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Dying Words

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Dear Dr. Nelson:

Thanks for your note and for your interest in my work [Letters, March 10].

Actually, while there are a few books regarding the clinical topic of prognosis (and not just ancient ones like those you mention, but more recent ones too), I think what the reporter, Mr. Sharlet ["Prognosis: Death," February 25], was referring to was that mine may be the first book-length, sociocultural study of the topic. I believe he is right.

Actually, I argue in the book that we might do well to rehabilitate prognosis and reintroduce it anew into medical practice, precisely because there was a time (actually as recently as the 1930s) when prognosis was a quite prominent part of medical care. So I am empathetic to your remark about "reviving" it.

Regarding Kubler-Ross, the story I have heard (which perhaps is apocryphal, or perhaps you can confirm) is that when she first wanted to study death she went to the oncologists at the U. of C. and asked if she could talk to some of their dying patients--to which they responded, "What do you mean? None of our patients are dying." (!!)

Again, thanks for your note.

Sincerely,

Nicholas A. Christakis

S. Maryland

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