Dr. Norma Hirsch: The COVID-19 pandemic and the grief it engenders have revealed things we never wanted to know about ourselves and about inequities in our society. -promoted by Laura Belin
When the tsunami of COVID-19 came in a year ago, it unleashed poisonous levels of uncertainty, and toxic levels of fear, especially fear of the unknown.
“Will my loved one get sick?”
“Will my loved one die?”
“Will I die?”
“How will we be able to work and teach our children?”
“How will we manage to keep or acquire life’s essentials?”
“When will this ever end?”
The opening lines of John O’Donohue’s poem For Grief well recognize the journey with grief that began back then and continues today:
When you lose someone you love,
Your life becomes strange,
The ground beneath you becomes fragile,
Your thoughts make your eyes unsure;
And some dead echo drags your voice down
Where words have no confidence.
Your heart has grown heavy with loss;
And though this loss has wounded others too,
No one knows what has been taken from you
When the silence of absence deepens.
Flickers of guilt kindle regret
For all that was left unsaid or undone.
Plainly, it is worth pondering what we have learned, and the first such lesson seems obvious. We have learned about losses — loss of life, jobs, economic stability, normalcy of daily life and so much more. Losses have hit individuals, families, organizations, businesses, the country, and the world of which we are a part.
All these losses are disruptions of connectedness and autonomy – calls for physical distancing and the use of facial coverings and working from home. Limited resources have at times forced health care professionals to abandon efforts to honor individual patients’ personal requests. Restrictions on rituals reserved for the terminally ill and dying and prohibitions on the recognition of the deaths of loved ones in traditional ways have further diminished the dignity and the individuality of those stricken by or dealing with COVID-19.
These are but part of the losses the world recognizes. So many beliefs about the ability of medicine to beat disease and thwart death and about the uncompromising nature of individual freedom — Me?! Wear a mask?— are called into question. Common assumptions are disrupted, if not destroyed, by the invisible culprit called COVID, making it all the harder to combat, much less to make peace within our hearts.
Beyond these fear-inducing questions we hear the news reports of scarce resources and the potential need for rationing of care (for those with COVID-19 and those with non-COVID-19 medical conditions). We learn about the deaths of those caring for the ill and we view and read news reports of temporary morgues, the body bags, the refrigerated trucks parked on side streets and in alleys behind hospitals, and overwhelmed funeral homes all detailed on the daily news, both morning and evening. The images and news stories take fear to a whole new level because they bring us face to face not only with death, but with morbid death.
In recent years – until the pandemic – the public rarely heard of health care professionals sacrificing their lives to diseases of the people they were treating. Prior to the pandemic such coverage had been reserved for war zones and massive natural disasters; they were for the most part the currency of those in the death trade.
Elizabeth Kübler-Ross’ pioneering contributions to scholarship surrounding death and dying remain helpful. Although later teachers have modified her insights and applied them more specifically to grief, the five responses that she described in her early work remain useful.
David Kessler, her protégé, describes their application to the vivid reminders of morbid death and its attendant grief in a grief-illiterate culture during a time of pandemic:
Denial (“This virus will not affect me.”)
Anger (“Making me stay home restricts my freedom.”)
Bargaining (“OK, if I social distance for a few weeks everything will be OK, right?”)
Sadness (“I do not know when this will end.”)
Acceptance (“This is happening; I must figure out how to proceed.”)
Kessler proposes that acceptance is where the power lies. That is, there is some degree of control in acceptance.
When it comes to grief, one size does not fit all or even many. One size fits one.
Our grief is as unique as our fingerprint. But all grief, whatever its source, does have one thing in common. There is a need for grief to be witnessed, a need that someone be fully present to the magnitude of the loss without any effort to lessen it, reframe it, or point out a silver lining in it. Recognizing this need to be fully present and fostering this ability among those suffering and those offering comfort will serve better than all the lists of things to do or things not to do.
Being present necessitates being aware of what it means to embrace one’s full humanity and to be comfortable in one’s skin knowing the limitations of one’s humanity. And throughout history that embrace has been most complete through the arts, perhaps especially through poetry. The poets of all time speak to the depth and breadth of life in places where life is otherwise easily reduced to the superficial.
The way out of the COVID-19 pandemic will necessarily leave behind a pandemic of grief. And that pandemic of grief will persist long after the COVID-19 pandemic has released its grip on the world. The grief of the pandemic, like all grief, will require witness. Let the witness be not only to the losses and the pervasiveness of the grief, but also to the memory of those who were lost and the contributions of those who persevered in the face of ineffable odds. Let us not despair; instead, let us continue to pursue that which draws us into a vision of a brighter future.
Let us acknowledge what has been revealed through the myriad losses and apply those revelations to initiatives that foster health and well-being and equality and justice. The COVID-19 pandemic and the grief that it engenders have revealed things we never wanted to know about ourselves and about inequities in our society. May those revelations inspire us to new heights and new manifestations of the goodness inherent within humanity.
And may the pandemic of grief that looms ahead of us arouse the creative, the imaginative, and the poetic so we may be fully present to our own grief, as well as, to the grief of others. And may it imbue us, not with the despair of the opening lines from O’Donohue’s For Grief, but with the hope incorporated in his concluding lines.
Gradually, you will learn acquaintance
With the invisible form of your departed;
And when the work of grief is done,
The wound of loss will heal
And you will have learned
To wean your eyes
From that gap in the air
And be able to enter the hearth
In your soul where your loved one
Has awaited your return
Dr. Norma Hirsch is retired after nearly 50 years of teaching, health care administration, clinical research and medical practice in areas of neonatology, hospice and palliative medicine, and academic medicine. She served as the Vice President and Chief Medical Officer of Hospice of Central Iowa (now EveryStep) and Assistant Professor and Interim Chair of the Department of Behavioral Medicine, Medical Humanities, and Bioethics at Des Moines University.
Top image by SvetaZi available via Shutterstock.