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THE STAGES OF LOSS

Several years ago a profound and dramatic research project began in Chicago's Billings Hospital. It was a seminar on death, in which psychiatists, chaplains, nurses, and medical doctors studied the ultimate human crisis of facing death.

Basic findings is that the very ill proceed through five emotional stages on their way to death—

The first stage is denial. Here the patient is unwilling to accept his fate and the nature of his predicament.

When physical indications make denial no longer possible the patient moves into the second stage, that of anger. He becomes angry for no apparent reason with his doctor, his friends, his family, and the nurses.

Following this comes the stage of bargaining. Dr. Ross explained here the patient bargains to stave off the inevitable by promising to "live for God," go to church, give his body to medical science, or some other futile means. Yet, the bargaining is little more than a temporary respite in the progress toward dying.

The fourth and most difficult stage is that of increasing depression. The patient finally realizes what is happening to him and enters a time when he is actually grieving for his own demise. It is a trying time for both patient and loved ones.

However, Dr. Ross says, this is followed by the fifth and final stage, and that is acceptance. Then, even though the smallest glimmer of hope will remain, he is ready to die.

An interesting note of this study was that if the patient is interrupted in any phase of this circle of suffering, he merely prolongs his agony. Therefore, Dr. Ross suggests ministers and doctors should understand these basic cycles; and rather than merely trying to cheer up the terminally ill, minister to their particular needs at that particular time.

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