I've been meaning to read this book for several years now. While I understand its importance in the literature of patient care and am glad that I finally read it, I couldn't help feeling that there was so much that could have been expanded upon. For example, the interviews that she included were interesting, but sometimes a little hard to follow because they were literal transcripts of her conversations with patients and didn't convey very well the emotion of the patients (and her talk of this patient's anger and that patient's attitude of denial seemed dissociated from the conversation I'd just read). Also, I know that she was striving to write dispassionately and analytically, but this arms-length approach seemed at odds with what her book was all about: taking a warmer, human approach to dying patients.

It has become cliché to say we live in a society that denies death. From her experiences with dying patients, Elisabeth Kubler-Ross sheds insight into how we face, or not face, death. She details the famous Five Stages --denial and isolation, anger, bargaining, depression, acceptance--through case studies of patients. These Five Stages, for better or worse, have become the model from which academics and lay people understand the process of dying. But more than the model, the book forces us to gaze death in the eyes and confront our fears. Only then can we integrate death into life and realize that death is part of our life and indeed a vital part. If we deny it or even just neglect it, our lives become incomplete. We don’t have to obsess over death just as we don’t just focus on our health to the neglect of other parts of lives. When death becomes an integral part of our beings, our lives become more dynamic.

Great insight into the psychology toward our ultimate end. On Death and Dying is not only for those facing death and their close ones, but for everyone, to prepare our journey to the end, and thus to gain strength in living our lives and in caring for those around us.

كتاب مهم عن مراحل الحزن الخمسة والتي تدعى بنموذج كوبلر للفقد
وهي دراسة قامت بها هي وفريق بحثها عن الاشخاص المحتضرين أو الذين لا شفاء لهم تحاورهم بكل لطف حتى تمكنت بسببهم من استحداث هذه المراحل الخمس والتي من شأنها أن تعين أيضا من فقدوا أحباءهم في فهم شعور الفقد والأسى بعد رحيلهم
كتاب لا بد أن ينضم لمكتبة المنزل
ستفهم كثيرا عن حزنك حتى تتكامل معه
الترجمة مبهرة شكرا لكم دار صفحة سبعة لترجمة هذا الكتاب وأتمنى أن تترجموا بقية أعمال الكاتبة خاصة كتاب
On grief and grieving

Elizabeth Kübler-Ross’s seminal work, On Death & Dying: What the dying have to teach doctors, nurses, clergy, and their own families (1969) seemed like a good place to start, so I started there.

You have probably heard the simplified version of Kübler-Ross’s stage theory: denial, anger, bargaining, depression, and acceptance. You may have heard it (mis)applied to those who grieve instead of those who are dealing with terminal illness (which was not the stage stuff’s original purpose, though Kübler-Ross later worked on grief). You may have heard criticisms that the Kübler-Ross stages are too prescriptive, leaving little room for patients and mourners to uncritically accept their own experiences. I had heard all these things, and arrived at the book with some baggage.

So, I was a little surprised to find the stages offered so cautiously here. Kübler-Ross writes straightforwardly and without any of the airs of a grand theorist or aspiring paradigm-shifter. Instead, Kübler-Ross briefly describes her dissatisfaction with the existing state of death studies. She boldly undertakes a simple project of finding dying patients and speaking to them, on their terms (this was logistically difficult and unpopular with the patients’ doctors). And she largely just records the interviews plus a bit of summary, without significantly theory-laden editorializing.

Then again, maybe I shouldn’t have been surprised: no abundance of clear writing has ever saved an important primary source from being misunderstood by would-be critics. Perhaps even enumerating the stages towards death creates too much pressure towards conformity of experience. But even if hearing about the stages has this tendency, it also has redeeming value: offering people in trying circumstances a quick way to make sense of one of the most difficult experiences of their lives. The stages are an entrance to understanding, not an ending.

This book, almost 50 years old, shows its age in places. Nurses at the time apparently tended to ignore terminally ill or actively dying patients. It was more common for doctors to adopt a paternalistic role, withholding details about conditions and treatments. My experience is limited to one hospital, but here in 2018 I’ve actually found the nurses aggressively cheery. It sometimes makes me want to scream “can’t you see how sick this person is??” Perhaps this is some kind of institutional overcompensation.

As for the paternalism, well now (for better or worse) we live in an age of the individual. Patient autonomy reigns supreme (at least in theory…). And in the pop psychology of today, emotional experiences are often assumed to be necessarily as unique as their bearers.

Sure, at some times, people really do like feeling special. But, in the face of death and loss, there might be more to say for drawing our attention toward human universals. No one can die or grieve for you, but the types of feelings you’re likely to feel are old and well-known to humankind.

Read this book if:

you like a classics/historical approach to learning new topics
you don’t know where else to start

Don’t read this book if:

you are an extremely special snowflake who finds generalities off-putting
you are not interested in transcripts of patients rambling a bit

A nice book about how people face death and dying, mostly their own. Almost a classic, however it's now outdated and there are many better books out there for helping yourself and/or your dear ones during the process of accepting death.

I give three stars to the book because of the wonderful humanistic style of the author and the many stories and interviews with real people that were facing their own upcoming death. Also, the author has grasped nicely many aspects of how people feel and react during the process.

However, this 5 "stages" model is not always accurate and can also be confusing. For example, The author separates denial from bargaining, but those two are actually part of the same reaction and also bargaining is not always part of the process. There is also a close relationship of denial with faith and hope and this book fails to deal with these as part of the same cognitive process.

The 5 stages model mixes reactions (such as "denial") with emotions (such as "anger") and this is one of the reasons for confusion. Also, you will read about "depression" when it actually suggests "despair" or related feelings, while depression is a more phsycological/medical term in our days.

The book is addressed to the layman, not scientists or doctors. I even doubt that it can be of much help to caregivers in our time, although it may have been back it's time of writing.

If you or someone close to you faces dying, then this book may actually be of great help to you (but don't take literally the 5 stages model), otherwise I believe you can skip it.

افرادی که برای ماندن در کنار بیمار رو به مرگ از قدرت و عشقی آنچنانی برخوردار باشند، در این لحظه، لحظه‌ای که سکوت از واژگان درمی‌گذرد خواهند دید که واقعه نه ترسناک است و نه دردناک، بلکه فقط توقف آرام کارکرد جسم آدمی‌ست. تماشای مرگ یک انسان، آدمی را به یاد شهاب ثاقب می‌اندازد، یکی از میلیون‌ها نقطه‌ی نورانیِ نشسته در دلِ آسمان پهناور که لحظه‌ای مختصر شعله می‌کشد و دمی بعد در شب بی‌نهایت فرو می‌رود

درباره‌ی کتاب

خود را بگذارید جای دانشجوی رشته پزشکی، پرستاری، مددکاری یا حتی الهیات عملی که روزی الزاما با بیمار بدحالی که مرگش نزدیک است روبرو خواهد شد. در ابتدای کار باید چگونه لاعلاج بودن بیماری فرد را به او اطلاع داد؟ واکنش شما در روزهای پایانی زندگی فرد باید چگونه باشد؟ یا نه، نیازی نیست حتما دانشجو یا پژوهشگر باشید، خود را بگذارید جای فردی که خدای نکرده یکی از نزدیکانش به بیماری خطرناکی دچار شده است. رفتار ��ما با بیمارتان چگونه خواهد بود؟ چگونه درباره‌ی نگرانی‌ها و بیم‌های بیمار سر صحبت را با او باز می‌کنید؟ باز هم خدای ناکرده خود را بگذارید جای فردی که خبر بیماری و مرگ قریب‌الوقوعش را به او داده‌اند. واکنش شما چیست و چگونه برای مردن آماده می‌شوید؟ با خواندن این کتاب احتمالا پاسخ خود را خواهید گرفت، اما این همه‌ی ماجرای کتاب نیست
دکتر راس در این کتاب پژوهش‌های خود و گروهش را به عنوان درمانگران بیماران رو به مرگ شرح می‌دهد. به این ترتیب که بیمار بدحال، با آگاهی و رضایت خود به اتاق مصاحبه آینه‌دار آورده می‌شوند و بجز دکتر راس یک کشیش هم بیمار را در گفتگو همراهی می‌کند. گروهی پنجاه نفره از دانشجویان و پژوهشگران هم در اتاق دیگری پشت آسنه نظاره‌گر گفتگو هستند. بیمار در این شرایط فرصت پیدا می‌کند تا افکار خود را بیان کرده و اضطراب، ترس و خشمی را که عموما به‌خاطر ملاحظه‌ی خانواده و سوءرفتار احتمالی پرسنل بیمارستان پنهان کرده، بروز دهد. بیمار بعد از پایان جلسه (که عموما به یک جلسه هم محدود نشده) با آرامش بیشتر به اتاقش بازمی‌گردد و در بیشتر موارد با دلی باز آماده‌ی رویارویی با مرگ می‌شود. اما عمده‌ی فایده‌ی این مصاحبه‌ها برای بیماران بدحال آینده‌ست. پژوهش‌های این‌چنینی دکتر راس باعث شد تا در محافل آکادمیک به چگونگی رفتار با بیمار بدحال بیشتر و دقیق‌تر پرداخته شود و در محیطهای بیمارستانی نیز منجر به برگزاری جلسات آموزشی‌ای شد که به پزشکان، پرستاران، مددکاران و روان‌درمان‌گران می‌آموزد چگونه نیاز‌های یک بیمار قطع امید شده را شناسایی و برآورده کنند تا مرگ او با عزت و آرامش قلبی همراه باشد
در خلال مصاحبه‌های این کتاب، دکتر راس نظریه‌ی پنج مرحله‌ای انکار- خشم - چانه‌زنی - ناامیدی - پذیرش را تبیین می‌کند و برای فهم هر مورد چند مثال مفصل هم می‌آورد و از این رو در این کتاب با مفاهیم انتزاهی کمتر روبرو می‌شوید و تمام مطالب کتاب کاملا برای خواننده - در هر جایگاهی که باشد - کاربردی‌ست

در کتاب "سوزان سانتاگ در جدال با مرگ" فرزند سانتاگ در موقعیت خویشاوند نزدیکِ بیمارِ رو به مرگ، سوالی را مطرح می‌کند که به‌تجربه بارها با آن روبرو شدم و قطعا در ایران امروز هم خانواده‌ی بیماران کم و بیش با آن درگیر هستند: تا چه میزانی باید در مورد پیشرفت بیماری به فرد بیمار اطلاع داد؟ آیا باید به طور کل بیماری را انکار کرد، یا آنکه صراحتا همه چیز را به او گفت؟ آیا در حالی که پزشک به‌طور کامل از بیمار قطع امید کرده، باید روزنه‌های امید را برای او بست یا اینکه کورسوی امیدی باقی گذاشت؟ کدام یک اخلاقی‌ست و کدام یک به نفع بیمار؟
دکتر راس پاسخ می‌دهد که اکثر بیماران حتی بدون نیاز به صحبت از وخامت اوضاع با خبر‌ می‌شوند و نزدیک شدن مرگ را حس می‌کنند، اما در هر صورت بهتر است تا حد ممکن بیمار را بدون ناامید کردن، از وخامت اوضاع و خطری که تهدیدش می‌کند مطلع کرد تا هم به کارهای نیمه تمام خود بپردازد و هم از جنبه‌ی روحی آماده‌ی شرایط سخت‌تر شود. تجربه‌های او حاکی از این است که اکثر بیماران از آنچه ورای نقاب خوشحال و خندان خانواده‌ها می‌گذرد خبر دارند و بیمار نیز اغلب به دلیل انکار خانواده علی‌رغم نیاز ضروری‌اش تمایلی به صحبت درباره‌ی این موضوع ندارد. در حالی که صحبت درباره‌ی ناامیدی‌ها و ترس‌ها و حتی مرگ باعث سبک شدن بار سنگین بیمار و آسودگی بیشتر او می‌شود و کار خانواده را هم برای پذیرش فقدان او بعد از مرگش راحت‌تر می‌کند. راس ثابت می‎کند که صحبت نکردن درباره‌ی این موضوع بیش از آنکه بخاطر بیمار باشد، بخاطر ترس و انکار پزشک یا خانواده‌ی اوست

نکته‌ی آخر اینکه تعدادی از دانشجویان و پژوهشگران حتی طاقت یکی از این مصاحبه‌ها را هم نداشتند و جلسه را به طور نیمه‌کاره رها می‌کردند. این موضوع درباره‌ی کتاب هم صدق می‌کند و علی‌رغم بکر بودن موضوع و هیجان انگیز بودن تجربه‌ها، مطالب گاهی آزاردهنده و طاقت فرسا می‌شود و به پایان رساندن کتاب ممکن است تحمل طولانی‌ای بخواهد. اما من تصور می‌کنم خواندن این کتاب برای بسیاری یک امر ضروری باشد، زیرا ما هیچگاه نمی‌توانیم پیش از تجربه کردن بیماری و مرگ خودمان با حقیقت آن روبرو شویم و مرگ از این رو رازآلود بودن خود را هیچ‌گاه از دست نمی‌دهد، ولی شاید بتوانیم از رهگذر این مصاحبه‌ها اندک مکاشفه‌ای داشته باشیم تا برای آن روز که نوبت خودمان رسید آماده‌تر باشیم

درباره‌ی ترجمه‌ی کتاب و نسخه‌های فارسی دیگر

امتیاز به ترجمه: دو
کتاب ترجمه‌ی روان و خودمانی‌ای دارد و آنطور که مترجم گرامی هم در مقدمه توضیح داده، تا جایی که امکان داشته دست به ایرانی‌سازی ترجمه زده است. من در ابتدا زبان ترجمه را پسندیدم و با توجه به مقدمه‌ی استاد ع. پاشایی بر این نسخه از کتاب، توقع ترجمه‌ای دقیق و وفادارانه به متن داشتم. اما بعد از مقایسه‌ی متن اصلی و ترجمه در چند مورد آزرده شدم و چنین نتیجه گرفتم که این ترجمه بیش از حد غیردقیق و عامیانه‌ ست. در ادامه به چند نمونه از اشکالات ترجمه اشاره می‌کنم


اول مترجم در بسیاری از مصاحبه‌ها دست به خلاصه‌سازی زده و در این راستا بعضی از قسمت‌ها بطور کامل از ترجمه حذف شده

در صفحه‌ی 226، قسمتی از مصاحبه (در حدود 6 سطر) به طور کامل حذف شده
STUDENT: Your daughter told us he had been a missionary in S. and you’re very active in church work. This was part of the reason for the deep religious background. What was the nature of his missionary work? Why isn’t he still in it?
MOTHER: Well, he was a Mormon. And they always paid all his funds, paid all his benefits and everything, and so when we were first married, I went along to church for about a year. Then he started going with me and for seventeen years he went every Sunday with me and the children. About four or five years ago he joined our church and has been a worker—has been in it all that time.

در صفحه‌ی 103 حین ایرانی‌سازی ترجمه، قسمت مهمی از متن اصلی ترجمه نشده
Our initial reaction to sad people is usually to try to cheer them up, to tell them not to look at things so grimly or so hopelessly. We encourage them to look at the bright side of life, at all the colorful, positive things around them. This is often an expression of our own needs, our own inability to tolerate a long face over any extended period of time

ترجمه‌ی خانم جهانگیر: در برخورد با آدم‌های غمگین، معمولا تلاش می‌کنیم آن‌ها را سرحال بیاوریم و چون نمی‌توانیم سگرمه‌های درهمشان را تحمل کنیم، ازآن‌ها می‌خواهیم نیمه‌ی پر لیوان و جنبه‌های مثبت زندگی را ببینند

دوم: من متن اصلی را مطالعه نکردم و صرفا بصورت موردی بعضی جاها به آن سرک کشیدم که در همین چند مورد، یکی دو اشکال در ترجمه‌ی اصطلاحت هم پیدا کردم
در صفحه‌ی 230
Sundy School Work
ترجمه‌ی مترجم: درس
ترجمه‌ی صحیح: فعالیت کلاس‌های مذهبی که در کلیسا برگزار می‌شود
و این مورد
she thinks they are going to fix me up in here!
ترجمه‌ی خانم جهانگیر: او فکر می‌کنه که دکترها بی‌خودی می‌خوان اینجا نگهم دارند
ترجمه‌ی صحیح: او فکر می‌کند که دکترها می‌خواهند اینجا سلامت را به من برگردانند

سوم: ایرانی‌سازی مدنظر مترجم هم به‌خوبی صورت نگرفته و در بعضی قسمت‌ها مترجم تلاشی برای رسا کردن ترجمه نکرده، مثلا در یکی از مصاحبه‌ها که بیمار از شرایطش بعد از رادیوگرافی روده‌ی بزرگ شکایت دارد، در نسخه‌ی فارسی نوشته شده: مجبوری بشینی روی صندلی ولی رغبت نمی‌کنی چون می‌دونی وقتی بلند شی صندلی پر از گچ سفیده

Then you are supposed to sit in a chair and you just don’t have any desire to sit in that chair. You know it’s going to be a mass of white chalk when you get up, and it’s an uncomfortable situation.

خواننده‌ ممکن است آنقدر از آزمایش‌های پزشکی مطلع نباشد و متوجه نشود که چرا صندلی باید پر از گچ شود. (در رادیوگرافی روده بزرگ محلولی از باریم سولفات از مقعد به روده فرستاده می‌شود و بیمار بعد از اتمام عکس‌بردای، دچار ممکن است به طور بی اختیار دچار برون‌روی مایعات از بدنش شود)


در نهایت با این اوصاف، به دلیل ترجمه‌ی دقیق‌تر و قیمت کمتر (حدودا نصف)، ترجمه‌ی آقای بهرامی/ انتشارات رشد تحت عنوان "پایان راه: پیرامون مرگ و مردن" را توصیه می‌کنم

Bardzo mądre to było

Almost a 4.
Helpful information on the variety of emotional responses a person may experience when they are dying.

Its amazing to me how widely information in this book has been taken out of context.
First, though K-R does imply there may be an emotional progression preparing for one’s own death, she never says the the person MUST go through each stage sequentially. She later agreed that the set-in-stone frame work people have taken as gospel is not realistic AND not the message she intended with her book.
Second, the stages she describes are intended ONLY to describe those who are in the dying process themselves, not for those mourning the loss of their loved ones. While I could see this book being helpful for those who work with and support people with terminal illnesses, people who are looking for insight on managing grief after a loss should look elsewhere.
My own critique: For being such a groundbreaking book, I felt like K-R could have gone deeper on some topics. A few sections felt almost too concise or I would have liked more information. Still a helpful read overall.

This was an interesting read for me, though it is a bit outdated now and some parts felt a bit repetitive for me.

I really liked reading the interviews with the patients, but the author's actual descriptions felt unnecessary sometimes.

I would love to read more about how this research impacted the hospital environment moving forward, though. Has there been any change in the last 50 years in how we treat the terminally ill in a hospital setting? Do we talk more openly about death with them and with their families? Or is the topic still as taboo as it once was?

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.

This is amazing. I had no idea so many people found death such a difficult topic to talk about. I don't know if it's to do with being an archaeologist (or, rather, a former archaeologist) and studying what dead people have left behind, including the evidence available in their bones, and the exhumation of graves and burial grounds that many archaeologists wind up doing as contract work which makes me so comfortable talking about death. It might also be the Asperger's, or maybe a combination of the two. I frequently wonder what my 88-year-old grandmother will die of, but struggled to understand why this wasn't something the rest of the family was interested in speculating about.

To me, death is a natural, normal part of life. It's something that happens to everyone and there's no reason to act like it's something out-of-the-ordinary. For that reason I found this book helpful because it made it clear to me that this is something that the vast majority of people struggle with, regardless of whether they're the person dying, or a relative or caregiver. This is an incredible, amazing book and everyone should read it.

Just 20 pages to the book, and I already give this masterpiece 5 stars... A must-read book for everybody.