I got on youtube this morning and searched for “grief”. I was pretty sad with what I found. After a few pages of scrolling through a lot of oddities, I simply closed the window, my head shaking from side to side.
I’ve decided that the only good stage is the one that people perform on… like my young friends here, my favorite hams…
“It is not meant to be a textbook on how to manage dying patients, nor is it intended as a complete study of the psychology of the dying. It is simply an account of a new and challenging opportunity to refocus on the patient as a human being, to include him in dialogues, to learn from him the strengths and weaknesses of our hospital management of the patient.”
I’ve re-read Elisabeth’s book for an essay I am writing for my qualifying essays at school on current grief theory. What I am wondering is if anyone in the field has read it lately?
I had no idea that people felt very passionate about Elisabeth’s work. I know that everyone has co-opted it and turned it into a cartoon about the stages of grieving something or another… but there is almost down right hatred out there. One journal article I read suggested that EKR (I’m just going to refer to her as EKR for short hand) had unfinished business with her father’s death and imposed her pathology on us.
I have read some articles that suggest she was a charlatan. But in all actuality, they thought that the entire field of thanatology and end-of-life work was a get rich scheme for pathologizing people and making a dime off their pain. I’d like to see who they think has made loads of money doing grief work.
I don’t like what we did with her work and we should slap our own hands that we have taken exactly what she said and done the exact opposite. But I don’t know if people have read just what they wanted to or they haven’t gone back to her work.
I feel bad at some of the choices in language that EKR used… like the stages…
Some of my training has been in existential phenomenological psychology and research. We are interested in qualitative research, like EKR’s but we frame it that are inquiry is to help illuminate the phenomenon that we are researching.
And in some ways, I think she did this. If she had said, I’m interested in the dying, I’m going to do some interviews and take some “snapshots” of what their inner world is like and share them with the world, then we wouldn’t be having this ongoing debate. If she had only stopped at what goes on, the interviews, and what we can learn from patients in order to help them.
Maybe it was because her first language wasn’t English? Maybe it’s because it was 1969? Maybe it’s because our country has a fascination with steps… quick steps to losing weight, making your man go crazy in bed, finding bliss consciousness, starting a business, recovering from 100 different things…. all I know is that despite some flaws, we can’t overlook what she did give us.
And what was that? She helped us all to see that dying patients were in the rooms at the end of the hall, far away from the nurses station.
We learned that doctor’s didn’t tell patients they were dying, they told their families.
We learned that patient’s knew they were dying before anyone had to tell them (I cannot believe that this was ever in question).
We learned that when doctors, nurses, chaplains, and social workers weren’t being honest with patients and listening to them, they would find it elsewhere, like in fellow patients or the cleaning woman if it meant that they might be seen and heard.
We learned that when a person has it in the forefront of their consciousness that they have a life-limiting illness that will most likely kill them, and they are in the hospital for treatment, there are some similar things that these individuals go through. There were 5 themes that EKR focused on in her writing.
But look at the quote from her book… she wasn’t going to write a Magnum Opus on the life-world of the dying patient. She didn’t want to write a handbook for people to quote and take step by step, literally, on how to manage people.
She wanted us to be in dialogue with people who are dying. She wanted us to listen deeply and speak compassionately with them like she did.
And what did she find when people did that, patients changed, softened, opened up, shared, had less stress, and found some peace.
There are many theories as to how the “stages” went from an understanding of a group of patients and what some of their experiences were when they knew they were going to die to the “stages of grief“. Some suggest that EKR was studying the grief that a dying patient goes through and if they did it, wouldn’t everyone who was grieving go through similar things was the thinking…
Hmmmm…. that’s like Bobby Flay grilling anything piece of food that comes his way… he’s a grill guy and that’s what he does. That doesn’t mean that the only way you can serve pineapple, pork chops, or porcini mushrooms is to grill them.
Over the next several months, I will be using Dr. Kubler-Ross’ own words from her book On Death and Dying to show you that we really had a lot to learn from her as we moved into the 1970s and well, there are a lot of people who could still benefit from reading her today — most doctors out there!
It’s hard to believe that 40 years ago it was a novel ideas to sit and talk to patients.
Well, not really.
The last time I knew anyone who went for a doctor’s visit and they had a 7 minute session and got charged hundreds of dollars.
Doctor’s listened for keywords while they were going through taxonomy trees in their heads rather than compassionately listening to the person before them.
They looked at what was wrong, rather than what was right and they looked at where the disease was rather than at the whole person as a whole being.
So, before everyone burns a copy of On Death and Dying, maybe they should take another look — or a first look. If she taught us nothing else 40 years ago, Dr. Elisabeth Kubler-Ross taught us the most valuable and healing thing… the healing power in being present to the person before us.
Expect to see more from Elisabeth. . . maybe we can honor what she did teach us rather than deciding everything she did in her career was wrong.