On Bargaining
Denial, anger, bargaining, acceptance. Kubler-Ross articulated the stages of grief with her
landmark book with a cheerful title, “On Death and Dying,” in 1969. Since then, nobody has
done better in this space though certainly many have tried. Allow me the conceit to attempt to
add something.
I feel like denial gets a lot of airtime, at least in the hospital setting. It’s pretty easy to identify and
seems to be a pretty common defense mechanism. Who among us has not indulged in a bit of
denial? I would argue dining indoors unmasked during a pandemic is a form of denial and
certainly there are many who do that. Most smokers know that tobacco is harmful to their health,
yet they persist. The grief stages are not linear, I think. They can occur out of order, some
stages can be skipped, and they do not always lead to acceptance.
But today we are here to consider bargaining. Bargaining is a natural human instinct. We have
all haggled over some price somewhere. What is marriage if not an agreement between two
people? Some people naturally take up bargaining while others are too embarrassed and gladly
pay full price. So for some, bargaining in the healthcare space is a natural reflex. It may not
even have that much to do with grieving after all.