for them. They are then sent off to relatives, often to the accompaniment of some unconvincing lie that"Mother has gone on a long trip "or other unbelievable stories. The child senses that something is wrong, and his distrust of adults will only grow if other relatives add new variations to the story, avoid his questions or suspicions, and shower him with gifts as a substitute for a loss he is not permitted to deal with. Sooner or later the child will become aware of the changed family situation and, according to his age and personality, will suffer an unresolved grief that he has no means of coping with. For him, the episode is a mysterious and frightening experience of untrustworthy grownups, which can only be traumatic It is equally unwise to tell a child who has lost her brother that God loves little boys so much that he took Johnny to heaven. When one such little girl grew up to be a woman she never resolved her anger at God, which resulted in a psychotic depression when she lost her own little son three decades later We would think that our great emancipation, our knowledge of science and of man, had given us better ways and means to prepare ourselves and our families for this inevitable happening. Instead the days are gone when a man was allowed to die in peace and dignity in his own home The more we are achieving advances in science, the more we seem to fear and deny the reality of death. How is this possible? We use euphemisms, we make the dead look as if they were asleep we ship the children off to protect them from the anxiety and turmoil around the house if the patient is fortunate enough to die at home, we do not allow children to visit their dying parents in the hospitals, we have long and controversial discussions about whether patients should be told the truth-a question that rarely arises when the dying person is tended by the family physician, who has known him from delivery to death and who understands the weaknesses and strengths of each member of the family I think there are many reasons for this flight from facing death calmly. One of the most important facts is that dying nowadays is in many ways more gruesome, more lonely, mechanical, and dehumanized; at times it is even difficult to determine technically when the moment of death has Dying becomes lonely and impersonal because the patient is Often taken out of his familiar environment and rushed to an emergency ward. Anyone who has been very sick and has desired rest and comfort may recall his experience of being put on a stretcher and especially of enduring the noise of the ambulance siren and the hectic rush to hospital. Only those who have lived through this may appreciate the discomfort of such transportation, which is only the beginning of a long ordeal-hard to endure % hen you are well; difficult to express in words when noise, light, pimps and voices are all too much to bear. It may well be that we should consider more carefully the patient himself and perhaps stop our well-intentioned rush in order to hold the patient' s hand,to smile, or to listen to a question. I consider the trip to the hospital as the first episode in dying, as it is for many. I put it starkly not in order to deny that lives should be saved if they can 1, e saved by a hospitalization but to keep the focus on the patients experience, his needs, and his reactionsfor them. They are then sent off to relatives, often to the accompaniment of some unconvincing lie that "Mother has gone on a long trip" or other unbelievable stories. The child senses that something is wrong, and his distrust of adults will only grow if other relatives add new variations to the story, avoid his questions or suspicions, and shower him with gifts as a substitute for a loss he is not permitted to deal with. Sooner or later the child will become aware of the changed family situation and, according to his age and personality, will suffer an unresolved grief that he has no means of coping with. For him, the episode is a mysterious and frightening experience of untrustworthy grownups, which can only be traumatic. It is equally unwise to tell a child who has lost her brother that God loves little boys so much that he took Johnny to heaven. When one such little girl grew up to be a woman she never resolved her anger at God, which resulted in a psychotic depression when she lost her own little son three decades later. We would think that our great emancipation, our knowledge of science and of man, had given us better ways and means to prepare ourselves and our families for this inevitable happening. Instead the days are gone when a man was allowed to die in peace and dignity in his own home. The more we are achieving advances in science, the more we seem to fear and deny the reality of death. How is this possible? We use euphemisms, we make the dead look as if they were asleep, we ship the children off to protect them from the anxiety and turmoil around the house if the patient is fortunate enough to die at home, we do not allow children to visit their dying parents in the hospitals, we have long and controversial discussions about whether patients should be told the truth-a question that rarely arises when the dying person is tended by the family physician, who has known him from delivery to death and who understands the weaknesses and strengths of each member of the family. I think there are many reasons for this flight from facing death calmly. One of the most important facts is that dying nowadays is in many ways more gruesome, more lonely, mechanical, and dehumanized; at times it is even difficult to determine technically when the moment of death has occurred. Dying becomes lonely and impersonal because the patient is Often taken out of his familiar environment and rushed to an emergency ward. Anyone who has been very sick and has desired rest and comfort may recall his experience of being put on a stretcher and especially of enduring the noise of the ambulance siren and the hectic rush to hospital. Only those who have lived through this may appreciate the discomfort of such transportation, which is only the beginning of a long ordeal-hard to endure ,.%,hen you are well; difficult to express in words when noise, light, ;pimps, and voices are all too much to bear. It may well be that we should consider more carefully the patient himself and perhaps stop our well-intentioned rush in order to hold the patient's hand, to smile, or to listen to a question. I consider the trip to the Hospital as the first episode in dying, as it is for many. I put it starkly not in order to deny that lives should be saved if they can 1,e saved by a hospitalization but to keep the focus on the patients experience, his needs, and his reactions