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Death, as Part of Life, Book Review Example

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Book Review

One of the characteristic features of human mind is its tendency to stereotypic thinking and acceptance of certain phenomena of reality the way most of the people consider them to be. This case is as true for ordinary people, as it is for the specialists, and health care people are not exceptions. There are probably no phenomena which are of more common denial and fear than death and process of dying. In 1970s, it was believed that nothing new can be written on the topic of death, since its terrible nature was undeniable and discussion of the matter could not improve the situation of terminally ill patients, so the issue remained silently ignored in the professional literature. This was the case before the publication of book by Elisabeth Kubler-Ross “On death and Dying”. The aim of the present paper is critical assessment of strengths and weaknesses of the book, its practical implementation and comprehension of author’s message for hospices and palliative care specialists.

The most remarkable thing about the book is its topic and the manner in which it was addressed. In this regard, the strength of the book is its sincerity and unconditional openness to comprehension and acceptance of death as part of human existence. The return to the old, ancestral attitude to death rose further questions of social and medical implications. By changing the emphasis in comprehension of death and dying process, Kubler-Ross showed the prevailing fear of death in every member of society, especially in specialists dealing with death (Kubler-Ross 11).  Although fear could be avoided, the main problem was lack of awareness of death and its taboo in society and clinical practice. Thus, the main strength and meaning of the book for the health care and medicine is in breaking this taboo and changing of view on death.

One of the strengths of the book is that it showed the prevailing ignorance of medical personnel to the terminally ill patients and lack of emotional support both at diagnosing and in further treatment. This ignorance was tacking various forms – desire to announce diagnose as soon as possible and restriction for the researcher to talk to those people (Kubler-Ross 20).  Although there was nothing new in describing abstraction of medical personnel from the topics of dying and death, Kubler-Ross was one of the first to explain it as personal human desire not to face death until their own time, even if they have to deal with it in the course of their professional duties (Kubler-Ross 24). In this regard, the author also addressed the issue of telling or not telling the patient diagnosis, and her answer was without any doubts “yes”. On the other hand, according to the author, it was supposed to be done properly – with concern and in the due time. The doctor is to “communicate to the patient that all is not lost, that it is a battle that they are going to fight together” (Kubler-Ross 26). Under conditions of personal abstraction from death, such approach was complicated for achievement. In this context, the strength of the book was Kubler-Ross’ showing that doctor’s attitude to the patient and subsequent treatment of his illness largely depend on doctor’s personal “attitude and ability to face terminal illness and death”  (Kubler-Ross 28).

The most crucial strength of the book and Kubler-Ross’ seminar is that through actual interviewing of the terminally ill patients she managed to distinguish stages of patient’s coping mechanism with diagnosis and dying itself. No matter how arguable the findings of Kubler-Ross might have been at the time when book was published, the undeniable strength of her findings was that they were based on empirical evidences retrieved from real patients. All five stages: denial and isolation, anger, bargaining, depression and acceptance are described in their medical/behavioural characteristics, but also in their personified vividness of patients dialogues with doctors, the author or chaplains. In this context, Kubler-Ross achieves vividness and certain palpability of death for the reader and health care specialists. In other words, through acquainting readers with the specific cases of patients, she managed to bring them closer to visualisation and even comprehension of death. It is quite difficult to forget the transformation of anger in case of the nun and sharing of mutual experience between the patient and the author (Kubler-Ross 71). Thus, the book makes both death and health care specialists more human.

From all mentioned above it may seem that the book has no weaknesses, but this is not true. Although from narrative perspective, novelty and practical nature of exploration, it is brilliant; from the point of practice, the book is a bit weak. Although there are a lot of analytical parts of the work and numerous examples of dialogues between the author and patients, there is no specific guidance for dialogue conduct, use of certain phrases or self-preparation for the conversation. In other words, unlike therapeutic and psychological guides, which explain both examples and application of certain techniques applied in those examples, Kubler-Ross uses examples as support of her arguments rather than educative guidelines of the way conversations should be conducted. On the other hand, in the beginning of the book, the author emphasised that she did not aim at writing “a textbook on how to manage dying patients”, it was about gaining experience and transfering it to the next generation of medical specialists (Kubler-Ross, xi).

One of the possible weaknesses of the book can be derived from its strengths. In this respect, spirituality and personification of the narration might be viewed as step back from strictly scientific and medical perception of death and subsequent application of the described ideas in the medical practice. In certain sense, it might be argued that the book shows the author’s personal perception of death and her analysis of the empirical data. Although, to a certain extent this might be true, the very essence of death is very personal and attitude of every individual is conditioned by personal experiences of facing or not facing death in one’s life. Therefore, although complete abstraction from the personal attitude to death and its interpretation is actually possible, it would not serve book’s aim – gaining of “experience enriched and perhaps with fewer anxieties about their own finality” (Kubler-Ross, xi).

After finishing the book, it leaves a certain impression of innuendo and hidden message. It is not only that the author writes about her mutual experience with the terminally ill patients, she actually shares it with the audience in quite a challenging manner. The non-prescriptive narration contributes to the freedom of interpretation by readers and subsequent development of their own experience of reading, understanding and further application of this book in their practice, both personal and professional. Thus, just as experience of the author with each terminally ill patient was unique, the experience of the reader with each of them was also unique and personal.

Through this free-interpretation, Kubler-Ross was teaching new generation of practitioners that there is neither a silver bullet in perception and talking of death, nor universal treatment suitable for all terminally ill patients. Proper and efficient communication with these patients varies on case-to-case basis and becomes more complex when doctor’s denial of death is involved. Therefore, the main hidden theme of the whole book is self-observation and acceptance of one’s process of dying as natural and common human thing. In certain sense, this book aims at self-exploration and comprehension of personal attitude to death and, only after that realisation, one might view death as nothing else than part of life.

Overall, the book by Kubler-Ross was revolutionary in the field of medical treatment of terminally ill patients, development of hospices’ roles and importance of palliative care programs in general. Although it is not a traditional practical guideline for treatment, it has an essential educative function of self-exploration and comprehension of death as part of human life and subsequent attempt of fighting the fear of death. From my personal point of view, this book is a must for all medics and ordinary people that want to live full life.

 

Work Cited

Kubler-Ross, Elisabeth. On Death and Dying. New York, NY: Routledge.1997. Print.

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