Elisabeth Kübler-Ross photo by Ken Ross

View a slideshow of Elisabeth Kübler-Ross's life

A Revolution in Dying

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By far, the best known of the hospice pioneers is Elisabeth Kübler-Ross, the Swiss-born psychiatrist whose international bestseller, On Death and Dying, was published in 1969. In the 1970s and '80s Kübler-Ross traveled the world lecturing on what she called the West's 'death-denying' culture and her theory about the five stages of grief a dying person typically goes through. On Death and Dying is still read in some thirty languages, but Kübler-Ross, now in her late seventies, has been out of the public eye for years.

On an outing with visitors, Kübler-Ross spends an afternoon at a zoo not far from her home in Scottsdale, Arizona. She's small and hunched. Partially paralyzed after a series of strokes in the 1990s, Kübler-Ross travels by wheelchair. She wears a baseball cap over her gray hair.

"Hello sweetie," Kübler-Ross says to a big blue macaw that squawks in her direction from inside its cage. "Yes, you're pretty. I'd take you home anytime."

Kübler-Ross is not the kind of cultural icon that gets recognized in public. When a young zoo worker, Peter Carter, offers her a ride in a golf cart, he asks her name. "Kübler-Ross," she says.

The name means nothing to Carter. But when he's told that his passenger helped pioneer the hospice movement, Carter gets wide-eyed.

"I can't tell you what a wonderful thing that did," he says. "My grandmother had Alzheimer's. And [hospice workers] came and they just - independence and support, and, you know, dignity. I mean there's nowhere else where they can get that." Carter laughs self-consciously. "I'm gonna get all emotional now."

Kübler-Ross made a mark on Western culture that will clearly outlive her.

In the recent movie "The Life of David Gale", Laura Linney's character breaks the news of her terminal illness to a friend played by Kevin Spacey. "You know those stages of Kübler-Ross?" Linney asks. " The ones the dying go through?"

Spacey replies gamely and the two complete the list: Anger, denial, bargaining, depression, acceptance.

After conceding that she's currently in the denial phase, Linney laments sardonically, "I'm not up to the job of Dying Person. Marveling at blades of grass. Lecturing strangers to relish every moment."

Kübler-Ross's ideas lent themselves to such lampooning. Some believed that she and the hospice movement were offering a one-size-fits-all recipe: incense and death with a smile. But it's never been that simple.

Passing her days now in a Scottsdale group home, Kübler-Ross is, herself, anything but serene. She cusses and smokes, and though she can be warm and witty, she's often crotchety.

"I was not lucky enough to die," she says. "Waiting to die is a boring process. Then I was angry at God, as well. I gave him hell, too. I said 'You are not any better than Hitler himself.' And he [God] laughed his head off."

When Kübler-Ross talks to God, it seems, God talks back.

But whatever the popular perception, Kübler-Ross never said there was one right way to die.

"The question is really, What does it mean to die with dignity?" she said in a radio interview back in 1975. "To die with dignity to me means to die within your character. That means there are people who have used denial all their life long; they will most likely die in a stage of denial. There are people who have been fighters and rebels all their life long, and by golly they want to die that way. And to those patients we have to help them, to say it's OK."

Next - Dehumanized Dying