1. Health

Coping With Grief - From Difficult Diagnoses to Medical Errors and Mistakes


Updated September 25, 2011

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Elisabeth Kubler-Ross's Five Stages of Grief, Stages 1, 2 and 3

Now that you understand how those rules apply to the stages, let's look at the DABDA stages of grief (also called the Stages of Death and Dying or the Stages of Loss.)

  1. Denial: When we first experience the loss, we may be in shock and feeling overwhelmed. We set our feelings and emotions on a shelf, and just begin going through the motions of life. We know intellectually that we have more to learn, and decisions to make, and activities to undertake, but, at least initially, we try to appear as if nothing has changed and life is not affected.

    Usually you can't begin to move to the next stages until you begin to get past the denial stage.

  2. Anger: Believe it or not, if you turn angry, then you are already past at least one of the stages (denial), because you can't be angry if you haven't admitted to yourself that something horrible has happened. Your anger may be conscious, or it may be unconscious.

    Anger will rear its ugly, but necessary head in many different ways. You may be angry at yourself (I should have never eaten red meat or sugary treats!). You may be mad at the perpetrator of your medical error (if that surgeon had been more careful, my spouse would not have died!). You may be angry at Mother Nature for taking something dear away from you. You may even be mad at God because you can't fathom that a loving God would allow such a tragedy.

    Experiencing anger is one way we cope with pain. Especially if we can define who or what we are focusing our anger on, it gives us blame to hold on to. When we can blame, then we actually have something we can do with that anger.

    Among those who have suffered from medical mistakes, that anger and blame stage is a place they often get stuck. This is where many people begin to learn about patient empowerment. It's also where many people make the choice to file malpractice lawsuits.

  3. Bargaining: This is the "if only" stage that will be targeted to ourselves, or toward someone we think can help. It's a stage where we attempt compromise in hopes of making the tragedy go away, where we want to trade our reality for something else and may even make a promise to be sure it will never happen again. This is the stage that those who suffer guilt can get stuck in, or may return to over and over again.

    "If only I hadn't done such-and-such" or "I promise never to do X again."

    Bargaining is the stage where many people use prayer, hoping that whomever their God is will help them out of their situation, making promises to their God that if the problem is reconciled, they will do something good in return.

Link to descriptions of the last two Stages of Grief.

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