Elisabeth Kübler-Ross, a Swiss-born American psychiatrist, pioneered the concept of providing psychological counseling to the dying. In her first book, On Death and Dying (published in 1969), she described five stages she believed were experienced by those nearing death—denial, anger, bargaining, depression, and acceptance. She also suggested that death be considered a normal stage of life, and offered strategies for treating patients and their families as they negotiate these stages. The topic of death had been avoided by many physicians and the book quickly became a standard text for professionals who work with terminally ill patients. Hospice care has subsequently been established as an alternative to hospital care for the terminally ill, and there has been more emphasis on counseling for families of dying patients.
Elisabeth Kübler was one of three triplet girls born in Zurich, Switzerland, in 1926. Though she weighed only 2 pounds at birth, she credited her survival to her mother's attention and love. At age 5, when she was hospitalized with pneumonia, Elisabeth Kübler witnessed the peaceful death of her roommate—her first experience with death. On another occasion, she watched a neighbor calmly reassuring his family as he prepared for death from a broken neck. Such experiences led her to believe that death is but one of many life stages and that the dying and those around them should be prepared to face it with peace and dignity.
When Kübler was 13, the German army's invasion of Poland marked the beginning of World War II. She volunteered to help the Polish war victims. She first worked as a laboratory assistant in a hospital for war refugees, and then in 1945 she became an enthusiastic activist with the International Voluntary Service for Peace.
While still a teenager, she worked in France, Poland, and Italy, rebuilding communities devastated by the war. Just after the liberation of Europe in 1945, she visited Majdanek, a concentration camp, where she met a girl who had been left behind when the gas chambers would not hold another person. Rather than remain bitter, Kübler-Ross recalled, this girl had chosen to forgive and forget. The girl said, "If I can change one person's life from hatred and revenge to love and compassion, then I deserved to survive." Elisabeth Küblers experiences in Poland changed her life forever—she decided to spend her life healing others.
Against her father's wishes, Kübler enrolled in the medical school at the University of Zurich in 1951 and graduated in 1957. In 1958, she married Emanuel Robert Ross, an American doctor she met in medical school. They moved to New York for internships at Long Island's Glen Cove Community Hospital. Kübler-Ross then completed a three-year residency in psychiatry at Manhattan State Hospital and trained for a year at Montefiore Hospital in the Bronx.
In 1962, after the birth of their first child, Kübler-Ross and her husband left New York for new jobs at Denver's University of Colorado School of Medicine. When their second child was born in 1965, they moved to Chicago, where she became an assistant professor of psychiatry at Billings Hospital, affiliated with the University of Chicago. There, she began to focus on the psychological treatment of terminally ill patients suffering from anxiety. She found that many health professionals preferred to avoid discussing death with them, leaving patients facing death alone. Medical schools preferred to focus on patients' recovery rather than their death. She persisted with her work, however, organizing seminars on death and dying with caregivers, doctors, nurses, ministers, and others. Her seminars attracted large audiences. "My goal was to break through the layer of professional denial that prohibited patients from airing their inner-most concerns," she said.
Kübler-Ross was forced to end her seminars but continued her work with dying patients. The success of her first book, On Death and Dying (1969), prompted her to devote her clinical practice to dying patients, and to establish Shanti Nilaya ("Home of Peace"), a healing center near Escondido, California. In the 1980s she began to focus on helping AIDS patients and children facing death. Kübler-Ross continued with this work until she retired in 1996.
