from
On Death and Dying
in
The Wheel of Life:
A Memoir of Living and Dying
by Elisabeth Kübler-Ross, M.D.
Scribner
Thank goodness for those few understanding doctors who permitted me
access to their dying patients. Those introductory visits all followed the
same
simple routine. Wearing my white lab coat, which displayed my name and
title,
"Psychiatric Liaison," I asked permission to question them in front of my
students about their illness, hospitalization and any other issues on
their mind.
I never used the words "death" and "dying" till they brought them up.
Nothing
but their name, age and diagnosis mattered to me. Usually the patient
agreed
to participate within a few minutes. In fact, I can't remember anyone ever
refusing.
The auditorium usually filled to capacity thirty minutes before the
lecture's
scheduled start. A few minutes beforehand, I personally brought the
patient on
a stretcher or wheelchair into the interviewing room. Before we began, I
stepped to the side for a moment to quietly ask that no harm come to the
patient and that my questions enable him to share what he needed to share.
It
was like the Alcoholics Anonymous Prayer:
God grant me the serenity
to accept the things I cannot change,
the courage to change the things I can,
and the wisdom to know the difference.
Once the patients started to speak-- and for some merely whispering was
an enormous and taxing challenge-- it was hard to get them to stop the
flow of
feelings they'd been forced to repress. They did not waste time with small
talk.
Most said they had learned about their illnesses not from their doctors
but from
a change in the behavior of their family and friends. Suddenly there was a
distance and a dishonesty when what they desperately needed was the truth.
Most of them felt their nurses were more empathetic and helpful than their
doctors. "Now's your chance to tell them why," I said.
I've always said the dying were my best teachers, but it took courage to
listen to them. Patients weren't shy about expressing their
dissatisfaction with
their medical care-- not the actual physical care but the lack of
compassion,
empathy and understanding. Experienced doctors found it difficult to hear
themselves painted as insensitive, frightened and inadequate. I remember
one
woman literally crying out, "All my doctor wants to discuss is the size of
my
liver. At this point, what do I care about the size of my liver? I have
five children
at home who need to be taken care of. That's what's killing me. And no one
will
talk to me about that!"
At the end of these interviews, patients felt relief. Many who had given
up
hope and felt useless reveled in their new role as teacher. Although they
were
dying, they realized it was possible for their lives to still have
purpose, that they
had a reason to live right till the final breath. They were still growing,
and so
were those in the audience.
After each interview, I took the patient back to his room and then
returned
to the lecture hall for lively, emotionally charged discussions. In
addition to
analyzing the patient's responses, we examined our own reactions. The
admissions could be, and usually were, startling in their frankness. "I
can
hardly recall seeing a dead person," said one doctor about a fear of death
that
caused her to avoid it completely. "I don't know what to say," admitted a
priest
in reference to what he found were the Bible's limitations in answering
the
questions patients asked. "So I don't say anything."
In these discussions, doctors, priests, and social workers confronted
their
hostility and defensiveness. Their fears were analyzed and overcome. By
listening to dying patients, all of us learned what we should've done
differently
in the past and what we could do better in the future.
Each time I brought a patient in and then took him out, his life reminded
me
of "one of the millions of lights in a vast sky that flares up for a brief
moment
only to disappear in the endless night." The lessons each individual
taught us
boiled down to the same message:
Live so that you don't look back and regret that you've wasted
your
life.
Live so you don't regret the things you have done or wish that you had
acted differently.
Live life honestly and fully.
Live.
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