Missing, But Not Lost

We are on the cusp of winter and as we usher out this difficult year, I find myself reflecting on those I have lost. I imagine the empty spaces that are left in the homes of those who have passed, the Zoom calls or visits that would be scheduled, the socially-distanced connections. This is a time of heightened loss for our country and world as the pandemic continues to rage. For many of us, keeping up with family and friends has been a challenge, which folds into the grief of many other losses we are exposed to currently.

It has only been six full months since I left the health system (I absolutely cannot believe that) and it has been a lot to process. There has been so much I have learned about grief and loss in the eight years I was working in a large health system. I worked in inpatient general medicine, gerontology, palliative care, and outpatient oncology. I covered many disease groups over the years. The ones I feel most familiar with are in hematology and oncology: leukemia, multiple myeloma, lymphoma, prostate, bladder, renal, head and neck and sarcomas were the cancer populations I covered. I also had the privilege of covering the anemias including sickle cell anemia.

As you can imagine, I was responsible for supporting many patients from all walks of life as they encounter a challenging and oppressive system, and cope with life altering illness. For some, I only had the privilege of serving for days or weeks. Some patients I had years with and, unfortunately, countless more were for only hours or minutes before death.

I am sure I will have many other pieces on the deeper parts of grief. For those interested in grief posts I have already written, check out this other post where I discuss grief counseling. However, this post is more of a dedication to those with whom I worked and not the specifics of our connections. This is an honoring of them and my grief.

For any clinicians or people who have multiple losses, this can be an important process to provide yourself. We know ourselves based on the vital relationships we have had with others, so honoring those relationships honors our own being.

For those whom I have unparalleled gratitude…

You were a patriot and a badass motorcyclist. You were the most gentle and open person I have ever come across. I couldn’t believe how strong your were the whole way through surgery, radiation and chemo. Those treatments may have stripped you of your biker beard, but they didn’t strip you of your spirit. Whenever I give thanks to veterans or drink a good beer, I raise my glass to you.

You were in so much emotional angst the entire time I knew you, but you didn’t let that angst dictate your life. You were whimsical. You brought back my love for reading. You deserved so much more in life. I hope you are at rest and got that chance to go to Disney World and Universal Studios. I hope to continue reading Stephen King with you.

You and I were just a few years apart. You also had a young family and you were so angry. You had every right to be. Leukemia isn’t fair and you didn’t have to come to terms with that. We talked about anger. We talked about our inner Hulks and how we can channel it for good. It’s our super power. You died much too soon. Your Hulk was always showing through, even towards the end. Hope you are at peace, friend.

Our relationship was, unfortunately, only in the ICU setting. You were awaiting a liver transplant. You were too healthy to get listed, but then rapidly declined to the point where you were no longer a candidate for transplant. It. Was. Not. Fair. You had just retired. Again, not fair. We talked of legacy, life lost, regret and we wept. We were four decades apart in age, yet we were on the same plane during our meetings. The human plane.

You were also a health care provider. You had only recently retired (sort of, retirement really wasn’t your style). It was hard for you to let go of teaching others. I got to know you over the course of a year and some change as you battled your blood cancer. You kept on teaching as you were slipping away from this plane. I am glad that you were able to make it home and find some peace and time with family. You were in so much pain.

You were a retired counselor and I was just starting off my career working with cancer patients. You embodied resilience. Your mind was so much stronger than your body gave it credit for. While so incredibly sad and painful, you were so graceful as your body failed you. I learned some of my most important therapeutic and life lessons when we shared space together.

I worked with you and your husband for over two years of brutal cancer treatment. You were a young couple experiencing more trials and tribulations than most people have to experience coming right out of college. I walked with you through your aggressive chemotherapies, your eventual stem cell transplant and recurrence. You were beautiful in your spirit and writing. You had so much more to offer this world. We are worse off for not having your voice with us right now. You have a legacy larger than you could know.

You would rarely schedule appointments with me, but you would drop by regularly when you were in clinic to ask if “Mr. Jesse” was around. You taught me so much about the history of Charlottesville and America, especially, our Black history. We talked about distrust with the medical system and your experiences of racism, both, inside and outside the medical system. We had a relatively long relationship (not long enough). You gave me a beautiful photo and note when you knew you were transitioning to hospice. I was fortunate to spend some time with you in your last home. We shared popsicles. You swore they were better than any palliative therapy available to you.

You were so young. Too young to be bed bound in the hospital so far away from family for so long. We spent countless hours together talking about videogames, music, movies, and wrestling. Cancer had taken your family away from you…it was also aggressively taking you. Again, it wasn’t fair that such a gentle soul had to come to terms with life so early on. You weren’t ready. I can’t imagine any of us would be. I always worried that you weren’t expressing enough of how much pain you were truly in. I am glad you finally allowed us to care for you.

You were my first long-term oncology therapy patient. We were the same age and we both had a kid not far apart from each other. I was with you and your wife on diagnosis through surgery, radiation, chemo and immunotherapy. You gave me tips on being a new dad. I gave you space to talk about your grief as a father and husband. You were a veteran, a fighter, and so gentle. Your daughter was lucky to have you. I weep about how much the both of you are missing. Thank you for the joined experience and the “Pickle Rick” pin (from the show Rick and Morty).

To all of you, and so many more…you have spaces in my heart and I will be forever grateful to have had the privilege to get to know you in such deep ways. What I have learned from y’all about grief, death, dying, family meetings, and more is so much more than I could ever be taught in academia or from a book. I am a better person, therapist, and advocate because of y’all.

Its been a year or two since many of you passed, but it doesn’t feel that way. I remember our conversations, the ambient noise of IVs and critical care monitoring. I honored each of you in my own way closer to the initial loss, but I found myself compelled to keep your memories on paper. Thank you.

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