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An old woman holding a cane.

Death is the last great mystery that all of us face. We don’t know when we will go or can really be sure what comes next. So there’s understandably a lot of fear and uncertainty that most of us feel around death, whether we’re thinking about ourselves or a loved one.

That’s why Julie McFadden's work is so important. As a palliative care nurse in the Los Angeles area, who has seen over a hundred people die, her TikTok videos shed light on the process to make us all a bit more comfortable with the inevitable.

McFadden is also the author of the bestseller, “Nothing to Fear.”

The nurse’s experience helping people in their final stages has given her a unique perspective on the process. In a recent video, she shared how she can see the first symptoms that someone is going to die a natural death about 6 months before they finally do.


Interestingly, she can determine that someone only has half a year left to live when most of us have no idea they have entered the final stages of life.

@hospicenursejulie

Replying to @Mariah educating yourself about scary topics will help decrease fear. ✨Nothing to Fear ✨- my book- out june 11th #hospicenursejulie #hospicenurse #caregiversoftiktok #medicaltiktok #learnontiktok #nothingtofearbook

What are the symptoms of dying at the 6-month mark?

McFadden adds that people who are dying are usually placed in hospice care when the symptoms begin to appear around the 6-month mark.

"You will have very generalized symptoms. Those symptoms will usually be, one, you will be less social. So you'll be more introverted than extroverted," McFadden said. "Two, you will be sleeping a lot more. And three, you will be eating and drinking a lot less. Literally, everyone on hospice, I see this happen to."

heaven, clouds, ray of lightA Ray of light over a mountain. via PIxbay/Pexels



What are the symptoms of dying at the 3-month mark?

You are going to notice more debility,” McFadden continues. “They will be staying in their house most of the time. It's going to be difficult getting up and just going to the bathroom. Again, sleeping a lot more and eating and drinking a lot less.”

What are the symptoms of dying at the 1-month mark?

Something usually begins to happen in the final month of someone’s life. They start to believe they are in contact with others they have lost. It’s like they are there to make the dying person feel comfortable with their final transition.

"Usually around the one month mark is when people will start seeing 'the unseen', they have the visioning. They'll be seeing dead relatives, dead loved ones, dead pets, old friends who have died,” McFadden said. “Again, not everyone — but many, many people will start seeing these things at around one month."

heaven, death, trumpetAn angel with a trumpet.via PixaBay/Pexels

Angela Morrow, a registered nurse at Verywell Health, agrees that people in the final stage of life often hear from those who have passed before them. Morrow says we should refrain from correcting the patients when they share their stories of talking to people and pets who have died. "You might feel frustrated because you can't know for sure whether they're hallucinating, having a spiritual experience, or just getting confused. The uncertainty can be unsettling, but it's part of the process," Morrow writes.

At the end of the video, McFadden says that the most important factors palliative care nurses look at to determine the stage of death are eating, drinking and sleeping. “Most people, a few weeks out from death, will be sleeping more than they are awake. And they will be barely eating and barely drinking,” McFadden said.

i.giphy.com

In the end, hospice nurses “allow the body to be the guide” as they help their patients transition from life to death.

McFadden’s work has brought a lot of peace to her followers as they go through trying times. "My mom is in hospice right now and she’s currently, I think, hours or days from death. YourTikToks have helped me out tremendously," Deb wrote. "My grandma passed away in February, and she experienced all of this. this page brings me peace knowing everything she went through was natural," Jaida added.

"Thanks, Julie. I volunteer in a hospice end-of-life facility, and this helps educate the families. Your posts are wonderful," Grandma Nita wrote.

One of the things that makes death so scary is the number of unknowns surrounding the process. That’s why it’s so important that McFadden shares her stories of helping people to the next side. She shows that death is a natural process and that hospice nurses are here to help make the transition as peaceful as possible.

LQBTQIA+

Trans comedian shares her transition journey on TikTok in an uplifting and funny way

"I am grateful for every single human being that's along with me."

Photo by Kyle on Unsplash

Transitioning is easier with humor and supporters.

Transitioning can be a scary and lonely process depending on the support system a person has available to them. In some ways it can be intimidating when the only examples someone has are people who are already fully transitioned, or have spent years living fully out as their gender discovered after birth. A comedian from Los Angeles, Dylan Mulvaney, found herself looking around for folks that were in the early stages of transitioning when she was starting her journey. She started recording videos for her own use, but quickly found herself with more than a million followers.

Mulvaney had discovered long ago that she was indeed a girl, and made the declaration to her mother at the age of 4, she told Good Morning America. "When I was 4 years old, I came to my mom and said, 'Mom I'm a girl trapped in a boy's body. Help!'” Mulvaney began her transition journey at the age of 25, stating that "ultimately, I had to do that to honor who I truly am. And now I've never been happier. And it feels so good to know that, like, all of the darkness throughout my life, all of the experiences that I've gone through ... the hard conversations have all been worth it."


Mulvaney has been sharing her journey with humor and while her videos were meant to be a sort of diary to mark how far she has come, she has been touched by the amount of support she has received. She gained her first million followers in just three weeks, and told GMA, "I didn't know I was this worthy of love or this worthy of attention, and there's something really affirming in the fact that, like, I now know that like I am a good person. I have good to put out in the world," Mulvaney said. "I am grateful for every single human being that's along with me."

@dylanjamesmulvaney

Day 11- Hormones 🏳️‍⚧️🌈❤️ #trans #hormones

Mulvaney shares her series titled “Day ___ of Girlhood” where she not only documents her transition, but points out things she had not considered before beginning to transition. In one of her videos she shares about how she froze when a woman in a public restroom stall asked to borrow a tampon. Before transitioning, she had not thought about being asked for a tampon, but since that interaction, she keeps them in her purse in case anyone should need one when she’s around.

@dylanjamesmulvaney

Day 12- TAMPONS #trans #tampon

Mulvaney says she’s received messages from people who have been encouraged by her journey and have decided to now come out to their families as trans. Parents of trans children have told her that they watch her videos with their children. "Anytime that a trans person reaches out and says that, like, I'm going through the same thing ... that is, like, such a gift," she says, "because I want to represent the trans community in the best light possible. The support from cis women has been insane and magical, because it feels like I really am part of something now and they've like accepted me into womanhood."


Mulvaney went on to share a message for people who are thinking about transitioning, "First of all, I'm proud of you," she said. "Second of all, take your time. This is not a race. It is probably one of the biggest decisions you'll ever have to make in your life and one of the craziest journeys that you'll go on. Start with people that you know, 100%, will support you and love you." Sharing her story can help others feel comfortable to share theirs. It can also help destigmatize what it means to be trans. While Mulvaney didn’t set out to be in the spotlight with her transition, she’s embracing her new found TikTok fame and showing people how to show up authentically as themselves, while being vulnerable and honest.

The summer before my junior year of high school, I came out as transgender.

I’d been raised a girl, but knew I was really a boy. What I didn’t know was that the person I’d always called "Dad" was about to transition too. The same year I came out as Alexander, Dad came out as "Mom."

Alexander Thixton, pre-transition, during his freshman year of high school. All photos via Alexander Thixton, used with permission.


I was driving my mom home, not yet knowing she was, in fact, a woman. I was talking for the millionth time about gender and gender dysphoria and about how shitty I felt training my friends to use my pronouns and name, teaching my school how to deal with transgender folks, etc. She nodded, offering advice on how to deal with the egregious misunderstandings of teachers and students at school. As she spoke, there was a small note of sadness in her cracking voice.

When we pulled into our driveway, I turned toward her. “I’m sorry if this is really inappropriate of me to ask, but have you ever … felt … this way? About gender?”

She looked me dead in the eyes. “I’m not gonna lie to you: I have.”

We sat there and talked for what felt like hours, still buckled in.

She told me about growing up, about when she was married to my biological mother and the strain being a trans woman put on her relationship with her unenthused heterosexual wife. She also recounted a familiar memory of mine from an angle I hadn’t considered — a time when she'd shaven her face clean. I was about 9 at the time and was used to her having a beard and, accordingly, made fun of her for not having one anymore. I told her she didn’t look right without it. She told me that was one of the moments that pushed her back into the closet. It was the closest she’d ever really come to trying to come out to me. I stared straight out of the windshield, seven years of guilt rushing up on me like a freight train.

I began to realize that, all these years, she’d been hiding who she was not only out of self-defense, but also because of how she was afraid I would react.

Thixton’s mother (right) at her wedding, pre-transition.

Finally, she asked me a question I’d been too afraid to broach myself: “Do you want to see pictures of me?”

The first photo was of her up close, wearing a sensible blouse and a huge smile. The second was of her in a sweater dress and short heels, once again grinning at whoever was operating the camera, a long auburn wig gracing her shoulders. I was transfixed.

As she continued swiping through photos I touched a hand to my face, in awe of how beautiful my mother was when she was able to freely express herself. Happiness was something I hadn’t seen on her face in years. I felt as if I was witnessing something secret and sacred.

I asked her if my stepmother knew. She told me that she had known from the beginning of their relationship, and that she had even helped her pick out her name: Autumn. Autumn. She said that with a warm, relaxed smile, as if she was getting to stand up and stretch muscles that had been tight for years. I asked her what she would like me to call her: Mom, Autumn, Autumn-mom?

She replied that she wasn’t sure she was actually going to transition.

Somewhere in my chest, my heart broke a bit. I understood why she might make this decision: an established, higher-level job in factory work; the idea that only young people can transition smoothly; the fact that transgender women are murdered at alarmingly high rates. I knew this was a decision that was hers to make. But no matter the reasons, it still hurt to know that the happy spark I’d been so proud to see was going to be buried yet again.

I brought my parents to my first session with my new gender therapist. Pressing my knees together tightly, I explained my situation, my childhood, how I felt about my body. As my therapist spoke, I began to see something emerge in my mother’s consciousness as she was briefed on the process of gender transition. I spotted longing in her hazel eyes.

Several months, a definitive decision to transition, and two prescriptions for hormones later, my mother and I stood together, engaged in one of our "gender rants."

“Did you know that estrogen makes you crave salt, like, constantly?”

“Nah, but I know testosterone has me eating way more than I used to. I took home an entire pizza from work yesterday just for myself — as a snack.”

My mom’s problems were very different from my own. Sure, there were some that were comparable — weird hormone side effects, switching names, drama in the trans community — but by the time I was legally changing my name, she was just starting to come out to people. While I was ranting about callous people at parties, she was struggling with the dangers of coming out at her new job, being scared to walk home alone at night while presenting as female, and being told to “keep her transition to herself.” Our lives were very different.

Eventually, my mom was ready to let people see her for who she was, consequences be damned.

As a teenager, I was exasperated at how long she was taking to transition. She was clearly miserable being anything other than who she really was; she was already starting to be read as female in public (she had been on hormones secretly for almost as long as I had been on them). Why not just get it over with?

What I didn’t realize then was that my smooth transition was built directly on the back of her rough one; she had suffered so that I wouldn’t have to. She’d been the one misgendered by the family, she’d been the one to make sure I would be safe, and she was the one who supported me when she felt she had little encouragement herself. She was the fierce support system for me that she never felt she had.

Thixton and his mother together.

This year, my partner and I went to my mother’s for Thanksgiving.

I’m now 20 and moved out. I have a decent beard and my chest is flat. My stepmother is pregnant, and my mother is happy. Watching her move about the kitchen with a glass of wine in hand, gender dysphoria was far from both our minds. Things had begun to fall into a sort of normalcy again — but this time, it was a normalcy we could both revel in.

This story was originally published on Narratively, a digital publication focused on ordinary people with extraordinary stories, and is reprinted here with permission. Visit Narratively for more stories about Game Changers, Super Subcultures, and Hidden History.