Microsoft Word Elisabeth Kubler-Ross On Death And Dying doc

for them. They are then sent off to relatives, often to the accompaniment of some unconvincing lie 
that "Mother has gone on a long trip" or other unbelievable stories. The child senses that something 
is wrong, and his distrust of adults will only grow if other relatives add new variations to the story, 
avoid his questions or suspicions, and shower him with gifts as a substitute for a loss he is not 
permitted to deal with. Sooner or later the child will become aware of the changed family situation 
and, according to his age and personality, will suffer an unresolved grief that he has no means of 
coping with. For him, the episode is a mysterious and frightening experience of untrustworthy 
grownups, which can only be traumatic. 
 
 
It is equally unwise to tell a child who has lost her brother that God loves little boys so much that 
he took Johnny to heaven. When one such little girl grew up to be a woman she never resolved her 
anger at God, which resulted in a psychotic depression when she lost her own little son three 
decades later. 
 
We would think that our great emancipation, our knowledge of science and of man, had given us 
better ways and means to prepare ourselves and our families for this inevitable happening. Instead 
the days are gone when a man was allowed to die in peace and dignity in his own home. 
 
The more we are achieving advances in science, the more we seem to fear and deny the reality of 
death. How is this possible? 
 
We use euphemisms, we make the dead look as if they were asleep, we ship the children off to 
protect them from the anxiety 
 
and turmoil around the house if the patient is fortunate enough to die at home, we do not allow 
children to visit their dying parents in the hospitals, we have long and controversial discussions 
about whether patients should be told the truth-a question that rarely arises when the dying person 
is tended by the family physician, who has known him from delivery to death and who understands 
the weaknesses and strengths of each member of the family. 
 
I think there are many reasons for this flight from facing death calmly. One of the most important 
facts is that dying nowadays is in many ways more gruesome, more lonely, mechanical, and 
dehumanized; at times it is even difficult to determine technically when the moment of death has 
occurred. 
 
Dying becomes lonely and impersonal because the patient is Often taken out of his familiar 
environment and rushed to an emergency ward. Anyone who has been very sick and has desired 
rest and comfort may recall his experience of being put on a stretcher and especially of enduring 
the noise of the ambulance siren and the hectic rush to hospital. Only those who have lived through 
this may appreciate the discomfort of such transportation, which is only the beginning of a long 
ordeal-hard to endure ,.%,hen you are well; difficult to express in words when noise, light, ;pimps, 
and voices are all too much to bear. It may well be that we should consider more carefully the 
patient himself and perhaps stop our well-intentioned rush in order to hold the patient's hand, to 
smile, or to listen to a question. I consider the trip to the Hospital as the first episode in dying, as it 
is for many. I put it starkly not in order to deny that lives should be saved if they can 1,e saved by a 
hospitalization but to keep the focus on the patients experience, his needs, and his reactions. 

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When a patient is severely ill, he is often treated like a person with no right to an opinion. It is often 
someone else who makes :he decision if and when and where a patient should be hospitalized. It 
would take so little to remember that the sick person too has feelings, wishes, and opinions, and 
has-most important of all-the right to be heard. 
 
Well, our imaginary patient has now reached the emergency ward. He will be surrounded by busy 
nurses, orderlies, interns, residents, a lab technician perhaps who will take some blood, 
 
another technician who takes the electrocardiogram. He may be moved to X-ray and he will 
overhear opinions of his condition and discussions and questions to members of the family. Slowly 
but surely he is beginning to be treated like a thing. He is no longer a person. Decisions are made 
often without taking his opinion. If he tries to rebel he will b e sedated, and after hours of waiting 
and wondering whether he has the strength, he will be wheeled into the operating room or intensive 
treatment unit and become an object of great concern and great financial investment. 
 
He may cry out for rest, peace, dignity, but he will get infusions, transfusions, a heart machine, or a 
tracheostomy. He may want one single person to stop for one single minute so that he can ask one 
single question-but he will get a dozen people around the clock, all busily preoccupied with his 
heart rate, pulse, electrocardiogram or pulmonary functions, his secretions or excretions, but not 
with him as a human being. He may wish to fight it all but it is going to be a useless fight since all 
this is done in the fight for his life, and if they can save his life they can consider the person 
afterwards. Those who consider the person first may lose precious time to save his life! At least this 
seems to be the rationale or justification behind all this-or is it? Is the reason for this increasingly 
mechanical, depersonalized approach our own defensiveness? Is this approach our own way to cope 
with and repress the anxieties that a terminally or critically ill patient evokes in us? Is our 
concentration on equipment, on blood pressure, our desperate attempt to deny the impending end, 
which is so frightening and discomforting to us that we displace all our knowledge onto machines, 
since they are less close to us than the suffering face of another human being, which would remind 
us once more of our lack of omnipotence, our own limitations and fallibility and, last but not least 
perhaps, our own mortality? 
 
Maybe the question has to be raised: Are we becoming less human or more human? Though this 
book is in no way meant to be judgmental, it is clear that whatever the answer may be, the patient is 
suffering more-not physically, perhaps, but emotionally. And his needs have not changed over the 
centuries, only our capacity to gratify them. 
 
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II 
 
Attitudes Toward Death and Dying 
 
 
Men are cruel, 
but Man is kind. 
 

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