Tahitian Mourner's Attire

From the British Museum, worn by the chief mourner at ceremonies honoring Tahitians who were especially important in the community.

Grief is a Ball in a Box

Lauren Herschel describes grief:

So grief is like this:

There’s a box with a ball in it. And a pain button.
In the beginning, the ball is huge. You can’t move the box without the ball hitting the pain button. It rattles around on its own in there and hits the button over and over. You can’t control it - it just keeps hurting. Sometimes it seems unrelenting.

Over time, the ball gets smaller. It hits the button less and less but when it does, it hurts just as much. It’s better because you can function day to day more easily. But the downside is that the ball randomly hits that button when you least expect it.

For most people, the ball never really goes away. It might hit less and less and you have more time to recover between hits, unlike when the ball was still giant

The Art of Dying Well

The Art of Dying Well by Katy Butler is about making honest choices that provide the kind of support for each person and each situation. It is about

living as well as possible for as long as possible and adapting successfully to change. Packed with extraordinarily helpful insights and inspiring true stories, award-winning journalist and prominent end-of-life speaker Katy Butler shows how to thrive in later life (even when coping with a chronic medical condition), how to get the best from our health system, and how to make your own “good death” more likely. This handbook of step by step preparations—practical, communal, physical, and sometimes spiritual—will help you make the most of your remaining time, be it decades, years, or months.

Butler explains how to successfully age in place, why to pick a younger doctor and how to have an honest conversation with her, when not to call 911, and how to make your death a sacred rite of passage rather than a medical event.

Michael Dirda writes in the Washington Post:

this “practical guide to a good end of life” delivers on its subtitle, offering detailed advice on dealing with — in poet Philip Larkin’s phrase — “age, and then the only end of age.” Butler’s factual, no-
nonsense tone is surprisingly comforting, as are her stories of how ordinary folks confronted difficult medical decisions. In short, if you’re coming up on three score and 10 or have already passed that biblical term limit for earthly existence, you will want to read “The Art of Dying Well” and keep it handy, if only for its lists of what to do as one’s physical condition changes.

Overall, Butler’s advice can be summed up in the Boy Scouts’ motto: Be prepared. If you’re merely approaching the end zone, do all you can to preserve your well-being. Exercise. Keep your weight down. Eat lots of vegetables. Control your blood pressure, cholesterol and sugar, ideally without medications or with the smallest dosages possible. Stay mobile, but watch out for falls. Be sure, too, that your financial and medical records are organized, comprehensible and digitally accessible to the appropriate people in case you are incapacitated....Throughout “The Art of Dying Well,” Butler stresses the vital importance of having what she calls a “tribe.” A tribe can be one’s extended family but might also include the neighbors you socialize with, or your bridge club and fishing buddies, or members of your church — in short, the people you care about and who care about you. What matters is that a tribe’s members are mutually sustaining: They help each other out. Loners don’t do well in old age.

Dear Prudence: When Mom Won't Admit Dad is Dying

Dear Prudence,
My dad is very sick with lung cancer, has a compromised immune system because of chemo, and has terrible gout in his hand. He was recently diagnosed with chronic obstructive pulmonary disease and is often exhausted. My mom has her own medical issues and, by awful coincidence, is having a terrible episode of knee pain that has reduced her mobility. My main worry is that my mom often says things like “Dad will be all right; he’s going to get through this.” My dad has occasionally talked about death and has started preparing me to take over his personal business (paying the bills, taking care of their estate and property, helping my mom out, etc.) if things take a turn. He also will comment to our mom a bit about death, to which my mom has replied, “I don’t want to hear that,” or “He’s going to be fine. I don’t want to hear him talk like that.” Both my dad and I are worried about what seems obvious: He’s very sick with cancer, may die from it, and is preparing himself mentally and emotionally for that possibility. Is it wrong of me to gently encourage my mom to develop a different coping mechanism to help my dad talk or think it through? Should I simply respect that she will have her own process, which may include a long period of denial (maybe never accepting death until it actually happens)?
—Mom in Denial

There’s a limit to how much you can force this conversation on your mother, which I think you realize. She’s dealing with chronic pain and immobility and a very ill partner, so she may feel like she doesn’t have the resources to think about your father’s death right now. It’s good that you and your father are setting aside the time to prepare for the worst, and to whatever extent you’re able to facilitate a smooth transfer of financial and logistical responsibilities without involving your mother directly, you should continue to act on her behalf. It might help, if she seems deeply distressed, to ask if there’s anything else she needs right now to help her manage her pain or get help taking care of the house. It may also help to offer her the chance to be part of this conversation without trying to force her into anything; say, if you and your dad set aside an afternoon to meet with a lawyer and estate planner to go over his will and end-of-life wishes, you can tell your mother about it in advance, ask her to join you if she’s able, but ultimately leave it up to her. You can stress that you’re not giving up: “We all hope that Dad is able to recover, but we want to be prepared for everything, including the worst.” But if she can’t or won’t participate, you shouldn’t push her.

Dear Prudence


An update from the letter writer:

Re: Mom in denial: Thank you so much for sharing this information. The rest of my family were all in the camp that it was ESSENTIAL to be absolutely positive and upbeat about my dad’s possibility of recovery. The doctors and I seemed to be the only ones who understood that Dad’s situation might worsen. He actually did pass on March 5, and I have spent some time worrying that I was unable to provide enough positivity and/or assistance to help him get well (because of my sisters’ inability to accept the possibility of death/wanting second opinions/wanting to change his care drastically, and all that comes when someone is in denial, in my opinion).

I appreciate the comment so much from this health care professional, as it tells me that I understood things and am not a terrible person for it. My mom actually did change and accepted my dad’s condition better after a heart-to-heart with a palliative care doctor in his final days. You do make a big difference, thank you. I miss him terribly but at least I can be assured that it was his time to go.

Three Magic Phrases to Say to a Dying Person

I fought back tears. Delivering this message was the hardest thing I’ve ever had to do. But I had to stay calm and say more. I had to find impossible words — words that would bridge the gap between life and death and make his predicament palatable. 3 Magic Phrases To Say To A Dying Person spilled out. It has became a mantra. Here is what I said to my distressed and dying child, as lovingly and reassuringly, as possible:

“You will not be alone. You will not feel pain. We will be okay.”

What Jenny Harrington said to her dying child

Francis Weller on Grief

In his book [Francis] Weller invites us to view grief as a visitor to be welcomed, not shunned. He reminds us that, in addition to feeling pain over the loss of loved ones, we harbor sorrows stemming from the state of the world, the cultural maladies we inherit, and the misunderstood parts of ourselves. He says grief comes in many forms, and when it is not expressed, it tends to harden the once-vibrant parts of us.

He explains more in an interview:

Expressing grief has always been a challenge. The main difference between our society and societies in the past is how private we are with it today. Through most of human history grief has been communal. The Pueblo people of the Southwest, for example, have “crying songs” to help move grief along. The Mohawk traditions have the “condolence ritual,” where they tend to the bereaved with an elegant series of gestures, such as wiping tears from the eyes with the soft skin of a fawn. The healers in those traditions know it is not good to carry grief in the body for a long time.

But now we’re asked — and sometimes forced — to carry grief as a solitary burden. And the psyche knows we are not capable of handling grief in isolation. So it holds back from going into that territory until the conditions are right — which they rarely are. The message is “Get over it. Get back to work.” Again and again in my practice clients come to me with a depression that is more of an oppression: a result of so many years of sorrow that have not been touched with kindness or compassion or community. You’re left with an untenable situation: to try to walk alone with this sack of grief on your back without knowing where to take it.

In traditional cultures people were often given at least a year to digest a major loss. In ancient Scandinavia it was common to spend a prolonged period “living in the ashes.” Not much was expected of you while you did the essential work of transforming sorrow into something of value to the community. The Jewish tradition observes a year of mourning filled with observances and rituals to help the grieving stay connected to their sorrow and not let it drift away. Most people today might get a week of bereavement leave, at best, and then everything should be fine.

In this culture we display a compulsive avoidance of difficult matters and an obsession with distraction. Because we cannot acknowledge our grief, we’re forced to stay on the surface of life. Poet Kahlil Gibran said, “The deeper that sorrow carves into your being, the more joy you can contain.” We experience little genuine joy in part because we avoid the depths. We are an ascension culture. We love rising, and we fear going down. Consequently we find ways to deny the reality of this rich but difficult territory, and we are thinned psychically. We live in what I call a “flat-line culture,” where the band is narrow in terms of what we let ourselves fully feel. We may cry at a wedding or when we watch a movie, but the full-throated expression of emotion is off-limits.

The Wild Edge of Sorrow

Death of a Father, a Doctor

This beautiful essay by James Marcus in the New Yorker tells the story of his father's last days.

Everything I have described so far seems to have happened to somebody else—to somebody else’s father. But the death of a parent happens to you, and, once it starts, it never stops. It dislodges everything. “Is he sick?” my friend Peter asked me a few days after my father drank from the invisible cup. “Or is he dying?” At that moment, it occurred to me with absolute certainty that he was dying, and I said so. I felt the truth of it, and also a terrible sense of disloyalty, as if I were abandoning my father.

I hurried to the hospital the next morning with my mother. My father was in a peculiar state: completely articulate and completely delusional. The blood in his brain was displacing gray matter, and this small compression of physical stuff—a few ounces of wrinkled tissue, hardly more substantial than cotton wadding—had spirited him away to a parallel universe.