok star, and New York Times bestselling author Hadley Vlahos about her extraordinary, heartrending memoir, The In-Between: Unforgettable Encounters During Life’s Final Moments. Hadley talks about her unexpected rise to fame on TikTok and her decision to put her experiences on paper. She also shares her views on death and some of her favorite hospice memories. Finally, she describes the trajectory of her own life, from unexpectedly having a child at 19 to now having her dream career, a beautiful family, and taking steps to open a nonprofit hospice house.

Transcript:

Zibby Owens: Welcome, Hadley. Thank you so much for coming on “Moms Don’t Have Time to Read Books.”

Hadley Vlahos: Thank you so much for having me.

Zibby: Your book has changed the way I think about life and death, as I’m sure it has for so many people. Why don’t you tell listeners a little bit about the book in general and why you decided to take your experiences as a hospice nurse and all these end-of-life moments that you got to experience — why turn them into a book? When did you even decide to do that? Let’s start there.

Hadley: Thank you. My book is twelve patient stories as my time as a hospice nurse that changed my life, changed how I viewed the afterlife, possibility of afterlife, and just really made me into the very happy, “excited to wake up every day” person that I am. I also share my own story going from a very young single mom with no plans and no direction to a very confident nurse that feels, like I said, excited to wake up every morning. That’s my book. About three years ago, I randomly went viral on TikTok just saying that I was a nurse. People started asking me what kind of nurse I was. I was very hesitant to share that because hospice is so taboo. I finally made a video and said, you know what, I’ve been a hospice nurse for many years now. I think I have really cool stories. Does anyone want to hear them? So many people said, yes, please. I had a loved one on hospice. I want to hear these, please. I feel like I don’t have anyone to talk to. I started sharing my stories. The first time that I was like, maybe I should write a book, was this direct message I got from someone who said that her husband was on hospice in the hospital, very quick thing. She felt very alone while the doctors and nurses rushed in and out trying to do everything they could. She sat there, and she said she watched all of my videos and felt prepared and like she could handle it. She said, “You were there with me,” almost like I am as a hospice nurse, “even though you don’t know me.” I was like, wow, that’s really powerful. My thought was, I can only do so much in a sixty-second video. For people like that or people who have lost a loved one, I would like to go a little bit in depth into these stories so people really, really get it. That’s how it all started, which I think is so cool.

Zibby: Oh, my gosh, that image of somebody sitting in a hospital and just watching your TikToks and feeling better, that’s amazing. Of course, the book too, but just the power of technology now to be in the —

Hadley: — Absolutely. You don’t think of it that way. I was just sharing stories. I had no idea social media could have that kind of impact.

Zibby: One of the things that has really stayed with me and that was so powerful was talking about how for everybody who dies, and how this is a standard thing that all the doctors told you, “Oh, yeah, no big deal,” was that your loved ones come back for you and that you see them before you die. It is not a hallucination. You were very careful to describe the differences. You share your own work even analyzing the medical files of the one patient who, when you first — Miss Ford or whatever her name was. I think Miss Ford. Anyway, that for all of us and for every single person regardless of religion or belief, you are visited by loved ones right at the end. Tell me about that.

Hadley: I think that’s one of the most amazing things. I never learned that in nursing school. It’s one of those things that once you get into the profession, everyone just says, yes, this is something that happens. Usually, what’ll happen is when I enter a home, the spouse or the caregiver will say, they’ve been talking to someone who’s been dead a long time. Are they okay? I’ll explain, yes, that happens. There’s always so much peace. They’re never scared. They have this sense of peace about them that I think is so beautiful. I’ll say, are you talking to them? They’ll talk to them just like there’s another person in the room that I just can’t see. They’ll talk to them, and then they’ll talk to me, which is why I call it the in-between. I feel like I’m with people when they’re between that world and ours, which is so cool.

Zibby: What do you take away from that? I know you said even in the afterword of the book how you are just convinced that there is something else there. You don’t know what, obviously, but you are completely convinced. What does this mean to you? How has it changed your own view of death?

Hadley: It means that it’s not a forever goodbye for me. It really has changed the way that I see death. Instead of seeing death as this final moment or this failure, it’s like a “see you later,” which is one of my favorite ways to put it. I love just saying that this is not the end. I really do believe that there is something after this world. It is because so many patients with so many different backgrounds all see the same thing. If it was all one religion, I would say, okay, that’s that religion. That’s what they believe. It’s atheists. It’s Christians. It’s any religion you can think of.

Zibby: What do we think is next?

Hadley: You know, I don’t know. That was something that I really had a hard time with. I discuss in the book where I was very black-and-white thinking. Either this is the answer, or there’s nothing. I have come to terms with the fact that it’s okay for me to not have all the answers and just say I am convinced that there is something next. One day, I’ll find out. We’ll all find out.

Zibby: If only we could share the information. You also talk about how at the end of the life, there’s something called an energy burst and how you saw this practice with the man that you visited who you talked about sports with for so long and who obviously —

Hadley: — Carl, yes.

Zibby: Carl, thank you. Sorry. Tell me about that and how you found him running around the house one time.

Hadley: That was crazy. He was in the bed — bedbound is what we call it — for about a year, just no energy to get up or do anything. I walked into his bedroom one day like I always do, and the bed was empty. At first, I thought, oh, my gosh, he’s died. No one told me. The funeral home’s already come and got him. Then a minute later, I have a flashlight in my face. I say in the book, it’s not the bright light that everyone talks about. No one sees that. It was a flashlight in his hand. He’s walking around and crouching down and looking under the bed playing hide and seek with one of his deceased loved ones. His wife is right behind him making sure if he fell, that she could catch him. I was like, “What is going on?” to her. She was like, “I thought that you were going to tell me what was going on.” I’m like, this is insane. People do, they get this surge of energy that’s just incredible. One of the reasons why I really thought it was important to include that in multiple different stories is that a lot of times, families will see this and think, my loved one is doing better. They’re going to recover. They’re going to do well. They’re going to come off hospice. They need to know that this is something that happens right before people die to savor that moment and to really say, okay, this might be what this is. Let me really stop everything else I’m doing and take this moment and really enjoy it.

Zibby: That story in particular brought tears to my eyes when you said he was playing hide and seek with his lost child. Oh, my gosh. The emotional moments that you witness and the gift of being part of these tender, poignant, amazing moments is so special. The fact that you get to share them with the rest of us so now all of us get these inside glimpse, it’s otherworldly. It’s amazing, so amazing.

Hadley: I agree. I love it. I love my job so much.

Zibby: You also share in the book about your experience having a baby at nineteen and having a total life-redirection moment and how that has affected your life and how you’ve since gone on to have two more kids and fall in love and all sorts of wonderful things. Take me back more to that time in your life and what it was like having a baby and even your pregnancy when you were at home again and all of that. Just take me back there.

Hadley: That was very, very, very difficult. That was the most difficult time period of my life, getting pregnant at nineteen and then, as I discuss in the book, deciding to keep my son. My world got very small. A lot of people did not want to be around that or be associated with that. All these people that were always so supportive of me all of a sudden just disappeared — it was really, really difficult — when I needed support the most. That was so difficult for me. I’m very glad that I made the decision to go into nursing school with the goal that it would, in a couple years, provide a very stable income for myself and my son. I feel like it was my calling. I feel like this was where I’m meant to be. I feel like I needed that redirection. That was such a difficult time in my life, but now I think that it was all worth it and put me where I’m supposed to be.

Zibby: Wow. How old are all the kids now?

Hadley: Brody, who I had when I was young, he’s ten. Then we have a three-year-old and a seven-month-old.

Zibby: Oh, my gosh, and you have a book coming out and your job. Tell me how you’re balancing life right now. What was the morning like for you?

Hadley: It’s chaotic. Thankfully, I have a very supportive partner. I always say that now. When I was a single mom, I didn’t. That was a lot more difficult. My husband right now, he probably does eighty percent of things right now while things are getting so crazy. I think that that makes a big difference. I think it’s important to acknowledge that whenever people are saying, how do you do it? I have a supportive partner, which helps. It can be a lot. I call my book my fourth baby. As you know, publishing can be kind of slow, so it’s not like I wrote this in a month. It’s been almost three years total. I work about two to three days a week right now.

Zibby: Has there been anything about the publishing journey and having the book actually come out and all of that that has been unexpected for you or particularly fun or particularly not fun?

Hadley: All of it’s been very crazy. I guess the craziest part for me is that you check your email, and you just never know what’s going to be in there. It’s so strange. You won’t hear from people for two to three days. Then one day, they’re like, you’re this pick for this list. You’re this and that. Congratulations. Here’s your preorders. Then it’s like, let’s get some champagne. Then the other day, it’s just nothing. It’s kind of strange.

Zibby: That’s amazing. I love it. Tell me where you want to take your whole thing. You have this coming out. Your whole career, your life, you’re in this really unique spot with your connections to the material of life and death and loss and all of that and now in publishing and TikTok and all of that. When you’re lying in bed at night, where do you fantasize about this all going, or have you just reached where it’s going?

Hadley: I’m actually already taking steps to open a nonprofit hospice house. I really see a big gap in care with hospice houses, which can provide care for up to five days for people who need a break without having to permanently move to a nursing home, so just if the caregivers need a break. Right now, at least in my area near New Orleans, we don’t have one that allows caregivers to stay. Unfortunately, when most people need the most help is near the end of life after they’ve been caring for them for a while and symptoms are getting a little bit harder to control. Many caregivers will not risk not being there when their loved one dies, so they will just completely be burned out. They will just refuse the hospice house care. I’m trying to open up a hospice house where not only are the caregivers welcome, but they’re taken care of as well. They’re given an actual break, food, a bed to sleep in, a break. I hope that I can open one here and then have them all across the US.

Zibby: That’s amazing. I love that. Are you taking donations for that? How are you raising the money and making that happen?

Hadley: Right now, I’ve applied for the 501(3)(c) through the government to become a nonprofit. Because it’s a medical facility, it is taking a little bit longer, which I understand. Then I can start raising money.

Zibby: Wow. Good for you. It’s really amazing. Have you read, by the way, Catherine Newman’s book that takes place in a hospice setting? It’s a memoir. We All Want Impossible Things. You have to read it. It’s so funny.

Hadley: I’m going to write it down. We All Want Impossible Things?

Zibby: Yeah, Catherine Newman.

Hadley: I’ve never even heard of it. I’m going to read it.

Zibby: Good. I’ll put you two in touch through your publisher. It all takes place at a hospice house when her is dying.

Hadley: I’m excited to read it.

Zibby: It’s really good. I recommend that. What was the effect of COVID on you as a nurse in this particular area? How did you navigate that? How do you see things now?

Hadley: It’s much better now. The most difficult thing starting out was that a lot of health care workers, especially our CNAs, left. We were very short-staffed. We’re really small. I only have three coworkers that are nurses. We had one that was pregnant. Totally understood. She went on leave. Now we have one less nurse, which is hard. Then at the same time, the hospital is constantly calling us and saying, hey, this person’s ready to go home on hospice. You knew that if you didn’t work overtime and take these patients, then they could potentially die without their family because the hospital wasn’t allowing visitors. That was the difference between someone dying without family or not. I burned out during COVID. It was very difficult to constantly feel like you can either go to a soccer game or this person’s going to die alone. It seems like an obvious choice, but whenever that’s happening seven days a week, that becomes extremely difficult. For a while, I thought that there was no end in sight. Thankfully, it is much, much, much better now.

Zibby: Oh, my gosh, all that stuff you’ve been through. You’re an angel.

Hadley: Thank you.

Zibby: Speaking of nurses, you write about, in the book, that there is this, perhaps not even unspoken, but unbeknownst to the laypeople, rivalry, if you will, or lack of care or competition — I don’t even know — from the older nurses to the younger nurses, almost like a hazing situation. Tell me about .

Hadley: They say nurses eat their young. That’s a pretty common phrase. I don’t really know why it happens. I was warned of it in nursing school. I saw it in nursing school. The older nurses, they — yeah, almost like a hazing, like you said. I do think it’s getting better because the ones that were hazed are not doing it. I’ve been a nurse for eight years now. All of us who were put through that are not doing it, so I do think it is getting better. That was very difficult. They’ll roll your eyes if you have to be with them for the day. They’ll say, I hate when they put these new nurses with me. They slow me down. It was rough.

Zibby: You think that’s so counterintuitive because nurses seem like caring people by trade.

Hadley: Absolutely. I see it sometimes. More so, there’s the nursing shortage. I’ll see my friends on TikTok sometimes, and they’ll be like, nursing’s the worst. Nursing’s horrible. Then they’re like, there’s such a bad nursing shortage. I’m like, well, you can probably talk about the positives. You’re not necessarily encouraging anyone to go join nursing.

Zibby: It needs some publicity rehabilitation here.

Hadley: Exactly.

Zibby: Do you find any time to read yourself? If so, what do you like to read?

Hadley: Yeah, between patients. I see rural patients right now, which I just love. They’re over an hour away from my house, so I can listen to audiobooks all the time. Right now, I’m listening to Yellowface. I love it so far. It is so good.

Zibby: I have to read that.

Hadley: You’ll love it. You will love it. It’s really, really good. Then occasionally, I’ll listen to nonfiction, just what I’m in the mood for.

Zibby: That’s my plan. I have that podcast coming up, but maybe I need to skip the line and start Yellowface early.

Hadley: It’s really good. It’s an unlikeable narrator. Usually, I don’t like those, but this one is really good.

Zibby: Interesting. What advice do you have for aspiring authors?

Hadley: Don’t give up. I always tell people I queried so many literary agents. I was rejected so many times. So many people said, I just don’t think people want to talk about death and dying. I started at the very beginning of COVID, querying. People were like, no, we’ve had too much of this. We don’t want to talk about this. No, thank you. Then finally, my agent Noah did accept it. Then it went to auction at the publishers. Just because someone’s telling you no does not affect the outcome of how well your book will do. That’s just one person’s opinion. I say that for reviews too. It’s just one person’s opinion.

Zibby: You are very inspiring and a role model in terms of so many things, of consideration and care and sensitivity, empathy. From reading your book and your steady disposition here, you’re just so giving. I’m so happy that the universe is giving back to you right now.

Hadley: Thank you so much.

Zibby: Best of luck. I will be following along and cheering for you.

Hadley: Thank you so much. I appreciate it.

Zibby: Thanks so much. Have a great day.

Hadley: Bye.

Zibby: Buh-bye.

THE IN-BETWEEN: Unforgettable Encounters During Life’s Final Moments by Hadley Vlahos

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