KÜbler-Ross, Elisabeth

Elisabeth Kübler was born on July 8, 1926, the first of three daughters born that day to a middle class family in Zurich, Switzerland. In her autobiography The Wheel of Life: A Memoir of Living and Dying (1997), Kübler-Ross commented: "For me, being a triplet was a nightmare. I would not wish it on my worst enemy. I had no identity apart from my sisters. . . . It was a heavy psychological weight to carry around." However, as an adult she concluded that the circumstances of her birth "were what gave me the grit, determination and stamina for all the work that lay ahead" and throughout her autobiography she describes herself as independent, unconventional, opinionated, and stubborn (Kübler-Ross 1997, p. 25).

"The first big decision I made solely by myself" involved defying her strong-willed father (who planned a secretarial career for her) in favor of her dream to become a doctor (p. 21). At school, Kübler-Ross was an excellent student, especially in math and languages, but not in religious studies. As her church, she preferred nature, pets, and animals of all kinds. One key childhood experience was a hospitalization in which an impersonal and uncaring environment isolated and separated her from her family. She often describes later encounters with conventional medical care in a similar way.

In the spring of 1942, the triplets completed their public schooling. Unwilling to become a secretary, Kübler-Ross took jobs as a maid and laboratory assistant. At the end of World War II, she volunteered to work in several areas of war-torn Europe. In Poland, necessity compelled her to practice rudimentary medicine and she was deeply moved by the concentration camp at Maidanek where more than 300,000 people had died.

Back in Switzerland, Kübler-Ross resumed working as a lab assistant and studying for the medical school entrance examination, which she passed in September 1951 with the intention of becoming a country doctor. In 1957 she passed her medical board examinations and became a physician. In February 1958 she married a fellow medical student from America, Emanuel ("Manny") Ross, and the couple moved to the United States. Becoming pregnant disqualified Kübler-Ross from a residency in pediatrics so she settled for one in psychiatry. There were problems of adapting to a new culture and eventually four miscarriages; as she later wrote, "You may not get what you want, but God always gives you what you need" (p. 111). A son, Kenneth, and a daughter, Barbara, were born in the early 1960s.

A new position brought Kübler-Ross to Billings Hospital of the University of Chicago. There, in 1965, four students from Chicago's Theological Seminary approached her to seek assistance in understanding death as the ultimate crisis in life. She offered to help and search out dying patients for interviews. Many physicians at the hospital were critical of Kübler-Ross for what they viewed as "exploiting" vulnerable patients, and the story of her difficulties in locating suitable interviewees is well known. Nevertheless, by early 1967 Kübler-Ross was leading an unorthodox but popular weekly seminar in which she would interview a patient behind one-way glass with a subsequent discussion with students and medical professionals after the patient had left.

An offer of a book contract from a publisher led to the international best-seller On Death andDying (1969). This book developed Kübler-Ross's now well-known theory of five stages in dying: denial, anger, bargaining, depression, and acceptance. As a result of this book, together in an interview with a twenty-one-year-old patient published in Life magazine on November 21, 1969, Kübler-Ross received numerous requests for interviews and lectures. Still, her hospital was not pleased with her success and she transferred to LaRabida Children's Hospital to work with ill and dying children. Finally, at the age of forty-six, she quit that post to do research on what death is like and to conduct weeklong workshops on life, death, and the transition to afterlife.

Kübler-Ross's research had convinced her that there was an afterlife. She was intrigued by stories of near-death experiences and experienced her first apparition about this time. As a result, she concluded that death does not exist in its traditional definition; rather it occurs in four distinct phases: (1) floating out of one's body like a butterfly leaving its cocoon, assuming an ethereal shape, experiencing a wholeness, and knowing what is going on around oneself; (2) taking on a state of spirit and energy, not being alone, and meeting a guardian angel or guide; (3) entering a tunnel or transitional gate and feeling a light radiating intense warmth, energy, spirit, and overwhelming love; and (4) being in the presence of the Highest Source and undergoing a life review.

At about this time, Kübler-Ross became convinced of the reality of her own spiritual guides and she eventually moved to California in early 1976 to pursue these inquiries. There, she founded a healing center (eventually called Shanti Nilaya, a Sanskrit phrase that she understood to mean "the final home of peace") where she could have a base for her workshops, explore out-of-body experiences, and develop a new lecture entitled "Death and Life after Death." Unfortunately, Kübler-Ross eventually lost confidence in some of her California colleagues and the center's property was sold.

In July 1983 Kübler-Ross purchased and later moved to a 300-acre farm in Head Waters, Virginia. There she built her house and a healing center for workshops. Around this time, the situation of persons with AIDS (acquired immunodeficiency syndrome) attracted her attention. However, when in 1985 she announced her intention to adopt AIDS-infected babies, she became, in her words, "the most despised person in the whole Shenandoah Valley" and could not get the necessary zoning approvals to carry out that plan. On October 6, 1994, her house was set on fire and burned to the ground with the complete loss of all her papers and possessions.

In the meantime, she experienced heart fibrillations and an eventual stroke. Again, Kübler-Ross had a low opinion of the medical treatment she received. She refused to give up smoking, coffee, and chocolate, and checked herself out of the hospital. After moving to Scottsdale, Arizona, Kübler-Ross experienced a massive stroke on May 14, 1995, that left her paralyzed on her left side and no longer able to live alone. While writing in January 1997, Kübler-Ross said she was enduring a "miserable" life resulting from pain and the limitations of her paralysis. Although she was "anxious to graduate" she remained opposed to efforts to foreshorten life (p. 280). Instead, she asserted that "our only purpose in life is growth" and that her task in these circumstances was to learn patience even as she was totally dependent on others for care (p. 281).

On Death and Dying and other books by Kübler-Ross have earned her a worldwide reputation. In addition, large numbers of people have been attracted to her many lectures, presentations, and workshops. Many have credited her with helping to draw attention to problems encountered by dying persons and to their needs as living human beings, thus tending to normalize and humanize such experiences. In all of this, she was an early and important contributor to the death awareness movement. The stage theory of dying that she proposed is simple and easy to learn. Its author and many others have since applied this theory to a wide variety of losses, even while some professionals have criticized its limitations. Her views about the afterlife, spiritual guides, out-of-body experiences, and near-death experiences have been consoling to some, but sharply criticized by others from both scientific and theological perspectives.

See also: Dying, Process of; Near-Death Experiences; Stage Theory

Bibliography

Gill, Derek. Quest: The Life of Elisabeth Kübler-Ross. New York: Harper and Row, 1980.

Kübler-Ross, Elisabeth. The Wheel of Life: A Memoir of Living and Dying. New York: Charles Scribner's Sons, 1997.

Kübler-Ross, Elisabeth. On Life after Death. Berkeley, CA: Celestial Arts, 1991.

Kübler-Ross, Elisabeth. AIDS: The Ultimate Challenge. New York: Macmillan, 1987.

Kübler-Ross, Elisabeth. On Children and Death. New York: Macmillan, 1983.

Kübler-Ross, Elisabeth. Living with Death and Dying. New York: Macmillan, 1981.

Kübler-Ross, Elisabeth. Death: The Final Stage of Growth. Englewood Cliffs, NJ: Prentice-Hall, 1975.

Kübler-Ross, Elisabeth. Questions and Answers on Death and Dying. New York: Macmillan, 1974.

Kübler-Ross, Elisabeth. On Death and Dying. New York: Macmillan, 1969.

CHARLES A. CORR DONNA M. CORR

Elisabeth Kübler-Ross

Swiss-born American psychiatrist Elisabeth Kübler-Ross (born 1926) has pioneered the idea of providing psychological counseling to the dying. In her bestselling 1969 book, On Death and Dying, she describes the five mental stages that are experienced by those approaching death and suggests that death should be viewed as one of the normal stages of life.

Psychiatrist Elisabeth Kübler-Ross has dedicated her career to a topic that had previously been avoided by many physicians and mental-health care professionals—the psychological state of the dying. In her counseling of and research on dying patients, Kübler-Ross determined that individuals go through five distinct mental stages when confronted with death, a discovery that has helped other counselors to provide more appropriate advice and treatment to their clients. Her ideas have been presented to the public in a number of popular texts, including her groundbreaking 1969 work, On Death and Dying. She has also offered instruction and treatment at the seminars and healing centers she has run for the terminally ill and their caretakers.

Kübler-Ross had a unique childhood as one of three triplet girls born in Zurich, Switzerland, on July 8, 1926. Although the girls were all extremely small at birth, their mother, Emmy Villiger Kübler, closely attended to their physical needs and ensured their survival. Kübler-Ross, her sisters, and older brother grew up in a strict but loving household. Their father, Ernst Kübler, expected obedience from his children, but he also took them on hikes in the Swiss mountains, instilling a great love of nature in his daughter Elisabeth. One of Kübler-Ross's main concerns as she grew up was finding a way to distinguish herself from her sisters. This search for a unique identity was hampered by the fact that she was physically identical to her sister Erika, and the two were often mistaken for each other. She would frequently escape to a favorite spot in the woods to enjoy some time away from her sisters, and she also tried to develop interests that would set her apart. Seeking something completely different from her own experience, she began to study African history and one of her prize possessions was an African doll that her father gave her after she had been dangerously ill with pneumonia.

Developed Early Ideas on Death

In addition to her own brushes with death as a child, Kübler-Ross witnessed the death of others around her in a series of experiences that shaped her attitudes about mortality. When she was in the hospital at the age of five, her roommate passed away in a peaceful state. She also knew of a young girl whose death from an excruciating bout of meningitis was viewed as a release from suffering. In another childhood episode, she witnessed a neighbor calmly reassuring his family as he prepared for death from a broken neck. Such events led Kübler-Ross to the belief that death is just one of many stages of life, an experience that the dying and those around them should be prepared to encounter with peace and dignity.

Kübler-Ross excelled in science as a student and was determined to fill her life with meaningful work, but her parents were not very supportive of her goal of an advanced education. Although their son was expected to prepare himself for a business career, the triplets were sent to local schools to receive only the basic education that their parents thought was necessary for futures as wives and mothers. When Kübler-Ross was 13, World War II began with the invasion of Poland by German forces. These events provided her with a way to contribute to the well-being of others; she vowed to find some way to help the Polish people, and throughout her adolescence, she participated in numerous activities assisting victims of the war. She first worked as a laboratory assistant in a hospital that treated war refugees, and in 1945, she became a member of the International Volunteers for Peace organization. Her volunteer work took her to Sweden and the French-Swiss border, and finally, in 1948, to Poland. There she helped Polish people to rebuild their cities and lives after the war by serving in a variety of jobs, including cook, nurse, and carpenter.

Planned Career in Psychiatry

These experiences after the war convinced Kübler-Ross that her life's calling was to heal others. She firmly believed that spiritual and mental health was a necessary part of healing the physical body and incorporated these interests in her planned career as a psychiatrist. She enrolled in medical school at the University of Zurich in 1951 and graduated in 1957. For a short period after leaving school, she worked as a doctor in the Swiss countryside. In February of 1958, however, she married an American doctor she had met in medical school, Emanuel Robert Ross, and moved with him to New York. The couple would be married for 11 years. In New York both of them were accepted as medical interns at Community Hospital of Glen Cove, Long Island. After completing her internship, Kübler-Ross began a three-year residency in psychiatry at Manhattan State Hospital; during this time she also trained for a year at Montefiore Hospital in the Bronx. In her work at psychiatric hospitals, she was disturbed by the failure of staff members to treat the patients with sympathy and understanding. She attempted to use a more personal means of communicating in which she showed an obvious interest in the welfare of the patient, and her approach yielded improvements even in the cases of people suffering from acute psychoses.

In 1962, after the birth of their first child, Kenneth, Kübler-Ross and her husband decided to leave New York City; they obtained jobs at the University of Colorado School of Medicine in Denver. The next year, Kübler-Ross began teaching at Colorado General Hospital. While in Colorado, another child, Barbara, was born to the family. In 1965, they moved again, traveling to Chicago, where Kübler-Ross became an assistant professor of psychiatry as well as assistant director of psychiatric consultation and liaison services for the University of Chicago. In the coming years, she increasingly turned her focus to the subject of psychological treatment for terminally ill persons suffering anxiety. She found that many doctors and mental health professionals preferred to avoid the topic, leaving patients with few resources to help them through the difficult process of facing death. Her interests were viewed with disapproval by medical school officials, who did not want to draw negative attention for focusing on death rather than recovery of patients. But Kübler-Ross went on with her work, organizing seminars to discuss the topic with a wide range of caregivers, including doctors, nurses, priests, and ministers. The seminars drew large numbers of interested people, demonstrating the need for information and ideas on counseling the dying. In these sessions, participants sat behind a one-way mirror and viewed Kübler-Ross interviewing terminal patients, discussing their fears and concerns.

Published Landmark Book on Dying

School administrators finally forced the psychiatrist to end her popular seminars. She continued her personal research, however, gradually discovering that all dying patients went through similar crises and discoveries. She organized her findings into five distinct stages of dying, which she identified as denial, anger, bargaining, depression, and acceptance. Her theory on the stages of dying and suggestions for how to use this information to treat patients were compiled in the 1969 book On Death and Dying. The book became a best-seller and was soon established as a standard text for all professionals who worked with dying patients and their families. Kübler-Ross's growing acclaim as an expert on the psychology of dying received an even greater boost when she was featured in a Life magazine article that described her frank discussions of death with terminally ill subjects. Overwhelmed by the tremendous public response to the article, Kübler-Ross decided to devote her career to helping dying patients and their loved ones.

While treating individuals on a case-by-case basis, Kübler-Ross also continued to put out more books. In 1974 she published Questions and Answers on Death and Dying, which was followed by two other books in that decade, Death: The Final Stage of Growth (1975) and To Live until We Say Good-bye (1978). During this time, she sought a way to reach more people with her counseling; the result was her creation of the Shanti Nilaya ("Home of Peace") healing center outside of Escondido, California, in 1977. In the 1980s, she began to focus on special themes within the topic of death, reflected in her books On Children and Death (1983) and AIDS: The Ultimate Challenge (1987). The early 1990s brought an apparent shift in her own philosophy of death. In the book On Life after Death she revises her earlier understanding of death as the final stage of life, stating that death is in fact a transition to a new kind of life.

Honored for Pioneering Work

In 1990, Kübler-Ross moved her healing center to her farm in Headwater, Virginia. After her house there burned down in 1994, she decided to hand over the operation of the center to an executive director, and she moved to Arizona to live near her son. She continues her work through ongoing workshops and lectures. Her groundbreaking career in the guidance of dying patients has been recognized with a number of awards, including receiving recognition as "Woman of the Decade" by Ladies' Home Journal in 1979 and honorary degrees from schools such as Smith College, the University of Notre Dame, Hamline University, and Amherst College. Such honors testify to the importance of Kübler-Ross's revolutionary approach of providing psychological support and comfort to the dying, an idea that has benefitted both doctors and patients.

Further Reading

Gill, Derek, "The Life of Elisabeth Kübler-Ross," Quest, Harper &Row, 1980.

Goleman, Daniel, "We Are Breaking the Silence about Death,"Psychology Today, September 1976, pp. 44-47.

Kübler-Ross, Elisabeth, On Death and Dying, Macmillan, 1969.

Wainwright, Loudon, "Profound Lesson for the Living," Life, November 21, 1969, pp. 36-43. □

KÜBLER-ROSS, Elisabeth

Born 8 July 1926, Zurich, Switzerland

Also writes under: E. Kübler-Ross, Elisabeth K. Ross

Daughter of Ernst and Emma Williger Kübler; married Emanual R.Ross, 1958 (divorced); children: two

Elisabeth Kübler-Ross, one of a set of tiny triplets, lived in Europe until after receiving her M.D. from the University of Zurich in 1957. She came to the U.S. in 1958 as an intern at Community Hospital in Glen Cove, Long Island, New York. She spent the next three years in residency in psychiatry at Manhattan State Hospital, Montefiore Hospital, and Colorado General Hospital. She has taught at the University of Colorado School of Medicine and at the University of Chicago.

Kübler-Ross travels throughout the world, giving hundreds of lectures, seminars, and workshops on death and dying. She has served on the advisory boards of more than 20 hospices and institutes on grief and dying and has received honorary degrees from 17 colleges and universities as well as numerous other awards. In 1976 Kübler-Ross founded Shanti Nilaya, a nonprofit organization "dedicated to the promotion of physical, emotional, intellectual, and spiritual health." She served as president of the board of directors. She married another physician and they had two children before divorcing. Kübler-Ross holds both U.S. and Swiss citizenship.

Although she does not administer medication or perform surgery, few people have Kübler-Ross' power to heal. On Death and Dying (1969, reprinted numerous times, including 1991, 1997), her groundbreaking book, and her subsequent lectures, writings, and workshops, have helped, as Anne Hudson Jones noted, to revolutionize "the way Americans think about death and dying, and consequently, about living as well." In On Death and Dying, Kübler-Ross reports on her work with terminally ill patients at the University of Chicago, where for several years she taught an interdisciplinary seminar on death and dying. She begins by outlining the changes occurring in the last few decades in the treatment of the dying. Instead of dying among family and friends, most people now die in impersonal institutional settings surrounded by medical personnel who are trained to prolong life but who do not know how to manage dying patients humanely. Kübler-Ross has identified five stages dying patients go through: denial, anger, bargaining, depression, and acceptance. Not all patients go through all stages, but those who reach acceptance die more peacefully, according to Kübler-Ross. The book includes some interviews with patients as well as a chapter assessing the reactions of the medical staff and students to her seminar.

In Questions and Answers on Death and Dying (1974, reprinted with two other titles, 1992), Kübler-Ross attempts to answer the questions most frequently asked of her by audiences. Although she reviews the material in her earlier work, there is useful new information about suicide and terminal illness, euthanasia, caring for the dying at home, the family's problems, funerals, problems of the medical staff, and beliefs in life after death.

Death: The Final Stage of Growth (1975), an anthology edited by Kübler-Ross, includes essays, poems, and letters, many of them written especially for this collection by former patients, colleagues, and her students. Selections address the psychological difficulties of patients dying in institutions, tell how other cultures handle death, and insist that death can be the final stage of personal growth. Of special interest is an autobiographical essay by Kübler-Ross, relating her early experiences with death, both in her community and in Europe during World War II, which she believes led her to her work with death and dying.

To Live Until We Say Goodbye (1978) is a volume of photographs by Mal Warshaw with text by Kübler-Ross. The first part of the book has photographs and interviews with three dying patients. The second part presents alternative settings for care of the dying—hospices, homes for the dying, and personal homes of the dying. The photographs are haunting; the text is informative. In this volume, Kübler-Ross says more about the death of children than she does in any of her other works. The final chapter tells of her teachings about life, death, and transition at Shanti Nilaya (Sanskrit for "home of peace"). In Working It Through: An Elizabeth Kubler-Ross Workshop on Life, Death and Transition (1981, 1987, 1997), her second collaboration with photographer Mal Warshaw, she briefly recounts the history behind Shanti Nilaya, and then describes the workshops, integrating photographs and letters from former participants.

In AIDS: The Ultimate Challenge (1987, 1997) Kübler-Ross recounts her ongoing efforts to help AIDS patients accept their condition with strength and serenity. She believes AIDS presents "the ultimate challenge" because the stigma attached to the disease has been as devastating as the disease itself. In one fascinating section, Kübler-Ross reprints a transcript of a town meeting held to discuss the founding of a hospice for babies with AIDS; she encounters hostile resistance from town members, whose concerns and prejudices reflect the fear and uncertainty shared by many across the country. Contrasting society's support for victims of "acceptable" illnesses such as cancer to the isolation and condemnation faced by AIDS sufferers, Kübler-Ross addresses her book to those who would still deny or ignore the tragedy of AIDS and withhold compassion from its sufferers.

Kübler-Ross' work has helped effect a much needed revolution in the way Americans think about death and dying and, consequently, about living as well. She has helped change medical education to include teaching about death and dying, and she is cited as an authority by almost everyone doing work in the field. She has received many honorary degrees, from Albany Medical College, Smith College, the University of Notre Dame, Hamline University, and the Medical College of Pennsylvania.

At the turn of the century, Kübler-Ross faced her own declining health, and the need to practice what she had so long, and so eloquently preached. In 1999, after six strokes, she spoke candidly to the media about her own imminent demise. She said she was already in the fifth stage (acceptance), and has been for nearly five years. Talking to ABC News in August, Kübler-Ross said, "That I could die tonight would be a good death. Not 10 years or even two years from now—that would be lousy. The sooner the better." Yet some wonder if Kübler-Ross is simply giving up, or depressed. For an independent woman, with an over-active, workaholic life, to be confined to a chair for better part of every day, has indeed been difficult. Her friend and holistic doctor, Gladys McGarey, told ABC News, "The strokes have been really devastating for her… another person, who was less in charge, might not be as deeply affected." For her part, Kübler-Ross states she is not truly living, just "existing." One hopes Kübler-Ross will achieve the peaceful passing she has advocated, the kind of death she helped many accept through her writings and seminars.

Other Works:

Living with Death and Dying: How to Communicate with the Terminally Ill (1981, 1997). Remember the Secret (1982, 1998). On Children and Death: How Children and Their Parents Can and Do Cope with Death (1983, 1997). Psychoimmunity and the Healing Process: A Holistic Approach to Immunity and AIDS (1987). On Life After Death (1991). On Death and Dying; Questions and Answers on Death and Dying; On Life After Death (bound in one volume, 1992). Death is of Vital Importance: On Life, Death and Life After Death (1995). Healing in Our Time (1997). The Meaning of Suffering (1997). Say Yes to It (1997). The Wheel of Life: A Memoir of Lving and Dying (1998). The Tunnel and the Light: Essential Insights on Living and Dying (1999).

Bibliography:

Chaban, M., The Life Work of Dr. Elisabeth Kübler-Ross and Its Impact on the Death Awareness Movement (1998). Elliott, W., Tying Rocks to Clouds: Meetings and Conversations with Wise and Spiritual People (1995). Felder, D. G., The 100 Most Influential Women of All Time: A Ranking Past and Present (1996). Groen-Colyn, S. M., "The Influence of Elisabeth Kübler-Ross on the Field of Thanatology: A Historical Analysis" (1998). Haney, D. M., Healing Waters Farm Cookbook: Favorite Recipes of Elisabeth and Friends of the Elisabeth Kübler-Ross Center, Head Waters, Virginia 24442 (1997). Molnar, L. A., "The Attitudes and Knowledge of Kübler-Ross' Stages and the Fears of Death and Dying in Junior and Senior Nursing Students an Exploratory Study" (thesis, 1981). Skog, S., Embracing Our Essence: Spiritual Conversations with Prominent Women (1995). Stille, D. R., Extraordinary Women of Medicine (1997).

Reference works:

Biographical Directory of the American Psychiatric Association (1977, 1991). CA (1999).

Other references:

Book World (17 Oct. 1982). Christian Century (14 Apr. 1976). Elisabeth Kübler-Ross (transcript, 1997). Family Circle (Sept. 1975). Life (21 Nov. 1969). McCall's (Aug. 1976). New Statesman (9 July 1982). NYTBR (10 Apr. 1988). People (Nov. 1975). Psychology Today (Oct. 1982). Readers' Digest (Aug. 1976). Register (Dec. 1966). Time (10 Oct. 1969).

Web site:

ABCNews.com, 1999.

—ANNE HUDSON JONES,

UPDATED BY JEROME CHOU

AND NELSON RHODES

Kübler-Ross, Elisabeth

(b. 8 July 1926 in Zürich, Switzerland; d. 24 August 2004 in Scottsdale, Arizona), psychiatrist, advocate of terminal health care reform, and author of On Death and Dying.

Kübler-Ross was the eldest and smallest of triplet sisters born to Ernst Kübler, an executive in a Zürich office supply company, and Emma (Villiger) Kübler, a homemaker. The family also included a son six years older than the triplets. When the girls were four the family moved from a small apartment in Zürich into a large country house near the village of Meilen, Switzerland, half an hour by train from Zürich. When they were ten, they moved into an even larger house near Meilen. The Küblers were a typical upper-middle-class German-Swiss conservative Protestant family. Only Kübler-Ross rebelled, mainly to create a separate identity from her sisters.

Kübler-Ross established herself while still a child as a defender of the weak. In elementary school she attacked bullies to protect her schoolmates. She was a good student, especially in mathematics and science, and worked hard for good teachers, one of whom was her science teacher. Kübler-Ross had worse luck with her abusive religious instruction teacher. After an altercation in which the teacher smashed together the heads of Kübler-Ross’s sister and another girl, Kübler-Ross stormed out of the room, declaring that she refused be part of any religion that preached love and compassion but allowed its ministers to be violent. Kübler-Ross was exonerated, and she and her sister thereafter took their religious instruction from a family friend.

Kübler-Ross’s father was a harsh disciplinarian who expected to choose his children’s careers without regard to their wishes, talents, or aspirations. When Kübler-Ross was sixteen her father dictated that she join him in business as his secretary and bookkeeper. She refused, breaking the taboo against openly defying the head of the household. From a young age Kübler-Ross had wanted to be a physician. Three early experiences of death—of her pet rabbit in a butcher shop, of a schoolmate of painful meningitis, and of a middle-aged man in a farm accident—caused Kübler-Ross to ponder the meaning of mortality. Rather than obey her father, Kübler-Ross left home to work as a maid in Romilly, near Geneva, Switzerland. By the time she returned home six months later, her father had relented. He allowed her to work wherever she wanted, but he would not support her further education.

Kübler-Ross worked in a biochemistry laboratory for dermatologists at Canton Hospital in Zürich, and as an ophthalmology research assistant at the University of Zürich. When World War II ended Kübler-Ross volunteered to help rebuild Poland and to counsel Polish victims of the Nazis. With the support of the ophthalmologist for whom she worked, but against her father’s wishes, Kübler-Ross entered medical school at the University of Zürich in 1951, studied mostly part-time, and received her MD in 1957.

On 7 February 1958 Kübler-Ross married Emanuel Robert (“Manny”) Ross, an American physician she had met in medical school. The couple moved to the United States later that year, settled on Long Island, New York, and had two children. Kübler-Ross was an intern at Community Hospital, Glen Cove, New York, from 1958 to 1959; a research fellow at Manhattan State Hospital from 1959 to 1962; and a resident in psychiatry at Montefiore Hospital from 1961 to 1962. She became an American citizen in 1961 but retained dual citizenship.

In 1962 the family moved to Denver, where Kübler-Ross was a fellow in psychiatry at the Psychopathic Hospital of the University of Colorado Medical School (later Colorado Psychiatric Hospital) until 1963 and an instructor in psychiatry at Colorado General Hospital until 1965. In 1965 the family moved to Chicago, where Kübler-Ross concentrated her practice on terminally ill patients and her research on their psychology. Kübler-Ross began to present seminars on dying and soon became a popular speaker. From 1965 to 1970 Kübler-Ross was on the psychiatric staff of La Rabida Children’s Hospital and Research Center. She was also an assistant professor of psychiatry at Billings Hospital of the University of Chicago and a consulting psychiatrist to the Chicago Lighthouse for the Blind, the Peace Corps, and the Illinois State Psychiatric Institute.

The appearance of Kübler-Ross’s first book, On Death and Dying (1969), brought her instant acclaim. Kübler-Ross’s most famous insight was that dying proceeds in five psychological stages: denial, anger, depression, bargaining, and acceptance. Kübler-Ross wrote or cowrote twenty-two other books, most on death but two on acquired immunodeficiency syndrome (AIDS), two autobiographies, and several works of practical advice on how to experience and express unconditional love, how to live to the fullest, and how to grieve responsibly, creatively, and productively. Kübler-Ross’s works were published in at least twenty-seven languages.

Kübler-Ross embraced the hospice movement when she heard of the work of Cicely Saunders. In London in 1967 Saunders had founded Saint Christopher’s Hospice, the world’s first modern facility to offer comfort to dying patients in an atmosphere of respect for their dignity. The two physicians collaborated to bring the hospice idea to the United States. In 1974 the first two hospices in the United States opened in Connecticut.

Kübler-Ross served as the medical director of the Family Service and Mental Health Center of South Cook County from 1970 to 1973 and as president of Ross Medical Associates in Flossmoor, Illinois, from 1973 to 1976. Mysticism and spiritualism captivated Kübler-Ross in the 1970s. She and her husband divorced in 1976. The children stayed with Ross in Flossmoor, and Kübler-Ross moved to Escondido, California, where in 1977 she founded the Shanti Nilaya Growth and Healing Center. Shanti Nilaya is Sanskrit for “home of peace.” Kübler-Ross was the president and chair of the board of the center from 1977 to 1995.

In 1983 Kübler-Ross bought a farm in Virginia, where she lived and built a healing and lecture center. She also became a clinical professor of behavioral medicine and psychiatry at the University of Virginia. She announced her plan to adopt infants with AIDS, but after being harassed by local residents, abandoned the plan. In 1994 Kübler-Ross lost her home to suspected arson. Her papers, diaries, case histories, patient records, art collection, and most of her family memorabilia were destroyed. She retired from practice and moved to Scottsdale in the spring of 1995 to live near her son. Kübler-Ross had several strokes beginning in the early 1990s and never stopped smoking. She died of natural causes on 24 August 2004 in Scottsdale surrounded by her family and friends. She is buried in Paradise Memorial Gardens, Scottsdale. Kübler-Ross summed up her life in her 1997 autobiography: “I was supposed to have been a... housewife. Instead I ended up an opinionated psychiatrist... who communicates with spirits from a world... far more loving and glorious than our own.”

Elisabeth Kübler-Ross, The Wheel of Life: A Memoir of Living and Dying (1997), is a series of introspective stories. Biographies are Derek Gill, Quest: The Life of Elisabeth Kübler-Ross (1980); and Michèle Catherine Gantois Chaban, The Life Work of Dr. Elisabeth Kübler-Ross and Its Impact on the Death Awareness Movement (2000). A study of Kübler-Ross’s work is Cathy Siebold, The Hospice Movement: Easing Death’s Pains (1992). Obituaries are in the New York Times, San Francisco Chronicle, and USA Today (all 26 Aug. 2004).

Eric v.d. Luft

Elisabeth Kübler-Ross

Born Elisabeth Kübler, July 8, 1926, in Zurich, Switzerland; died August 24, 2004, in Scottsdale, AZ. Psychiatrist and author. Early in her medical career, Elisabeth Kübler-Ross developed an interest in the way hospitals cared for dying patients. Mostly, she was alarmed that the medical community, so focused on saving lives, seemed unable to deal with those who were dying. At the time, terminally ill patients were generally ignored and left to die on their own without ever being told the entire truth of their condition.

Kübler-Ross changed all that. She befriended thousands of terminally ill patients and interviewed them personally to find out how to meet their needs. She published her findings in a 1969 best-seller titled On Death and Dying, which ultimately helped transform the way the medical community dealt with terminally ill patients. In the book, Kübler-Ross categorized the five stages of grief terminally ill patients go through—denial, anger, bargaining, depression, and acceptance. The book, which sold millions of copies, provided a vocabulary for doctors, patients, and families to use when discussing the process of death. In the end, her work helped spawn the hospice-care movement.

Kübler-Ross, a triplet, was born on July 8, 1926, in Zurich, Switzerland, to Ernst and Emma Villiger Kübler; she weighed just two pounds. By sixth grade, Kübler-Ross had decided to become a doctor. Her father, believing this was a foolish pursuit for a girl, tried to force her into becoming a secretary in his office supply business. Rebellious and free-thinking, Kübler-Ross, just 16, left home and supported herself by working as a cook, a mason, a roofer, and assisting in an eye clinic. During this time she also became familiar with hospitals while working as a volunteer helping refugees from Germany.

After World War II came to an end in 1945, Kübler-Ross traveled across Europe helping set up first-aid clinics in war-torn countries. In her journeys, Kübler-Ross met refugees and survivors of concentration camps and visited the Majdanek death camp in Poland. Afterward, she decided to become a psychiatrist so she could help people deal with the grief of death.

Kübler-Ross graduated from Switzerland's University of Zurich medical school in 1957. There she met her future husband, a Jewish-American neuropathologist named Emanuel Ross. They married in 1958 and settled in New York City. She became a research fellow at Manhattan State Hospital and was instantly alarmed by the way doctors there treated the dying. Often, they were isolated and ignored. Kübler-Ross noticed that doctors would not even give them pain medication for fear of addiction.

Intrigued by the process of dying, Kübler-Ross began talking with the terminally ill in an attempt to understand their misery and loneliness. She was eventually given permission to care for them and offer counseling. According to the London Independent, Kübler-Ross berated the medical community for teaching "everything about your liver and nothing about you as a person."

In 1961, Kübler-Ross became a U.S. citizen and in 1962 she and her husband accepted teaching positions at the University of Colorado medical center in Denver. One day, when asked to fill in for a well-liked instructor, Kübler-Ross brought in a 16-year-old girl who was dying of leukemia. The students, who had never spoken with a terminally ill patient, were teary by the end of the class. Afterward, Kübler-Ross regularly offered similar lectures.

In 1965, Kübler-Ross joined the faculty at the University of Chicago medical school, where she served as an assistant professor of psychiatry. While there, some theology students asked her for help on a research project concerning death. To help with the project, she began holding intimate interviews with terminally ill patients in front of hospital staff members, medical students, and theology students. Initially, the medical community shunned her seminars but in time they became so well-attended they had to be moved to a large auditorium. Eventually, her seminar became an accredited course. Today, courses on death and dying are included in medical school curriculums.

These interviews, as well as others, became the basis for Kübler-Ross's book On Death and Dying, where she identified and described the five psychological stages terminally ill people go through. The book became popular beyond the medical community and helped open up discussions on death in a culture that was generally uneasy with the subject. After the book's publication, Kübler-Ross was a household name. She also advocated that the dying need respect and dignity. Her work was integral in generating the creation of the U.S. hospice system.

Kübler-Ross left the academic setting after the University of Chicago began to question the validity of her work as genuine medical research. She went into private practice and spent her time writing, speaking, and giving workshops on "Life, Death, and Transition." She began interviewing patients who had had near-death experiences and these discussions led her to an investigation of life after death. As Kübler-Ross began to explore this phenomenon and talk freely about out-of-body experiences and spirit guides, the medical community lost faith in the science of her work and her credibility waned. However, as the 20th century drew to a close in 1999, Time magazine named her one of the "100 Most Important Thinkers" of the century.

Throughout her career Kübler-Ross maintained a heavy travel schedule and her husband eventually left her. They divorced in the 1970s and he raised their two children. In the early 1980s, she established the Kübler-Ross Center, a healing facility, on a 300-acre farm in Virginia. Kübler-Ross also began working with AIDS patients, babies in particular. In 1985, she tried to open a home for AIDS-infected children at the center; however, nearly every adult in the area signed a petition to bar the center from opening. In 1994, the center burned in an arson-suspected fire. Kübler-Ross's life's work—her notes, journals, and photos—were lost in the blaze.

Later in life, Kübler-Ross relocated to Scottsdale, Arizona, where her son and former husband lived. In the 1990s, Kübler-Ross suffered a series of strokes that left her partially paralyzed. She continued working on books, though, and moved into a hospice in 2002.

Kübler-Ross died on August 24, 2004, of natural causes at a group home in Scottsdale, AZ; she was 78. A week before her death, Kübler-Ross had lost consciousness and suffered from infections. She is survived by her son, Kenneth; her daughter, Barbara; her sister, and two granddaughters. Her exhusband preceded her in death.

Sources

CNN.com, http://www.cnn.com/2004/US/Southwest/08/25/obit.kublerross.ap/index.html (August 26, 2004).

Independent (London), August 28, 2004, p. 48.

New York Times, August 26, 2004, p. B8.

Washington Post, August 26, 2004, p. A1, p. A11.

—Lisa Frick