Switzerland & Midwest Connections: Dr Elisabeth Kübler-Ross: The Chicago Years

Welcome to the History Blog featuring the connections between Switzerland and the Midwest. I am Joerg Oberschmied, Deputy Consul General in Chicago. My interest in history started at an early age and continues to this day. The views expressed are solely mine and I hope you enjoy these journeys through time.

Elisabeth Kübler-Ross was born in Zurich in 1926 as a triplet sister and studied medicine at the University of Zurich where she graduated in 1957. She was recruited by the University of Chicago in 1965, first as Acting Director of the Psychiatric Inpatient Service and later as the Director of the Death and Dying Program. In 1969, she published a book that made her world famous — “On Death and Dying: What the Dying have to Teach Doctors, Nurses, Clergy and their own Families”.

The University of Chicago Death and Dying Program

In 1966, Dr. Kübler-Ross began to work closely with hospital chaplain Carl Nighswonger, who established the Death and Dying Program as part of clinical pastoral education, and by 1970 had trained almost 100 theological students, pastors, and chaplains in that program. Working with Chaplain Nighswonger’s team, Dr. Kübler-Ross helped to expand and intensify the University of Chicago program on Death and Dying. In addition to the chaplains trained by Reverend Nighswonger, Dr. Kübler-Ross taught medical students and psychiatry residents on how to meaningfully and effectively care for terminally ill patients.

Recollections of Professor Mark Siegler

In his senior year as a medical student at the University (1966–1967), Professor Mark Siegler would frequently attend the weekly Death and Dying meetings. Dr. Kübler-Ross invited him to help her find dying patients whom she could interview at the weekly meeting of the Death and Dying Program. In those days, in the mid-1960s, dying patients were usually not told that they were dying or that they were terminally ill. Indeed, Dr. Kübler-Ross wrote “When I came to this country in 1958, to be a dying patient in a medical hospital was a nightmare. You were put in the last room, furthest away from the nurses’ station. You were full of pain, but they wouldn’t give you morphine. Nobody told you that you were full of cancer and that it was understandable that you had pain and needed medication.”

Dr Siegler began to talk with fellow residents and would ask them if there were any patients on their service who they believed to be terminally ill or dying. They would then visit the patient to break the dreadful news about their terminal illness and ask if they would agree to be interviewed in a public setting by Dr. Kübler-Ross, an expert on death and dying. “To my surprise, patients whom we had just recently informed about their terminal disease almost always consented to be interviewed in front of a group of chaplains and medical students and medical residents” he later recalled. “To this day, I vividly recall the way the weekly Death and Dying meetings were organized. A patient who had been identified as ‘a dying patient’ and who had given his or her consent to be interviewed by Dr. Kübler-Ross about end of life issues, came to the seminar room either on foot or by being wheeled in a wheelchair or a gurney. The patient was settled at the head of a long-table, opposite Dr. Kübler-Ross, while the remainder of the students and chaplains (usually 40–50) sat either at the table or on chairs adjacent to the table. Dr. Kübler-Ross would welcome and introduce the patient to the conference attendees and then would begin to interview the patient about matters relating to the patient’s terminal illness and about death and dying. In my 53 years of clinical work, I have never observed a better and more effective interviewer than Dr. Elisabeth Kübler-Ross. Within seconds of the interview beginning, the patient’s focus was entirely on Dr. Kübler-Ross, almost as if the other people around the table and in the seminar room did not exist. I always thought it was a breathtaking achievement to conduct an intense and seemingly private interview on the difficult issue of death and dying when many people in the room were at the same table and were observing the interview. Dr. Kübler-Ross was an interviewing genius.”

The Great Physician

According to Dr Siegler, during the five years they worked together, he always regarded Elisabeth Kübler-Ross as a great physician. “She was a brilliant psychiatrist, who had all the clinical skills I admire in a colleague and that patients hope for in their physicians. She always displayed deep concerns for her patients’ physical and psychological functioning. Her greatest abilities related to her deep and abiding respect for her patients, her constant display of compassion even for patients she had just met for the first time, and her willingness to help patients with the decisions they would make. These abilities were not routinely displayed by most physicians in the 1960s, an era of medicine when paternalism remained the prevailing and dominant tradition in the doctor-patient relationship”.

In the 1970s and 1980s, Dr. Kübler-Ross travelled the world giving lectures and to set up hospices. In 1999, Time Magazine named her one of the 100 most important thinkers of the 20th Century. Thanks to Dr. Kübler-Ross’s pioneering work, programs in both palliative care and hospice care today are widespread across the U.S. Elisabeth Kübler-Ross died in 2004.

Special thanks go to Dr Mark Siegler, the Lindy Bergman Distinguished Service Professor of Medicine and Surgery at the University of Chicago and Founding Director of the University of Chicago’s MacLean Center for Clinical Medical Ethics, for his recollections of Dr Kübler-Ross. www.uchicagomedicine.org, www.macleanethics.uchicago.edu. You can also learn more about the work of Dr Kübler-Ross at www.ekrfoundation.org.

Dr Elisabeth Kübler-Ross in 2001 (courtesy EKR Foundation)
Professor Mark Siegler, MD (courtesy Dr Siegler)

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