Microsoft Word Elisabeth Kubler-Ross On Death And Dying doc

was likely to collapse if he sat for more than five minutes -yet, after a full hour of conversation he 
had difficulty leaving and felt perfectly all right physically as well as emotionally. He was 
preoccupied with many personal losses, the most serious one the death of a daughter far away. 
What grieved him most, however, was the loss of hope. It was related at first as the doctor's 
presentation of his illness: ". . . they gave me no hope. 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 . . ." 
 
Mr. H. did not give up and admitted himself to another hospital, where hope was offered. 
 
Later in the interview he expresses another sense of hopelessness, namely, his inability to have his 
wife share some of his interests and values in life. She often made him feel like a failure, he was 
blamed for the children's lack of achievements, he did not bring enough money home, and he was 
fully aware that it was too late to satisfy her demands and ever meet her expectations. As he felt 
weaker and unable to work, looking back at his life, he became even more aware of the discrepancy 
between her values and his own. The gap seemed to be so great that communication became almost 
impossible. All this happened to this man during the mourning process for his daughter and 
reawakened the sadness he experienced after his parents' deaths. As he describes it, we had the 
feeling that he had so much grief, he was unable to add more sorrow to it-thus leaving the most 
vital dialogue unspoken, which would have, we hope, given him a sense of peace. In all this 
depression there was a sense of pride, a feeling of worth in spite of his family's lack of appreciation. 
So we could not help but wish to be instrumental in a final communication between the patient and 
his wife. 
 
We finally understood why the hospital staff was unable to tell how much Mr. H. was aware of his 
illness. He was not thinking of his cancer as much as he was reviewing the meaning of his life and 
searching for ways to share this with the most significant person-his wife. He was deeply depressed 
not because of his terminal illness but because he had not finished his own mourning for the dead 
parents and child. When there is so much pain already, some added pain is not experienced as much 
as when it hits a healthy pain-free body. Yet we felt that this pain could be eliminated if we could 
find means to communicate all this to Mrs. H. 
 
The following morning we met with her, a strong, powerful, healthy woman, energetic as he had 
described. She confirmed almost verbatim what he had said the day before: "Life will go on much 
the same when he has ceased to be." He was weak, he 
 
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could not even cut the lawn or else he might faint. Men on the farm were different kind of people, 
they had muscles and were, strong. They worked from sunrise to sundown and he was not much 
interested in making money either . . . Yes, she knew he had not long to live, but she was unable to 
take him home. She had made plans to bring him to a nursing home and she would visit him there ... 
Mrs. H. said this all in a tone of a busy woman who had a lot of other things to attend to and could 
not be bothered. Maybe at that time I felt impatient or had a sense of Mr. H.'s hopelessness, but I 
repeated in my own words once more the essence of her communications. I summarized briefly that 
Mr. H. had not fulfilled her expectations, he was not very good in many things really, and would 

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not be mourned when he ceased to be. Looking back at his life, one might wonder if there was 
anything memorable in it .... 
 
Mrs. H. suddenly looked at me, and with feeling in her voice she almost yelled: "What do you 
mean, he was the most honest and the most faithful man in the world ...." 
 
We sat for another few minutes during which time I shared with her some of the things that we had 
heard in the interview. Mrs. H. admitted that she had never thought of him in these terms and was 
quite willing to give him credit for these assets. We returned to the patient's room together and Mrs. 
H. repeated on her own what we exchanged in our office. I shall riot forge the patient's paleface 
deep in his pillows, the expectant look oil his face, the wonderment in his expression at whether we 
were able to communicate. And then his eyes lit up when he heard his, own wife say, "... and I told 
her that you were the most honest and most faithful man in the world, and that's hard to find these 
days. And on the way home we would pass by the church anti pick up some of your church work 
that was so meaningful to you It will keep you busy for the next few days ...." 
 
There was some genuine warmth in her voice when she talked with him and prepared him to leave 
the hospital. "I shall never forget you as long as I live," he said when I left the room both of us 
knowing that this would not be long, but it mattered little at this point. 
 
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VII 
 
Fifth Stage: Acceptance 
 
I have got my leave. Bid me farewell, my brothers! I bow to you all and take my departure. 
 
Here 1 give back the keys of my door-and 1 give up all claims to my house. I only ask for last kind 
words from you. 
 
We were neighbours for long, but 1 received more than 1 could give. Now the day has dawned and 
the lamp that lit my dark corner is out. A summons has come and 1 am ready for my journey. 
 
Tagore, from Gitanjali, XCIII 
 
If a patient has had enough time (i.e., not a sudden, unexpected death) and has been given some 
help in working through the previously described stages, he will reach a stage during which he is 
neither depressed nor angry about his "fate." He will have been able to express his previous feelings, 
his envy for the living and the healthy, his anger at those who do not have to face their end so soon. 
He will have mourned the impending loss of so many meaningful people and places and he will 
contemplate his coming end with a certain degree of quiet expectation. He will be tired and, in most 
cases, quite weak. He will also have a need to doze off or to sleep often and in brief intervals, 
which is different from the need to sleep during the times of depression. This is not a sleep of 
avoidance or a period of rest to get relief from pain, discomfort, or itching. It is a gradually 
increasing need to extend the hours of sleep very similar to that of the newborn child but in reverse 

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