THE WHEEL OF LIFE - A Memoir of Living and Dying by Elisabeth Kuebler-Ross, MD, Scribner, New York, 1997. Simon & Schuster Audio Book, two cassettes, 180 minutes, read by Ellen Burstyn. $18

Review by Del Meyer, MD

Doctor Kuebler-Ross has been popular with physicians and nurses for almost 30 years since her psychological study On Death & Dying was published in 1969. She is still living at 71 in Scottsdale, Arizona, but is herself in the process of dying. Her memoir, The Wheel of Life, records a most remarkable life. Kuebler-Ross provides the introduction to the cassettes which are well worth acquiring and sharing. Her story is always interesting and at times heart-rending.

Born in 1926 to "a typical upper-middle-class, conservative couple in Zurich," she was one of a set of triplets, which she describes as both a nightmare and a blessing, Her father designated a different future for each triplet; hers was to become secretary/bookkeeper for his business. She refused this assigned career at age 15; she was far too restless and ambitious to sit at a desk all day. She wanted to enter the medical profession.

She initially toiled as a maid for a tyrant of a widow until Christmas Eve when she asked to see the family Christmas tree and was told "that's for family, not employees." She left immediately for home. On her return, her father had softened his stance somewhat and told her she could find a job she was really happy in, which turned out to be a doctor's apprentice. Seeing her lab coats with her name embroidered on them sent her into ecstasy. "There could not have been a happier human on the planet."

One of the doctors she worked for, Dr. Karl Zehnder, sent the young apprentice to take blood samples from live patients--prostitutes in the late stage symptoms of venereal disease. "In those days, before penicillin, VD sufferers were treated like AIDS patients would be in the 1980s--they were feared, abandoned, shunned, locked away. Later Dr. Zehnder admitted that he expected me to say no. Instead I marched right into the dismal ward. I think that is what separates those who are called into the healing profession and those who do it for the money."

Kuebler-Ross draws to suffering as a moth to light. She worked as a nurse through World War II, first in her native Switzerland, then in Poland to care for war-shocked children. Before leaving Poland, she is compelled to visit Maidanek, wanting to see a concentration camp with her own eyes. She describes her visit with scientific care--she examines the gas chambers, the barracks, the walls and the graffiti left behind, puzzling over the prominence of butterflies carved everywhere. What could the symbol mean? She's too young to understand the symbol, but the intently scientific mind had turned toward the human spirit as it suffers, and her path was chosen.

She was finally able to enter medical school where she met her husband, Manny Ross, (they were introduced over a cadaver), and thrived on studying medicine. She went into a psychiatric residency and relates in detail psychiatric experimentation of the 1950's and how over two years she discharged 94% of the schizophrenics, changing them from zombies into productive workers.

Kuebler-Ross changed her career when a teenager was facing death, and she was given a teaching assignment. She had the class interview the dying young patient and when they were not getting to the real patient concerns, the patient took over the interview and frankly talked to the students about death. She transformed a rowdy class into one that sat in awe as she spoke. When the class was over, the students did not leave the classroom or even their seats. It was then that Kuebler-Ross saw her future--to help physicians become more comfortable with death and dying. When Kuebler-Ross was given a book offer with an advance, her fate was sealed when the publisher also gave her the title she would write about, which was "Death & Dying." The book gave her international acclaim among physicians, nurses, students, chaplains.

In a culture that is determined to sweep death under a carpet and hide it there, Kuebler-Ross has consistently defied common practice to bring it out and hold it there for us to see. Now as she faces her own death in Scottsdale, she interfaces with doctors and nurses after her stroke and says it's as if her work was nonexistent. Nevertheless, her memoir is a fitting climax for a fascinating career and life, a book which should be on every physician's shelf--at least those interested in helping the sick and the dying.

Del Meyer, MD