Miriam acquired paralytic polio in the late 1940's and required an iron lung or other breathing assist devices continuously ever since. She was one of the first patients placed in a new Commonwealth of Massachusetts Hospital built in Boston for rehabilitation. Built for 600 patients, it had fewer than 200. All employees were state civil service. The budget was adjusted each month depending upon the average census. I was the chief of Medicine and principal administrative medical officer. In this capacity, I supervised Miriam's care for five years starting in 1968. A Chief Executive Officer (CEO) managed the budget and approved all hiring; patronage was rampant.
Miriam was slight, weighed less than 100 lbs and required total care. Most nights, she was in her iron lung. Days were spent on a rocking bed which rocked her head down, feet up, then rocked head up, feet down; that provided breathing, and permitted access for necessary care. While on the rocking bed, she could speak clearly; she had daily bathing, skin massage, muscle exercises and help with toileting and feeding, all by external hands. She read books using a special device that held her book and turned the pages when she moved her head to the side. She listened to music and news on portable radios adjusted by staff or visitors. When her door was open and she was on the rocking bed, she encouraged and welcomed visitors. She acquired polio at age 19, and now almost 30 years later still looked 19 years old. Her skin was pale and wrinkle-free. Her attendants did her hair nicely and applied makeup, and at her insistence often changed her hair style. She adored most staff and they loved her, everyone feeling uplifted by her cheerful positive outlook despite her handicap. She knew most staff and visitors by the sound of their footsteps or voice. My presence in the corridors was always recognized by my rapid footsteps or my voice. She loved and invited conversation from anyone who stopped by. She shared news about hospital and staff activities and willingly discussed what she heard on her radio or was reading. I was surprised when I first met her that she knew the names and interests of my wife and children. Her up-to-date conversation was remarkable but her craving for company was continual. She had no close relatives and few visitors from her distant past.
I initiated new programs in liver disease and alcoholism that doubled the occupancy of the hospital that increased both the budget and jobs to be filled. These endeared me to the CEO. A recovering alcoholic named Larry wandered into Miriam's room during his initial hospital stay and enjoyed her companionship. Each day he spent time with her while she was on the rocking bed, discussing the challenges of his and her lives. When he completed his 14-day detoxification and was to be discharged, he volunteered for a long-term research study that extended his stay in the hospital for three additional months. Thus he continued his daily time with Miriam. Their platonic relationship was considered important to both by all of our staff.
Larry was immature and playful and became a harmless prankster. The staff was mostly tolerant and amused by his antics. One morning he concealed himself behind the artificial greenery in the hospital lobby. When police officers arrived for a break from their squad car route to enjoy a subsidized breakfast and walked eagerly into the hospital, he jumped out with a toy pistol and shouted, "BANG, you're dead!" Since he was well known, this was taken as a joke by most policemen, but one sensitive neophyte placed him under arrest for assaulting an officer and took him to jail. In short order, he appeared before a judge and was sentenced to one year in the Suffolk County jail. Miriam was devastated by the loss of her daily companion and mad as hell about this unfair outcome. Like the smoke signals from warring Indians, she verbally mobilized her extensive contacts. They arranged an emergency hearing with the judge and organized the hospital to convey her in her emergency portable breathing apparatus to the hearing. The portable respirator was a metal device enclosing her chest like a partial ancient suit of armor and operated by a 200-pound battery pack.
Miriam and her portable respirator were loaded into a van to reach the courtroom. She was accompanied by the CEO, four hospital attendants and myself, and two police officers to support her. She astonished the judge by the widespread organization needed for her first and only departure from the hospital in nearly 30 years. She clearly presented the importance of Larry to her life and the true nature of his prank. The two police officers emphasized that the event was a harmless prank which they enjoyed. I certified the importance of her relation with Larry supporting her wonderful adjustment to her paralysis, and the CEO testified to the morale boost she provided to all of the staff with her continued optimism about her life. The judge changed Larry's sentence from jail to one year's probation under Miriam's daily supervision. The CEO responded with a paid part time job as a cleaner, including room and board at the hospital for Larry.
When this sentence was completed, Larry became an full time employee of the hospital and continued to visit Miriam daily until she died, 49 years after her paralysis first developed.
* * * * *
Publication history: This article first appeared in "The Broadmead Journal of Poetry and Prose," Fall, 2016.
Dr. Iber is a retired gastroenterologist, a specialist in diseases of the liver. He has written widely and taught extensively. He maintains many active interests in addition to his profession, including the travels of Lewis and Clark. He and his wife live in suburban Baltimore MD.
Sunshine through Raindrops: Grief and Growth, An Unfinished Reflection
Rea L. Ginsberg, LCSW-C, ACSW, BCD
Sunshine through raindrops
There is always a way.
No one said it would be easy.
Grief work is transformative.
It is not a gentle gift.
It is hard, it is bitter, and it hurts.
It is powerful, cold, and frightening.
It is lonely and outrageous.
It is monster memories untamed, out of control.
It is long and longing, disruptive and disorienting.
It is ceaseless tears, vanished laughter,
Nightmares and daymares
Contending with disbelief;
Stifling the cry: Live - Don't Die;
Illusions that healing is hopeless and hope is dead.
Allow it. Hold tight others who listen and care;
They usher us back from sorrow’s stark forces.
We can rise as the wild river rises in the spring,
Returning to the tender realm of warmer living.
“In wildness is the preservation of the world.” *
From the fury and the storms come release and mending.
Discovering our life's meaning lies along this path.
Death defines life. Accept the invitation to grow.
Don’t stop there; it’s a lifetime affair; courage counts.
It is worth the effort, like sunshine through raindrops,
An unfinished reflection.
☼ ∞ ∞ ∞ ∞ ☼
*Henry David Thoreau: "The West of which I speak is but another name for the Wild, and what I have been preparing to say is, that in Wildness is the preservation of the World. Every tree sends its fibers forth in search of the Wild. The cities import it at any price. Men plow and sail for it. From the forest and wilderness come the tonics and barks which brace mankind. . . ." [Emphasis added]
Rea L. Ginsberg, LCSW-C, ACSW, BCD (originally published June 25, 2013)
I know an elderly gentleman. He is 85 years old. He is a physician, and he is my friend. One day, he joked about his mother. She died 60 years ago. He said with a slightly wry smile, “I think I’m over it!” He isn’t. He knows it. I know it. And he knows that I know. He likes that. It is our special secret.
Mark is also one of my friends. He was 20 when his grandfather died. The two were very close. Mark wrote a letter of thanks and sorrow to Grandpa. He folded it into the box with the ashes. That letter was buried with the ashes. Then we hugged each other and he cried. Of course we know Grandpa didn’t read the letter…unless he did. I know Mark still hurts. He knows I know. It is something we share. It is good. Mark will not “get over it.” He will grow with it. He will grow into it.
Every loss changes us. We incorporate the experience. It revises our concept of who we are. Self concept. Self identity. Every loss is finally a growth experience. In that sense, every loss also makes us more fully alive and unique. That deserves recognition.
Too often, we think of strength as a stoic disregard for feelings. It is the no-tears approach. “Move on,” we say. “Get over it.” Not so fast! That attitude makes it nearly impossible for the bereaved caregiver to feel accepted – accepted by himself and by others. It is an unrealistic expectation. Grief is for keeps, not for weeks. And that’s OK. It needs respect. It is normal. Even in the best circumstances – the well-planned “good death” – the caregiver is left to cope with a weight of conflicting emotions. Each of us has our own time line for grieving. That time line needs permission and appreciation, both from the grieving person himself and from those who surround him. If given a chance, then, emotional strength will show up. Strength comes from working with those feelings in an atmosphere of dignity and compassion.
What is strength? How does it show? In broad practical terms, it looks like this:
1. Having strong feelings that are not necessarily pleasant;
2. Having the courage to become aware of those emotions and look at them squarely;
3. Not being afraid to express them openly – belief in self-resilience.
These are almost inseparable qualities.
The “good stuff” is easy to take and to express. It is the happier feelings. The “good stuff” is the sense of having done it “right,” of having conducted the passage to a “good death.” Pride of accomplishment feels fine. All the details of dying receive attention: advance directives, place of dying, pain control, gentle care, promises made and kept, forgiveness requested and received and offered, permission to die granted, goodbyes said, important people present, after-death care given as expected. More. All of that is a distinct source of self-congratulation, self-esteem, and growth for the bereaved caregiver. It is an achievement. It feels grand and extraordinary. It feels just. It feels moral!
Dealing with the “bad stuff” is not as easy. What’s the bad stuff? At least some or all these:
Guilt (for any suffering that might have been prevented – the what-if’s; survivor guilt);
Anger (at the loved one, because he left);
Sadness (of course);
Fear of abandonment (by the whole human world);
Fear of losing one’s mind (becoming insane; uncontrollable repetitive thoughts);
Fear of inability to recover successfully from the loss (sense of enduring emptiness);
Preoccupation with health (exaggerated concerns about physical illness and dying);
Flashbacks, nightmares, and restless nights…
At first, it is hard for the bereaved caregiver to differentiate these feelings. They are overwhelming. They are usually irrational. They are always excruciating. They are also natural.
Even under the best circumstances, recovery for the caregiver is tough. The “bad stuff” needs attention and expression. The feelings are mixed up, and they are powerful. They feel more than a little crazy. The caregiver needs to be able to face these feelings. Strength is not stoic silence. It is not the buck-up stiff-upper-lip way. It is not denial of pain. And it is not “forgetting” about death and dying.
Strength is having the energy to reach out, to show pain, to ask for a sympathetic ear or two or three. It is unashamed tears. It is the guts to talk about the unspeakable and to know, at the same time, that those words and that talk are survivable. It is the belief in the adaptability of the self. It is the maturity of insight. It is trust in intuition. It is confidence that life will return to some sort of balance, an equilibrium. It will be a new and different balance but a balance nonetheless. It is knowing that the relationship to the loved one endures, but in a different form. Strength is the caregiver’s ability to gradually rearrange the relationship in his mind, internally. It is knowing and accepting that he will never exactly “get over it.” The process takes patience and perseverance. All of this is strength. All of it contributes to recovery – to a brand new and higher level of being well. It is a level that has included healthy grieving. Inner resources have been enriched. Life will feel OK again, and renewed. Refreshed. Death shows us how.
Yes, it’s OK to die. And yes, it’s OK and clearly wonderful to live on. **************************************** * Dying is a pre-existing condition: we all do it someday. A fundamental fact of life is that it ends (to paraphrase Dr. Monica Williams-Murphy). Dying is not a mental disorder, although it is an unprecedented event in the life of every human being. Grief is not major depression. This is so obvious that it hardly deserves a footnote. Grief is a normal occurrence in our lives. By definition, it hurts. It has no automatic timetable for ending. This essay is not an effort to address or rewrite any part of the controversial Diagnostic and Statistical Manual of Mental Disorders (DSM), nor does it reflect on the International Classification of Diseases (ICD). Rather, it is an attempt to broadly view the sense of grief as it is perceived by the close caregiver(s) after the death of a loved one. In addition, it is intended to help the bereaved caregiver to cope with, and understand, various intense emotions – some of which reoccur every year, on or near the anniversary date of the death.
Here is a Dr. Murphy “mantra” from her excellent book, It’s OK to Die. Read it, keep it, and then reread. Memorize. It will make mourning easier to bear.
Life is fleeting and fragile. Live and love as though every day is your last, or your mother’s last, or your child’s last. Leave no words unsaid, leave no plans unmade. (pp. 19 & 21)
The Blue Cat: Life, Afterlife, and Transformation
Rea L. Ginsberg, LCSW-C, ACSW, BCD
Two scribes and the elegant Blue Bastet Cat with earring
The life of the dead is set in the minds of the living. ~~ Marcus Tillius Cicero
Cats were revered in ancient Egypt. The domesticated cat became a symbol of poise and grace, protection and motherhood – the visible soul of the Egyptian home. Cats were considered sacred, a subject of religious worship, and adorned with fine jewelry like golden earrings.  Wearing gold jewelry was a sign of the cat’s importance.
Egyptian cat with gold earrings & gold nose ring; bronze, c. 600 BC
The history of the Egyptian cat involves the land itself. Egypt’s economy was primarily agricultural, and an empire was built on Ancient Egypt’s enormous agricultural wealth. Cats were highly valued for their skill in controlling the rodent and snake populations that plagued homes, farms, fields and granaries. Cats helped to protect precious crops. Originally for this reason, they were gradually domesticated, maintained in grand style, and deified as purveyors of fertility and sun. They were seen as a divine force that harnessed nature to the benefit of the empire.
Carved black limestone statue of a reclining mother cat nursing her 3 kittens; c. 300 BC; Sadigh Gallery, NY. Representation of fertility and motherhood, a visual prayer.
Amulet: cat with a kitten in front of her, Egyptian faience, c. 400 BC; Charm with magical powers, protection against evil. Walters Art Museum, Baltimore
Felines: goddess Wadjet depicted as a lion-headed woman. Bronze, c. 600 BC; Brooklyn Museum
Hieroglyphic: Cat-headed figure of a demigod, Balancing Life, Death, and Afterlife; International Council of Museums Committee for Egyptology; Museo Egizio, Turin, IT
Archaeologists believe that cats were also important in dream interpretation. If a cat appeared in a dream, it meant that the dreamer would have a bountiful harvest.
Cats received great respect after death. "The cat's body was placed in a linen sheet and carried amidst bitter lamentations by the bereaved to a sacred house where it was treated with drugs and spices by an embalmer.”  Cats often received a full embalming ceremony, like humans, and were buried in some of the great cemeteries along the Nile. Many were buried with provisions for the afterlife, such as mice and pots of milk. Grief was boundless, endless, infecting.
Mausoleum & dwellings along the Nile River of Egypt
In some ancient artifacts, Nile boatmen are pictured paddling into the afterlife, accompanying an Egyptian on death’s long voyage.  We can safely assume that the same moral obligation would apply to the sacred, noble cat.
Boatmen accompanying an Egyptian on death’s long voyage into the afterlife. Artifacts found in an ancient Egyptian grave.
The scholarly scribes carefully documented, by hand and with reed brushes and pens on papyrus paper, the lives, deaths, and burials of cats owned by royalty. Hieroglyphs on papyrus.  The cats were mourned at length and in ways similar to the mourning of humans.
Hieroglyphics on papyrus paper, c. 600 BC. One figure bears the head of a cat.
Mummification was supposed to keep a cat’s body intact for transporting to the spiritual afterlife. Because of the Egyptians’ deep affection for cats, and the elaborate after-death and burial procedures created for them, the mummies of ancient cats survived and can still be seen in plenitude today. All these extensive and painstaking preparations give fresh significance to the phrase, "Undying love."
Cat mummy -- Canadian Museum of Art
Death is not the end of the story. Far from it.
Their spirit is reaffirmed now by our admiration and awe. We are their afterlife! That is an honor and a responsibility we owe to the cats and their grieving human preservers. We must behave accordingly, with reverence.
The Egyptian cats offer us the privilege, even if only for a momentary glimpse, of living in their times, many ages ago.
Cat mummies -- British Museum, Our impressive company from antiquity. Grief from a different perspective.
How old is old? How long is forever? Are 3,000 years a long time? Who is measuring? The mind is not a passive learner, and individual perception and observation matter.
When each of us learns something from the lookback, the cats have made our lives a little better than before.
Death yields its benefits. We are required to find them. Until then, we are not whole and free.
“If not for death, would we appreciate life?” 
When we deny death, we cannot serve life well. All of us have the power to write our own story, the courage to make our own choices, the resilience to fathom death as well as life.
Egyptian hieroglyphics, c. 600 BC, Carved into the wall of a tomb. Writing it down… ...so important to the health and soundness of the individual & the community.
Tombs of Ramses V and Ramses VI, in the Valley of the Kings near Luxor. Hieroglyphics carved into walls and ceilings. The tombs were looted about 3,000 years ago, in times of Egyptian crisis, But the radiant writing still lives, bearing witness for the dead. It was their duty to write it down - for Self, for the gods, and for generations yet unborn.
Tomb of Ramses VI, a lasting legacy, deep and complex; fathoming Life and Death and the Afterlife.
That becomes the root and the richness of life’s meaning. “Life is primarily a quest for meaning. The greatest task for any person is to find meaning in his or her life….The quest for meaning is the key to mental health and human flourishing.”  Hope and sense of purpose.
What counts is not so much what happens to us, but rather, how we perceive what happens to us -- how we frame life’s events. We have the aptitude to imagine, to reframe, to revise our perceptions, and thereby to rise.
That is strength and growth.
The deaths and burial rituals of ancient cats teach us tales about the beauty of life and the importance of the past. The past is the foundation of the present and a herald of the future. It must not be denied or ignored as some people suggest. Forgetting the past in order to soothe today’s grief pain is not a restorative option. "Forget about the dead and move on" is shallow advice. Impossible. Choose the past and the present. They are actually factually indivisible. They form a whole. It is not a question of either / or.
We cannot live as though history had not happened.
“Turkish” Angora kittens – Angoras are a “landrace” breed, one of several descendant breeds from the ancients ! Past is present and informs the future.
This choice opens our pathways to the fullness of life, containing all that is possible and complete in every particular, and a lasting legacy of dignity, integrity, sincerity, and grace.
Envision. Remember. Become.
Those immortal dead live again In minds made better by their presence. ~~ George Eliot
An Appreciation: Thank you, MTC and HMC, for your friendship and for the Blue Cat. – 6/4/16 -- Viva la Blue Cat. “Each of us has a unique constellation of gifts, an unreplicated radius of influence, and within that radius, be it as small as a family or as large as a state, we can be a transformative presence.” [J. H. Sacks]
And always a Debt of Gratitude to MWM, without whose steady encouragement this pen would still be silent. “We each have…capacities that can lie dormant throughout life, until someone awakens them. We can all achieve [that] of which we never thought ourselves capable. All it takes is for us to meet someone who believes in us more than we believe in ourselves. Such people change lives.” [J. H. Sacks]
Map of Nile River region, burial ground for many ancient cats. The Nile is the longest river in the world.
Older map of the Nile region -- British
Hieroglyphic word for NILE
Hieroglyphic words for male cat & female cat. The name for "cat" was MAU, an onomatopoeia.
I love cats because I enjoy my home; and little by little, they become its visible soul. ~~ Jean Cocteau
Divine Felines, 305 BC; Wood, gilded gesso, bronze, rock crystal, glass; Scarab placed between the ears symbolized the morning sun. Brooklyn Museum SCARAB: used in ancient Egypt generally as "a symbol for the soul."
The Back Page: Even the smallest feline is a masterpiece. Cats have a rare grace, elegance, and absolute emotional honesty, Glad for company and yet possessing secret lives. They are like spirits come briefly to earth. Time spent with a cat is never wasted.* Life, Afterlife, and Transformation.
(*Leonardo da Vinci, Mark Twain, Ernest Hemingway, Pam Brown, Jules Verne, Colette)
Childhood Bereavement  Rea L. Ginsberg, LCSW-C, ACSW, BCD
Grief is not optional. Shared sorrow helps healing. We need others.
In the case of childhood bereavement, the death of a parent, the term “bereaved caregiver” no longer applies. The tables are turned. The child is indeed bereaved, but he himself is in need of a caregiver.
It seems senseless to debate which types of grief are the worst. Which are the hardest to bear. Every form hurts so very far beyond normal limits, beyond ordinary words. Profound sadness. It takes our breath away. It aches that much. Every form requires extraordinary coping skills. Every form holds its hazards. However, this childhood form does appear to be among the very worst.
“When his parent dies, a child finds himself in a unique situation because of the special nature of his ties to the deceased. An adult distributes his love among several meaningful relationships – his spouse, parents, children, friends, colleagues – as well as in his work and hobbies. The child, by contrast, invests almost all his feelings in his parents. Except in very unusual circumstances, this single relationship is therefore incomparably rich and intense, unlike any close adult relationship. Only in childhood can death deprive an individual of so much opportunity to love and be loved and face him with so difficult a task of adaptation….The death of a parent engenders a longing of incomparable amount, intensity, and longevity.” 
The child’s loss of a parent is one of the most difficult forms of bereavement. The mind of the child is immature. It is filled with magic, denial, narcissism, and self-reference. It says he is omnipotent and responsible for all external and internal events. If he is omnipotent, all-powerful, then his thoughts and/or actions must have caused the death. “Bad boy!” he imagines. Furthermore, he may well believe that the dead parent left him because he is unlovable. He may wonder about, and fear for, his own survival and death. Annihilation fears. Reality testing has not been mastered. Abstract thinking is only embryonic. The understanding of catastrophe has nothing much to do with reasoning. It is completely a matter of emotion. Emotional coping skills are primitive, undeveloped. He is more likely to express his feelings in physical actions rather than in words. Hyperactivity is a frequent defense against grief and anxiety. Adequate, nuanced verbal vocabulary is still narrow and unformed. The concept of “waiting” is virtually nonexistent. Postponement of gratification is merely a work in progress. It is not yet a reality. All of these are some of the reasons that the bereaved child’s needs are so special.
“The ability to love – like other human faculties – has to be learned and practiced. Wherever, through the absence of or the interruption of personal ties, this opportunity is missing in childhood, all later relationships will develop weakly, will remain shallow. The opposite of this ability to love is not hate, but egoism. The feelings which should go to the outside objects remain inside the individual and are used up in self-love. This is not what we want to produce.” 
Death makes no sense in these formative years. The child’s experience tells him: an object which disappears may eventually reappear. Fear tells him otherwise. Separation anxiety is intense. This thought of reappearance co-exists with the fear and outrage of abandonment. Fear of – and outrage about – abandonment become a sustained, screaming, breathless reality in the case of death. The loss is far-reaching. Recovery is arduous, exhausting, and hard to accomplish. The death of a parent is life-altering on a permanent basis. It is a severe emotional wound. It is traumatic.
“Although we know that, after such a loss, acute mourning will subside, we also know that a part of us shall remain inconsolable and never find a substitute. No matter what we believe may fill the gap…we will nevertheless remain changed forever…” 
From their many experiences with children, child psychotherapists tend to agree that the child’s mourning process never does entirely end, nor should it. The mental representation of the lost loved one, the memories and an accompanying degree of longing, remain with the child through childhood and adulthood – throughout his lifetime.  The lost parent remains loved and missed. Of course the bereavement process evolves, and remaining fragments come under far better psychological control and management as the child’s thinking matures. Mourning resolves but nevertheless, vestiges continue for a lifetime.
This troublesome outlook for the child can be mitigated by the understanding and compassionate presence of the other parent or another adult. Even an older sibling can soften the hardship. Someone must be there to receive and relieve the child’s distress. The child cannot be left alone to cope with loss and still remain healthy – both in mind and in body. Sorrow must be shared. Every person needs to know he is not alone with grief. The child is especially vulnerable and needy in this respect.
The optimistic side of this equation is the malleability of the child’s mind. In important ways, he is easily influenced, persuaded. His thinking and feelings can be shaped by sympathetic others. The “bad boy” of the child’s imagination requires immediate recognition and attention by at least one caring adult. If not immediate, the child’s sense of guilt and self-loathing over the death only grows stronger. These feelings then become increasingly less open to remedy. The fear and rage need the mature balance and moderation of others’ views. To save life and sanity, it takes only one human being who cares. 
Children draw great strength from their caregivers. The child needs the love and gentle guidance of a perceptive, patient, and capable caregiver. The caregiver must have a strong, intuitive understanding of children and their varied ways of expressing emotions. The adult was once a child. The caregiver should be in touch with the child within himself. That is one primary route to the necessary and sufficient comforting of the bereaved child. Also, “the child…profits especially when the [surviving] parent can reassure him that the family will remain together, that his needs will be taken care of as best possible, and that he will be told step by step as each arrangement is planned.” 
The caregiver, perhaps the surviving parent, functions as a protective “auxiliary ego” for the bereaved child. The strength and reassurance of the caregiver deeply influence the child’s ability to cope with the loss. Children in wartime have been the subject of many psychological studies. We know from those studies that children were least traumatized when the primary caregiver – usually but not always the mother – remained close, loving, calming, and comforting. Children’s reactions to loss depend mainly on the reactions of the primary caregiver. “Analytic date show us, time and again, that the child’s healing process is greatly facilitated when the [parent] is not only physically available but emotionally aware of the child’s experience, active in assisting him with integration, and supportive of his efforts….Prevention is so much easier than cure….Not all but many traumas can be avoided.” 
Experiences tend to build on each other. Certainly, if this is the child’s first major experience with bereavement, it may well set the stage for many future experiences with death and dying. An appropriate grief experience could help the child to manage future loss experiences successfully. The child at any stage of development possesses both character strengths and character weaknesses. Those and the impact of the psychosocial environment determine the outcome of bereavement.
[The importance of chronological age and developmental stage are emphasized.] “The total character of the child and…the totality of environmental circumstances…determine the outcome of the experience….The interaction between internal and external forces decides between the possibility of normal developmental progress and the incidence of pathological developmental distortion or arrest.” 
If the child’s caregiver is the other parent, we have come full circle, returning to the bereaved caregiver. Grief is not optional.  The caregiver must attend to his own grief and to the grief of his child. Perhaps, in some important sense, parent and child comfort, soothe, and reassure each other. They support one another. The feeling of deep sorrow is shared. The process and progress of the caregiver’s bereavement is then highly significant not only for himself but also for his child. The child’s mastery of his situation depends substantially on the caregiver. It is a large responsibility. Honesty and openness are virtually always good policy with children. The subject of death will carefully follow this pathway – when the caregiver is strong enough and wise enough to pursue it. He will know intuitively how to listen well and respond to the child’s expressions of grief.
Children are resilient despite obstacles. Grownups are, too. Children draw healthy, lasting equilibrium from their caregivers and from the memory of the loved one. Parent and child honor the life of the lost loved one with their enduring love and their continued lives. Love is bigger than Death. 
“Feeling good is hard to describe and to define, but is readily recognized. It is characterized by pleasure in living, is often accompanied by a heightened sense of bodily and mental well-being, by an ability to extend oneself to others and to initiate and enjoy harmonious interactions with them, by an ease and comfort in giving to and taking from life what it has to offer, and by being creative in thought, word, or deed, however humble a form it may take….It is a treasured feeling, and sorely missed when absent.”  This feeling-good is the aim of appropriate grief resolution. It is part of the transformation.
This childhood form of bereavement holds perhaps the greatest potential for healthy growth. Pleasure in living. Love of self and others. Creativity. It is the hidden value of adversity. The hint of later beauty, sensitivity, and wisdom in adulthood. Grief – suffering – has its own very special, enduring bonuses.
No hurry to heal. No pressure to “snap out of it.” Honesty and openness. Love. Memory. A firm, soothing hand to hold. Talking. It takes only one human being who cares. That is the route to strength and growth.
** "If ever there is tomorrow when we're not together... there is something you must always remember. You are braver than you believe, stronger than you seem, and smarter than you think. But the most important thing [to remember] is, even if we're apart... I'll always be with you." ~~ A. A. Milne
* * * * References:
1. A group of highly sophisticated psychotherapists/researchers working with bereaved children wrote:
“Throughout the work, in our direct contacts with our patients and their families, in our private thinking and in our research discussions, we lived with the intense distress, pain, and anguish engendered by bereavement. We have come to understand that this emotional distress is an inevitable burden for all who work with bereaved children. It is essential in facilitating appropriate empathy and insight, and helpful in integrating an intellectual grasp of the psychic processes within the patients’ personalities. Only those willing and able to bear the impact with feeling can hope to work with bereaved children fruitfully and to understand them scientifically.”
Erna Furman, A Child’s Parent Dies: Studies in Childhood Bereavement, New Haven and London: Yale University Press, 1974, p. 9.
2. Erna Furman, ibid., p. 12 & p. 16.
3. Anna Freud and Dorothy T. Burlingham, War and Children, New York: Medical War Books, 1943, p. 191.
4. Sigmund Freud, letter to Binswanger, 1929, in: E. Freud, editor, Letters of Sigmund Freud, transl. Stern & Stern, New York: Basic Books, 1960, p. 386. With special thanks also to Joanne Cacciatore, PhD, for pointing to this quote and for her uniquely beautiful word picture showing these thoughts: private e-mail communication, 28 June, 2013. [Please see picture below]
5. Marie E. McCann and Edward J. Schiff, MD, “The Process of Mourning,” in Erna Furman, op. cit., p. 52.
6. Elisabeth Kubler-Ross, MD, On Children and Death, New York: Macmillan Publishing Company, 1983, p, 19. [Please see also: www.ekrfoundation.org]
7. Erna Furman, op. cit., p. 20.
8. Erna Furman, “On Trauma,” The Psychoanalytic Study of the Child, New Haven: Yale University Press, volume 41, 1986, pp. 203 & 207.
9. Anna Freud, Forward to: Erna Furman, A Child’s Parent Dies: Studies in Childhood Bereavement, New Haven and London: Yale University Press, 1974.
10. Monica Williams-Murphy, MD, private e-mail communication, 5 July, 2013. [Please see also Dr. Murphy’s blog at website: www.oktodie.com]
11. Joanne Cacciatore, PhD, private e-mail communication, 4 July, 2013. [Please see also the website of the MISS Foundation: www.missfoundation.org]
12. Erna Furman, “On Fusion, Integration, and Feeling Good,” The Psychoanalytic Study of the Child, New Haven: Yale University Press, volume 40, 1985, pp. 81-82.
The article is written by Monica Williams-Murphy, MD, expert in this special area of healthcare. Dr. Murphy is an emergency physician and medical director for Advance Care Planning and End of Life Education at Huntsville Hospital, Huntsville, AL. She and her husband are the authors of the book, It's OK to Die.* Her companion website, http://www.oktodie.com, is also overflowing with valuable information and suggestions. Dr. Murphy's article (link above) is clear, insightful, carefully organized, and offered in usable detail. It includes links to a Personal Self-Assessment Scale form and a free Advance Directive form.
Take a look.
A plan is better than no plan at all. It could save lots of unnecessary grief, before and after the DYING. Our decisions DO matter! And they matter where it counts most, with the Self and those we deeply love.
"Remember, such decisions can never be made too early, but they can always be made too late." ~~ Dr. Murphy
*Please see my Mosaic page for a Comment on this book.
This shoe is designed to anticipate performance and the needs of athletes. The self-lacing feature is called “adaptive lacing.” Athletic shoe designer Tinker Hatfield says, “The potential of adaptive lacing for the athlete is huge, as it would provide tailored-to-the-moment custom fit. It is amazing to consider a shoe that senses what the body needs in real-time. That eliminates a multitude of distractions, including mental attrition, and thus truly benefits performance…. Wouldn’t it be great if a shoe, in the future, could sense when you needed to have it tighter or looser? Could it take you even tighter than you’d normally go if it senses you really need extra snugness in a quick maneuver? That’s where we’re headed. In the future, product will come alive.” 
While Nike prepares for its athletes, we have other, additional thoughts. For many individuals with disabilities, the future is coming alive Now. Lacing and tying shoes are major challenges for people with a variety of handicaps. Even those with moderate-to-advanced dementia could well benefit from this kind of shoe that simply (or not so simply!) laces/ties itself. Think of people with finger, hand, wrist, elbow, arm, or shoulder restrictions. Think of those who, for various reasons, cannot bend far enough to reach their feet. Think also of some with mental illnesses.
We know that Nike, Inc. is a large, prosperous retailer, a company with vast international reach. It is the world’s largest footwear seller. It displays fine research, product innovation, futuristic plans and futures orders, and attractive growth opportunities. Its distinctive name and “swoosh” logo are recognized and admired worldwide. It is strongly favored by the financial investments community. It sports a hefty market capitalization of $107.60 billion. It is number 106 on the Fortune 500 list of companies for year 2015. 
We know that Nike’s products are often on the rather expensive side, in part because of the famous brand name. Some people in need of these particular shoes might also need cost relief. So we have to wonder if this big, rich, revered company might be willing to discount various items (like the self-lacing shoes) – sometimes and with good, proven reasons, of course. These would be discounts for certain people with special footwear needs and documented, means-tested insufficient income to purchase Nike self-lacing shoes. Big companies do know how to meet their socially ethical obligations.
Or perhaps we could entice the health insurance industry to explore the possibility of covering all, or part of, the cost of the shoes, provided that the shoes are declared a medical necessity. In this case, we would probably first need a physician’s prescription for the shoes.
We fully expect that possession of these necessary shoes will contribute to the needy individual’s sense of psychological wellbeing. We also know that psychological wellbeing is a vital factor in promoting good physical health. Better mental health can lessen the risk of diseases and promote longevity. And this, in turn, would reduce the longer-term cost of medical care.  Cost of care is always a priority consideration in our funding-conscious society.
The self-lacing shoe is like a dream come true. Certain groups of people stand to benefit hugely, far beyond athletics.  What a gift of independence and self-confidence, first cousins of self-respect and personal dignity, forerunners of Hope! 
…shoes are the most important. Good shoes take you good places. -- Seo Min Hyun
I’ve learned that people will forget what you said, People will forget what you did, But people will never forget how you made them feel. -- Maya Angelou
We are often asked, “How can you do that?” How can you stand to do that work? Such a dreary subject. Grim but supposedly necessary. Don’t you get depressed with all the talk of dying? Facing death and its consequences every day must be the prime route to burnout. Are mental disorders prevalent among grief counselors? Aren’t you afraid all the talk of dying will make you a little crazy? Don’t you find it frightening, talking about death and dying all the time? Don’t you want some joy in your life? Do something else, anything that doesn’t relate to death.
What were they thinking? Grief counselors seem to have a mournful reputation.
Let’s re-view. Look below the surface. Our society does not like pain in general. We do not appreciate it. We do not want confrontations with it. We have a national aversion to it. We are busy developing a pill or procedure for every manner of pain, physical and psychic. If it hurts, then by definition it is bad and requires fixing. We are determined to find a surefire anti-aging formula that will also extend our lives forever. Cryogenics? Yes. It shows promise. Really intriguing, actually very exciting, but it is not yet ready for wide use. It could be a future plan. Think forward to pain-free existence. But when?
In our society, death is a painful subject for the patient and for the family. It is an unacceptable outcome of care, health care. We don’t like it. We are inclined to do everything possible to avoid it, even when the alternatives bring far worse health and increased suffering to the patient. Overall, we still prefer to avoid and deny death in our national and personal conversations. Let’s change the subject and be happy. After all, in our American tradition we are entitled to happiness – plus life and liberty. In our attitude, we presume to live forever. It is just easier that way. Finding the easiest way is our American goal. No pain, no awkward planning, no scary discussions, no sad thoughts about loss. We like to live in a wish-fulfillment bubble, a place where death does not happen. Not to ourselves, not to those we love. No talk of tears and fears and sorrow.
The only trouble is that a pain-free life is impossible. For all our pushback and passionate hopefulness, the search is in vain. Pain is inevitable in every human life. Like it or not, wish against it or not, there it is. Pain waits patiently and outlasts our resistance. It is a fundamental fact of life. Death is also a fact of life, a fact until further notice. Significant loss occurs in every life. Death occurs to every life. Death hurts. It causes grief. There is yet no pill to make it go away. Maybe there should not be such a pill. Enter: the supportive grief counselor.
Survivors need interpersonal help and healing. Usually, friends and family do the job. The path is painful and also lonely at times. Sometimes, a professional counselor is just the right remedy. He is prepared to be a companion for a time, along the way to reconstructed balance and equilibrium. Along the way to adjustment. He is equipped to hear the hurt and lighten the load. In a hurry-up, get-over-it society, the grief counselor is a safe harbor in the mourning storm. His focus is not time. It is not a predetermined schedule. It is not a deadline for completion. His focus is connection, understanding, and support. It is helping the survivor to feel comforted because someone who knows grief is actively listening. The center of his attention is less advice and more the not-so-simple act of being with the survivor, to facilitate self-rediscovery and restore dignity.
Psychologist J. William Worden writes, “When unanticipated or incongruous events such as the death of a loved one occur, a person needs to redefine the self and relearn ways to engage with the world without the deceased. The person cannot return to a pre-loss level of functioning but learns how to develop a meaningful life without the deceased loved one.…Death can challenge one’s assumptions about the world (spiritual adjustments) and one’s personal identity (internal adjustments).”1
The power to heal psychic wounds is rare and precious. Few people have this skill. It is needed. It is a service. It becomes a moral obligation for those who have that power. To have it is to take pleasure in exercising it. To have it and withhold it is unethical. It is contrary to conscience. It defies accepted standards of professional behavior. It is also unhealthy because there is nothing more important in life than human connection. To assist the progress of connection provides further integrity and growth to the facilitator. The grief counselor is rewarded in greater wholeness, in life lessons studied, learned, and integrated. Death is not an enemy. It is a creative disrupter. It is one of our most profound and valuable teachers. It is life-affirming. It is our gateway to meaningful and vigorous life.
Emergency physician Monica Williams-Murphy comments similarly, from a slightly different perspective: “What human would rob another of the most touching and beautiful moments of life?.…Death…allows us to cherish both life and time more fully.”2
Dreary? Depressing? What were they thinking…?
1. J. William Worden, PhD, “Introduction,” Grief Counseling and Grief Therapy, fourth edition, New York: Springer Publishing Company, 2009.
The moment we cease to hold each other, The moment we break faith with one another, The sea engulfs us and the light goes out. -- James Baldwin
My town is on fire. Spreading now to Washington D.C., New York City, Minneapolis, Philadelphia. No wonder. This is not just a Baltimore problem. This is a USA problem. This is a worldwide problem.
Long ago, I worked in those inflamed communities. I worked there for a year, 1966-67. When Dr. King was murdered in 1968 (he was 39 years old then), we set up a phone bank at the School of Social Work and tried to bring families and friends back together. The rioting was so ferocious and disorienting that people got lost in it! Urban agony and “the fierce urgency of now.”
One of my assignments focused on a cluster of public welfare individual homes. Society named it “the projects.” The community was isolated, far from view by most Baltimoreans. Clearly planned residential segregation. Out of sight and mostly out of mind - invisible, inaudible, and denied - as local government designed and desired. Despite the Civil Rights Act of 1964, racial segregation was entirely alive and very active. The homes were built next to long-haul railroad tracks that ran flat on the ground. There were no barriers to protect the residents from stepping onto the tracks and into train traffic. No fence, no bars or walls, no inclines or gates, no barricade against bloody disaster. WHY.
In the beginning, when I walked the streets in those impoverished neighborhoods, I was somewhat apprehensive. Much had been said about crime and substance abuse, alcoholism. But soon I noticed that the residents had embraced my presence. Wherever I walked, people watched me from their windows to see that I was safe. They nodded and gave a brief wave as I passed by, as if to say, “Don’t worry. We’ve got your back.” So, after a short time of acquaintance, my tension eased, and I could give full concentration to my job.
We called it “a voice for the voiceless.” I tried to find more money and work and child care for families. I found medical care for some. I wanted to turn a blind eye to fathers who lived with their families because the "Aid to Families with Dependent Children" (AFDC) law never made sense to me. (Families could not receive welfare funds if the father lived in the home! What self-evident nonsense! Does it really take a genius to see the obvious?) Here was an offensive and cruel paradox. First we passed a law that only broken families could receive financial aid. Many caring fathers - those who couldn’t find jobs or sufficient pay - left home in order to qualify their families for this assistance. Then came the “news” that broken families were a serious national socioeconomic problem, perhaps even requiring Federal government intervention for remediation.
I grew devoted to the people and committed to the job of righting wrongs. At the same time, I noticed that those outside the welfare communities disrespected the social workers who worked inside them. Society viewed the public welfare social worker and her low-income clients with almost equal contempt. So open was societal scorn. All of us, workers and clients, were vilified as incompetent loafers – or worse. It was a further confirmation of intractable, unmanageable discrimination. I don’t know why I was surprised by this, but I was…and this is still true, and I am still appalled and dismayed. The conscience of our country is put to shame. Is there indeed nothing new under the sun, I sometimes wonder…?
We can change what people do and what they say, but we cannot always or easily change how they feel. (We know it is possible, though.)
Racism is a thing of misery on every side! It is mind-bending. We can hardly imagine it if we haven’t experienced it. I used to dream of ending the poverty and anguish I saw there, the profound societal disrespect that seeped deeply into the souls of my low-income clients. Those inner souls would scream, “I’m a person, too!” It was a poignant protest against the unendurable: annihilation of the Self. They hated the wider world that so totally despised and rejected them, and they hated themselves especially. Rage turned inward – there is often no other place to safely direct so much intense feeling…until its periodic explosion in riots…during which the rioters also trash, burn and otherwise violate their own neighborhoods.
Self-loathing. It is a learned reflection. It mirrors society’s disposition: disposable sub-human. It is a terrible, horrible, no-good, very bad disease. It says life is cheap, and any behavior eventually becomes OK because “my life doesn’t matter.” Baldwin wrote that “the most dangerous creation of any society is the man who has nothing to lose.” In other words, we were - and still are - effectively “radicalizing” whole groups of our own citizens, right here inside the USA. Some kids talked about “if I grow up,” not “when I grow up.” They were afraid of dying young, by senseless violence not of their own invention. The boys would join gangs to make themselves strong against society’s hate and an early death. The girls often had babies so that something precious and beautiful, of their own making, actually belonged only to themselves.
In his 1951 poem, “Harlem,” Langston Hughes warned the country this way:
What happens to a dream deferred? Does it dry up Like a raisin in the sun? Or fester like a sore-- And then run? Does it stink Like rotten meat? Or crust and sugar over-- Like a syrupy sweet? Maybe it just sags Like a heavy load. Or does it explode?
Racism is toxic. Its consequences are poison to the racist himself, the injured, their communities, and the entire nation. Sometimes I was overwhelmed by what I saw. I always imagined myself in others’ place. It was a suffocating, paralyzing and helpless feeling, desperation, with no visible and assured escape hatch. I dreamed of ending that anguish. That was 50 years ago. I am still dreaming...
Baltimore is on fire, but this is not only a Baltimore problem. Senator Daniel Patrick Moynihan, PhD sociologist and a U.S. Dept. of Labor assistant secretary at the time, knew it 50 years ago and wrote about it in what became known as the Moynihan Report, “The Negro Family: The Case for National Action,” 1965. The next year, it was required reading in our social science classes. He reported on socioeconomic issues for black Americans, issues of discrimination, social inequality, and limited opportunity. He argued in favor of government intervention for improvement: job programs, vocational training, educational programs and more. I am not sure 50 years have changed us very much in this requisite regard. We might need a contemporary, dedicated Moynihan to move our mountain of moral misdeeds. Or maybe we already have one such mover in our midst: our president – community organizer, lawyer, orator and author, biracial, Nobel Peace Prize laureate, experienced politician, man of influence and high connections – in his post-term years. We don’t know that yet.
I wish my dream would come true before I die, but wishing doesn't make it so. Neither does walking the streets. The one-by-one approach alone will never end the problems. They are too big and too complicated. A one-track answer won’t work. Much must be done. Laws should be a large part of the response, sensible national/Federal legislation. Positive government action. Over time, laws can change feelings, too. We know that because we have seen it. Maybe the new Attorney General of the U.S. can help... Maybe someday soon, Congress will return to functional sanity… Maybe the Supreme Court can help, if the justices are open-minded… Maybe we should revisit the Moynihan Report and commit ourselves to further exploring his suggestions. Education is most certainly one useful answer for good growth and change… Maybe a double dose of ongoing self-examination and compassionate whole-life partnerships would help us all. If that doesn’t work, increase the dose… Maybe all of this and then some… It could happen.
My dream may be deferred, but it is unbroken. Hope never stopped at all. Hope. A powerful force. Only with hope can we sustain the motivation to forge ahead. I found it in the most unlikely places – on the side streets of Baltimore. It was a lifetime gift donation from all my clients who refused to give up.
One of the most inspiring creations of any society is the person who has nothing to give but kindness, care for others, and hope.
There will be neither rest nor tranquility in America until the Negro is granted his citizenship rights….One day this nation will rise up, live out the true meaning of its creed: “We hold these truths to be self-evident, that all men are created equal.” -- Martin Luther King, Jr., May 28, 1963, On the steps of the Lincoln Memorial In Washington, D.C.
You must be the change you want to see in the world. -- Mahatma Gandhi
Tags: riots, racism, poverty, self-hate, change, legislation, education, partnership, hope * * * Rea Ginsberg is a retired director of social work services, hospice coordinator, and adjunct professor of clinical social work.
The Red Horses, c. 1930 -- oil on canvas (Influenced by Marc Chagall, "the quintessential Jewish artist of the 20th century.")
The artist's name is unclear. We will call him Wolfson. As the story is told, he was a Russian immigrant to the USA. He lived and worked in New York City.* While we are not sure of his name, we are more certain of his inner personal narrative.
Although he immigrated for reasons of religious persecution and political dislocation, he was often homesick. He grieved for the comforting familiar, the people and towns and language of his childhood homeland – his Motherland. He expressed his grief and longing especially in his paintings. This picture is an example. Take another look.
Note the blackened doors and windows and the absence of people. And yet, through his tears, Wolfson found the promise of life, a celebration: blue sky, green growing grass, horses helping, and a wagon full of fresh hay. Also, with such a vivid blue sky and white puffy clouds, we have a sense that the sun must be shining somewhere nearby. HOPE.
And, of course, the picture’s dominant bright color is red, considered by some to be the warmest color in the visible spectrum. In the Russian language, the words “red” and “beautiful” come from the same Slavic root. Red Square in Moscow meant “beautiful square.” In ancient Roman times, red also symbolized courage; soldiers wore red tunics. The color holds vast, international, cross-cultural symbolism – for instance: majesty, nobility, liberty, power, love, happiness, fire (“Chinese red”).
If he were asked today, maybe Wolfson would have chosen all of these words to describe his works. We are left to wonder and imagine. That is finally the enduring beauty of art: the beholder’s eye and the perennial question, “What was he thinking?” We see Wolfson’s resilience – and our own – in this picture. Resilience: the ability to recover, to rebound, to spring back from an impact even if it takes a lifetime. His painting shows us that he did not succumb to sorrow. It reveals that he could use his sadness and bend it and mold it … and heal from it. That is strength and growth. In his grieving, he also found a way of giving to others through his artistic talents. The ability to give to others is itself a gift. As he gave, his gift for painting returned to him much recognition, praise, and a highly favorable reputation in the world of visual arts. That enhanced his self-esteem, confidence, energy and inspiration to continue painting. It brought him community, support, and encouragement. It soothed him, like palliative self-care for the mind.
He was not defeated nor diminished by loss. He transformed his suffering, making it, for long and memorable moments, a dance of light and life.
* * *
*A firmly implanted family folktale with probable and significant alterations of name and places. Memory for facts is sometimes unreliable, but the feeling tone remains strong, unmistakable, and well defined. RLG 24 February 2016 Tags: #art #painting #red #hpm #grief #courage #hope #resilience #giving #transformation
The Holocaust: Bereavement Takes a Different Course
The Red Velvet Album
Rea L. Ginsberg, LCSW-C, ACSW, BCD
Jewish history has all too often been written in tears… I am fascinated by people and groups with the capacity to recover, Who, having suffered the slings and arrows of outrageous fortune, Are not defeated by them but fight back, Strengthened and renewed. Rabbi Jonathan Sacks, PhD, From: To Heal a Fractured World
In some situations, the whole idea of complete recovery from bereavement makes no sense. Bereavement can be fully expected to last a lifetime. That must never be considered a mental disorder. Among the most obvious of these situations is Holocaust survivorship.
Very few Holocaust survivors are still living. The last prisoners of the European concentration camps were freed in 1945. Their suffering before release is virtually unimaginable and incomprehensible to the vast majority of us. We have absolutely no mental yardstick with which to measure such suffering. Imagination completely fails. We cannot do it. The children of survivors are perhaps the only ones who come slightly close to a true understanding. They sense the meaning of the emotional horror of the experience and the problems of survivorship.
Fern Schumer Chapman, the daughter of a survivor, said it this way in her book, Motherland: Beyond the Holocaust: A Mother-Daughter Journey to Reclaim the Past: “The past is a presence between us. In all my mother does and says, the past continually discloses itself in the smallest ways. She sees it directly; I see its shadow. Still, it pulses in my fingertips, feeds on my consciousness. It is a backdrop for each act, each drama of our lives. I have absorbed a sense of what she has suffered, what she has lost, even what her mother endured and handed down. It is my emotional gene map.”
We have a habit of using certain old adages to comfort and humor others. We often use these sayings to dismiss from our own minds what otherwise makes us fearful and uncomfortable. One adage says God never gives us more than we can handle. Another says that what doesn’t kill you will make you stronger. In the case of the Holocaust survivors, so false. So weirdly irrelevant. So insulting. So empty. So absent in understanding of the Holocaust experience. Would we say that to someone who has survived starvation and certain annihilation in a Nazi death camp? The answer resounds with No. Then, too, why do we say it to each other? Life lessons; applied ethics. The wretched Holocaust is still our teacher, so many years after. From the survivors, another exercise in living.
It must be noted that the survivors had been surrounded by death in the extermination camps. It was not just one death but massive deaths. Most survivors lost many family members, not only one or two. They lost many friends and neighbors, not just one or two. The camp inmates bore witness to many deaths every day, not just on one or two days. The deaths occurred primarily by premeditated, deliberate and vicious murder, not by disease or natural causes. Murder routinely took place after extreme torture. Intense humiliation before death was standard practice. Des Pres wrote that human dignity was treated with cynical contempt. The value of life had been reduced to zero. There was no escape except the grave. In many instances, physical survival was an accident of time and place, not an act of strong determination to live. It was a Holocaust, a great devastation, a systematic mass slaughter. That was genocide. That is the background of survivorship. That is monstrous, shockingly hideous.
This is a different kind of loss and a different course of bereavement. This is not ‘good death.’ It is brute force and mass killing. This is not fear. It is terror. It is panic. This is not anger. It is outrage and despair. This is not guilt. It is inner conviction of crimes committed or omitted. Judgment has been passed by the jury of the inner self. The verdict is pronounced. The finding is guilty on all counts. The question is not: is the verdict right? The question is: to what extent is that verdict right? No punishment fits the magnitude of the crimes. The sentence is lifetime-plus-time atonement. These thoughts form a survivor mindset.
In most instances, talking does not help. Only in groups with other survivors does discussion seem to bring some heartfelt relief. After all, in extreme situations, only experience knows experience. The rest of us remain mere outsiders peering in. Imagining carries us to the outer edge. The Holocaust was located very far beyond that point. All of us have an intuitive understanding of personal tragedy. We find comfort most of all in others whose experiences match our own. We find it also in those who have lived lovingly beside us as we suffered. Survival is a collective art. We need other people.
In notable instances, writing also helps to soothe. As an example, Dr. Elie Wiesel long ago became one of the most prominent survivor authors. From his book, Night:
"Never shall I forget that night, the first night in the camp, which has turned my life into one long night, seven times cursed and seven times sealed. Never shall I forget that smoke. Never shall I forget the little faces of the children, whose bodies I saw turned into wreaths of smoke beneath a silent blue sky. Never shall I forget those flames which consumed my Faith forever. Never shall I forget that nocturnal silence which deprived me, for all eternity, of the desire to live. Never shall I forget those moments which murdered my God and my soul and turned my dreams to dust. Never shall I forget these things, even if I am condemned to live as long as God Himself. Never."
He had vowed that, if he survived, he would devote the remainder of his life to telling the story of the Holocaust. It was his moral duty to tell it, he said. If the world knew the facts, another holocaust might be prevented. As the old Santayana adage goes, “Those who cannot remember the past are condemned to repeat it.” Wiesel has turned his torture and lifetime of bereavement into one of the world’s most treasured and admired literary art forms. A thing of beauty. In so doing, he eases his pain. He brings us news not only of man’s evil but of his goodness as well. He is successfully saving himself and memorializing his dead family and others as he guides the rest of us. His writing is his public monument to the 6 million and so very many more.
Once again he found meaning in life and regained the will to live. Eventually, he was even able to say, “I have not lost faith in God. I have moments of anger and protest. Sometimes I’ve been closer to Him for that reason.” As we read his works, we fervently wish him to be right: no more war and injustice! Horror transformed into beauty and the embodiment of moral righteousness. That is quite an achievement of chronic bereavement. It is not a disorder. It is a rare and wondrous gift. The Nobel committee recognized and honored this life of achievement with an award for Peace in 1986.
An elderly lady of my acquaintance lived with her family in Eastern Europe during the War. As the German army advanced, she sent her only child, a teenage son, to live in hiding and safety in the countryside. Her son was discovered by the German army, tortured, and then shot before her eyes. All the remainder of her family died in the concentration camps. She herself became a subject of the infamous Nazi medical experiments. She was never able to talk about her son and her experiences without dissolving into tears of guilt and despair. The wound never healed, nor could that be expected.
Late in her life, she was hospitalized. Due to a medication error, she became delusional. One auditory hallucination brought her to a state of panic. We found her behind the door of her room, frightened and shaking. Over the intercom, this hearing-impaired lady had clearly heard the voice and commands of the Gestapo. They were taking a lineup of concentration camp inmates to the “showers” (gas chambers). She saw a camp guard pass her door. She beckoned us to quickly hide with her behind the door. The Holocaust trauma survived and burned in her vivid memory. Through her vision, we could sense the smoke and feel the flames. That was 50 years after liberation. She had seen the face of evil. Like Dr. Wiesel, she would never forget. Why would she? Why should she? How could she? Who would?
She managed to make her peace with life by giving to others. It was her own personal Kindness Project. It brought her purposeful life. It commemorated her dead. She was an expert, avid needle point artist. She was passionate about her skill. Everyone in her surroundings received, with great pleasure, something she had created. She lived to be well over 90. Her bereavement remained raw, but it never brought her down. She was never defeated. She found meaning and healing in her life by giving the fruits of her talent. Her son lived once more in her generosity. Bereavement’s achievement.
Given the depth and breadth of the trauma, it seems an act of heroism just to return to so-called normal life. From Dr. Wiesel again: “I survived the Holocaust and went on to love beautiful girls, to talk, to write, to have toast and tea and to live my life – that is what is abnormal.” The feeling tone is obvious. After such trauma, a life of normal routines seems at first crazy, surreal, disorienting. It seems almost disrespectful of the dead. At best, the reentry is a struggle. It happens nevertheless. At the center of the healing are other people. Connection is the core principle. Hope can be given only by others. Also in Jewish folk wisdom, a Yiddish proverb states: even in Paradise, it is not good to be alone.
Needed: people of warmth and compassion. A shared knowledge that the Holocaust situation was evil and extreme. A firm flow of support and reassurance that guilt for past and guilt of survivorship are misplaced. A conviction from others that the survivor has always been worthy of dignity and respect. Acknowledgement that bereavement is forever and is sane. An understanding that the dead are kept alive inside the grief. Therefore grief is necessary and has a purpose. There is no incentive to finish grieving. On the contrary, there is every incentive to urge grief to remain fresh. Needed: people for whom death is no stranger. People willing to lift the veil of fear and find the beauty and resilience of the human spirit.
So much is said about the devastation of World War II, fascism, and Nazi Germany. Atrocity and abject misery seem to be an endless source of fascination. The reasons are many but the fact remains. Much less is said about reintegration. It is the human will and ability to rise above past contempt. The survivor had to regain entry into a sensible, open society and sane living. Lost through radical suffering. Found, as Des Pres tells us, through social interaction and keeping dignity and moral sense active.
Those of us who did not experience the full horror of the Holocaust will never fully understand its emotional power. But we can help those who did. Never become discouraged by the scale of the problem. Just keep inching forward. This bereavement is a victory for connection, the value of relationships. Accepting, respecting, and appreciating are fundamental qualities of relationship. Attentive listening is also basic. For the survivor, learning to trust again is demanding. It takes great mental effort to accomplish. We can help to point the way, again and again. Repetition is part of the answer. Telling the Holocaust story is that part of the answer. Dr. Wiesel: “I decided to devote my life to telling the story because I felt that, having survived, I owe something to the dead, and anyone who does not remember betrays them again.” To forget the Holocaust, he said, would be to kill twice. Bearing witness gives voice to the dead. That voice is indispensable. Silence speaks.
Connection is a gift we can freely give. It does not require full understanding. It requires only empathy, honesty, and compassion. Maybe a little altruism as well. Each connection provides links to the wider community and further connections and friendship. The support system expands this way. Self-respect and dignity are reinforced this way. Life finds meaning again this way. Life is reaffirmed this way. Once more an achievement of bereavement. Survivors fight back, strengthened and renewed.
Our task is to make music with what remains. Yitzhak Perlman, violinist
Everything can be taken from a man but one thing: The last of the human freedoms – To choose one’s attitude in any given set of circumstances, To choose one’s own way. Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom. Viktor E. Frankl, MD, PhD, Psychiatrist, Author, Holocaust survivor
Anne Elizabeth Applebaum, Gulag: A History Hannah Arendt, Eichmann in Jerusalem Bruno Bettelheim, Surviving & Other Essays Bruno Bettelheim, The Informed Heart: Autonomy in a Mass Age Fern Schumer Chapman, Motherland: Beyond the Holocaust: A Mother-Daughter Journey to Reclaim the Past Terrence Des Pres, The Survivor: An Anatomy of Life in the Death Camps Helen Epstein, Children of the Holocaust: Conversations with Sons and Daughters of Survivors Anne Frank, The Diary of a Young Girl Viktor Frankel, Man’s Search for Meaning Bernard Goldstein, Five Years in the Warsaw Ghetto John Hersey, Hiroshima Lucette Matalon Lagnado and Sheila Cohn Dekel, Children of the Flames Primo Levi, Survival in Auschwitz Robert Jay Lifton, Death in Life: Survivors of Hiroshima Konrad Lorenz, On Aggression Daniel A. Mendelsohn, The Lost: A Search for Six of Six Million Emmanuel Ringelblum, Notes from the Warsaw Ghetto Rabbi Jonathan Sacks, To Heal a Fractured World: The Ethics of Responsibility Andre Schwarz-Bart, The Last of the Just Varlam Shalamov, Kolyma Tales Alexander Solzhenitsyn, One Day in the Life of Ivan Denisovich Jean Francois-Steiner, Treblinka The Black Book: The Nazi Crime and the Jewish people (out of print) Gordon Thomas and Max Morgan-Witts, Voyage of the Damned Leon Uris, Exodus Elie Wiesel, Night Elie Wiesel, A Beggar in Jerusalem Elie Wiesel, One Generation After Elie Wiesel, The Oath
IT CAN'T HAPPEN HERE: Considering dying -- with a special thought concerning mass murder/terrorism and how soon we "forget." Remembering the San Bernardino massacre.
You'll miss the best things if you keep your eyes shut. -- Theodor S. Geisel
It can’t happen here. It won’t happen to me.
How many of us report this from our snug, smug homes. Complacent to a fault. A little self-righteous. A lot of turning away from painful realities. Refusing to admit what does in fact exist. Denial. It is the omission of truth. That is the essence of our belief that “it can’t happen to me.”
How we fool ourselves, willfully, joyfully, inviting others to follow, insisting that this is the right and righteous way forward. Others are captivated, convinced by our cheerful confidence. They do follow because the path of denial is so much easier and more attractive. Better by far than a harsh reality that we can usually grasp only with accompanying pain and suffering.
Maybe denial is necessary in our arsenal of defenses. We cannot live in fear and outrage all the time. We must have relief. We must find periodic escape. We “forget.” However, to fully protect ourselves, we also need to confront truth head on. Otherwise, truth will catch us by surprise and hurt us even worse because denial prevents adequate mental/emotional preparation for adversity. Unarmed truth must have the final word.
Yes, denial protects – sometimes. Thinly. Self-awareness and insight bring us solidly to who we really are and how then to proceed. Insight is the ability to perceive clearly and deeply, understanding the true nature of a situation. It is the capacity for understanding our own mental processes. It is our personal truth. It is not easy and it is sometimes painful. What counts is the courage to consider.
We are stronger than we suppose. Emily Dickinson said it memorably, poetically:
We never know how high we are Till we are called to rise; And then, if we are true to plan, Our statures touch the skies--
Dr. Charles Seymour, an historian and former president of Yale University (1937 – 1951), once famously remarked, “We seek the truth and will endure the consequences.”
What’s the point? Death, of course. In our case in this article, keep in mind death especially by sudden and unexpected violence like terrorism. But also think of dying by many other means as well: illness, accident, disease, and “natural” causes.
How much we gain from looking directly into the depths of death and remembering to prepare, remembering to test the what-if’s – reality testing. What if “it” did happen here; what if “it” did happen to me? Imagining our place in a future reality is a “what-if.” It poses a question of how we would feel and behave in various circumstances, if they occurred. We can mobilize hope and moral energy through questions.
We cannot afford to be trapped by living only in the moment or mostly in the past. We must also wrestle with future possibilities. They deserve careful and lengthy consideration. Very soon – sometimes too soon – the future becomes Now.
We do not need to have all the right answers, but we need to ask the right questions. It is mental preparation for the future. It is a search for safety; we can never be too safe. It is a self-taught and vital lesson in caring for the Self – call it self-defense or creativity. It is a buffer against FutureShock. Imagination lights the way. Something new is born this way.
Maybe this should become a required high school/college course, a how-to, the new iPsych 1.0 - IntroToPreparedness. It would examine and debate the crucial psychosocial first aid kit, what to pack, how to pack, and why. There, we would also teach how and why to carry on this learning for a lifetime. We would advise our students to reality-test often, to be prepared in case of various hurtful developments / crises. Don’t “forget,” and sooner is better than later – the later which may be too late. Don’t turn the unenlightened yesterday into tomorrow’s sorrow. Think about it.
The future is unknown and unknowable. It is radically open. It can be predicted only without certainty. The future remains to be made – largely but not only by our choices. Nevertheless, we can imagine it in many forms if we care to try. Denial often fails, but preparation often triumphs. Preparing is protective. It informs choice. It has the force to save lives…promoting health and strength and positive energy.1 Heaven can wait awhile.
Life is richer this way. The honesty of insight pays. Each relationship becomes a greater gift to be cultivated, tended, and harvested. We need others and others need us. Every day grows to be more meaningful, powerful, even precious and peaceful. We are freer, unbound from denial and its hapless aftermath. Choose the informed heart.
It’s not about what it is, it’s about what it can become. -- T. S. Geisel
1. The field of medicine offers a parallel concept, a more concrete and literal example of the value of preparedness. It is called “prehabilitation” or prehab. It optimizes post-operative recovery. Patients who participate in prehab physical therapy regimens are more likely to have better surgical outcomes, fewer and less severe complications, faster recovery, and shorter hospital stays (thereby reducing the cost of care). Studies show that prehab targeted interventions reduce hospital readmissions and improve survival outcomes of cancer patients. Also, the prehab exercises tend to trigger mental health benefits such as decreasing anxiety, increasing positive and optimistic feelings, and restoring the patient’s sense of control over his illness and treatment. Simply said, eyes-open, focused prehab helps the patient to prepare for a better, healthier future.
“You will come to a place where the streets are not marked. Some windows are lighted, but mostly they're darked. But mostly they're darked. A place you could sprain both your elbow and chin! Do you dare to stay out? Do you dare to go in? How much can you lose? How much can you win?” ― Theodor S. Geisel