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In 1969, Elisabeth Kubler-Ross wrote the book “On Death and Dying.” I can remember this book being a part of our required reading when I was in nursing school about two decades ago. From what I understand after speaking with a few current medical students, the book remains a required reading for many healthcare professionals.
The book centers mainly around five stages that Ross says we all go through when confronted with grief and tragedy, and they are often centered around the impending loss through death or otherwise. The stages mainly relate to the death process of either one’s self or a loved one.
While going through my own cancer diagnosis and treatment, I began to notice the similarities between the stages Ross describes and my own feelings and experiences. More than four decades later, her words are still as relevant now as they were then.
The first stage involves denial, or the refusal to accept our diagnosis or perhaps prognosis. It doesn’t matter what type of cancer you may have; the word cancer alone strikes fear in the hearts of most people. The need for immediate treatment will often push one through the denial phase, requiring him or her to adjust rather quickly in order to discuss treatment options and make plans surrounding them.
When going through treatment, often accompanied by pain, the second phase of anger is not one some would gravitate to. I know I didn’t. Sadness was the more prominent emotion, at least until such a time when the physical pain had subsided. Once the pain had cleared enough for me to think straight, anger followed, and it was directed at almost everything—cancer related or not.
The third stage involves bargaining—the need to try anything and everything possible to gain more time, even one more day. This is often the point at which you hear about cancer patients flying off to other countries to obtain treatments unavailable in the United States, which often turn out to be nothing but quack cures for fast cash on the part of those offering them. It is tragically sad to see people in such a place, grasping at straws, when those around them are all too aware of the truth. Trying to get someone in this place to see anything otherwise, however, is like trying to make a blind man see.
When there is no more bargaining to be done, the depression can be overwhelming—like a feeling that one has been tossed into a lonely, black pit. Self-pity can become the focus of the day, or the week, depending on the circumstances.
The final stage, acceptance, is something I believe can be debatable. The definition of acceptance is receiving favorable reception. Resignation may be a more appropriate term for many.
We are each the product of our own reality, and as such, we each will process these stages in different ways and over varying lengths of time. What I believe is most important through each and every one of these stages is the support of others. Humans need to be connected to one another.
If you have the opportunity to be that supportive figure, embrace it, along with the knowledge that you are fulfilling one of the most important roles in that person’s life and death.
Sources:
http://en.wikipedia.org/wiki/K%C3%BCbler-Ross_model
http://www.psych.ufl.edu/~undergrad/f11_courses/dep4930_bluck_f09.pdf
http://www.amsa.org/AMSA/Homepage/About/Committees/DeathandDying.aspx
http://www.ekrfoundation.org/
Reviewed July 6, 2011
by Michele Blacksberg R.N.
Edited by Kate Kunkel
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