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NDE are the national educational radio network presents special of the week. This is the audio portion of an award winning television program called until I die produced by WTT W. in Chicago. The production was aided by a grant from the Reader's Digest foundation. It concerns the Chicago psychiatrist Dr. Elisabeth Kubler-Ross who has developed a compassionate and realistic approach to the care of the terminally ill. The program opens with a brief portion of an interview with a man 62 years old dying of cancer. I wasn't aware that most of that timing and conditions. Wasn't more days. When you hear patients talking about dying you just have to come to grips with the meaning of death for yourself. Those of us who work with dying patients and have taken part in a seminar on death and dying which
Dr. Ross began a few years ago are all very much moved by the extraordinary openness and humanness and honesty we find there. It's very very hard to deal with your own death before you have to. But all of us really ought to because it has something to do with the quality of life. That's why Elizabeth Ross is a loved woman a truly loved woman. She has in a way made something which is really natural. All right again I think she started us on a long journey. When we talk about the feel of this we should remember that most people are not afraid of falling asleep one day in bed and just not waking up. But we are all afraid of catastrophic death associated with pain suffering violence and destructiveness we know we really
can defend ourselves physically against the possibility of death. So we defend ourselves psychologically and naturally the biggest and strongest defense is to deny that it clearly exists. We say oh it's not going to happen to me. We say it's going to happen to the and to the but not to me. So many people are afraid of having to sit down and I just have to. Do I Do. Not care because that would give me time to think about. So I did that and I look. And I look on the right and I see a stalled car wearing a police car where with an accident there are things that it kind of confirmed in my mind. Oh yes the child happened to me and people who knew what this day and good faith or fact and. Then.
It confirmed to prove that the child happened to down this country especially as a death denying suicide. And I mean the death and dying are no longer than the acceptable part of life in the old days came in different ways and it comes now. People died in familiar surroundings with now more than half the people in this country die in hospitals. And this makes dying. And the mechanical and the human eyes. And it would do that because of the better the more sophisticated the horse for the worse it is. So trained in medical schools to cool to heal. But we don't stress enough the people also dialed up a dying person or turned help. Now Carol can a character live a human dignified life and killed a
guy who has had a hierarchical model hospital. Yeah. Many times when a person is beyond medical help they are put in a different room. They are left alone. They are very often isolated and lonely. And people say well what's the use of going in there. There's nothing much we can do. The staff feels very uncomfortable and doesn't know what to talk about. You can going to talk about the beautiful weather outside the next spring but deep down in your soul you know that this person put people into next spring and so it's a process. We are not teaching and that's not only true for physicians but nursing staff social workers hospital chaplains. Is that these people have their own very specific needs and most of them don't want to beat around the bush they don't want to
talk about. The jovial trivial superficial things but they have very important things to talk about namely what it's going to be like. They want to talk about death and dying if only for five minutes due to playing out an unfinished business to raise a question that's on their mind and then afterwards it's OK again to talk about next spring. How difficult it is for the members of the helping profession to be comfortable with those patients. And I think if we can help. People to realize that we are all finite and that there can be a very comfortable part of life and it's not so horrifying and frightening as our fantasies if we can help them. So you can listen to dying patients. It doesn't only help the dying patient but it helps the person who's comfortable doing that. We have talked with 400 to 200 patients in order to find out what did he'll need and how we can best help them. We found out
that most patients go through five stitches in coming to terms with the fact to deal with dying and their families and sometimes even the medical staff go through the same stages depression does when a patient is told that he has a serious illness. He first reacted with shock and denial. No not to me. We have seen patients maintaining their denial for months from month to with their family and to their physician and then we came in and asked them how sick are you conveying to them good three don't need denial and I said I'm full of cancer. Many many times we have seen a patient who said I know I have cancer but my family doesn't know and the doctor says I know he has cancer but the patient doesn't know and the family says I know he has cancer but don't tell him. And usually we ask the patient to convey to the family that he knows and that it's much better to talk about it frankly in the open or rather the greatest of all or
a little of the meaning and not him playing a game. When a patient can no longer say no not to me his next question is usually why me and the patient get angry and he questions why this is happening to him. He's angry at the people he's angry with guard here faces his voice he becomes very very difficult management problem sometimes hearings for the new house all the time. He complains to the family about their wi sitting where they would do is no good. We found that the murderer could be the move and not just to get in the way the more effective you are. The more you get. This patient's anger. They are angry at what you have Chris and if you come in and live in Nazi functioning you are being robbed his patient is in the process of loosing. You make a way out of that. Yes two weeks ago I would walk around quick
compared be like this. I was able to I was able to go home fix dinner for my children. I was able to do this and that include between. And they are angry about all the things they are in the process of loosing and they are hanging with you only because you remind them of all the things that they were able to do. Road to found most helpful to those patients is not to make them feel guilty and kind of convey to them that they are bad patients but to kind of put yourself into the patient shoes for a moment and say you know I think I would be angry to get it out get it off your chest. I think its a perfectly normal human reaction and if you can get a dolefully Beaty helps you a little bit. Then the patient usually becomes almost up to him to close. Difficult to manage and to handle and to top load and. He enters what we call the stage of bargaining. The balcony. He's beginning to know all that she
asked me. But he had so little rules to it. And that really means. Maybe if I'm a good creation of a good Christian or a commie something maybe I can leave for a little bit longer. And I think everybody needs this kind of truce. Need to little time of temporary peace where you don't really think about it to really feel that you have a certain time and the patient can fully complied to mobilize new energies for the final stages. When the bargain income is out going to says yes me but when he drops the bat then he begins to lose the face yes it's me. And the patients then become depressed. 30 God grief and depression in this period of time of a patient's life is very very normal. What do we do when we come into a patient's room the patient who cries especially if it to mean. That our tendency is to come in and try to cheer them up until it all isn't
it a lovely day outside and she got up it's not so bad. For a patient who has the courage to face. Not only did she was losing one last one but everybody here several laughed and they've looked in years they've all left us to separate himself. This is a very fair they did for fair and he should be allowed to express this Khalif he has two more on not only the things he has already lost which includes probably to cheer up and come and just to be in a tone with the family which includes maybe an organ maybe a protest maybe a limb. But he goes then go with the purpose of telling. That means he's beginning to separate himself from this earth. And that shows in. A practical way in doubt he asks for all the friends to come and visit him once more. Then he would like to seize children once more. And then a diverting into you only need one or two people who are comfortable
and who can too. In what we call the silence that goes beyond the sound companionship of a loft one who can just sit and hold your hand or touch your hand or just be with you without a word a patient cannot reach this if he is not allowed to create it. Search of acceptance is not perfect nation. I think Nation is kind of a bit of giving up the defeat it worked for you. Acceptance is not the happy stage but the feeling of I have finished my and finished business. I have done my best. I would like to live back in my pillows now and I am afraid for the last year only that I have people come to you for food if you can help them. And at the very end they have much less physical pain they are had peace inside and outside the
family and the patient himself. When they reach the stage of acceptance of this together it's really a kind of victory. But the target is to reach this stage when we are dealing with the death of a child. There were other small children actually have absolutely no concept of death. There were only controlled about to predation. Thank you proud to have the pair of them and if we are both careful to bring them up again with the children so that their little girl. Laid that on many other Berkeley before but I feel so old they begin to be very concerned about. The image of the thing has to be kept and so the biggest concern perhaps he said that time should look surgical procedures will still doing anything that the interest their body and they have to talk about it. And so we talk about that if that's relevant today and if the issue and question is raised about. That most important thing perhaps if they are. Released into the.
Ground when they ask a question that we don't kill them live. We had a seven year old who was in the hospital terminally ill with leukemia and she went to the doctor haunted look this is like when I'm going to die. And they said oh I had my page and he left. And then she had to know under new said you're a bad girl don't talk like this to take your medicine you get well you see what this means is if you take your medicine you will live from the jail and if you don't take your medicine when you talk like this you have there to cling to I'm not going to get well this is a little punitive thing of dealing with it. And then she asked the hospital chaplain the same question and he looked at her and he said Well do you think it's going to be life. Which is a beautiful land because it has many things it says the most important of all yes it may have been but the world do you think it's going to be
done. Then she looked at him like only a little girl can look at you and she said one of these days I'm going to fall asleep and when I wake up with Jesus and my little sis. That simple. So chilled to them too. They know when they are dying. They have their own concept depending on their age and they can convey these to you if you can see it and hear him and then use their language and in this way I think it can help them the most. In comes down to be starting to look like in the hospital they started drawing most of the old children was probably going to look and run boy group picture or for you to choose which canon. And did for all the flower the whole was a tiny little boy. The diameter of the bell with a stop sign in his hand. And look this one up at us and beautifully is our concept of there
is so huge destructive powerful force that keeps us from the outside. We can't do a thing about it. The tiny little boy has stopped and standing in front of you you would just do just Cameron. For this tiny little boy. Rude you could tell to her child is it must be terrible to feel so terribly and this thing here her so weak. When this pro was able to talk about it the next picture he made was a beautiful bird flying up and the sky and everything was tall in black and white except for his ring which had a little touch of gold on the edge of the wing. And when asked what this was he said but naturally this is a piece of a good cook and scary with a little bit of sunshine on my wing. And that was the day he died.
Death is something you can't experiment with you can't experience. So we need hospital we have to face death all the time and learn to deal with it. Realize that the only way you can get the feeling of what it's like is to ask seriously ill patients themselves to be able to teach us. How long have you been you know. About. This brief period. Only going by goodness was you were infected it was. Able to cope with change. You know what this feel how are you. What year wouldn't you want to. Happy for. The. Militant groups who have a Muslim calling every living through him the writing on the. Ground and you didn't know that until the beginning with this. I wasn't aware of this but you know what else which you don't like Phillips in street made lakes cableway and I just.
Tell. Him No one ever ever had to tell a patient that here the CDC almost. And you would never even dream of telling a patient he's dying anyway. But you can talk about dying smite all our patients that have told us that they were terminally ill and yet they have their say and this is irrelevant of the fact that they have been told or not told this week. Basic cause it's gross is it. How did you take it told that you had the money. I was aware it didn't and we can see you were suspected as much. How how do people feeling instinct I don't know I just felt instinctively that this was the case and it something bad. The other thing that patients always share with us is that with the flack to be told I did serious but they don't like to be told there's nothing else that can be done. If they are told that it's serious they would like to be told with a glimpse of
hope. Surgery couldn't do any good it couldn't have helped us with money. He gave me some out. By you. Telling me to. Do. Radiation. Could control the decision that was affecting me. How I feel more how going since Jan. You know. What he going to do you mean you can't go to any corner and beachy head against a wall while you pull your hair out. I wish to be like you one day I will have something like that I can't think of any other attitude how I lead would know how fast approaching. A homemade task played out Oh Mr. Atkins. Oh yes she's been a terrific Annis with me and for. 24 hours make sure I. Was last happy much off in fact. The only fingers over and over. Yeah it's been quite a terrific companion. There's never enough. It certainly. Was lovely to watch. Will be now.
We're now if you missed back into shape. Similarly. I think this is pretty much what brought us together. She made three children going to. The terminal cases. At the frisky help one can allow. Yes I wish I could get more. Into. That setting. Thank you to miss me I didn't tell him what to buy she was old when I came and told him that we had the biopsy results and we transfer him to work to treat. As he did and told me I should move league next year and he should say yes and he has my shank was actually what he said was that it will be benign watching. From home he was. Running. Around. OK I'll take you there to talk about it. And I have since learned if any U.S. residents return she ain't seen too much debt is paid to face waste and subjected to a discussion subject. Am I going. To know what to say to him and his family. For me. It's that fall down the stairs a
position you claim to care I want to carry. And it's very hard sometimes to face when you came to a political. Point after giving suggestions to take up Seize Sur. Because actually extremely secure change to me. That shows how important it is to have confidence in the eye doctor patient the remaining chain of poor to rich to rich to. Many intervention many residents still don't see this value. They don't know you know and it's very hard to teach them. They're said to do the hour the do over to the no commission. Process. To you. I know it or not there I mean everyone has to do. This if they have a special. In the chair back to you. Is it just me and you. Just so Ed. and miserable. You know. Well Dr. Levy. Would. Lay an egg a nice long period
Tony. Well. Is there anything afterwards. Yesterday she. Asked him. And asking him to look forward to. Thank you. OK DOWN me for not too long to kind of a. Girlish character to begin and I hope that. Some of those things will help. Perhaps. I don't think. It's funny to you as a little bit the playschool. Good companionship but not to be alone. I think you just don't mind the wisest thing. Good luck to you. Before we going to details what the cigar reaction to this. Do you remember the word refill the back last time words that mean Vika reaction. How do you feel good. Whats the station. Here. Not the pale. My him. What they also say solely what they also said he was too. So you
were suspicious of him don't you. We were it's. You. That's up here however you know I think that was my. Reaction. To what you say. What would you call in the army. I. Don't want to. Phone you. No no no because you know we. Were just discussing. Kind of. Denial. I want this man is possible and here you are. Good bye. That's clear but certainly the British know the diagnosis how did people hear. It's very hard but you have to learn to do that because it's what you feel here to lift the patient picks up and eventually helps in that relationship for the personal computer. Yes KSU. They also. I think. People are peaceful. Are you sure you're hearing here. Will. Rescue me. Who will
forget you. I felt like you want to. Thank you thank you. Thank you. Thank you. How did that make you feel. Me. Me I'm so sorry we. Don't think it is. Very We should already be facing. This situation. We. Beat. Anyone who approaches to just reaction thank you very. Much for you. My opinion on. This is it is to my school this is this Do it my. WAY YOU AND WE CAN WE CAN WE will satisfy me. All there was was killing people here. We could go from them is what he was really like to share with us. It's not that you know whatever they say but they feel comfortable sometimes to say I don't. Feel willing to disapprove and if you were to say Man we do condone
their action is to push this patient to me. You'll never quite know why you don't take it. You took me. To the patient's needs. Fuel needs to endure long treatment because those two. Not that appeal for those two gut reactions they're still think he's abetting a political mission shaping up for me for about a year ago we had to go back to. Canada. To be. With. You. She was diagnosed as being seduced to deceive. Them to believe that she would be good. For the one woman and she came back to her because knowing that she had to show up. On the roof. And up made. Even more. Difficult because we would be now suicide if we aim for the ways of knowing why which we can do this then we could not accept this
but they did go to the beautiful fields and they could not accept the feeling we would. Have done if you can say no this is to very early you know I know I'm going to die of it this week. When I die it's just like going to keep the bombs planted on this go to the next. And I think my gut reaction to that was that and to the community said no it's not that we get some food in the back with my finger and she couldn't do it and that's one of the perhaps because it was so a few days when that was going to see her and then I went to visit till she had the same. Child. It would be. The finish I'm finished. So we said to be able to check in with somebody we have lost but not quite knowing what. To do all she could see them better. And this search to go
with them. Finally she was able to say you know. At the. Boarding door. No. One seems to care. That people. Would. Be down there. And I told the two of them to do this so that when they go to market and when they're OK they go they go in many ways. And she looks with a happy peaceful smile and to sit you know what you're saying is that this. And I know if my kids. Into this line. Back in the pillows very peacefully and then she did something that no other patients able to. She looked at me and just sit with this you can sit there and I look to. The. Side. And then it dawned on me. You know we always think that you have. To be. You. Know. To me. And then I could there and I know the face of this beautiful food. And I said. That you. Were. Going to look. Back if we would.
Consider I'm going. To do. This. For the next. Move. NPR's special of the week thanks television station WTW in Chicago for the audio portion of this award winning program until I die. With Chicago psychiatrist Dr. Elisabeth Kubler-Ross producers for WTW part Barry I'm Gloria collage. This is an E.R. of the national educational radio network.
Special of the week
Issue 16-71 "Until I Die"
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University of Maryland (College Park, Maryland)
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