"Here's some of what I learned: the grim reaper is not always grim; our last days can be the most loving time of life; last words have remarkable staying power; and learning about the mechanics of how we do death can make the prospect less daunting. The more prepared we are for the logistics of death, the less those who profit from death (the so-called death industry) can exploit us. The more open we are about our own deaths, the more prepared our survivors will be to face their own ultimate truths one day. The more emotionally generous we are with words, affection and regrets, the easier it will be to control the fear. We can achieve happier endings.
"Studying death through speaking to the dying and their survivors also made me question Elisabeth Kubler-Ross, the physician and writer, whose five stages of grief radically altered the way we think about death and loss. Denial, anger, bargaining, depression and acceptance have become such an axiomatic understanding of loss that we may, as a result, limit our fullest and most warming experience of death. I am no longer convinced that these stages truly capture what is taking place during the period when one's death or the death of someone we love is imminent. Many therapists have questioned Kubler-Ross's stages, believing that the word 'stage' may be misleading. Not everyone experiences all five stages, nor do these stages occur in a linear fashion, with people waiting for one stage to stop and the next to begin. My problem with this ladder of loss is that it is missing its most important rung. The last, most potent stage or development within the framework of loss is not acceptance. It is inspiration. I humbly believe Kubler-Ross missed something in her categorization that may be the key to the fine art of dying well, if we can ever truly call it that.
"I turned Kubler-Ross's list into a different and abbreviated outline in my own mind. Denial is undoubtedly the first stage, bold and tenacious. Then, in my new death outline, anger, bargaining and depression become subsumed under denial as different manifestations of the unwillingness to accept death. They are all — anger, bargaining and depression — mechanisms of denial. They represent different fields of the battleground, the fight against a truth that cannot be broken. Kubler-Ross's acceptance turned into resignation in my new scheme. There is a moment when the fight ends and the resignation begins.
" 'Acceptance' is a little too positive to describe this stage. It gives the impression of being welcome, and death is rarely welcome. If we define 'acceptance' as consent or receiving something with approval or favor, then 'acceptance' becomes too cheery for what most who grieve experience. 'Resignation' seems the semantically more appropriate word. We submit to the inevitability of our fate, aggressively, passively or unresistingly. We tell ourselves: This is real. It will not go away. It is a new fact of our existence, which is one of the only old facts of human existence. In happier endings, the observation 'This is real' is twinned with the maturing understanding 'I am unprepared.' And this confession is critical to achieving the next stage: 'I need to be prepared.'
"Once someone is able to utter these words — 'I need to be prepared' — a flood of change takes place that enables us to face death without fear. This is the stage I call 'inspiration,' a stage that never appeared in Kubler-Ross's framework but appeared in virtually every conversation I had with a person or family who managed to do death better. The intentional decision to become better prepared for death gives the dying permission to love more fully, to say the words they've wanted to say for a lifetime, to repair and heal troubled relationships, and to entertain a range of ethereal and spiritual thoughts and actions often previously closed off, sealed or masked by the pragmata of everyday anxieties. It gives the family the chance to reach out to the dying with an emotional range previously unknown or unexperienced. By not acknowledging that the stage of inspiration exists, many never believe that it is possible; they retain the stubborn belief that acceptance alone is the last station. In so doing, they deny themselves the beautiful closure that only the enlightened ever achieve but that is a possibility for almost everyone."