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Elisabeth Kübler-Ross's book, 'On Death and Dying', is one of the classic works in the field, still used to educate and inform medical, counseling, and pastoral professionals since its original publication in the 1960s. Kübler-Ross did extensive research in the field by actually talking to those in the process of dying, something that had hitherto been considered taboo and an unthinkable, uncaring thing to do. Kübler-Ross asked for volunteers, and never pressured people to do or say anything they didn't want to. One of her unexpected discoveries was that the medical professionals were more reluctant to participate than were the patients, who quite often felt gratitude and relief at being able to be heard.
Kübler-Ross also spoke to families, and followed people through their ailments, sometimes to recovery, but most often to their death. She let the people guide her in her research: 'We do not always state explicitly [to the patient] that the patient is actually terminally ill. We attempt to elicit the patients' needs first, try to become aware of their strengths and weaknesses, and look for overt or hidden communications to determine how much a patient wants to face reality at a given moment.'
This caring approach was often an aggravation for Kübler-Ross and her staff, because they would know what the patient had been told but was not yet ready to face. Kübler-Ross recounts stories of attempts to deal with death in different ways; denial, anger, bargaining, depression, acceptance -- in fact, the various stages of grief were first recognised in Kübler-Ross's research.
There are those who dislike the `stages' theory of grief, but it is important to know (as the quote above indicates) that these are not set-in-stone processes, but rather dialectical and perichoretic in nature, ebbing and flowing like the tide, so that where a person was `stage-wise' would vary from meeting to meeting.
Kübler-Ross explained her interest in this research by saying that `if a whole nation, a whole society suffers from such a fear and denial of death, it has to use defenses which can only be destructive.' Her work is primarily geared to health-care providers, and provides verbatim transcripts of conversations with a wide range of people in different classes, races, family situations, education levels, and ages. The reader can then get a sense of how to better communicate with someone in a terminal situation.
'Early in my work with dying patients I observed the desperate need of the hospital staff to deny the existence of terminally ill patients on their ward. In another hospital I once spent hours looking for a patient capable to be interviewed, only to be told that there was no one fatally ill and able to talk. On my walk through the ward I saw an old man reading a paper with the headline "Old Soldiers Never Die". He looked seriously ill and I asked him if it did not scare him to `read about that'. He looked at me with anger and disgust, telling me that I must be one of those physicians who can only care for a patient as long as he is well but when it comes to dying, then we all shy away from them. This was my man! I told him about my seminar on death and dying and my wish to interview someone in front the students in order to teach them not to shy away from these patients. He happily agreed to come, and gave us one of the most unforgettable interviews I have ever attended.'
She concludes with a chapter explaining the reactions of doctors, nurses, counsellors and chaplains, professionals who deal with the dying every day, on how the kinds of listening and care she outlines can change their work and lives as well. It is remarkable to see some of the transformations which take place among these people.
I have used the advice and insight given by this book in my own ministry, and heartily recommend it to everyone, regardless of medical or ministerial intent, for it can give guidance on how to deal with the deaths of friends or family members and, ultimately, our own death.
Death will never be a happy subject, but it needn't be a dark mystery devoid of meaning and guidance.
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on November 2, 2000
Loved the book. I think there are only two types of people who need not bother with this book: a) those who are not mortal, and b) those who can't read. All the rest of us should look into it. Rather than duplicate the excellent book description and synopsis above, I will try something else to let you know if this book will interest you at all. Early on in the first chapter, the author makes three statements, and I quote:
1) "In simple terms, in our unconscious mind we can only be killed; it is inconceivable to die of a natural cause or of old age."
2) "The more we are making advancements in science, the more we seem to fear and deny the reality of death."
3) "When a patient is severely ill, he is often treated like a person with no right to an opinion."
If those type of blanket statements provoke your interest, or make you want to hear more, then this book is for you, because the author never leaves them in blanket form. The book is an enfleshment of those ideas. The author states her objective very clearly midway through the book by saying "If this book serves no other purpose but to sensitize family members of terminally ill patients and hospital personnel to the implicit communications of dying patients, then it has fulfilled its task."
The book is clearly written, no technical jargon to trip over. I found the whole genesis and history of Kubler Ross's interdisciplinary seminar on death and dying fascinating. The actual patient interviews revealed that (more often than not) the people most willing to TALK about dying are... the dying. I found these interviews for the most part very ennobling. They exalted the human spirit and showed the importance of faith and hope.
Above all, the book will make you "think". I've finished reading it, but I certainly haven't finished thinking about it. And that is always my criteria for the fifth star!
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on August 17, 1999
A brilliant book by E. Rubler-Ross who has dedicated her life to researching the needs of terminally ill patients & their families. This is essential reading for everyone, whether you have had to face death (either your own or a loved one) or not. It is common for Westerners to deny death by not discussing it, or even thinking about it. This book illustrates the many problems that can arise from this attitude & the heartache it can cause the terminally ill & their families. Thanks to E. Kubler-Ross for an amazing lifetime achievement.
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on October 16, 2001
"On Death and Dying" is an excellent resource book for someone who has or is about to lose someone close to them. As a counsellor I have counselled many individuals through grief and while each family/individual is unique, the patterns are generally the same. The book deals with the five stages that accompany grief: 1)Denial and isolation, that is shutting yourself off from family and friends, social or work related activities and refusing to accept the reality of what has happened. 2)Anger, "the why did this have to happen to me" stage and the need to blame. 3)Bargaining, for example, if I could just have this person back, I would not do this, or I would do that. 5)Depression, the feeling there is no reason to go on and a sense of being constantly overwhelmed, often feeling loss of control over their life. 5)Acceptance, of the way things really are and choosing to live the best possible life you can, anyway.
While these stages can be applied to death under any circumstance, I found the book primarily revolved around the terminally ill as opposed to someone who has died suddenly without prior warning. However, it is important to remember that even though death may not be anticipated at a particular moment in time, most of us go through the same stages of grief regardless of whether or not the death is anticipated or unanticipated. The book will NOT lessen the grief, but the words found here may help readers to understand the grieving process and that grieving is a natural life process, even though it feels very un-natural, confusing and totally devastating at the time.
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on May 2, 1997
When my mother was dying, I was confronted with a *lot* of issues to which I had never given much thought, having never been in that kind of position before. So, even the attitudes and beliefs about death I had carried for some time were brought into question, and I really needed some kind of simple guidance into how to approach all the very painful and confusing issues, both externally and internally. After I read this book, I was very much more confident about my own reactions, and had a lot more insight into how to handle the various communication and interpersonal difficulties inherent in this very stressful time.
It's a simple book, easy to understand, and addresses all of the most important issues in a kind but factual manner.
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on March 10, 2010
I was looking for how to deal with my own feelings after being 24 and watching my mother die of lung cancer. This book helps you understand how the dying deal with death. It is interesting....I found out what kind of dying person my mother was (but she had already passed). I dealt with her dying how I knew how to and not how she wanted to deal with it. So I would suggest you read this before they die so you know how to console them. It doesn't really help you for after they pass because then they aren't there for you to help them.
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on March 16, 2000
I read this book 10 years ago when I was coping with my father's suicide. The author does an excellent job of framing the stages -- something I used daily to help myself understand and track my own progress through my grief. Though I read many books during that time, this is the only one I remember.
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on August 30, 2001
I knew my Mother was going to die from her cancer, and I needed help understanding what was going to happen. This book is a classic for good reason. It talks about stages of grief, giving examples by talking with actual dying patients, of each of the stages. It helped me to deal gracefully with what I saw my Mom going through, and to be able to be understanding and supportive instead of feeling lost and afraid. I recommend this book highly.
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on August 12, 2005
For most of us, the area of thanatology is something quite new, despite the fact that death is such an intimate "companion" that can come at any moment of our lives, whether by degrees or instantaneously, irrelevant of our ethnic, social and economic backgrounds. It is a plain truth that can not be avoided, and no technological advancements can make it go away. I would personally like to consider death as the ultimate best friend who would never desert you, despite what your feelings may be. And as a child has the innocent ablity to humanize a doll or a toy soldier, the adult must equally do so with death, not shy away from it and be totally uncommunicative to what it means: the total cessation of physical life, for if one denys its existence and its inevitability, the person could not only suffer from added unnecessary physical heartache, but he or she could also augment the physical stress with mental, spiritual and religious grief as well. Submission to and acceptance of the truth, no matter how difficult it would be to hear, could be the highest catharsis that medicine could not come close to healing. In Elizabeth Kubler-Ross's classic study of the dying process, she interviews patients of various age brackets who teach the living what dying means to them. But even though the experience is individualistic to that specific person, the process of dying has a universality to it which connects us all. Hence, how do you take the sting from the wound? In On Death and Dying, you remove the sting by communication and by simply being there to let the patient say what he or she has to say, to let them vent, and at their own pace, go through the classic defined stages of the dying process: denial and isolation, anger, bargaining, depression and acceptance. The patients become our teachers. We learn of their fears, their possible financial burdens, in one woman's case, the fear of the worms, et cetera. But we also learn about what the families go through, their own anger and disbelief and guilt. It is about pacing and the opening up of repressed fear for all the people involved. Sometimes there is cohesion in the shock and anger, other times not. The United States is one of the most death-denying countries out there, a fact most evident with plastic surgery on the rise and chiseled bodies to reverse the aging process, for going foward means only one thing: death. Ross's overall message is that death does not have to be and is not the horror that we all think it is, the grim reaper with the skeletal hand and the sharpened scythe. Death has issues for everybody, doctors, faith-filled people, even Ross heself. It is a step that we are all going to take sooner or later. But it is comforting to know that we are all in it together.
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on April 21, 2006
This book is one of the first great books that Dr. Kubler-Ross has gifted us with. Her insight and compassion are unremarkable. I am sad she won't be writing any more books though. Her latest book, "On Grief and Grieving" is a wonderful book also. There are some case studies to go by and it truly touches your soul.
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