In the Midst of Life

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Authors: Jennifer Worth
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sort of thing to the nurses,’ was the implied response. She questioned medical students and found that they were taught nothing about death and how best to handle a patient with a terminalillness.
    At first she was intrigued, and not a little amused by the head-in-the-sand attitude of her colleagues, and wondered how it would be defined in the school of analytical psychology. But then she began to wonder what effect it had on the patients themselves; and she gravitated towards those who were the most sick and the closest to death. Her experience in war-torn Europe made it easy for her to talk to these people, and she would sit with them for hours. What she discovered, mainly, was the grief of loneliness and isolation. Very often a patient had first learned of the gravity of his condition by the altered behaviour of those around him – avoidance, evaded questions, lack of eye contact. The silence of physicians added to their fears. Relatives and friends, it seemed, were also engaged in a massive game of ‘let’s pretend’, thereby closing the door on empathy and understanding. There is not a single dying human being who does not yearn for love, touch, understanding, and whose heart does not break from the withdrawal of those who should be drawing near.
    What she was observing was so at odds with her upbringing in her village in Switzerland, where a dying person was treated with love and compassion, that she thought it must be something peculiar to New York. But in 1962 the family – by now they had two children – moved to Denver, Colorado, and she and her husband got jobs at the University Hospital. Quietly, she continued her observations and discovered, to her astonishment, that the medical and social attitude to the dying was exactly the same in Colorado as in New York. Throughout America, apparently, death was a subject no one wanted to deal with.
    ‘This is a national sickness, more serious than anything I have seen on the schizophrenic wards,’ she opined.
    Her new job was working on liaison between psychiatry and general medicine, covering all disciplines. The team was headed by a professor whose main interest was in measuring the relationship between the mental, emotional and spiritual with the pathology of physical illness. Elisabeth and the professor were on the same wavelength, and she was able to discuss with him the effects that rejection and non-communication had on terminally illpatients.
    He was the first doctor with whom she had been able to express her concerns, and he understood, and encouraged her to continue her quest.
    The professor was a brilliant and charismatic lecturer, and he drew large crowds to his weekly seminars, at which he discussed with students of all faculties how psychology and psychiatry could be applied to general medicine. One day, in 1964, he called Elisabeth to his office and said that he would soon be travelling to Europe for a period of time, and that he would like Elisabeth to take over his lectures.
    ‘I don’t follow a syllabus. You can choose your own subject. You have two weeks to prepare,’ he said.
    Her first reaction was blind panic. She would never be able to take the place of this brilliant man, and hope to hold the attention of his audience. But it was an honour, and she knew she had to do it. Her subject would be death.
    Her thesis was simple: doctors would be more comfortable dealing with death if they understood it better, and if they simply talked about what it was like to die.
    She went to the university library to research the subject but found nothing that would help her. There were a few obscure and difficult psychoanalytical treatises, and a few anthropological studies about the death rituals of American Indians, Eskimos, Hindus and Buddhists, but nothing more. She had to write her own lecture, with no precedent and no references.
    But a greater problem faced her. The professor’s lectures were two hours long – an hour for the lecture, then a break,

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