Kubler-Ross helped others confront death

Appreciation

August 26, 2004|By Holcomb B. Noble | Holcomb B. Noble,NEW YORK TIMES NEWS SERVICE

Elisabeth Kubler-Ross, the psychiatrist whose pioneering work in counseling terminally ill patients helped to revolutionize the care of the dying, enabling people all over the world to die more peacefully and with greater dignity, died Tuesday in Scottsdale, Ariz. She was 78.

Family members reported that she died of natural causes.

A series of strokes had debilitated her, but as she neared her own death she appeared to accept it, as she had tried to help so many others to do. She seemed ready to experience death, saying: "I'm going to dance in all the galaxies."

Kubler-Ross was credited with ending centuries-old taboos in Western culture against openly discussing and studying death.

From her patient interviews, Kubler-Ross identified five stages many patients go through in confronting their own deaths. Often denial is the first stage, when the patient is unwilling or unable to face his predicament. As his condition worsens the patient displays anger - the "why me?" stage. This is followed by a bargaining period ("Yes, I'm going to die, but if I diet and exercise, can I do it later?"). When the patient sees that bargaining won't work, depression often sets in. The final stage is acceptance, a period in which the patient is ready to let go.

She set in motion techniques of care directed at making death less dehumanizing and psychologically painful for patients, for the professionals who attend them and the loved ones who survive them.

She accomplished this largely through her writings, especially the 1969 best-seller On Death and Dying. She was a powerful intellectual force behind the creation of the hospice system in the United States through which special care is now provided for the terminally ill. And she helped to turn thanatology, the study of physical, psychological and social problems associated with dying, into an accepted medical discipline.

"Dr. Elisabeth Kubler-Ross was a true pioneer in raising the awareness among the physician community and the general public about the important issues surrounding death, dying and bereavement," said Dr. Percy Wooten, president of the American Medical Association.

In the later part of her career, she embarked on research to verify the existence of life after death, conducting, with others, thousands of interviews with people who recounted near-death experiences, particularly those declared clinically dead by medical authorities but who were then revived.

Her early childhood may have been the "instigator," she said, in shaping her career. Barely 2 pounds at birth, she was the first of triplets born to Ernst and Emma Villiger Kubler on July 8, 1926, in Zurich, Switzerland. She might have died, she wrote, "If it had not been for the determination of my mother."

In 1962, she became a teaching fellow at the University of Colorado School of Medicine in Denver. A small woman, who spoke with a heavy German accent, she was highly nervous when asked to fill in for a popular professor. She found the medical students rude.

But the hall became noticeably quieter when she brought out a 16-year-old dying of leukemia, and asked the students to interview her. Now it was they who seemed nervous.

As Kubler-Ross awaited her own death at her home in Arizona, she acknowledged that she was in pain and ready for her life to end.

Kubler-Ross is survived by a daughter, Barbara Ross, a clinical psychologist, of Wausau, Wis.; a son, Kenneth, a photographer in Scottsdale; her brother Ernst, of Surrey, England; and her triplet sisters, Erika and Eva of Basel, Switzerland.

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