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كتاب «همدلي با بيماران رو به مرگ» اليزابت كوبلر راس، آداب اقتدارگرايانه و تعصب‌آميز را به چالش مي‌كشد. در دوره‌اي كه اهل حرفه پزشكي از بيماري‌هاي پيشرفته در لفافه و با اگر و مگر حرف مي‌زدند، دكتر راس نه تنها با بيماران درباره بيماري آن‌ها صحبت مي‌كرد، بلكه به طور اصولي و به دقت حرف‌هاي آن‌ها را گوش مي‌داد


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On Death and Dying was one of the hardest books I have ever read. The subject matter was, obviously, in part the reason for this. But there was more than just the topic that made this a difficult book. Elisabeth Kübler-Ross wrote this book at the end of the sixties, almost some fifty years ago and there is much about the world that has changed, and some of what she describes can become difficult to apply to the world we know now. Some level of personal experiences and beliefs that seemed to go against some aspects of the book and the people within its pages also made some aspects of the reading difficult.

Hospitals (at least in the places that are part of the ‘first world’) do not entirely resemble what Kübler-Ross speaks of. They may not be perfect, may be over populated and overly busy, but some of the aspects of them has changed greatly, namely the way the family members of the patients are handled, and also the way that patients themselves are treated and what is available to them to help them not be so alone. Of course, a lot of this changed thanks to the work of people like Kübler-Ross and although the change made it hard to look at her work as being entirely usable in today’s hospitals, it was in itself an enlightening way to see what exactly had changed throughout the years.

That aside, the fifty years since this book was written, show in a myriad of way throughout the pages. Someone I talked to this about joked that ‘People don’t die the same anymore’, but I do think there is a difference in how a lot of the aspects of dying are approached in today’s society, and not all of them are changes that occurred because of research done on this topic. Some, simply happened because the world, our society, changed and evolved. One of the most often evoked worry of the dying in the book is that their spouse is having to take on responsibilities that were not theirs before: for men they worry about their wives looking after the financial and business side of things; for women they worry of leaving their husbands to have to do everything around the household and look after the children.

Gender roles were still strongly enforced and respected when Kübler-Ross wrote this book. Nowadays they are slowly—but surely—being forgotten. Women work, men raise children and for the most part no one bats an eyelid at it all. As such it could be quite difficult, and extremely jarring to fully understand the worry of these patients who felt like they were putting on their husbands too much or not feeling confident that their wives could handle the business they were leaving behind. I think that, as someone who sees themselves as a feminist and stands against gendered stereotypes, these parts were particularly hard to get through. It made me angry because, surely, surely it shouldn’t have been that way. I had to remind me when this book was written several times to get through these particularly bits. Similarly, the heavy emphasis on religion, Christianity I should say, was troubling to me. It was this tacit understanding that bar a few exceptions (there is mention of a Jew at one point), this was the religion that everyone shared, that was accepted as the norm and, in a way expected. Again, this is something that from my personal experience has changed and I cannot imagine that researchers would so easily involve members of the clergy in their research as Kübler-Ross did back then. Finally, the last outdated, rage-inducing part of this book was the use of the word ‘negro’ that felt so out of place and so wrong in the context that it made me extremely uncomfortable and judging how hard as a world we have to fight against racism if it might be a plan to edit such words out of texts that are supposed to be open-minded.

Now all these things aside, On Death and Dying made for a truly interesting read, not least of all because it reveals the origins of what we take now for granted as the five stages of grief: denial, anger, bargaining, depression, and acceptance. Nowadays these are applied to any grief, but when Elisabeth Kübler-Ross developed and first talked about them, she was not talking about the grief of the living, of those that stay behind, she was talking of the grief of those that are dying and know that they are going to lose everyone and everything that they grew close and worked towards in their lifetime. In this the book holds several revelations. First of all, when studying grief, I had always struggled with the stage of bargaining, and more importantly with when it came in the process. When looking at the grief I had experienced, bargaining suddenly didn’t come after anger, or at least not in the way textbooks had presented it to me. And also it seemed to apply only to cases where the grieving person had known that the deceased had been dying and could not be applied so easily to sudden and violent deaths. Seeing it as a part of the stages that the dying goes through made tremendously more sense.

But more than anything, On Death and Dying made me look at dying in a way that would have been impossible without experiencing it myself or working on the wards where these people spent their last hours, days, months or years. I did not find it as scary as I thought, or as difficult. Instead it made me understand some things attached to my own grief attached to the friend I had to watch die recently. I understood more about what she went through (and how she struggled) and I truly wish that I had read this book earlier. I think, simply, Kübler-Ross asks us to be more human, to look at people and see them as a person no matter their state or their pain. And it should sound an easy enough thing to do but we are famously bad as a race to see things from a point of view that is not our own and in that, her work is tremendously important.

I don’t know if I could handle working with the dying as she did, for I found their stories in turn heart breaking and frustrating, but I have learnt a great deal for learning this book. Not least of all that hope is something we should be able to carry with us until the very end. I had never considered that the dying too grieve, for it is something so little talked about. But now all I can think is, of course they do. It seems now like such obvious a thing that I can but be grateful as this book for how it opened my eyes. I cannot imagine anyone who works with terminally ill patients who should not read this book. They made find it difficult in places, as I did, for our world has changed, but the lesson that it carries, the wisdom within its pages has no need to change, because no amount of time passed will ever make it entirely irrelevant.

مشاهده لینک اصلی
I read this book 30 years ago. It was recommended I read it -- and for the life of me cant remember who recommended it -- but Im glad whoever and wherever they are, they did. It was a difficult time for me then because I was losing a parent. Dying from disease can be an ordeal, more so for the dying, of course, but also for those of us left behind who care. Today the five stages of grief are widely known, but it was from this book I first learned of those stages. In my opinion, to have compassion for the dying, and also for those who have lost someone they care about to death, is one of the highest expressions of humanity. The wisdom in this book now considered a classic on death and dying widened my perspective and understanding what we all must go through, eventually.

مشاهده لینک اصلی
This book and the research behind it clearly were revolutionary and in some ways have not yet had sufficient impact on the practice of medicine. The topic is extremely important, and many concepts put forward here have become heuristics of medical education about how to talk to dying patients (e.g., use simple, straight forward language including the word death; sit down; find a quiet spot to tell people bad news; make sure all the important people are present).

So, why did I say it was ok rather than great despite its obvious importance? First, perhaps it was overhyped and I had inappropriate expectations. Second, since I knew most of it, it had less impact for me. Third, I was horribly turned off by the historical frame for the work she provides in the first 20 pages. It is ridiculous to purport, and especially without significant citations from people who experienced it, that death during the Middle Ages was a more idyllic, peaceful experience with the potential to be home and surrounded be loving family than death in the 20th century was. Those in the Middle Ages died in wars, at the hands of masters, of infectious disease, through torture or childbirth, in unexpected, horrible, and often painful ways. If it wasnt plague, it was gangrene, etc.

Fourth, the stages of dying (denial, anger, bargaining, depression, acceptance) with hope scattered in, seem bald, inflexible, and to hinge a lot on ones attributing many subconscious urges to people. Sometimes, were just more straight-forward. And, what about grief? People should grieve things that are lost. Forcing people to be in certain heuristic classes when they should just be able to be where they are emotionally seems nearly as bad as not letting them be where they are emotionally.

مشاهده لینک اصلی
On Death and Dying is Elizabeth Kubler-Ross discourse on the psychological stages of grief before and after death. Ross headed a study in the 1960s where she and a team of students, doctors, and clergy interviewed patients who were suffering from various maladies with low to fair prognosis. Some of these patients knew they were in the end stages of life, others did not. Some interviewed were family members of the patients. Ross covered the various stages of death and grief and the effects on patients, family, and attending medical staff. Some were able to handle news of their prognosis better than others. Some were reluctant to talk, but all opened up once the questions began and felt better to have their stories told, their fear vocalized, and their hearts opened. It became evident that all wanted and needed to talk, even if it was just to open themselves to the inevitable.

This is a classic book written in the 60s but many of the lessons still ring true today. Everyone handles death and grief a little different but most go through the basic stages of denial and isolation, anger, bargaining, depression, and acceptance. Having recently lost my father and having lost my mother many years before, I realize that each died in much the same way and I now know that when it was time they were ready and were peaceful.


مشاهده لینک اصلی
One of those comfortable books,that I re-read as my partner of 39 years lay dying from bone cancer in the magnificent Princess Margaret Cancer Palliative care unit,in Toronto, were he was treated with great love, care and compassion, in spite of very little of what we like to call @Quality of life@ he was cared with much love. I was able to spend 24 hours a day with him, a bed was provided for overnight stays, Robert passed away while I was with him. much of the care given there, originated with this great book.
Sorry if I digress, but it has been a rough ride these past few weeks, Robert is at peace and pain-free. hence my re-reading of Kubler-Rosss book, it provides comfort, information and understanding about a subject we hear far to little about, this book should be taught in junior schools, lets get real, everyone of us will die one of these days, it deals with the patient and common sense ideas for care-givers, I have recently borrowed some books on bereavement and grief,that simply do not have the information, their content tends to be scientific @blather@ I still give Dr. Kubler-Ross a #10 for her book, which is easy to read, its contents easy to understand,based on her personal @hands on@ research. whether you agree with it or not.
I highly recommend this book!

مشاهده لینک اصلی
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