How Virtual Reality Can Take You "Over the Rainbow"

This week we explore Virtual Reality (VR) and how VR can be incorporated into palliative care with studies documenting people reporting effectiveness in pain and symptom management and its psychological impact. VR can provide people with meaningful and uplifting experiences, thereby enhancing their emotional well-being, improving emotional state by fostering social connections and boosting self-esteem.

VR can transform the experiences of people at the end-of-life, providing them with comfort, support, and meaningful engagement during their final stages. The immersive and interactive nature of VR allows people to experience moments of joy, relief, and connection, which are crucial for emotional well-being. https://bit.ly/4czbiU6

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In this Episode:
03:54 - 7 Ways to Die in Future: The Simulation is Unplugged
05:57 - Recipe of the Week: Honeybun Cake
07:31 - Virtual Reality Takes You Over the Rainbow
21:28 - Over the Rainbow Lyrics
23:09 - Outro

Chapters

• 0:00 Intro
• 3:54 7 Ways to Die in Future: The Simulation is Unplugged
• 5:57 Recipe of the Week: Honeybun Cake
• 7:31 Virtual Reality Takes You Over the Rainbow
• 21:28 Over the Rainbow Lyrics
• 23:09 Outro

Transcript

How-Virtual-Reality-Can-Take-You-Over-the-Rainbow

Hello and welcome to Everyone Dies, the podcast where we talk about serious illness, dying, death, and bereavement. I'm Marian Matzo, a nurse practitioner, and I used my experience from working as a nurse for 46 years to help answer your questions about what happens at the end of life. And I'm Charlie Navarette, an actor in New York City, and here to offer an every-person viewpoint to our podcast.

We are both here because we believe that the more you know, the better prepared you are to make difficult decisions in a crisis. Welcome to this week's show. Please relax, get yourself some sweet tea, lots of ice, a little lemon, and a cupcake, and thank you for spending the next hour with Charlie and me as we continue our series about the digital world and death, with our fourth installment about virtual reality and the end of life.

Like the BBC, we see our shows offering entertainment, enlightenment, and education, and divide that into three halves to address each of these goals. Our main topic is in the second half, so feel free to fast forward to that ragtime-free zone. In the first half, Charlie continues his series on ways to die in the future and has our recipe of the week.

In the second half, I'm going to talk about how virtual reality can be used for people at the end of life. And in our third half, Charlie shares with us the poetry and the lyrics of Somewhere Over the Rainbow. So, Charles, how was the UP? It was up there.

Oh dear. Listen, it's absolutely spectacular. I highly recommend it.

We're talking about the Upper Peninsula. Gosh, I was about to say New York. Let's try this again.

It is the Upper Peninsula of the state of Michigan. Absolutely wonderful. So natural, so many trees and winding roads through forests, lots of waterfalls, vistas.

Man, you couldn't make something like that. Just unending views, rolling hills, just spectacular. So are you a wanna-pee-ooper now? No, but I will definitely go back many times.

My cousins have been going, have been visiting every year. Sometime in the 80s. Just spectacular.

I can't recommend it enough. Well, there you have it. The New Yorker is a wanna-pee-ooper.

A wanna-pee-ooper. I'll just go and enjoy it. What's going on there in Oakey? It's hot.

Oh, I'm surprised you hear that. Yeah, I know. It's hotter in Hades.

But then again, so am I. Yes, you are. Yes, you are. Folks, in our first half, the publication Futurism published an article titled, Seven Ways to Die in the Future.

In upcoming episodes, I am going to report their predictions. This week's predicted cause of death is ceasing to exist when someone unplugs the simulation. In 2003, Nick Bostrom published, Are You Living in a Computer Simulation? A paper that asserts we're likely living in a simulated reality.

His theory is partially based on the assumption that, in the future, we will have enormous amounts of computing power that enable incredibly advanced simulations. Assuming this is true, later generations might use these computers to run tons of powerful and detailed simulations of their ancestors. In the nesting doll of universes that would lead to, it'd be far more likely that we're living in one of those fake realities than that we're living in a top-level reality.

Some tech billionaires are even reportedly paying scientists to try to break us free of the simulation on the off-chance that we are already in it. Is breaking out a good idea? Bostrom doesn't think so. It's kind of unwise to try to break out of the hypothetical simulation, he told Vulture.

The chances of success are negligible. If it doesn't work, it's a waste of money, and if it does, it might be a calamity. If the theory is true, nobody knows what motivates those who control the simulation.

Perhaps they'll get bored the same way we do when playing The Sims and decide to start a new game, resulting in the end for us. Or maybe some overworked IT drone will trip over the server's power cord. In that case, everything could go dark while you're sitting on your hover couch watching the 2100 Olympics and eating a bowl of cereal intravenously.

No quick save. Good night. The end.

But wait, there's more. How about some honey bun cake to take to your next funeral lunch? Honey bun cake is inspired by classic honey buns, fried confections that were a beloved part of countless childhoods. Made up of a sweet, honey-infused dough with a swirl of cinnamon, honey buns are fried and glazed with a white, sugary icing.

They're standard convenience store and vending machine fare and are typically individually wrapped and served at room temperature or warm for breakfast or a midday treat. This honey bun cake calls in that classic honey bun flavor with a dense, rich yellow cake, a swirl of cinnamon sugar filling and a sweet, white icing. Bon Appetit! Sounds good.

Yes it does. Please go to our webpage for this week's recipe of honey bun cake and additional resources for this program. Everyone Dies is offered at no cost but is not free to produce.

Please contribute what you can. Your tax-deductible gift will go directly to supporting our non-profit journalism so that we can remain accessible to everyone. You can also donate at www.everyonedies.org. That's every, the number one dies.org or at our site on Patreon, www.patreon.com and search for Everyone Dies.

Marianne? Thanks Charlie. Today I'm going to talk with you about virtual reality or VR and how VR can be incorporated into palliative care. But first, let's talk about what VR is.

Virtual reality is a technology that creates a simulated environment, allowing users to interact with a three-dimensional world that feels real. Here's how it works. First, you put on a head-mounted display.

The core of VR is the headset, which includes screens placed close to your eyes. These screens display images that create a 3D effect through stereoscopic lenses. The headset has motion tracks, which are sensors to track your head movements and adjust the display accordingly, so the virtual environment will move with you.

There are controllers, which are handheld devices that track your hand movements, allowing you to interact with the virtual world. Some advanced systems even track finger and body movements. The audio system enhances the immersive experience by providing sound from different directions, making the virtual world feel even more real.

The entire system creates an immersive simulated environment so that you feel like you're in the world the system is creating. It allows the user to engage in a virtual environment, creating an illusion that the environment exists. It's like Dorothy going to Oz.

She thought she was there battling the Wicked Witch of the West and palliating the squeaks of the Tin Man with oil, but she wasn't really there. Was she? VR can be used for a range of purposes, including entertainment and education. More recently, VR in healthcare has become popular for everything from therapy for phobias or post-traumatic stress disorders, PTSD, to healthcare practitioner training.

VR allows people receiving palliative care to explore different environments and scenery based on individual preferences, providing an alternative setting from their routine environment and allowing them to engage in sights and sounds that provide distraction from their illness and help occupy the brain in a positive way. Using VR in palliative care offers a range of physiological and psychological benefits, according to experts and the available research. According to a 2022 meta-analysis in palliative medicine, some of these benefits may include improved pain management, reduced anxiety and depression symptoms, improved comfort, improved mood, decreased feelings of loneliness and isolation, and improvement in symptoms of shortness of breath.

For older adults in general, VR can offer meaningful activities which are essential for the well-being of people with serious illness. However, many don't have the financial resources, health, energy, or family support to engage in their interests and events. VR can overcome these barriers and help older adults engage virtually in activities they find meaningful.

Experts have found that improved anxiety, depression, and mental health disorders occur in older participants using VR. Virtual reality has the potential to create moments of joy and pleasure. People with only months to live could virtually travel to places on their bucket list, feeling almost as if they were there.

They could also visit places that hold sweet old memories. Martin and colleagues documented that they found that reminiscing by visiting memorable places was more positive for people receiving palliative care than visiting new or desired sites. See, Charlie, I could see you using VR to go back to the UP at some point if you're not able to physically get there.

Maloney and colleagues conducted a review of the literature to document how VR was used in palliative care, and we have podcasts that review what palliative care is if you want that review. But briefly, palliative care focuses on relieving and managing symptoms associated with serious illness and improving a patient's quality of life. It's often used alongside other medical and non-pharmacologic treatments that can be provided at any stage of an illness.

They document that in palliative care, VR offers a meditative, relaxing experience, while others offered exciting experiences or travel. Meditative and relaxing VR experiences involved either photorealistic still images or animated videos, some with or without music, and some offered guided meditation. Visually, options included nature scenes such as beaches, forests, waterfalls, parks, city landscapes, and mountain landscapes.

In other cases, people had the option of an exciting experience with choices involving simulations of rollercoaster rides, rocket launches, and space travel. The purpose of using VR was to look at the effect of people's reported outcome indicators, which included quality of life assessments, physical and psychological symptoms, functional assessments, physiological signals, spiritual well-being, and behavioral changes. Many of these studies had a small number of people in them, so it would be hard to document statistically significant changes in people's outcome.

In relation to physical and psychological symptoms, people reported perceived improvements in their symptoms related to underlying health conditions. For example, improvements in pain, tiredness, body relaxation, breathing, depression, and anxiety. In addition, an increased sense of well-being and happiness was reported, as well as positive feelings of relief from the burden of being in a hospital.

Although there were few reported negative responses to VR, the possibility of physical risks such as infection or emotion sickness and unexpected emotions from immersion in a virtual world are possible. Other studies have written that the headset was heavy, causing discomfort or sore shoulders. A few people reported difficulty adjusting straps, focusing on the image, or claustrophobia.

Additionally, one study of VR used with dementia patients noted that one of their 25 participants experienced increased crying, while another hallucinated. The other 23 participants tolerated it well. Virtual reality use in the public can cause nausea, headaches, dizziness, lightheadedness, confusion, and cyber sickness, a type of motion sickness.

Now, most people want to die at home, but for a variety of reasons may die in hospitals or nursing homes. Virtual reality could allow conscious patients to choose their ideal location to feel like they are dying at home or some other idyllic place. VR was used with a grieving mother to meet a virtual recreation of her deceased daughter.

A South Korean documentary called Meeting You shows a mother named Jang Ji-Jeong, who was able to interact with a virtual version of her daughter, Nayeon, who had died at the age of seven from cancer. The VR experience was created using a combination of her daughter's photos, videos, and voice recordings, allowing Jang Ji-Jeong to see, talk to, and even celebrate her daughter's birthday in a virtual park setting, and this simulation took a year to create. Film scholar Tom Dunning wrote that in the 19th century, inventions such as the photograph and motion picture were all greeted as technological responses to the ultimate limit of human life, mortality.

They claimed to preserve human traits like expression, movement, and voice after the subject had died and were promoted as an objective form of memory and man's triumph over death, which is where VR is going. The reality in that Meeting You produces an avatar of a real person, that of a deceased child. This is a technological resurrection as a response to human mortality.

This kind of technology is still in its early stages and can evoke a range of emotions from comfort to discomfort depending on the individual's perspective. I found it unsettling and tried to imagine myself as a mother in Jang Ji-Jeong's shoes. I couldn't do it.

Violet Kim writes in her exploration of this film that Meeting You does present a compelling case for VR as a creative medium such as writing or painting for processing death rather than a creepy technophilic panacea that denies death with interpretive complications that a creative medium entails. I just found it to be painful and a trip over the rainbow that I would not wish to take. Charlie, thoughts? Yes.

Yes. I mean, to me, Marianne, it's something similar what we've covered before about music, how music just stimulates people. Either you're very conscious or you're dying and that just seems to soothe a lot of people having a playlist.

It also reminded me of a movie not too long ago called Marjorie Prime, which basically is a service that provides a hologram of a deceased loved one and you can interact with that person. As you were saying, you know, all the materials loaded up and you can interact with the person. And in this particular one, this elderly woman played by the actress Lois Smith is interacting with a younger version of her husband played by John Hamm.

And it's at times there's some comfort to it, but it gives her a chance like a closure by basically pointing out to him to him how much of a piece of shit he was. Yeah, but there you go. So, yeah, but that, yeah, if it, you know, it's the end of life, you should have some comfort.

So good. Well, this film, I put a link in for like maybe a 10 minute clip from it. The film itself is in Korean, but even watching it in Korean, you get the gist of what's going on.

And it's painful to watch this mother interact with her child that's now dead. And they created the child as a seven year old, even though she would be a few years older than that now. And I don't know.

I don't know that I would find it comforting. Do you think you would? No, no, no. And I'm hesitating.

I'm trying to think of everyone who just died. No, not me. You know what? Maybe my mother may only, only because she finally started to have some peace toward the end of her life.

And I'd like to know if with her, if she's happy now that, but I can't, I can't think of anyone else now. But I mean, if you think about it, you're not, you're not interacting with her. You know what? You're right.

Sorry. You're right. You're right.

Happy or not. You know, you're interacting with whatever data there was before she died. Unless you had the programmers program her to say, I'm happy now, but then that wouldn't be real.

Nope. It would not. Yeah.

Okay. So in that case, nope. There we go.

Well, see, I do have some influence over you. Yes, you do. Okay.

In our third half, Over the Rainbow, also known as Somewhere Over the Rainbow, is a ballad by Harold Arlen with lyrics by Yip Harburg. It was written for the 1939 film, The Wizard of Oz, in which it was sung by actress Judy Garland in her starring role as Dorothy Gale. It won the Academy Award for Best Original Song and became Garland's signature song.

Somewhere over the rainbow, way up high, there's a land that I heard of once in a lullaby. Somewhere over the rainbow, skies are blue, and the dreams that you dare to dream really do come true. Someday, I'll wish upon a star and wake up where the clouds are far behind me, where troubles melt like lemon drops above the chimney tops.

That's where you'll find me. Somewhere over the rainbow, bluebirds fly. Birds fly over the rainbow, why then, why can't I? If happy little bluebirds fly beyond the rainbow, why, oh, why can't I? And that's it for this week's episode.

Stay tuned for the continuing saga of Everyone Dies, and thank you for listening. This is Charlie Navarette, and from computer scientist Jeffrey Hinton, regarding whether artificial intelligence poses an existential threat, I was born just after the Second World War. I was a teenager before there was AIDS, and now I'm going to die before the end.

And I'm Marianne Matzo, and we'll see you next week, or somewhere over the rainbow, whichever comes first. Remember, every day is a gift. This podcast does not provide medical advice.

All discussion on this podcast, such as treatments, dosages, outcomes, charts, patient profiles, advice, messages, and any other discussion are for informational purposes only, and are not a substitute for professional medical advice or treatment. Always seek the advice of your primary care practitioner or other qualified health providers with any questions that you may have regarding your health. Never disregard professional medical advice or delay in seeking it because of something you have heard from this podcast.

If you think you may have a medical emergency, call your doctor or 911 immediately. Everyone Dies does not recommend or endorse any specific tests, practitioners, products, procedures, opinions, or other information that may be mentioned in this podcast. Reliance on any information provided in this podcast by persons appearing on this podcast at the invitation of Everyone Dies or by other members is solely at your own risk.