Microsoft Word Elisabeth Kubler-Ross On Death And Dying doc

DOCTOR: You are angry at people, too. 
 
PATIENT: Yes, I am, but it even kind of made me angry for that person to say I'm an introvert 
when this person hasn't cared to discuss much that's off the beaten track. Isn't interested in news 
and isn't interested in what's happening that day. I mean you could never talk about the civil rights 
thing ... 
 
DOCTOR: Who are you talking about now? 
 
(P68) 
 
PATIENT: My own Sisters in the convent. 
 
DOCTOR: I see. All right, I would love to go on, but I think we should finish. Do you know how 
long we have had the discussions? 
 
PATIENT: No. I imagine an hour. 
 
 
DOCTOR: Over an hour. 
 
PATIENT: Yes, I suppose we have. I know counseling goes fast when you are absorbed. 
 
CHAPLAIN: I was just wondering though-wondering if there are any questions you want to ask us. 
 
PATIENT: Have I shocked you? 
 
DOCTOR: No. 
 
PATIENT: Because of my spontaneity, I might have destroyed the image of what 
 
DOCTOR: A nun is supposed to be like? 
 
PATIENT: Yes, ah 
 
CHAPLAIN: You've impressed me, I'll say that. 
 
PATIENT: But I would have hated to hurt someone because of my image, I know 
 
DOCTOR: No, you didn't. 
 
PATIENT: I mean, I don't want you to think less of the nuns or the doctors or anything, or the 
nurses 
 
DOCTOR: I don't think I will, okay? We like to see you being you. 
 
PATIENT: Sometimes I wonder if I'm hard for them. 

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DOCTOR: I'm sure you are at times. 
 
PATIENT: I mean, being a nurse and a Sister I wonder if I'm hard for them to deal with. 
 
DOCTOR: I'm delighted to see that you don't wear a mask of a Sister. That you remain you. 
 
PATIENT: But this is another thing I tell you, this is another problem with me. At home I could 
never leave my room without my habit. Here I would find it a barrier and yet this-there's situations 
where I will leave my room with a dressing gown, which shocked some of the Sisters so much at 
home. They tried to remove me from this hospital. They thought that I was not behaving myself 
and that I would allow people to come in my room whenever they wanted. This was all kind of 
shocking to tbem. They would not think of giving me the same thing in my need-coming to visit me 
more often. And that they visit me more often when I'm here than when I'm in the infirmary. I 
could lie there, I did lie there for two months and very few of the Sisters ever came in to see me. 
But this I understand because they are working in the hospital set-up and in their free time they are 
getting away from it. But somehow I must convey to others that I don't need them. And even if I, 
you know, ask them to come again, yet they just don't seem to believe it. They believe I have a 
strength or something, that I do better on my own, they're not important. And yet I can't beg them 
for it. 
 
CHAPLAIN: It destroys the meaning of it. 
 
PATIENT: It isn't right. I can't beg somebody for something that I need. 
 
CHAPLAIN: I think this-you've communicated this very well to us. Very meaningfully. The 
importance of one's dignity of the patient. Not having to beg or not being overwhelmed and 
manipulated. 
 
DOCTOR: But I think, if I may end this with maybe a bit of advice. I don't even like the word. I 
think sometimes when we are in pain and agony and we look as well as you do, it is very hard 
perhaps for the nurse to know when you want her or when you don't want her. And I think 
sometimes to ask takes perhaps more and is not the same as begging. You know? It is perhaps 
harder to do. 
 
PATIENT: My back is aching very much now. I will go back to that desk as I pass and ask for a 
pain pill. I couldn't tell when I need it but my asking for a pain pill should be enough, shouldn't it? 
That I have pain whether I look well or not, I have. The doctors have said that I should try and be 
comfortable, meaning to have the day without pain because when I go back to work I'm going to 
have to sweat through some classes whether I am in pain or not. Which is good, but I appreciate 
their understanding that you do need once in a while to be free of pain, just for somebody to relax. 
 
This interview shows clearly the need that this patient had. She was full of anger and resentment, 
which seemed to originate in her early childhood. She was one of ten children and felt as an 
outsider within the family. While the other siblings enjoyed sitting home doing embroidery and 
pleasing mother, she appears to have been more like her father, reaching out, wishing to go places. 
This was equated as not pleasing Mama. She appeared to have compromised her needs to be 

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different from her siblings, to have her own identity, and to be the good girl that Mama wanted by 
becoming a nun. It was only in her late thirties when she became ill and more demanding that it 
became increasingly more difficult to remain "the good girl." Part of her-resentment of the nuns 
was a repetition of her resentment of her mother and siblings, their lack of acceptance of her, a 
repetition of her earlier feelings of rejection. Rather than understanding the origin of her anger and 
resentment, people in the environment reacted to it personally and began to reject her even more in 
reality. She was able to compensate for this increasing isolation only by visiting other sick people 
and making demands for them-thus gratifying their needs (which were really her own) and at the 
same time expressing her dissatisfaction and blame for the lack of care. It was this hostile demand 
which alienated the nursing staff, understandably, and which gave her a more acceptable 
rationalization for her own hostility. 
 
In the interview, several needs were met. She was allowed to be herself, hostile and demanding 
without judgment and personal feelings about it. She was understood rather than judged. She was 
also allowed to ventilate some of her rage. Once she was able to relieve this burden, she was able to 
show another side of her, namely one of a warm woman, capable of love, insight, and affection. 
She obviously loved this Jewish man and gave him credit for finding the real meaning of her 
religion. He opened a door for many hours of introspection and finally made it possible for her to 
find an intrinsic rather than an extrinsic belief in God. 
 
Toward the end of the interview she asked to have more opportunity to speak up like this. She 
paraphrased this, again angrily, in form of asking for a pain pill. We continued our visits and were 
surprised to hear that she had stopped visiting other dying patients and was more amenable to the 
staff. As she became less irritable to the nurses, they visited her more often and finally asked for a 
meeting with us "to understand her better." What a difference this made. 
 
In one of my last visits to her, she looked once more at me and finally asked me something that I 
was never asked before, namely, to read her a chapter from the Bible. She was quite weak by then 
and just put her head back, telling me which pages to read, which ones to omit. 
 
I did not enjoy this assignment as I found it somewhat peculiar and beyond the usual things I was 
asked to do. I would have felt much more comfortable had she asked me for a backrub, emptying a 
night stool, or something like that. I also remembered, however, that I had told her we would 
attempt to fulfill needs, and it seemed somewhat cheap to call the hospital chaplain when her need 
seemed urgent at that very moment. I recall the dreaded thought that some of my colleagues might 
come in and laugh at my new role, and I was relieved that nobody entered her room during this 
"session." 
 
I read the chapters, not really knowing what I had read. She had her eyes closed and I could not 
even elicit her own reactions. At the end I asked her if this was her last acting-out or if there was 
something else behind it that I did not understand. It was the only time that I heard a hearty laughter 
from her, filled with appreciation and humor. She said that it was both, but the main purpose was 
really a good one. It was not only her last testing of me but was at the same time her last message to 
me, which she hoped I would remember after she had long gone .... 
 

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