‘On death and dying’ by Elisabeth Kubler-Ross: A book review

‘On death and dying’ is a book that is all too familiar to any hardcore ‘Grey’s Anatomy’ fan because of the extremely famous line used from it in the series about the five stages of grief. Usually, I’m not a reader of non-fiction but this book was calling out to me! Even though it was obvious from the foreword itself that the intended readership of the book did not comprise of someone like me, due to the fact that I’m a human being and very much obsessed with killing off characters in my stories and getting too affected by some real-life deaths of people I may have only met once in life, I knew I was not going to back out. And then there is the fact that I completed my engineering in a branch that is supposed to help the healthcare sector in improving the lives of patients (or not quite so, I realized as I kept on reading) and my love for biology was still intact for me to understand medical terms so, that put me back on the ‘targeted readers’ list.

The book started off by discussing how people are wary of accepting their own mortality and went on to cover the rituals used worldwide to confront someone’s death. The simplicity of the words used for the description instantly took me in. The stress was mainly on better treatment of the patient’s wishes and consideration of their feelings which briefly reminded of an elective I had taken in college which emphasized on hospital ethics and though I should have felt tired of the similarity the book showed with academics- something students have learnt to hate even if they haven’t learnt anything else from the education process, the reality of the situations portrayed stretches beyond mere academia to reach daily lives, if not ours then those of whom we encounter! By the way, some unforeseen highlights for the Indian in me (as well as the literature lover) were all the Rabindranath Tagore quotes used throughout the book.

Beginning with an emphasis on how physicians must be empathetic and share the news of terminal illness in the right manner with the patients, the book looks into the coping mechanisms learnt during the research work carried out by the author as well as her students. The first stage is that of denial and isolation. The author’s fear of being in the position of the subject of the case study was what stood out for me the most in the chapter because it is a rational fear of abandonment which any normal human has deep inside them and the need to not acknowledge harsh realities is in-built for most of us. On a lighter note, I would like to remind you all of Ross Geller’s (from the series ‘F.R.I.E.N.D.S’) “I’m fine” response as an inappropriate exhibit! The second stage of ‘anger’ which I expected would talk more about the ‘why me?’ question most of us have atleast asked once in our lives, focused more on the anger that we have subdued within us that comes forth only when we understand that expressing it, though may provide no relief whatsoever to the pain, may be the only thing left that can make others conceive of us as a living, breathing human! The standout point of the chapter was the transcript of the interview of a feisty nun whose anger at the inefficiency of the staff helped her establish good connections with other patients while jeopardizing her relations with the management and later led her to finally overcome her resentment and accept her true self. The chapter on the third stage of ‘bargaining’ was surprisingly small. The next stage of ‘depression’ drove attention to the significance of having a good mental state of health even when not facing an end-stage disease physically. The final stage of ‘acceptance’ was about the sense of peace that settles in after some time and in the case discussed in the chapter, the acceptance is accredited to the family’s as well as the patient’s faith. The concept of religion is deeply explored throughout the book and is very notable in this chapter.

The undying (pun unintended) hope that one harbors until acceptance is attained is discussed about in the next chapter, followed by a very important chapter on ‘the patient’s family’, in which the author, according to me, has covered all matters of importance with zero omissions. ‘Interviews with terminally ill patients’ follows next and the complaint I have about the chapter is that it does not include the viewpoints of anyone who is an atheist because insight into the kind of faith that does not stem from religion is seriously lacking in most of the books I’ve read. Information about the reactions of the seminar and therapy with the terminal ill are the concluding chapters and honestly, the book did not hold my interest in these chapters as much as it did in those of the stages. The book could have been outstanding (the research work is definitely appreciable, can’t deny that fact!) if it had included the coping mechanism of grief with interviews from the relatives of the ill after their departure because curious readers like me who aren’t medical professionals and read the book just to delve deeper into human behavioral aspects or for the sake of being less swayed by emotions with the help of expert analyses would benefit greatly from that. However, even without the author providing proof in the last few chapters about the research’s success, it is quite obvious how beneficial her work has been to the society as well as the patients who contributed to the work and I would recommend this book to anyone who is even remotely associated with hospital work. And I would like to end the review by quoting a quote used in the book which, I hope, would make you think about the meaning of life, even if only for a minute, since it resonated with me:

“Death is just a moment when dying ends.”



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