Authors

  1. Dellasega, Cheryl A. PhD, RN, CRNP

Abstract

There's no lesson plan for recovering from loss.

 

Article Content

As an assistant professor on tenure track, I was assigned to teach Death and Dying, an elective course. Although I had worked clinically with many grieving people and experienced personal losses, the daunting syllabus covered everything from the history of death rituals to euthanasia.

  
Figure. Illustration... - Click to enlarge in new windowFigure. Illustration by Jennifer Rodgers.

After a harrowing first semester, it got easier to teach the course. Surprisingly, in a small auditorium packed with over 100 upperclassmen, students were always willing to share tender feelings. They spoke of near-death experiences, the slow demise of a beloved family member or friend, personal recovery from serious illness, drive-by shootings and other forms of violence, abortion, suicide attempts, and traumatic accidents they blamed themselves for. Often, there were tears, and sometimes, referrals to counseling.

 

Always, there was a search for better answers than mine:

 

"How do you know people ever finish grieving?"

 

"What exactly makes it harder to live without a child than a parent?"

 

Eventually, another junior faculty was assigned to teach Death and Dying, and I went on to join a study that required focus groups about end-of-life care. The issues that emerged there were strikingly similar to those voiced by my students.

 

Then came "the Morning." There was coffee, the newspaper, and ironed shirts. I was getting ready for a student's dissertation defense and Paul, my husband, faced his own challenging day. As I prepared to shower, a crash sounded beyond the bedroom door. Something about the silence that followed made me grab my robe and go running.

 

My middle-aged husband was sprawled at the bottom of our basement steps, as peaceful as a young boy floating down a stream on a hot summer afternoon, arms and legs loose and eyes closed. I was able to keep his heart and breath going until the ambulance crew arrived.

 

Months earlier, an older married couple we loved died within months of each other. He had Parkinson's and she had cancer; it was painful to witness their mutual decline. After one visit, Paul shook his head and said, "Don't let that happen to me. Just pull the plug and give me morphine."

 

In the ED, when a physician showed me a CT scan outlining the flood of blood in my husband's brain, I wondered if the declaration had been some kind of morbid deja vu.

 

The ventilator was turned off and the nurses administered morphine, even though they assured me he wasn't in pain. Family and friends waited until his heart rhythm dwindled to nothing and his breathing slowed, then quit.

 

In the months that followed, I was stunned by my failure to manage any aspect of grief. Sleep became my preferred activity of daily living because in the light stages of slumber, Paul's voice would seem to rumble in the next room, or stairs would squeak under his step. Three times he appeared in dreams, so much like his living self that I awoke in the midst of a conversation with him.

 

For months, I could only eat nutrition bars that tasted like cardboard. I lost so much weight I was referred to an eating disorder specialist, who diagnosed the anorexia of grief.

 

As the first anniversary of Paul's death approached, I booked a cross-country train trip. It wasn't to meet new people or see new scenery, but a desperate attempt to grab onto something bigger than my life.

 

I slept, showered, and ate on board, all new experiences. Passing through the Midwest, I took my laptop into the clear-domed observation car, intending to write about my sorrows but sightseeing instead. The next morning, I woke to the Columbia River Gorge in Oregon, a place too beautiful to be captured by a cell phone camera focused through a train window.

 

Everywhere, there were metaphors for life and loss-homeless people squatting in the Sacramento station during morning rush hour, "family style meals" eaten with strangers, and memories of other train trips, with and without Paul. As we headed back east, I still didn't believe the pain of loss would ever go away.

 

That's when a woman in the compartment across from mine struck up a conversation. As we crossed miles of Mississippi water and swampland, our stories spilled out. She was older, but also a nurse and a recent widow.

 

"We had a wonderful and long life together. He survived his cancer for more years than anyone thought he could, so I'm grateful," she said with a slow nod. Hours later when she got off the train, a shimmer of her peace remained.

 

Late that night, the long, low train whistle reminded passengers that someone was guiding us safely forward while we slept. Guru Elisabeth Kubler-Ross's stages of grieving kept time with the wheels rocking against the track as I drifted into dreams: "denial," "anger," "bargaining," "depression," and finally, "acceptance."

 

No amount of expertise could have prepared me for such a sudden and searing loss. My students had pressed me for better, more specific answers, but as my train sped onward, I understood just how few there really were.