Yes to both. Epiphanies (flashes of understanding) are integral to spiritual growth and synonymous with spiritual perfection. Meaning, that cause and effect are never separated. Our experience of reality mirrors our sins – which are mostly unconscious beliefs in some unfixable, unforgiveable past error. Guilt and or shame then permanently glues the recurring pattern of experience to us. Until the truth (real facts) sets us free, spiritual growth/transcendence is not possible.
But, for some fragile souls, the learned egoic self – our survival thought system – can be overwhelmed. Death and illness is the result of our psychological “defensive” system being swamped with no ability to look at the truth in the light of reason. Death and illness become the only escape hatch or ejection system from reality when the truth triggers existentlal unexamined fears. I have observed this directly.