It might well be said that she invented this field as an area of legitimate discourse in the medical community. Her now-classic first book, On Death and Dying, is today considered the master text on the subject, and is required reading in most major medical and nursing schools and graduate schools of psychiatry and theology.
Her influence has reached far beyond these professional settings. Her lectures, workshops, media appearances and books have reached millions of people around the world, opening lines of communication on these issues which so profoundly affect us all.
Dr. Kubler-Ross received her medical degree from the University of Zurich in 1957. She began her pioneering work with the terminally ill at the University of Colorado Medical Center in Denver, and is currently Clinical Professor of Behavioral Medicine and Psychiatry at the University of Virginia in Charlottesville. In 1979 the Ladies’ Home Journal honored her with a Woman of the Decade Award, after having named her Woman of the Year in Science and Research in 1977. She has also been the recipient of other honors and awards too numerous to mention.
Even a partial list of her superb books is lengthy: Questions and Answers on Death and Dying; To Live Until We Say Goodbye; Living With Death and Dying; Working It Through; Death, The Final Stage of Growth; On Children and Death; and AIDS:The Ultimate Challenge.
In this interview with Dr. Daniel Redwood, Dr. Kubler-Ross describes her strikingly powerful experience as a young woman visiting a concentration camp just after the liberation in 1945, an experience which was to shape the future course of her life. In this context, she addresses the highly controversial idea, first raised to her by a young Jewish camp survivor, that there is an aspect of Hitler in all of us. Recognizing the unspeakable horror of the Holocaust, she raises troubling questions on the nature of human evil and the roots from which it springs. She also shares her thoughts on the fear, denial and uncertainty which characterize much of modern Western humanity’s approach to death.
Due to illness, Dr. Kubler-Ross’ no longer teaches, lectures, or leads workshops.
Elisabeth Kubler-Ross Interview
DR: What has led you to devote so much of your time, skill and attention to issues of death and dying?
ELISABETH KUBLER-ROSS: It started in Maidanek, in a concentration camp, where I tried to see how children had gone into the gas chambers after having lost their families, their homes, their schools and everything. The walls in the camp were filled with pictures of butterflies, drawn by these children.
It was incomprehensible to me. Thousands of children going into the gas chamber, and this is the message they leave behind–a butterfly. That was really the beginning.
In this concentration camp there was a Jewish girl, and she watched me. I hope you understand, I was a very young kid naturally, who hadn’t gone through any windstorms in life. When you grow up in Switzerland, there is no race problem, no poverty, no unemployment, no slums, no nothing. And I went right into the nightmare of postwar Europe.
So I asked her, how can men and women, like you and I, kill hundreds and thousands of innocent children, and the same day they do that, day after day, they worry about their own child at home who has chicken pox. It just didn’t compute in my brain, you know, being very innocent and ignorant.
This young woman had lost all her brothers and sisters, parents and grandparents in a gas chamber. She was the last one they tried to squash in, and there wasn’t room for one more person, so they pulled her out. What she didn’t understand was that she had already been crossed off the list of the living. They never got back to her. She spent the rest of the war years in this concentration camp swearing that she would stay alive to tell the world about all the atrocities that she witnessed.
When the people came to liberate the camp, she said to herself, “Oh my God, if I spend the rest of my life telling about all these horrible things, I would not be any better than Hitler himself. I would plant seeds of hate and negativity.” She made at that moment a promise to whoever she talked to, God presumably, that she would stay in the concentration camp until she could learn to forgive even a Hitler. When she had learned that lesson, then she would be worthy of leaving. Do you understand that?
The last thing she said to me was, “If you would only know that there is a Hitler in every human being!” If we can acknowledge that Hitler and get rid of it, she said, we could then become like, what we now would say is, Mother Theresa.
And I thought, “She is crazy, I don’t have a Hitler in me.” A few days later, I hitchhiked back to Switzerland, because I was very sick. I was near death. I never made it. They found me unconscious in a forest in Germany, with typhoid. But before I ended up in a hospital (I was picked up half dead in a forest, unconscious), I had been so hungry. I had no food in my stomach for three days and three nights. I suddenly realized in the midst of this hike, that if a small child would walk by me with a piece of bread in its hands, I would steal that piece of bread from that child’s hand.
This was like an illumination in my head. I said, “Now I know what she means, that there is a Hitler in all of us.” Depending on the circumstances, you can do horrible things, which you would never even consider when you have a full belly.
That was the beginning of my journey. When I went back to Switzerland, I said I’m going to study medicine, and I’m going to understand why people, from beautiful, innocent, gorgeous children, turn into Nazi monsters.
What we are doing now in our workshops is to get in touch with your Nazi monster in you, symbolically speaking, and get rid of it so that you can indeed become a Mother Theresa.
But that was the beginning, and I am eternally grateful for that experience.
DR: Is there any good reason to be afraid of dying?
ELISABETH KUBLER-ROSS: No, if you have enough people who love you, who will see to it that your needs are met, so that if you request to die at home you will be allowed to die at home. If you don’t want to die in a hospital, you should at least be able to go to a hospice.
For that, you need a support system around you, people who really know you, because people don’t volunteer that. You have to speak up as a patient. If you can’t speak anymore, like I couldn’t speak after my stroke, you need somebody who speaks up for you. I hope that when I die, if I can’t speak anymore, that they at least let me go to my farm and die at home, where I can have a cup of coffee and a cigarette. Which is a bad habit, but I know it’s a bad habit.
DR: Do you think there’s such a thing as a “sacred inconsistency,” such as your smoking cigarettes, which is justified even though destructive?”
ELISABETH KUBLER-ROSS: If we would only live “healthy,” we would probably all have to be on a macrobiotic diet, and not enjoy coffee, not enjoy meat, not enjoy Swiss chocolates, not smoke, not even breathe the air we breathe in. I mean, the planet Earth has been so polluted with so many things, there is not a place on planet Earth where you could live a totally healthy life.
We should all try to live as healthy as possible. I mean, I grow vegetables for over 100 people, and it’s a totally organic garden, and it’s healthy. We live off the farm, and it’s totally self-sustaining and self-supporting. But I have my weaknesses. I drink caffeine-free coffee, not that it matters terribly, but at least I make an attempt to live healthier. And as I get older, I can’t drink alcohol anymore. I used to like a glass of wine, and I can’t do it anymore.
I think that as you evolve spiritually, automatically your body tells you what is acceptable for your body and what is not. I could not now smoke the way I used to smoke when I went to medical school and worked nights. That’s where I started smoking, to keep awake. I can’t drink 15 cups of coffee,which I still did 20 years ago. Now I have caffeine-free coffee.
I survive. Eventually, when my body tells me it’s time to quit smoking, I will quit smoking. But if somebody tells me you can’t smoke, you can’t do this, you can’t do that, the aggravation of this constant nagging is, I think, more damaging to my health than if I listen to my own body and live accordingly.
I have beef on my farm. Maybe once a year I have beef. Not that I don’t like it anymore, I just don’t have the desire for it anymore. I think everybody who is on a path of spiritual evolution, which all human beings are at different levels . . . you will know yourself what you have to give up. It will be one giving up after another. But it is replaced with things that are much more precious and much more valuable than what you give up. But we don’t tell that to people, because then they do it for the wrong motivation.
DR: Do you find that there are great differences between cultures regarding attitudes toward death? Which ones do you feel have the most healthy approaches?
ELISABETH KUBLER-ROSS: Yes, like Mexicans. They go and visit the graves. They bring food, they talk to them, they have a feast. There are lots of cultures who have much less of a hangup. The old, old, old cultures are also much more natural. In the more sophisticated, more materialistic Western world, even to die costs a fortune.
They put shoes on the dead that are comfortable to wear, and silk pillows, and put rouge on the cheeks, so they look like they’re only asleep. It’s so phony and so dishonest. But that’s more of a modern day deterioration. In the old days, the farmers died here just like in Switzerland. They had what you call a wake. It was in the house, in the best living room. People came. I remember my neighbor. I was able to say goodbye to him, I was allowed to touch him. I touched for the first time in my life a dead body. My father talked to him, like he could hear him, and I was very impressed by that.
Nothing was covered up with rouge and lipstick and makeup and all that baloney. Things have really deteriorated in the last hundred years, and more in the big cities than in the country. There are still places in the country here where it’s much more natural. But that changes very rapidly now anyway.
DR: Does the belief in reincarnation, or the lack of such belief, strongly influence people’s feelings about death?
ELISABETH KUBLER-ROSS: It comes up very, very rarely with my patients. Very rarely. Those that believe in reincarnation, sometimes they’re annoyed that they have to come back, you know, that they haven’t done what the could have done and should have done. My patients, you understand, are usually more indigent and not terribly educated. Many of my patients don’t know anything about reincarnation.
It makes not much of a difference. What makes a difference is if your spiritual quadrant is open. If you have a faith, any faith, any, that is solid and internalized, you have much less of a problem than if you are a wishy-washy Protestant or a wishy-washy Catholic or a wishy-washy Jew.
Of the religious groups, there are some that have a much harder time than others. The Jewish people have a terrible issue about death. I tried to find out why they have such a problem. I asked lots of rabbis. It’s one of the few religions I know of, where if you ask twenty rabbis, you get twenty different answers. One says you continue to live through your son and your son’s son. And what happens if you have no son, if you only have daughters? Do you understand?
Let me ask another rabbi. “You will survive in their memory.” Well, after a hundred years, nobody remembers you. If you have not concretized your concept, then you have a heck of a time.
DR: How can an atheist or agnostic most constructively deal with the inevitability of death? Is there an existentialist sense of angst that enters , and…
ELISABETH KUBLER-ROSS: (interrupting) You have no problem!! When I started this work, I wouldn’t know what that was. I was raised Protestant. In my heart I was Catholic, and I was made into a Jew. For 22 years I was a little bit of everything. Then I worked with dying patients, and I began to realize that we’re all the same. We’re all the same human beings. We all are born the same way.We all die the same way, basically. The experience of death and after death is all the same.
It only depends how you have lived. If you have lived fully, then you have no regrets, because you have done the best you can do. If you made lots of goofs– much better to have made lots of goofs than not to have lived at all. The saddest people I see die are people who had parents who said “Oh, I would be so proud if I can say ‘my son the doctor.'” They think they can buy love by doing what mom tells them to do and what dad tells them to do. They never listen to their own dreams. And they look back and say, “I made a good living but I never lived.” That, to me, is the saddest way to live.
That’s why I tell people, and I really mean it literally, if you’re not doing something that really turns you on, do something that does turn you on, and you will be provided for to survive. Those people die with a sense of achievement, of priding themselves that they had the guts to do it.
DR: Is there ever any justification for not being honest with someone who is dying, about the fact that they are dying?
ELISABETH KUBLER-ROSS: You have to be honest, but you don’t have to be totally honest. You have to answer their questions, but don’t volunteer information for which they have not asked, because that means they’re not ready for it yet. If somebody thinks you’re a good guy if you tell them the whole truth, that there’s nothing else we can do, this is baloney.
Without miracles, there are many, many ways of helping somebody, without a cure. So you have to be very careful how you word it. And you never, ever, ever take hope away from a dying patient. Without hope nobody can live. You are not God. You don’t know what else is in store for them, what else can help them, or how meaningful, maybe, the last six months of a person’s life are. Totally changed around.
So you don’t just go and drown them in “truth.” My golden rule has been to answer all the questions as honestly as I can. If they ask me statistically what are their chances…I had a wonderful teacher, who once said that of his patients 50 percent live one year, another 35 percent live two years, and another so-and-so many per cent live two and a half years, and so on. If you were very smart and added all the percentages up, there was always one per cent left. And the real shrewd ones said, “Hey, you forgot, what about that last one per cent?” And he always said, “the last per cent is for hope.” I like that. He never gave it to them with 100%. He was fantastic.
DR: Could you tell us about your work with the AIDS babies?
ELISABETH KUBLER-ROSS: What bothers me most is that we have been able to get only a few out of hospitals. It’s horrible to get them out. They do not want to discharge them to private families. We have 154 families who are waiting to adopt an AIDS baby, or to become a foster mom to an AIDS baby.
ELISABETH KUBLER-ROSS: It’s monetary gain. The institutions get $1000 a day per baby. They get research grants, and they do research on them. They are the pin-cushion babies. They do research and nobody stops them. Nobody says, “one bone marrow per week is too much.” That has to stop. They need to be held and cuddled and loved, and see butterflies and grass, and be able to go outside and live as normal a life as humanly possible in the short time they have.
If you do that, they just blossom like a flower.
DR: With the children you have seen who have gone from being HIV-positive [carrying the AIDS virus] to being HIV-negative, what particulars were there in those cases that you feel made the difference?
ELISABETH KUBLER-ROSS: The only brief way I can tell you is that they were totally marinated in love. Totally. You understand that from a scientific point of view, those are children who had the antibodies of their mothers, and if there is bonding, and if there is love and cuddling and all the things children need to survive, then they begin to develop their own antibodies. And about 10% of all our babies will become negative, if they get the bonding, if they get the one-to-one. It’s not such a big miracle from a medical point of view.
But people have to know that not every HIV-positive child is born with AIDS, and has to die with AIDS. That is not true. They can get well.
DR: That message certainly has not gotten across yet.
ELISABETH KUBLER-ROSS: No, it hasn’t.
DR: Please tell us about the Elisabeth Kubler-Ross Center in Virginia. What is your main work there?
ELISABETH KUBLER-ROSS: We are building a place which was supposed to be for giving the workshops, on my own land so I don’t have to travel so much anymore. The [surrounding] community is petrified of me. I am called the AIDS Lady, and they say I am of Satan. They are all reborn Christians. They got up [at a community meeting] and said, “if you call for an ambulance, we will not respond.” They said, “I am a reborn Christian, but if you ever send one of these kids to school, the school will be closed.” So they give me a very hard time.
They arranged to only give us permission to house forty people, which makes it impossible for me to do my workshops as planned on my one million dollar project, on that land. So we thought, if that has to be, that will be. We’ll still be able to serve and help people. So what we’ll probably do is use it as a training center. We train a lot of people worldwide. And we will give some workshops there too. So it will serve its purpose, but exactly what it is going to be after they have finished the harassment, I don’t know.
They have shot bullets through my bedroom window, because they are convinced that I am hiding some AIDS babies. But that’s, you know, the stuff you have to live with.
DR: Is the community there divided about this? Is everyone there feeling so negatively?
ELISABETH KUBLER-ROSS: I have old neighbors and sick people in the neighborhood that I visit, and they are the best neighbors any human being could have. They’re a handful. The others are quiet, because they are all inter-related. If one would dare to say something nice, they would probably be shot during hunting season. So they’re very guarded. It’s all intermarriage and all fanatic, and they’re all hunters. I’m sure it’s an aggressive minority, but they’revery aggressive, and the others are so intimidated.
But if I see them alone, I know there are lots of good people there. I live in the forest alone. I am not afraid of the bears nor of the hunters. I feel very protected.
Eventually, if AIDS eventually goes into the community, maybe there will be a change. But anybody who has AIDS in my community, they would be lynched if it were known. So they probably will disappear, for years to come, until there is somebody who can’t get away, and that may be a child. And then maybe things will change. It will change in time, if I live long enough. And if I don’t, at least I planted some seeds.
DR: What goals do you have for the remainder of your life?
ELISABETH KUBLER-ROSS: To continue as long as I can.
Daniel Redwood is a chiropractor and writer who lives in Virginia Beach, Virginia. He is the author of A Time to Heal: How to Reap the Benefits of Holistic Health, and is a member of the editorial board of the Journal of Alternative and Complementary Medicine. He can be reached by e-mail at Redwoods@infi.net. A collection of his writing is available on the World Wide Web at http://www.doubleclickd.com, and also on the New Age Forum of the Microsoft Network.