Clinical Vignette - Grief

"If I had known what the grief process was like, I would never have married, I would have prayed every day of my married life that I would be the first to die," reflects Margaret, 9 years after the death of her husband.

She recalls her initial thought, denying and acknowledging reality simultaneously, when James was diagnosed with multiple myeloma in October 1987: "It's a mistake... but I know it isn't."

For 2.5 years, Margaret and James diligently followed his regimen of treatment while taking time for work and play, making the most of their life together in the moment. "We were not melodramatic people. We told ourselves, 'This is what's happening; we'll deal with it.' "

For Margaret, it was a shock to realize that some friends who had been readily present for social gatherings were no longer available. She waited alone in the wee hours of the night when James had emergency surgery. Again, she was shocked when she told a priest who came into the room, "My husband is having surgery," and his reply was, "Oh, sorry to bother you; I'm looking for the paper."

Margaret began to undergo a shift in her thinking: "You begin to evaluate your perceptions of others. I asked myself, 'Who is there for me?' Friends, are they really? It can be painful to find out they really aren't. It frees you later, though. You can let them go."

When James died, Margaret remained "level-headed and composed" until one day shortly after the funeral when she suddenly became aware of her exhaustion. While shopping, she found herself in protest of the emotional pain and wanting to shout, "Doesn't anybody know that I have just lost my husband?"

Surprised with how overwhelmed she felt, one of her hardest moments was putting her sister on the plane and going home to "an empty house." It was at this time that began to feel the initial shock of her loss. Her body felt like it was "wired with electricity." She felt as though she was "just going through the motions," doing routine chores like grocery shopping and putting gas in the car, all the while feeling numb.

Crying spells lasted for 6 months. She became "tired of mourning" and wouldd ask herself, "When is this going to be relieved?" She also felt anger. "I was upset with James, wonderingwhy he didn't go for his complete physical. Maybe James' death may not have happened so soon."

After a few months and well into the grief process, Margaret knew she needed to "do something constructive." She did. She attended support groups, traveled, and became involved with church activities.

Her faith in God was a plus. Exercising this faith, she trusted that eventually her emotions would catch up with the intellectual understanding of all that had transpired in James' dying. She developed an "inner knowing that God is all-seeing, all-knowing." This belief gave her spiritual strength and empowered her as she grieved.

Nearly a decade after James' death, Margaret views the grief process as a profound and poignant, "search for meaning in life. If he had not gone, I would not have come to where I am in life. I am content, confident, and happy with how authentic life is."

Even so, a sense of Jamess presence remains with her as she pictures the way he was before he became ill.

She states, "This is good for me."