No one ever told me that grief felt so like fear. The same fluttering in the stomach, the same restlessness, the yawning. I keep on swallowing.
Thus wrote CS Lewis in A Grief Observed after his wife died from cancer. I have thought a lot about these words while bearing witness to my friend’s grief at the sudden death of her mother.
One ordinary afternoon, she tells me of mother’s heart attack at a relatively young age and the pessimism of her Indian doctors. When she complains that her mind is in tumult, I counsel patience and offer to decode the medical reports while emphasising that I don’t want to be one of those dreaded “foreign” doctors second-guessing the treating team. Alas, we run out of time as the very next day I receive a tragic message: “Mum died. I am on my way to India.”
When I call, she is about to board a flight feared by so many immigrants: the long journey home to see a seriously ill, or worse, deceased parent. Her voice is hushed and dissociated, a world away from the upbeat, happy person I know.
My medical brain is in overdrive. Why did she arrest? Did anyone perform CPR? For how long? What kind of hospital was she in? What did the angiogram show?
A whole morbidity and mortality meeting jostles in my head but thankfully, sense prevails. I tell her I am sorry and slip in just one morsel of medical advice to assuage her guilt: no matter where people arrest, the outcomes are generally poor.
The next time I check in she describes her flight as unbearable, suffocated by her own thoughts. Stunned by the fragility of life, I can imagine neither her awful experience nor an adequate response. What I don’t know at the time is that the ensuing days won’t make it easier for me to find the right words to mitigate my friend’s grief.
Grief is the constant companion of so many of my patients, the grief of a cancer diagnosis compounded by the grief of abandonment. Even they who have people bringing them food and driving them to appointments often feel emotionally alone. Many of my elderly patients have lost a spouse; they lament that after the immediate aftermath, well-wishers drop away quickly, leaving them dismayed by the weakness of their relationships exposed.
As I grow older, so grows the number of my friends experiencing their first “real” grief. The loss of a parent heads that list, a loss so hard-hitting that it’s impossible to describe its manifest implications.
After her mother’s funeral, I text a tentative, “How are you?”
“OK,” she says. It’s the text equivalent of a shrug. I wish I had a better question.
The next day, I ask if there is anything I can do – even though I tell other people this is one of the worst ways to “help”.
I promise to let you know, she replies, in the way of every polite, overwhelmed person.
I yearn to do better.
Our next few exchanges feel similarly stilted. It’s as if a crevasse has opened between us, swallowing all that was fun and funny about us. She is an orphan, I have both parents but I want her to know that we are “in this together”. Maybe it isn’t possible.
Last year David French wrote about avoiding his close friend’s hospitalised father because he didn’t know what to say or do and (admittedly, at the age of 18) was unprepared to face pain and loss. After his father died, French turned up at the funeral (“that’s what friends do”) where the wounded friend asked him a haunting question, “Where were you?”
This is how French mourned his mistake:
I had violated the first commandment of friendship: presence. Simply being there was all that had been required. I couldn’t pass even that one simple test.
I can’t help thinking that my good intention runs deep but my words keep missing the mark. Still, I want to obey the first commandment of friendship: showing up.
I remember reading a paper about the surprising value of even a brief check-in with one’s friends: “We document a robust underestimation of how much other people appreciate being reached out to.”
In other words, people who initiated even brief and casual check-ins with their friends underestimated how much the friends appreciated hearing from them.
As both an initiator and recipient of casual text messages, this idea resonated with me and increased my fondness for them, especially when time zones can make it hard to speak to friends scattered around the world.
Now I decide to take the same approach with my grieving friend. Instead of quietly receding and waiting for her to engage with me, I text a short message most days.
You’re in my thoughts.
What prayers will you do today?
It must be difficult talking to so many people.
Are you getting some sleep?
The individual messages feel a little lame but I keep hoping that their sum will amount to an embrace.
As the iron grip of grief loosens a tiny bit, her messages get longer until one day she sends me a stirring composition in the form of an ode to her mother. My friend’s voice is dignified, sonorous and breaking all at once. It’s enough that she responds to my messages at all but to be allowed into a private sanctuary of emotion is a privilege.
Later she surprises me by saying that she had been comforted by my remark that most arrests were fatal. Having offered this without much forethought, only some kind of fervent hope, I am gratified to learn that it is the consolation she held on to during her flight.
Well, everyone can master a grief but he that has it.
In Much Ado About Nothing, Shakespeare reminds us of all the times we expect people to hurry up with their grieving.
When my friend returns from India, it will not mark the end of mourning but a new beginning.
Walking along someone’s grief takes a certain mindfulness – with so many of my middle-aged friends losing a parent, I wonder how I will manage this emerging responsibility.
Like my friend who forgot the first anniversary of the death of her best friend’s father (despite noting it in her calendar), I worry that in a year of rituals I will be guilty of neglecting a significant date or a weighty emotion, saying something or not saying something.
In those times it’s tempting to stay quiet and pretend the mistake never happened.
My friend immediately apologised and promised to do better. I make a mental note of this.
If simply being present during grief is the first commandment of friendship, trying to find the right words to share that grief might be the second.
• Ranjana Srivastava is an Australian oncologist, award-winning author and Fulbright scholar. Her latest book is called A Better Death
