Posts under ‘grief’

She sits on the double bed in her studio apartment with great dignity, the early morning light streaming in the window. Gospel music plays on a small CD player on a table by the kitchen door. This is our first meeting since I’m just covering for her usual nurse.

“How are you this morning, _________?”

“Oh, I’m OK. I’m here with the Lord beside me,” she says with a nod of her head towards the CD player. The music plays on.

“Did you sleep well last night?” I ask.

“Well, I only slept a few hours. I can’t sleep much since the doctors killed my daughter last year.”

I look her in the eye, and she stares back. Her gaze makes me slightly uneasy, but I hold it.

“I am so sorry for the loss of your daughter. That must be so hard.”

“Yes, but He sees me through.”

We listen to the gospel music for a moment.

“The music is really beautiful,” I say sincerely.

“Can I give you your meds now?”

“Sure, honey,” she replies.

I put her morning meds together, prefill her evening meds to take with dinner, and ask if she needs anything else.

“No, I’ll be alright. My PCA will be here in a few hours.”

“OK. I hope to see you again some time, my dear.”

“God bless you, and thanks for coming.”

She stares at me with that unsettling gaze again. Sometimes the chronically mentally ill can be socially awkward or unaware of how they look at people or how they speak. But in this case, I just feel like she’s looking at me very deeply, and I simply try to meet her gaze.

“God bless you, too, and I’m very sorry about your daughter.”

“Thanks you. Bye bye, dear,” she says as I close the door.

Walking to my car, the ubiquitousness of loss and grief hits me, and I take a deep breath as I open the car door.

Just another day on earth.

Grief moves like a subterranean stream through my life, and its liquidity is a constant yet frequently unconscious presence. Days can pass wherein I dip nary a toe in the rushing waters. Yet other days, the waters rise, and the briny fluid reaches the wells of my eyes.

These past few weeks, that subterranean tributary is quite less than subterranean. Its level has risen, and the melting winter snows seem to have swelled the stream, feeding its depth, its breadth, and its velocity of movement.

This month of March brings with it the dying breaths of Winter, as well as the birthdays of three dearly departed loved ones. Grief is natural at this time of year, and the lack of sun in this New England late winter only adds to the challenge.

So, what to do in the face of grief’s rise? Watch, breathe, cry, and breathe some more. It is, after all, simply an energy. Grief has no substance, no true physical form, although it will often manifest in the body as pain. Yet grief is a mind state, an emotional space, a spiritual state. But notwithstanding, I do not have to choose to live there. When grief moves through me, it is enough to simply be, to breathe, to cry, to breathe through grief to the next moment, and then the next, and the next. If grief is truly a stream, a tributary of the waters of life, then perhaps I can simply choose to enter—and exit—on the pillow of a mindful breath.

December 2nd is a sadly significant day for our family. It marks the anniversary of the murder (at the hands of the police) of Woody, our best family friend, whose untimely and unnecessarily voilent death occurred on this day in 2001, not three months after the events of 9/11. Interestingly, on the day Woody was killed, we were in New York City visiting my great-aunt Theresa, who at the time was around 112 years old. At her advanced age, straddling three centuries, she managed to outlive Woody by three months.

Our dear Woody—who was my wife’s former partner, my son’s best friend, mentor and honorary uncle, and my closest confidante—is as sorely missed now as he was five years ago. As much as I am able to embrace death as merely a continuation of life on another energetic and spiritual plane, his physical absence from our lives and home is still a palpable emptiness that has persisted over time.

The 2nd of each month also marks yet another month that our dear beloved dog Sparkey is gone. Sparkey and Woody were joined at the hip, twin flames who are inextricably linked in my mind due to their many adventures together over the years prior to Woody’s death. When Woody would walk through our door, he would always immediately drop to the floor and allow the dogs to lick him ceaselessly, covering his red beard, mustache, eyes, and cheeks with their kisses of greeting. He would giggle as he lay there, the dogs intent on their right (and responsibility) to slick him down with joy and gusto. Once he was done greeting the dogs, we were next, and his entry was almost always a source of upliftment for all. Rene would have his “uncle” and playmate, I would have my best male friend, and Mary would have her old friend for whom she functioned as confidante, maternal figure, and spiritual sister.

When Sparkey died in September of 2006, we carried his golden and red body to his freshly dug grave in our yard. His coat always reminded me of Woody’s hair and beard in its orange-red brilliance. It was like burying a part of Woody that day. Now a small dogwood (purchased and lovingly planted by our son Rene) sits on Sparkey’s grave, some of Woody’s and Tulane’s ashes and Rene’s baby teeth mixed with the rich soil of loss.

This first week in December carries with it a great deal of energy reflecting loss and grief. Yesterday, December 1st, used to be my parents’ wedding anniversary up until their divorce in 1976 when I was 12 years old. Tomorrow, December 3rd, will mark three months since my step-father’s death on September 3rd. Finally, the next day—December 4th—will mark what would have been my mother’s and step-father’s 30th wedding anniversary. Multiple blows of grief and loss billow through this week, and I/we just roll with the punches.

Still, I am grateful. These beings have fed me with their friendship and loyalty, adding immeasurable quality to my life’s trajectory. My step-father (80), Sparkey (14), and Theresa (112) each died from natural causes—pancreatic cancer, renal failure, and old age, respectively—and they were all considerably old (especially Theresa!) based upon their respective species’ life expectancy.

As for Woody, his demise was premature and tragic, although I give thanks in this moment for the wonderful times we shared together. Since we were both born in 1964, we had shared visions of our middle age and old age together, and had always looked forward to celebrating our 40th birthdays together. Sadly, we were robbed of that opportunity, and he left me to celebrate my birthdays without him—and there will doubtless be many, many more before I am ready to join him in the Great Beyond.

Woody’s loss helps me to more fully appreciate and understand the loss experienced daily by people the world over who lose their loved ones to violence. Granted, I did not watch him be killed—a fate suffered by many individuals in Rwanda, Darfur, Burma, L.A., The Congo, and elsewhere—but he was still robbed from us, wrenched from our lives, and he is sorely missed.

So, here it is 5am and I am awake again. Morning has broken, mourning has broken, and we stand on this troubled planet looking up at the stars, wondering how our dearly departed are faring in their new manifestations, in whatever form that may take. Sparkey, Tulane, Theresa, Woody, and the many others: your days here are not forgotten, your departure still hurts, but we bless you and send you on your way. You are released, and when our blessed release comes, we will also know the sweet surrender of leaving this mortal coil, and entering those realms unknown to those of us still embodied.

May all beings be free. May all beings be happy. May all beings be free of suffering.

Grief—and its active cousin, mourning—settle into the bones, and one becomes accustomed to their presence over time. If, like me, one suffers from underlying mental illness—in my case, chronic depression—recovering from grief and moving through its inescapable trajectory is an elongated process.

Resilience is defined on Wikipedia as “the ability to recover from (or to resist being affected by) some shock, insult, or disturbance”. In my case, and in the case of many others who walk this troubled planet, resilience is a skill or quality which cannot be taken for granted. Our American culture seems to be built upon values of positivity and self-reliance, as well as the innate ability to “pull yourself up by the bootstraps”. Consequently, depression and mental illness, as well as the slow recovery from “some shock, insult, or disturbance” are often seen as character flaws and are frowned upon as a sign of personal weakness. Oh that it were so simple.

For those of us for whom mental illness (and I do not use that term lightly) is a lifelong struggle, recovering and moving through grief or personal tragedy can be inordinately slow and arduous. Support and patience from our friends, family and colleagues is of the utmost importance. Beyond the care and succor of others, what is most crucial is the gentleness of quiet and consistent self-care.

Many of my patients lack the benefit of strong personal resilience. This commonality which we share is perhaps the reason why my compassion for suffering runs so deep, but also perhaps why my well of compassion can sometimes run dry. When there is suffering both within and without, emotional fatigue may become the order of the day. Today I pray for resiliency and gentleness, and the ability to nurture them both.

…for this special blogging bulletin.

I am painfully aware that the last several weeks’ blog entries have all focused on my step-father’s dying process and my subsequent grieving. While this blog is generally a “nursing blog”, I have injected it with a great deal of my own personal journey with chronic pain, depression, and Multiple Chemical Sensitivity over the years. If all of this grieving is tiresome to some readers, please know that grief is not forever (thankfully), and more front-line nursing stories and patient anecdotes will be forthcoming.

Thank you for bearing with me through this experience, and please stay tuned for our regularly scheduled blog.

Tonight, while swimming in the clear water illuminated by underwater lights at our local health club, I ruminated on my grieving, drawing parallels between these two seemingly unrelated processes. As I glided through the water, many things came to mind for me to consider.

Stroke, stroke. Grieving is like swimming through water which sometimes seems syrupy thick, and at others more like a gauzy film.

Stroke, stroke. The resistance I feel against my body as I swim is like the resistance I feel to the emotions which continue to well up at inopportune times.

Stroke, stroke. Around lap number eight, my goggles fog up and my vision is murky at best, just as my mental vision has been subsumed at times by the powers of grief.

Rest. The exertion of swimming becomes overwhelming, and I tire around lap nine. I take a respite, just as one must from the tiresome exertion of grieving.

Stroke. The pool is representative of the well of emotion one must experience through this process of loss and recovery of self.

Stroke, stroke. I continue along my trajectory, but now my arms feel leaden, like the water is actually made of sand. Grief can make life feel this way—heavy, thick, almost impossible to wade through without exhaustion.

Rest again. The water now feels like a protective cloak, and my body can also revel in its enveloping softness.

Stroke. I push through the resistance, overcome inertia, just long enough to accomplish a small earthly task.

Can grieving end with such certainty? Does one just exit the pool, towel off, and head for home? Certainly not, for better or for worse. And the swimming has only just begun.

How does one reenter daily life following a life-changing event like a death? Beyond that, reentering the workplace is perhaps the most challenging of all. Woe to the grieving worker who has not neatly sown up the grieving process before the following Monday at 9am!

Returning to work after a three-week absence to tend to my step-father’s dying process and death, I gingerly returned to work and was immediately dizzied by the frantic comings and goings of my colleagues. Standing in the office on my first day back to work, it seemed as if I was a reluctant swimmer poised on the edge of a raging river, considering touching my toe to the water yet highly aware that the undertow would drag me under at my first sign of surrender to its horizontal power.

Of course, my compassionate colleagues welcomed me with hugs and kisses and offers of assistance. Several individuals went out of their way by offering concrete tasks which they could shoulder: filling med boxes for my more dependent patients, making phone calls I was reluctant to place. Still, as I sat at my desk, the cobwebs of absence began to clear, and the onrush of details needing attention quickly filled my brain which until that moment had been busy with other processes of a more personal nature.

Stepping (however reluctantly) into the rapids of the workplace, I realized quite readily that my colleagues’ stress and my patients’ neediness neither lessened nor took a break while I was otherwise engaged with family. Our “disability care management” office is without a doubt a rushing rapid of information and nursing care which has a laudable goal of keeping the most disabled and chronically ill inner-city patients aligned with the overarching pursuit of preventive health, self-care, and crisis management. In pursuit of that goal, we nurses, nurse practitioners, and medical assistants bend over backwards, often pulling out our hair in order to deliver the quality care which we see as necessary to the well-being of our patients. That said, in order to accomplish this goal, it seems widely accepted that our workplace must function like a battleship at full bore, the ammunition (of health) at the ready, and the crew in a constant state of hypervigilant combat against disability, addiction, disease, and poverty. In delivering such care, the caregivers wear themselves pretty thin.

So, in walks the bereaved nurse, fresh from a parent’s illness and ultimate death, still reeling with emotion and saturated with stories of my own family’s newest evolution. At 9:00 on Monday morning, I again took on the yoke of the needs of more than eighty people, fifty of whom consider me their first line of defense for most any situation related to their health and well-being. And a yoke it seems.

For more than two weeks, the travails of my patients (and my colleagues who cared for them in my absence) were shadows which would flit across my consciousness, yet danced on the periphery of my mind. With the care of my step-father and coordination of his own care team as a top priority, the worries of the workplace slowly sank to the bottom of my cognitive well. However, even as my enfeebled brain again made attempts to grasp the enormity of the task before me, this first week back was an enormous challenge, and the journey from Monday to Friday seemed at first Herculean, but ultimately felt most Sisyphean.

The boulder is now at rest during this blessed weekend, balanced delicately on my desk some twenty-one miles from our home, patiently awaiting my return. Come Monday, it will again be time to shoulder that burden, and also to continue to seek ways which will decrease said burden’s impact on my physical health, grieving process, and emotional well-being.

Yes, the reentry is difficult. When the Space Shuttle is reentering the earth’s orbit, the fires of the atmosphere will put the Shuttle’s outer layer of protective skin to the ultimate test. That skin is all that protects the astronauts within from the searing and destructive heat of the earth’s gaseous envelope. And so for me, my emotional “skin” is what similarly protects me from the vicissitudes of nursing practice, the double (and at times paradoxical) challenge of embodying the noble goal of self-care while I deliver care to others in need.

This Saturday evening, I am grateful for the weekend, for the winds of late summer, for the fickle September weather, for the peace that home affords, for the love that buoys me in times of trouble. I also give thanks for the skin which protects me from the elements, be they emotional or physical in nature.

Dying is hard work, but the dying person is eventually (and thankfully) released from that process, moving beyond all notions of corporeal suffering. But here on earth, the grieving must release themselves from their suffering, all the while maintaining the activities which keep home and hearth upright and functional. And here is the challenge: grieve, move beyond the loss, enter a new relationship with the dead, and embrace life anew.

Following a life-altering experience, how does one reintegrate back into one’s former life? When one has been living in an altered state, with “normal” daily life in suspended animation, how does one comfortably fit back into that daily routine? Superimpose the grieving process on that reintegration, and all bets are off.

Many of us are aware of the five classic “stages” of the grieving process: denial, anger, depression, bargaining, acceptance. But nothing is ever so cut and dry, and our emotional lives are varied and complex. For me, in this moment, there are various layers of exhaustion coloring my experience, my body slowly coming into some semblance of equilibrium. Powers of concentration and focus remain relatively unreliable, but hints of the balanced self peek through the haze. Patience is a virtue at this stage, both with others and one’s self.

Grief comes in many guises, and it manifests in so many ways throughout the day. Circumspect self-care and self-awareness seem to be the best tools at my disposal. But the first step in using those tools is at least opening the tool-box. As Sogyal Rinpoche has said, “Our present condition, if we use it skillfully and with wisdom, can be an inspiration to free ourselves from the bondage of suffering.”

A brief quote from a line written in an email to my beloved siblings with whom I share the bittersweet burden of mourning:

So, now for the work of grieving. The hourly pay is poor, but the dividends will be worth every moment invested. Remember, “unshed tears will make other organs weep.”

And now the grief settles into our bones. Mary and I have been complaining today of profound aches and pains, an experience which my sister shares. Our muscles are like stones which have lost the long-ago suppleness of soil. Our joints ache and creak like wintry tree limbs. We move through a syrup of feeling, even as we unpack the car, wash clothes, and attempt to resume “normal” life following the experience of a death.

Today we avoided a neighborhood picnic, lacking all motivation for superficial conversation and pleasantries. At the supermarket, we ducked in order to not encounter someone who we knew would only drain us with her narcissism. Tomorrow, I work from home, and Mary enjoys one more day of bereavement leave. Tuesday, we re-enter the proverbial rat-race, even as we continue to feel like we’re still in a parallel universe, the Universe of the Grieving.

This special universe is inhabited by many, and even as some of us lose sight of it as we become enshrouded in the everyday world once more, a part of our heart remains in the Universe of the Grieving, holding the memories of our departed loved one in a special and tender place.

Pieces of my soul dwell permanently in the Universe of the Grieving, holding a spirit candle for my beloveds who have since left this earthly plane. The candle I burn for my step-dad glows most brightly, having only recently been lit. Some day another beloved’s candle will be the newest one to grace my spirit altar, but for now his soul occupies the center of that most sacred space, and I send love and light to him as he claims his most righteous prize.