When Grief Comes Slowly …

Every Monday evening on Because Hope Matters Radio, my co-host Rob Harris and I provide a network of hope and support for families walking through life’s toughest journeys. The passionate entrepreneurs, leading researchers and medical experts we feature are world-changers, who are making a uniquely positive difference for others. Dr. Christina Charbonneau was our most recent guest. Her heart-vested approach with her patients was transparent during the episode. She’s an award-winning physician in practice for more than 30 years, delivering patient care with a spirit of compassion and encouragement. Her insights and wisdom are treasured as much by the medical community as by her patients. She’s been recognized with the Most Compassionate Doctor Award and the Patients’ Choice Award in 2010, 2011, and 2012. Dr. Christina’s message is powerful, yet gentle. She provides a refreshing approach to care that warrants a spotlight. When grief comes slowly … understanding, mercy and grace are needed for the long-haul. In today’s guest blog post, Dr. Christina delivers those essentials mixed with a message of hope, in a story about “anticipatory grief.”

Anticipatory Grief with a Twist

According to Wikipedia, anticipatory grief refers to a grief reaction that occurs before an impending loss. Typically, the impending loss is a death of someone close due to illness, but it can also be experienced by the dying individuals themselves.

Anticipatory grief is perhaps one situation that none of us ever want to experience. Unfortunately, one day we will all face this inevitable event, not only within ourselves but also with our loved ones.

Is there such a thing called normal grief or mourning?

The answer really is no. The individual impact of what death means to each and every one of us is unique due to all of the various cultures and customs we observe.  We all have different responses and behaviors to when one anticipates the end of life, but grief is, for most of us, like impending doom.  Others may see it as a relief.

DrChristina - signature shot - webYou may ask: What do I know as a doctor, when I have seen so many deaths so many times?  Some patients ask if doctors have some sort of immunity when it comes to our feelings about anticipating death, since we have had to face it so many times with our patients and their loved ones.  I cannot speak for all physicians, but I would like to express my own feelings, not only as a doctor but as a human being who has experienced this myself at a very young age before I was ever a medical professional.

I personally don’t feel any immunity, for I experienced anticipatory grief as an 8-year old child when I had to face the imminent death of my mom. Unfortunately she was diagnosed with renal cell cancer at a stage that was too late for treatment and the cancer had metastasized throughout her body. She was given two months to live.

What does that mean to a child?

– The fear of the unknown.

– Perhaps the feelings of helplessness.

– Believing that miracles can still happen.

– Not really understanding what the meaning of “death” is and the confusion of what it means to “die.”

– The fear that cancer and death can be “catchy” or contagious, meaning that if you touched that person perhaps you will get it and die too.

– Fear of abandonment and the loss of basic survival needs like home, food, and love.

– Concerns about changing family dynamics, such as who will show you at that age how to be a woman and who will be your role model.

Killer Thoughts picNow how does  the knowledge that your loved one is going to die feel to adults?

– Sometimes it is hard to have a conversation with the person who is suffering and dying. What is the right thing to say?

– Sometimes it is hard to argue with that person due to feelings of guilt.

– Fear that saying the wrong words will upset that person.

– Concerns about not being able to plan for the future.

– Stepping into the role of being the caretaker and being uncomfortable with it. Feeling guilty and being afraid to leave that person alone.  Trying to overcompensate for your dying loved one’s needs. Doing too much and perhaps even compromising your own health in the process.

– Denial that anything is going to happen.

– Feeling angry with that person for not going to the doctor sooner.

– Getting frustrated with yourself for feeling so helpless.

– Feeling guilty as a result of having your feelings hurt by this person and being incapable of forgiving them for it.

– Becoming depressed and feeling lonely at the thought of losing a loved one.

For my family, it was a matter of uniting forces as a group and learning to pray for a miracle to happen, for there was nothing that any doctor or medicine could do to save her. Had the doctors not been so specific about the time limit she had left to live, maybe it would have been different.  So, every night as a family we prayed.  We lit candles and prayed to the saints to help save my mom.  We tried to think of anything that would make my mom happy and what she truly wanted to do. Although we were not rich, we made what you would call a “bucket list” of all the passions she had expressed an interest in experiencing. Each day, we packed in so many things to do in order to live life to the fullest with her.  As a matter of fact, we didn’t even go to school so we would not  lose any time with her.  Since the doctors had given us a time limit of two months, the anticipation of her death became ever so real as each day went by.  When the two-month time period ended, my entire family was dumbfounded. We didn’t know what we should do next.

Lesson learned. No one, I mean no one, should ever give anyone a time limit as to when a death is expected. Doctors really have no idea about the exact time, and should never express that they do to a patient and/or family.  You can say approximately, but we cannot predict when the end of a life will happen.  This leads a patient to believe that life as they know it is over, and that there is no exception to the rule. Many people believe that the doctors are all-knowing. This type of approach may also make some patients give up hope and believe death will be their destiny — that they are going to die at the appointed time the doctor stated.

Each day after the time limit had been reached became as a time bomb for us.  We didn’t know what to do as a family.  Finally, we decided to just live one day at a time. We agreed that it was agonizing not knowing what was going to happen next. We had to change our mindset from a time-limit that had expired, to the anticipatory grieving process. At times it was so grueling that we just wanted it to end, and let death take my mom. It all became more confusing and even agonizing.

Guess what? My mom lived 35 years after the doctors’ time limit.  Yes, she did succumb to cancer later, but at that time it was a different diagnosis — pancreatic cancer.

We did as much as we could to live during those years and helped her to live a life that reached her fullest potential.  She got to see her children grow up, graduate school, and she even held her grandchild before her death.  However, as a family that was learning what anticipatory grief was, it was brutal to have to go through so many years without knowing what each day would bring and whether today was the day death would finally come.

Lesson learned. We have no idea of what the future has in store for us. The only thing that we do know and have is the present moment, and this moment is so precious.  So if you have a person in your life that is about to die, the only thing that can be done is to spend time with him or her each day as if it was his or her last day on this earth.  I truly learned this when I was young and now, as a doctor, I choose not to play God.  All my cancer patients are told not to anticipate death, for we know that it will happen to us all one day. Instead, I encourage them to anticipate life.  Until that time comes, then and only then can we truly say that we have given them the best that we have to offer, which is our love of life.drChristina

When the time came, I remember asking my mom if we could’ve done anything different, given the fact that she had lived 35 years longer than what was expected.  She said no and that she was glad that she lived life as if there was no more tomorrow instead of just waiting to die.

To all of you who are in this situation, my heart goes out to you and to your family. Live each day as if it was your loved one’s last, and be sure to say all of those things that you want to make sure you say. You never know if today will be the last day – or not.

In keeping with tradition here at Hope Matters, Dr. Christina provided a touch of whimsy about herself to close the post. “She loves animals, and especially sharing the unconditional love she enjoys with her 3 dalmatians. Plus she’s a foodie, open to tasting foods of all kinds and cultures.”

To visit Dr. Christina at her website, click here


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