Dying: Out of Darkness

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A group of medical and theological students, nurses and social workers gathers every other Wednesday in a room at the University of Chicago's Billings Hospital to learn about dying. The seminar's instructors are indisputable authorities on the subject. They are all terminal patients in the hospital who have volunteered to share with strangers the last and most terrifying experience of life. Now in its fifth year, the Chicago seminar has vanquished the conspiracy of silence that once shrouded the hospital's terminal wards. It has brought death out of the darkness. In so doing, it has shown how, and with what quiet grace, the human spirit composes itself for extinction.

The course was the chance inspiration of Psychiatrist Elisabeth Kübler-Ross, 43, born and trained in Switzerland, who joined Chicago's faculty in 1965. She tells the story in a book, On Death and Dying (Macmillan; $6.95). It began with a visit from four Chicago Theological Seminary students who wanted to do a study of life's greatest and final crisis. "When I wanted to know what it was like to be schizophrenic," Dr. Kübler-Ross told her callers, "I spent a lot of time with schizophrenics. Why not do the same thing? We will sit together with dying patients and ask them to be our teachers."

On Borrowed Time. To her surprise, the psychiatrist encountered stubborn resistance not from the dying but from the quick. The reaction of physicians ranged from annoyance to overt hostility. Once this wall of official resistance was breached, Dr. Kübler-Ross found that the dying themselves were only too willing to talk. In four years the seminar has heard from 150 patients; there have been only three refusals. The author now understands why. "To live on borrowed time," she writes, "to wait in vain for the doctors to make their rounds, lingering on from visiting hours to visiting hours, looking out of the window, hoping for a nurse with some extra time for a chat, this is the way many terminally ill patients pass their time. Is it then surprising when such a patient is intrigued by a strange visitor who wants to talk to her about her own feelings?" From these feelings, freely given, the seminar has been able to trace the five successive stages of life's last journey:

> The dying patient's first reaction is denial: "No, not me." The response serves an important function. Writes Dr. Kübler-Ross: "It allows the patient to collect himself and, with time, mobilize other, less radical defenses."

> Denial eventually yields to deep anger: "Why me?" A 50-year-old dentist, dying of cancer, told the seminar: "An old man whom I have known ever since I was a little kid came down the street. He was 82 years old, and he is of no earthly use as far as we mortals can tell. And the thought hit me strongly, now why couldn't it have been old George instead of me?"

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