(Translation into most languages at tab to the right.)
The other day, I was thinking back over the tragic deaths of many of my family members. And I thought about how I felt towards people a few decades ago when they suffered various illnesses or struggled with disease or addiction. I didn’t have much compassion because I hadn’t ever experienced those types of painful and heart-wrenching needs myself or in anyone I loved.
But in 2000, when my younger brother was in intensive care for two months on a ventilator and in a coma, I began to learn about the sorrow and desperation that hover around situations like this – for the one who is ill and for those who love them and who cannot do a thing to help or change the outcome. His diagnosis of HIV/AIDS and slow but impending death broke my heart – maybe for the first time in my life.
(Translation into most languages at tab to the right)
In a world where ‘nothing is certain except death and taxes’ and loss is unavoidable, grief is guaranteed to be an emotion each of us will experience in our lives sooner or later. If we have lost a loved one and grieved well, we can understand grief in others and empathize more fully.
But what about those who are living with a loved one with mental health problems, or in active addiction, or in a recovery program for the umpteenth time, or whose whereabouts are unknown? How do they live with the constant flux between hoping against hope, waiting, and praying for a miraculous change, and discouragement and depression as they watch their loved one struggle against an unrelenting enemy no one can see? My husband and I lived in this twilight zone for years – as do millions of others. While he was still living, we were grieving the loss of the son we loved and raised and had hoped to see move successfully into adulthood.
In an excellent article, Grieving the Living, Dr. Susan D. Writer shared insights that are an invaluable help and source of comfort for this all too common situation:
(Twenty-ninth in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)
I have never been one to accept something without question – anyone who knows me well, knows this – and they live with the frustration my incessant questions create. But it’s the way I need to process what is happening to or in or around me in order for me to honestly make the decision to accept or reject whatever the issue is at hand. I don’t think I could live with myself if I pretended I agreed or accepted something when I didn’t – the dishonesty would keep me in turmoil. And many times, it is ultimately for self-preservation that I accept something distasteful or painful when I finally understand there is no other option.
Death leaves us no other option – it is not negotiable. For most of us, our survival instinct brings us to the realization that in order to retain our sanity, we must eventually accept death – even of those we love the most in this world – whether we like it or not.
(Twenty-eighth in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)
Memories are strange things. How much control do we have over them? What triggers bring up which memories? How do triggers differ with each individual personality? Does grief affect memory? I know it does mine because I continue to experience new associations and memories being formed from what were once familiar items with no particular memory attached before—which now, after my son’s battle with addiction and death, have a specific memory related to him.
(Twenty-sixth in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)
Nine months after our son, JL’s, sudden death, we were gradually unearthing our grief, as we gradually unearthed pieces of his life. We were miners searching for something precious, digging through the layers of years as if through layers of rock. Or perhaps we were more like survivors of an earthquake. Our entire earth, with everything we had built on it, was suddenly shaken to the point of collapse, and we were sifting through the remaining buildings and rubble to see what was left. Deciding what to keep and what to dispose of. “Dispose of” has new and unwelcome meanings now. Clothing, personal belongings, furniture, files, photos, childhood toys, keys, memorabilia.
John’s journal entry on May 12, 2015 expresses some of our feelings:
Dear JL,
It’s dad again. We are going through more of your things and I spent a half-day shredding your old papers and notes. It is so odd that much of our lives comes down to boxes of paper to shred. This is very, very hard for me. Shredding your life.
I love you – Dad
Grief is about what is going on inside us after a loss—how we feel. We have no more control over it than we have control over other feelings. Our choice involves how we deal with it.
Mourning is the action of dealing with our loss—what we do, the common rituals, the external part of the tragedy. Again, we choose how we mourn.
Some people put acts of mourning off indefinitely – leaving a deceased loved one’s belongings just as they were when they died until they die themselves. Others, urged on by society or their own distraught emotions, will almost immediately begin sorting and throwing. For us, there were some natural milestones when deep inside we seemed to know it was time to face the loss of another part of our son’s life. The grief-work we were engaged in – being aware of the various stages of grief and facing them as they surfaced – was our internal guide. We never let societal custom or any external pressure guide us, while we did read and listen to other’s experiences.
One thing became clear: this loss of our child was very, very different than the loss of our parents or siblings. Although each of those were difficult in their own distinct ways, the level of personal pain with our son’s death was unique. He was an intimate part of who we are – of course – he came from us. As he grew and became his own person, he yet remained a part of our life and more significantly, our future. All is engulfed in a thick fog. Which is why the quote in the photo is so poignant:
When you lose a parent, you lose the past. When you lose a child, you lose the future.
(Eleventh in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)
Honesty is one of the main themes that ripple under the surface of “The Blues.” Expressions of honest feelings, whatever they may be at the moment – themes of lost love, painful relationships, dashed hopes, and heartache. The majority of us have or will experience heartache in our lives. Although it seems counterintuitive, most of us feel consoled by songs that express what we are feeling deep inside but may have a hard time putting into words. In order for me to be honest, I have to acknowledge that I am singing The Blues.
(Tenth in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)
When there is a rupture in the earth’s crust it creates a seismic disturbance, the prelude to an earthquake. Something seismic happened deep inside us the day our son died – a fissure opened, and all our energy was expelled. What followed that shock was the onset of grief and, as with earthquakes, the aftershocks. But unlike earthquakes, the aftershocks of grief continue for days and months and even years.
(Eighth in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)
When I was young, I only went to one funeral. I can’t remember who it was for or where it was, but it must have been for a close relative or I wouldn’t have been there. I do remember seeing everyone dressed in black. It was a very somber setting, people talking in hushed voices, and I didn’t comprehend what was happening. I just knew everyone was sad. After that day, I never thought about that person again – and even if my parents thought about him or her, their acts of mourning seemed to stop with the funeral. And I had no knowledge of any grieving on their part because at that time and in their cultural setting, people kept feelings regarding their grief to themselves.
It wasn’t until 20 years ago when my younger brother died from AIDS that I was faced with a death that was so close I felt a personal loss that tore at my heart. There was no way to just quickly plan a funeral and burial and then move on. My life as I had known it, now had a gaping chasm where my brother had once been and it was not going to close up anytime in the near future. I needed someone who had travelled this path before me to guide me through the overwhelmingly disturbing and depressing feelings. None of my friends had experienced a close loss like this. So, I looked to the books that were most recommended: On Grief and Grieving by Elisabeth Kübler-Ross and A Grief Observed by C. S. Lewis.
(Seventh in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)
When public health is at risk, one can only wonder about the motives behind politicians’ decisions – our “public servants” as they used to be referred to – regardless of what they may say. But we don’t have to guess their motives because actions speak louder than words and the actions of the US Department of Justice (DOJ) this week regarding Purdue Pharma and the Sackler family are unconscionable. This deal is not justice for the victims and their families for this pervasive and criminal corporate greed.
(Fifth in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)
After many years of not having a dog, we decided to adopt one from our local shelter. We found a beautiful German-shepherd/wolf mix who was 18 months old. Bella was docile, sweet and quiet. The next day, as I headed out to the grocery store, I gave her a hug and saw her watch me through the window as I got into the car.
When I returned an hour later, I was met with a shock. I found her, panting rapidly and pacing nervously in our bedroom where our wooden shutters were open and had bite marks. She had tried to escape while I was gone. I had no idea why. I immediately called the shelter. “She is having separation anxiety: she needed to escape being left alone.” We found out that she had been with two families previously when she was dumped at the shelter because she continued to try to escape when she was left alone for hours on end. They gave us the name of a dog behaviorist and we started down the long road of helping Bella manage her fear when we had to leave her at home.
Children and adults can experience separation anxiety when someone they are attached to leaves them. They can have recurrent and excessive distress just anticipating being separated from loved ones and the anxiety can be so intense that it is hard to function in everyday life. Panic attacks and physical symptoms such as nausea and headaches can occur. For me and my husband, on the morning of our son’s death from overdose, standing over our son in that body bag we experienced the ultimate separation anxiety. The overriding emotion we felt was fear: fear of the unknown future we were facing. We couldn’t visualize how we would survive without our son as part of our lives and the future we thought we all had together. He had not only been an integral part of our lives for 25 years but he was literally a part of us–the combination of our DNA that formed him as a particular and unique human being. To say that it was like having part of you taken away doesn’t describe it. This was having our hearts torn out.
We would never embrace or kiss or stroke the cheek of our son again. We were facing an existential crisis, shaken to the core, questioning our reason for living. Regardless of our strong faith that had seen us through many other deaths in our families, this separation seemed incomprehensible and cruel. It was only by falling down on our faces and waiting for Mercy to gradually pick us up that we were able to survive this traumatic separation from our son and move forward again in life.
The Ohio Society of Addiction Medicine is a chapter of ASAM - A professional society actively seeking to define and expand the field of addiction medicine.
Opiate Nation 