The Plowboy Interview: Elisabeth Kubler-Ross

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PLOWBOY: You seem to have been drawn to the most seriously ill or disturbed patients.

KÜBLER-ROSS: I guess that's because I grew up in a very nice, affluent home but I was a triplet, and felt I had no real identity. Do you understand? Among the earliest memories of one of my sisters is the time my father gave her a bath twice and skipped me.

PLOWBOY: Is it sometimes best for terminally ill people to die at home.

KÜBLER-ROSS: I'm very much in favor of letting patients die at home. When you've done all you can to prolong or save life, you should then let people spend at least their last few weeks in a familiar environment ... a place where they can have unrestricted visits or smell the aroma of soup or coffee in the kitchen, and where they can have their favorite dog or cat on their knees or see their children or grandchildren at play.

PLOWBOY: How can you tell when someone should be allowed to go home to die?

KÜBLER-ROSS: A good doctor has to be able to judge when further medical treatment is purposeful And the family needs to listen to the patient to know whether, for emotional reasons, taking him or her home is the right thing to do.

I can remember telling an old man how hard we were trying to save him, and he said, "Could you try a little less hard?" After we laughed over that remark, he added, "All I want is to be left in peace. I've lived a long life and think I'm entitled to stay home." And he was right. On the other hand, though, a depressed cancer patient who has a good chance to make it into remission, but is so discouraged that he or she just wants to give up and go home, may need to be told to wait until the potentially helpful treatment is over.

PLOWBOY: I imagine many families are overwhelmed by the thought of caring for terminally ill relatives.

KÜBLER-ROSS: Yes, families often need help. Frequently, they'll need an "outside" person to assist in caring for a patient, so—for example—the wife of a dying man can still get to the hairdresser, or a teenager can go out on a date. It's important not to make the house into a morgue in such a case, because the other people living there still have to continue to lead normal lives. If they're not allowed to, those individuals will quickly become exhausted, and very bitter.

PLOWBOY: How does a family find such a helper?

KÜBLER-ROSS: If they really look, they'll find someone—perhaps a neighbor or friend—that they and the patient feel comfortable with. As an example, I once paid a house call to a young Swedish lawyer who had ALS, Amyotrophic Lateral Sclerosis disease. He was paralyzed from the neck down and couldn't talk. His wife and two small children were totally worn out from caring for him, and they were about ready to give up and send him to the hospital. The man sensed his family's desperation, and with the help of a speakingboard—a wonderful tool that helps such paralyzed people communicate—had begged to see me.

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