Microsoft Word Elisabeth Kubler-Ross On Death And Dying doc

aware of the discrepancy or conflict between the patient and his environment, they could share their 
awareness with their patients' families and be of great assistance to them and to the patients. They 
should know that this type of depression is necessary and beneficial if the patient is to die in a stage 
of acceptance and peace. Only patients who have been able to work through their anguish and 
anxieties are able to achieve this stage. If this reassurance could be shared with their families, they 
too could be spared much unnecessary anguish. 
 
Our first interview with Mr. H. follows: 
 
PATIENT: Do I have to talk very loudly? 
 
DOCTOR: No, that's all right. If we can't hear you then we'll say so. You speak as loud as you can 
as long as you are comfortable. Mr. H. said if I keep him up psychologically he will be having a 
good conversation because he has been studying communication. 
 
PATIENT: The reason for that being that I am physically very dizzy and tired. 
 
DOCTOR: What did you mean by "psychologically keeping you up"? 
 
PATIENT: Well, it's possible to feel physically up to par even though you don't. Providing you 
have a kind of psychological lift. In a way you feel extra good, you know, like if you have good 
news or something like that, that's all I meant. 
 
DOCTOR: What you are really saying is to talk about good things and not about bad things. 
 
PATIENT: You say we are? 
 
DOCTOR: Is that what you are saying? 
 
PATIENT: Oh, no, not at all . . . 
 
CHAPLAIN: I think he was just saying he wants a little moral sup. 
 
port. 
 
DOCTOR: Yes. Well, naturally. 
 
PATIENT: What I mean is that if I sit here more than about five minutes I'm likely to collapse from 
sitting here because I'm so tired and I've been up so little. 
 
DOCTOR: Okay, so why don't we get right into the matter that we want to talk about. 
 
PATIENT: Fine. 
 
DOCTOR: We know practically nothing about you. What we are trying to learn from the patients is 
how can we talk to them as human beings without going through the whole chart and all that first. 

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So maybe, just to start, could you give us a very brief summary of how old you are, what your 
profession is, and how long you have been in the hospital. 
 
PATIENT: Been here about two weeks and, roughly, and I'm a chemical engineer, by trade. And I 
have a graduate degree in chemical engineering and in addition to that I took courses at the 
University in communications. 
 
DOCTOR: (Not clear) 
 
PATIENT: Well, not really, because at the time that I was doing this they had a communications 
course and by the time I finished with it they dropped it. 
 
DOCTOR: I see. 
 
CHAPLAIN: What prompted you to get interested in communications? As a chemical engineer, 
was this part of your job or your own interest? 
 
PATIENT: My own interest. 
 
DOCTOR: What brought you to the hospital this time? Is this the first time you have been in a 
hospital? 
 
PATIENT: First time I've been in this hospital. 
 
DOCTOR: What brought you here? 
 
PATIENT: Well, the fact that I needed more work on my cancer. I had had an operation in April 
 
DOCTOR: April of this year? 
 
PATIENT: -in a different hospital. 
 
(P80) 
 
DOCTOR: Of this year? And then you were diagnosed as having cancer? 
 
PATIENT: And then without any further diagnosis I requested admission to this hospital, and I got 
it. 
 
DOCTOR: I see. How did you take it, this news? Were you told in April that you had cancer? 
 
PATIENT: Yes. 
 
DOCTOR: How did you take that, how was it told to you? 
 
PATIENT: Well, naturally it was a blow. 
 

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DOCTOR: Um hm. But different people react very differently to blows. 
 
PATIENT: Yes, well, it was more of a blow than it might be because they gave me no hope. 
 
DOCTOR: Not a bit? 
 
PATIENT: Not a bit. The doctor himself said that his father had had a similar operation, in the 
same hospital, with the same surgeon, and that he failed to recover and died within about a year and 
a half at the same age. And that all I could do was just to wait for the bitter end. 
 
DOCTOR: That's pretty cruel. You know, one wonders if this doctor did that because it happened 
in his own family. 
 
PATIENT: Yes, the end result was cruel but the cause was the fact that he had actually had this 
experience. 
 
DOCTOR: Makes it excusable, you think. It makes it understandable. 
 
PATIENT: Yes. 
 
CHAPLAIN: How did you react when he did this, when he told you? 
 
PATIENT: Well naturally I felt quite low and stayed at home as he requested and rested up rather 
than doing too much. But I did do too much, I did also get around quite a bit, you know, visiting, 
this and that and the other thing. But after I got here and found out that there was some hope for my 
condition and that my condition wasn't hopeless, then I found out that I had done the wrong thing, 
that I had exercised too much, and that if I had only known it at that time I would be in top-notch 
shape right now. 
 
DOCTOR: It means you are blaming yourself now for doing almost too much. 
 
PATIENT: No, I'm not saying this, I didn't know. There's no blame one way or the other. I don't 
blame the doctor because of his own experience, and I don't blame myself because of the fact that I 
had no knowledge. 
 
DOCTOR: Yes. Before you went to that hospital, did you have any hunch? What kind of symptoms 
did you have? Did you have pain or did you have the feeling that there was something seriously 
wrong? 
 
PATIENT: Well, I had been getting lower and lower, but one day I had this very bad condition of 
my bowels and I had a colostomy. That was the one operation I had. 
 
DOCTOR: Yes. What I'm really asking is how much preparation did you have for this blow. Did 
you somehow have a hunch? 
 
PATIENT: None at all. 
 

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