Grief: The Ongoing Season

I thought that summer was going to be the hard season after the death of my father due to his love for the garden, the outdoors, and baseball. Summer is now coming to a close, but I'm finding that my grief has not been as short. My dad was healthy-sick for so long, living 2 years well despite metastatic cancer. I had no clue that last summer would be the last healthy time with my dad. How do you go back and relive every moment when he was the 'normal' him?

There is the age old question of whether death is better sudden or drawn out where you have time to say good-bye. My thoughts: they both suck. I have seen plenty of death in my short time as a pediatrician, and death is death. The chronically ill child that dies does not hurt any less than the unexpected death of a healthy child. It hurts immensely as a physician to watch your patient die even if you only cared for the child for a few minutes, but I had been lucky to be the one standing from the outside looking in compared to the families going through it. One of my main goals was for my dad's death to not be dragged out to where he was suffering: if only illness and death operated so fairly.

He was healthy until all of the sudden he wasn't. I try to replay the past 10 months or so in my head, and it's hard to wrap my head around that my strong, invincible-to-me father is gone. How did cancer slowly yet so quickly steal him from us? Anyone who has witnessed cancer knows it is a thief. It literally stole the past 6 months from us (longer to him and my mom who dealt with it on a daily basis). It is hard to remember my healthy dad, because cancer tortured him until he was almost unidentifiable physically and mentally. I feel cheated that my last memories of my father weren't with his best version. God covered us through the hard times and created some beautiful memories with him during his last few months with us, but it's really hard to look past the bad memories and remember the good.

It's autumn and I picture my dad in his sweaters driving his Toyota Corolla all over Missouri and Iowa attending Football games. I imagine him taking his country drives with a Coke in hand and Starbursts in his cup holder. He's driving to the nearest orchard to buy apples to share with me for my next visit home, or maybe he's home whipping up a batch of his famous 5-Alarm chili or vegetable stew. He's in the garden harvesting his beloved sweet potatoes, or maybe he's sitting in the living room watching football with my mom. Somedays it is unfathomable that this version of my dad is no longer with us, because in my deep recesses I think I lived with the idea he would always be alive. Who doesn't live with these superhuman ideas about their parents?

I was in Whole Foods the other day, and they had their cranberries and stuffing material out already. I teared up in the dang grocery store aisles thinking of Thanksgiving without my dad's cornbread dressing. Grief: It can hit out of nowhere. My first experience with losing someone close to me was my 2nd week of medical school when one of my high school best friends tragically died in a car wreck. I can remember for months afterwards her death felt like we were in a really bad fight, and we weren't talking but that everyone else got to see her and keep making memories with her. My dad's death feels like he is gone on a drive and that we just moved on with life without him, and that he is really sad that we won't talk to him. Grief: It distorts reality.

My mom told me to listen to this song the other day, and she is right: It perfectly describes how we are feeling. I am hopeful in that God promises more than the confusion and hurt that death leaves behind. It's just a matter of meditating and praying on these promises until I am living out again what I know in my heart.


1 Thessalonians 5:17-18,"After that, we who are still alive and are left will be caught up together with them in the clouds to meet the Lord in the air. And so we will be with the Lord forever. Therefore, encourage one another with these words.'

Grief and Medicine

My dad had been sick with cancer for 4 years before his passing 3 weeks ago. It was a tumultuous time for our family with many peaks and valleys as anyone who has experienced cancer knows. My life personally has been a firestorm in conjunction with his illness. There is no need to recount every small woe I experienced, but the entire toll of the process has finally collapsed on me.

I knew times were changing about 6 months ago. Living six hours away allowed for some naieveity about the daily happenings of my father, but in January I went home for vacation and could feel the change of tide. He had more loss of appetite, more weight loss, and loss of independence. The man who used to travel to sporting events, drink coffee with his pals, and who had enormous energy for an 83 year old man started to prefer to sleep-in and stay home during the day. He underwent a trial of palliative radiation, even though doctors kept saying the metastatic lesions were fairly stable. There were no improvements.

I made a spontaneous trip home in February for my birthday and to watch my brother coach wrestling, and I was shocked. My life-filled father was ridden with pain. His oncologist utterly failed him as he basically told my dad he was a drug seeker and that he needed to get off the narcotics. My dad would sit and cry in pain, and I had never seen my dad cry before. I was furious, and took a week off work to help straighten out the failures of his local oncologist. As a physician I try not to publicly judge what another physician is thinking, but this was only the beginning of being completely disgusted with the care my father received. I would be written up and fired 10 ways until Sunday if I treated my pediatrics patients and their parents like my father was treated. Physicians are to read between the lines and interpret what our patients are unable to put in medical terms, and that is quite the skill I need as a pediatrician. What am I missing that my patient cannot verbalize? Hey doc, maybe you missed that a hardworking, tough man in his 80s with metastatic cancer is not ready to use the word 'pain' and that the cancer is winning? I digress.

The week at home left me knowing that things would never be the same. I went back to work the night shifts, and my husband was gone for a period of time for his classes. I would cry myself to sleep, wake up and put on makeup to hide the weariness, go to work and deal with stressful night shifts, and then cry while I walked out to my car in the mornings. I remember trying to sleep during the day, and waking up straight from sleeping hysterical that my dad was dying and I would never see him in the garden again. No one knew that every moment I was not at work that I was consumed by sorrow. Doctors are good at hiding.

The garden has been a reoccurring theme for me the past few months. My family loves the outdoors, and our parent's garden is the family gem. I cannot remember a summer where my dad did not spend every spare minute meticulously tilling and sowing seed, and then harvesting his crops. He was particularly proud of his strawberries and sweet potatoes. He was famous for his pints of juicy, sweetness he shared around town, and for his gargantuan potatoes that sometimes required a saw to cut they were so big (or so the tale goes). My favorite memories of him are toiling in his garden for his friends and family.

Unfortunately, the life of a resident doctor does not allow much time for family life. We put on happy faces, and encounter our patients pretending we do not have a care in the world. We do not take time off until it is dire. We have our own medical crises, parenteral illness, sickness of our kids and spouses, and we put a facade pretending we are brave and tough. We give-up a lot to ensure our patient families do not have to go through their hard times alone. Doctors do this like it is a good trait to shove our tragedies aside to do our jobs. I guess it is until time catches up with us, and we can no longer ignore the pain we have been enduring. It often feels like weakness to say we need time or that we need help. Needless to say, I plowed through the past few months and did not share with many of my friends or colleagues what I was experiencing outside of work.

The past 2.5 months were awful. I was trying to get through NICU and another set of night shifts, and then I knew I would be on vacation. My heart wanted to be home, and I knew it would be good if I could be, but that would have meant taking time off, paying people back for working for me, and extending my time in residency. How to balance work, marriage, and imminent death of a loved one? I remember standing in a patient's room listening the concerns of the parents and thinking, "I DON'T CARE." They were the nicest parents, but I had no ounce of empathy left in me. I never had that happen before.

I went home when I could, and then got that fateful call that it was time to come be at home for awhile. I deal with cancer and death frequently at work, but personally experiencing it was quite different. He suffered terribly. I felt guilty that I had not been there to navigate the confusing and harsh world that medicine can be. We set-up Hospice, and for 2 weeks watched him suffer and fade. Cancer is not friendly.

We had our happy moments. I spent many hours picking strawberries, and loved seeing my dad still manage a big smile when he saw the bowl full and smelled the fragrance of fresh berries. My mom would load my dad up in the car to take him for a drive around the garden. It was the epicenter of our happiness the final weeks. He lived to the end of strawberry season: how fitting.

I was luckily able to arrange back-to-back vacations allowing for time with my family. It's still hard to go back to work, and to move on like the last 6 months did not happen. The garden that brought me much happiness is now a bitter reminder that my dad isn't out working in it in his jeans, boots, and ball cap.

Grief is a lot easier when I am not the one going through it, but I have already learned that the only person that can make room for my grief is myself. Dealing with death is a process, and the mourners are left to navigate the process alone, or so it feels. CS Lewis said, "There is an invisible blanket between the world and me. I find it hard to take in what anyone says," and that is exactly how I feel.

I know that God is greater than my grief, and that the loneliness is a lie from Satan. I am allowing myself time. Doctors, we are only humans. We aren't immune from our own pain and suffering, and know that you are not weak to need healing and help. It is the lesson I am learning each day as I wake .