Death: it’s impact on grief

Dying Well.  These words are, I suppose, a good example of an oxymoron.  It’s something I think about with frequency these days—mainly because of the reports about those dying of the Coronavirus—which seems to me to be: Dying Unwell.  And then there’s the recognition that more of my peers are dying these days—including those that are my counterparts in our family.  In this case, I’m referring to my grandchildren’s “other” grandmothers.  Two of them died of cancer, but—from my perspective—only one of them “died well”.  The other? Not so much so. 

Why?  The first family confronted the topic of death head on.  This counterpart grandmother was in the driver’s seat of her death as I suspect she was in life.  The second family denied and avoided the topic of death.  It appeared to me that this counterpart grandmother did not experience death on her own terms. 

I am a strong believer in talking about life’s uncomfortable situations.  I adopted that standard from the time that I realized how destructive it was to live a life of unspoken secrets—the life I’d lived since the approximate age of ten, when I first learned that my father had been diagnosed with a terminal illness and was only expected to live another four years.    

As children, we are formed by the people, places, and events in our surroundings that are consigned to our formative environment without choice. The circumstances surrounding my father’s illness and death were not only heartbreaking—they impacted my ability to cope effectively. I was ill-equipped.

Development depends on the interaction between internal and external forces. Honesty and openness are good policy; duplicity fosters insecurity. Nothing was open or honest in how my father’s illness was handled. And then he died.

My life took a new direction late in 1958 when one morning I got up to go to school and discovered that my father was sick in bed and unable to go to work. I felt concerned because this was very unusual. His condition worsened and he was soon hospitalized with a medical crisis. The doctor told my mother that our father might die.

That evening, while my Mom drove my older brother and me home from the hospital, she told us that my father had a blood cancer and that he might have another four years to live. We were instructed not to tell anyone, including Dad. This is the way cancer was handled during those times. It became “our secret,” and was never discussed.

 It was at this point—just as I was about to turn eleven years of age—that my childhood came abruptly to an end. Although I was chronologically still a child, I now felt an oppressive weight upon my shoulders. Girlhood was interrupted.

During my father’s last health crisis, he traveled to the Mayo Clinic for treatment.  According to the policy of that institution, he was told of his diagnosis honestly for the first time.  He contracted pneumonia and died there, never having returned home.  We never got to say, “I’m sorry” or “I love you” or even “Goodbye.”

Grief is agonizing, and childhood grief is among the most excruciating forms. It deprived me of the opportunity to give love to my father and to be loved by him in return. I was alone in my grief; there was no one with whom to share the sorrow. During the time of my father’s illness, his death, and the years beyond, my mother was just not capable of attending to her own grief and to the emotional needs of her children as well. 

Childhood trauma and the corresponding “loss” of childhood were the extreme hazards of my formative years; they required extraordinary coping skills that I had not yet developed. Without the benefit of an understanding and compassionate parent figure, I was vulnerable and needy. As a child left on my own to manage —how could I have remained emotionally healthy? My recovery was arduous, exhausting, and difficult to accomplish. It was grueling because there was so much, it was so intense, and it lasted so long. It was life-altering on a permanent basis.

If I were to choose what life experience defined me most, I would have to say it would be the unresolved grief due the death of my father.  As a wounded child—I was forever changed.

I was at a caregiving conference many years ago, and attended a hospice workshop. A comment was made about the support systems available to children to help them through the trauma and grief of losing a parent. Upon hearing that comment, I found myself suddenly in tears, and thought, “Oh…if they would only have had something like that when I was a kid!”

It’s pointless to debate which types of grief are the worst—the hardest to bear. Grief hurts far beyond ordinary words—it is profound sadness; it takes your breath away because it aches so much. The child’s loss of a parent is one of the most difficult forms of bereavement, and childhood grief is among the most damaging. It confronts the child with the difficult task of adaptation. It requires the guidance of a capable parent figure, someone from whom to draw strength, someone to receive and relieve the child’s distress.

The death of a parent is life-altering on a permanent basis; it is a severe emotional wound and engenders a longing of incomparable amount, intensity, and longevity. The pain of my father’s death was exacerbated by the fact that it was verboten for us to talk to him about it or even to our mother for that matter—ever.

It has now been nearly sixty years, and yet the pain of it never goes entirely away.  Although acute mourning subsides, we remain forever changed. I was literally formed by the conditions and context of how my father died.

Eventually, bottling up became so profoundly painful, that I did a 360 degree turn and became blatantly honest—a characteristic that set a whole new set of complications into motion. Any attempt to hold back and to be more prudent with my remarks just creates anxiety. For me, the consequences are better than the alternatives.  This is why I cannot just ignore problems and move on; I have to actively deal with them before I can put them away.

Honesty. Openness. Love. Memory. Communication.  I believed this was the route to strength and growth.  I believe that the journey would have been less difficult if that approach had been used from the onset.  I think the following NPR TED Radio program “Dying Well” bears this out. 

On this program, Jason Rosenthall shares the story of his wife Amy’s death from Ovarian Cancer. 

Amy wrote an essay about her life, her husband, and her impending death.  She said, “My husband is a great guy, and he’s available.”  Although she wanted to spend more time together with Jason and their children, she wanted to liberate them to move on in life without her.  She did that by saying, “You may want to marry my husband,” with the hope that if the right woman would read it, find Jason, and another love story would begin. Amy wrapped it all up on Valentine’s Day. 

On the TED Talk, Jason tells his Story of Grief:

Our love grew up until last day.  I have memories that haunt me, such as when I carried Amy’s lifeless body downstairs and through the house to the gurney waiting to take her to be cremated.  I will never get that out of my head. 

He admits that milestones are always difficult to get through, such as his son’s college graduation, and his own birthday.  “There’s always something to remind me of our life together.” 

I could not stand to be alone with these feelings and images. I want to take the taboo out of it; to talk about it and not be afraid of it. Thanks to Amy, he learned how to talk about dying without fear, to make plans while there is still time, and to plan for a good death. He says its better to have these conversations while healthy, and that being able to talk death openly was liberating.

Dying Well : TED Radio Hour : NPR


My daddy didn’t turn 49

See the source image

Your tribute to your father is touching. Although I do not follow any particular rituals in the mourning of my father, something I have done for nearly 60 years, I find that every milestone crossed is accompanied by the thought: I wish he could have known ______, or experienced _______, or that we could have shared _____. His death, and the circumstances surrounding his death were formative to who I grew to be as a person. The pain of losing him never goes away completely, and I know by now that it never will.

Cherish your memories and be thankful you have them.

Today Papa did not turn 73

The skeptic's kaddish

Today is Papa’s birthday.

In Jewish tradition, we tend to commemorate the dates (on the Hebrew calendar) of our loved ones’ deaths, rather than their birthdays. Same goes for historic figures like our Jewish sages of the many centuries.

Generally, as somebody who deeply appreciates and respects his people’s traditions, I tend to think of them as frameworks for expression of human experiences. I don’t believe that they were designed by or mandated by God, but I do believe that they reflect and are the culmination of many, many centuries of Jewish wisdom.

That’s how I approached my year of mourning, following Papa’s death.

But the truth is that I often find our traditions to be… lacking? No, not quite lacking… insufficient? At least – insufficient for me. The practice of reciting the mourner’s kaddish on a daily basis during the first year of mourning for a parent was –…

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Rethinking End of Life Care

End of life.  While we all know that it’s coming—someday—it is something we tend to ignore, until the moment it gets right up in our face and we can deny it no longer.

Snubbing death has become a real challenge in the midst of the pandemic.

I learned to deny death early on in life.  Because of that, there is still within me the lasting impact of unresolved childhood grief.  The death of my father, with all its surrounding circumstances, probably had the greatest formative impact on who I grew up to be. 

“Daddy went away, never to return home. No last phone call. No last touch.”

An Unremarkable and Imperfect Grandma (Life Stories and Life Lessons) p. 95

So as a young adult I made a purposeful change to be candid and straightforward.  This is the person I became; it does not always serve me well. 

I am now in my seventh decade and find myself confronted by loss with increasing frequency.   The thought of losing those who I love without the opportunity to see them again or even to say goodbye has intensified from fear to terror due to the coronavirus. 

I encourage all of you to rethink your attitudes about end-of-life care and death before you find yourself in the situation where there is no going back. 

11 Inspiring Quotes to Help You Rethink End of Life Care by Easy Living, August 31, 2020

This excerpt refers to quote NINE below:
Because the extent of his illness had been kept from him, so many other opportunities were lost. I am quite sure there was much more that he would have liked to say to help guide me into adult life. As it was, he didn’t even have the chance to say, “Goodbye.”

An Unremarkable and Imperfect Grandma (Life Stories and Life Lessons) p. 111

  • ONE:  At the end of your life, you will never regret not having passed one more test, not winning one more verdict or not closing one more deal. You will regret time not spent with a husband, a friend, a child, or a parent—Barbara Bush
    No matter what your life stage there is benefit from thinking with an end-of-life mindset.
  • TWO:  In the end, it’s not the years in your life that count. It’s the life in your years—Abraham Lincoln
    “Quality of life” is vital to end of life care.
  • THREE:  It’s not what you have at the end of life, it’s what you leave behind that matters—Stedman Graham
    What legacy will you leave behind?  How will you be remembered?  What values did you impart?  What impact did you have on others?
  • FOUR:  Our worst fear isn’t the end of life but the end of memories—Tom Rachman
    How will we be remembered?  Make memories loved ones will cherish.
  • FIVE:  I wanted a perfect ending. Now I’ve learned, the hard way, that some poems don’t rhyme, and some stories don’t have a clear beginning, middle and end—Gilda Radner
    Life does not always go the way we want.  Unpredictability is both the struggle and the beauty.
  • SIX:  In the beginning of life, when we are infants, we need others to survive.  And at the end of life, we need others to survive.  But here’s the secret, in between, we need others as well—Morrie Schwartz
    We neglect to consider all the ways we need others throughout life and all the ways we are needed, even as we near the end of life.
  • SEVEN:  Culturally, now, we’re really tight around death, and as a result I think people miss out on a lot of the beautiful aspects of the end of life process that can be very helpful for the grieving process, that can be a really beautiful part of transition of life that we don’t get to experience because it’s not in the conversation—Chrysta Bell
    When we avoid talking about end of life, we deny ourselves the opportunity to be involved in our end of life care. Confront what is happening.  Talking about your feelings and making your preferences known benefits both you and those around you.
  • EIGHT:  Have a conversation with your family about your end-of-life wishes while you are healthy. No one wants to have that discussion… but if you do, you’ll be giving your loved ones a tremendous gift, since they won’t have to guess what your wishes would have been, and it takes the onus of responsibility off of them—Jodi Picoult
    Or: “End of life decisions should not be made at the end of life.” Give your family the gift by planning ahead and sharing your wishes for end of life care.  If you wait until the crisis is upon you, it may be too late for you to express your wishes.
  • NINE:  Having the choice at the end of my life has become incredibly important. It has given me a sense of peace during a time that otherwise would be dominated by fear, uncertainty, and pain—Brittany Maynard
    Choice is vital in end of life care. A sense of choice through advance care planning helps reduce fear and uncertainty and gives peace.
  • TEN: You matter because you are you, and you matter to the end of your life. We will do all we can not only to help you die peacefully, but also to live until you die—Cicely Saunders
    In trying to deny or hide from death, too many miss out on the palliative care available for better living during the process of dying.
  • ELEVEN:  The end of life deserves as much beauty, care, and respect as the beginning—Anonymous
    In summary of end of life care.

This excerpt refers to Quote TEN above.
A hospice group supplied my mother-in-law with a transport chair so I could get her out of the house to go to the senior center, and with travel oxygen so she could go to the beach with her daughter. In other words, although hospice eases the process of dying, it also facilitates and encourages the process of living. 

What to Do about Mama? p. 171