Kübler-Ross · Grief, Loss & Transplant

Who Was Elisabeth Kübler-Ross?

Elisabeth Kübler-Ross (1926–2004) was a Swiss-American psychiatrist and one of the most influential voices in modern hospice and palliative care. Her 1969 book On Death and Dying grew out of interviews with terminally ill patients and helped shift medicine toward a more honest, compassionate conversation about dying. ^[1][2]

She described five common emotional reactions to facing death or major loss — denial, anger, bargaining, depression, and acceptance — which later became known as the “five stages of grief.” ^[3][5]

Today, the Elisabeth Kübler-Ross Foundation continues her work by providing education, grief resources, and international chapters focused on end-of-life care and healing after loss. ^[1]

The Five Stages of Grief — With Important Caveats

Kübler-Ross originally described the stages as emotional responses in people facing their own dying; later, they were applied more broadly to many kinds of loss, including serious illness, transplant, and bereavement. ^[3][5]

• Denial — “This can’t be happening.” People may feel numb, shocked, or disconnected. Denial can be a short-term “buffer” that protects us from being overwhelmed all at once.
• Anger — “Why me?” “Why now?” Anger can be directed at doctors, family, God, the health-care system, or oneself. It often hides fear, loss of control, or a sense of injustice.
• Bargaining — “If I do everything perfectly, maybe this will go away.” People may bargain with God, fate, or themselves in hopes of reversing or softening the illness.
• Depression — Sadness, withdrawal, low energy, or hopelessness as the reality of illness or loss sinks in.
• Acceptance — Not “liking” what happened, but beginning to live with it: making plans, asking questions, and engaging with treatment or with the time that remains.

Important: research and grief experts emphasize that people do not move through these stages in a neat, linear way. Feelings can come in waves, repeat, overlap, or skip entirely — and many people do not recognize themselves in the five-stage model at all. ^[3][6][7]

Grief in the Liver Transplant Journey

Grief is not only about death. Transplant patients and families often grieve lost health, lost independence, lost plans, and the “old life” that existed before cirrhosis or liver failure. ^[8][9][10]

Studies of transplant recipients describe waves of anxiety, sadness, guilt, and even anger both before and after surgery — sometimes mixed with gratitude and relief. It is very common to feel “all over the place.” ^[8][9][10]

Limits, Misuse & Criticism of the Five-Stage Model

Over the years, the five-stage model has been widely popularized — sometimes in ways that Kübler-Ross never intended. Some people are told they “should” be in a certain stage by now or that they are “stuck” if their grief does not follow the model.

Research has found that grief is highly individual and that not everyone experiences discrete stages at all. Some critics worry that rigid use of the model can make people feel defective when their grief does not follow the pattern. ^[6][7]

Kübler-Ross herself later emphasized that the stages were a framework, not a law of nature. Emotions can be fluid, overlapping, and influenced by culture, prior trauma, and personality. ^[3][5]

Coping Tools for Liver Transplant Patients & Families

Several transplant and grief organizations suggest practical steps to cope with the emotional impact of serious illness and transplant. ^{[8][9][10][11]}

Videos & Further Learning

The Elisabeth Kübler-Ross Foundation and other groups host lectures, interviews, and educational videos that can deepen understanding of grief and serious illness.