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Relating to the dying

Relating to the dying
Relating to the dying
Dr. Wayne Willis

Time Magazine, at the end of last millennium, declared her to be one of the 100 most important thinkers of the 20th century. All she did was revolutionize the way our society, especially physicians, see and relate to the dying.

One day, about this time of year, as Elizabeth Kubler Ross, psychiatrist at University of Colorado Medical School, was raking brown leaves, her mind turned to thoughts of death. Her annual flowers and vegetables would soon die in the first hard frost. Her father had died at home in the fall three years earlier. Her epiphany was that she needed to understand better dying people.

One day she introduced her medical school students to a 16-year-old girl dying of leukemia. The students questioned her about her diagnosis, progress of her disease, her labs and medical interventions performed. At one point, the girl left the class in tears. She later explained that only Dr. Kubler-Ross had asked her about her feelings, about how it felt to be 16 and dying, the proverbial elephant in the room.

Much of Kubler-Ross’ career was based at the University of Chicago School of Medicine in helping terminally ill patients die a “good death,” peacefully and with their dignity intact. She found five dynamics in most deaths: denial, anger, bargaining, depression and acceptance. She found that most dying patients, given the chance, want not a “conspiracy of silence,” but opportunity and invitation to talk about it with a compassionate listener.

Many physicians opposed her, thinking that talking about dying sounded ghoulish and would depress the patients or make them lose hope or become suicidal and die sooner. Kubler-Ross persisted, championing among other things the hospice movement and palliative (comfort) care units.

The pioneer persisted, liberating the discussion of dying and death from a dark closet.