The Long Goodbye (16 page)

 

 

A death from a long illness is different from a sudden death. It gives you time to say goodbye and time to adjust to the idea that the beloved will not be with you anymore. Some researchers have found it is “easier” to experience a death if you know for at least six months that your loved one is terminally ill. But this fact is like orders of infinity: there in theory, hard to detect in practice. On my birthday, a friend mused out loud that my mom's death had surely been easier to bear because I had known it was coming. I almost bit her head off:
Easier to bear compared to what—the time she died of a heart attack?
Instead, I bit my tongue.

What studies actually said was that I would begin to “accept” my mother's death more quickly than I would have in the case of a sudden loss—possibly because I experienced “anticipatory grief” while she was still alive. But until that acceptance arrived, it was as hard to bear as any other major loss.

And that was why one afternoon, about three weeks after my mother died, unable to get far from bed, I googled “grief.” I was having a bad day. It was two p.m., and I was on the bed wondering: Was it normal to believe surviving was pointless? Was I losing my mind? I wanted a picture of this experience from the outside: a clinical picture. So I began to read, thinking that information might stop me from feeling that I was floating away.

Not surprisingly, perhaps, the clinical literature on grief is extensive. Much of it reinforces what I had already begun to realize. Grief isn't rational; it isn't linear; it is experienced in waves. “No one ever told me that grief felt so like fear,” C. S. Lewis had written at the beginning of
A Grief Observed
, and scientists have in fact found that grief, like fear, is a stress reaction, attended by deep physiological changes. Levels of stress hormones like cortisol increase. Sleep patterns are disrupted. The immune system is weakened. Mourners may experience loss of appetite, palpitations, even hallucinations. Just as I had, they sometimes imagine that the deceased has appeared to them, in the form of a bird, say, or a cat. Addressing my mother in the sky was not as bizarre as I'd thought; mourners often talk out loud—or cry out—to a lost one, I found. Freud theorized that the reason for all this distress has to do with energy. In his essay “Mourning and Melancholia,” he suggests that mourners have to reclaim the energy they have invested in the deceased loved one. Grieving is that process of reclamation. When you lose someone you were close to, you have to reassess your picture of the world and your place in it. The more your identity is wrapped up with the deceased, the more difficult the mental work.

The first systematic survey of grief, I read, was conducted by Erich Lindemann. Having studied 101 people, many of them related to the victims of the Cocoanut Grove fire of 1942, he defined grief as “sensations of somatic distress occurring in waves lasting from twenty minutes to an hour at a time, a feeling of tightness in the throat, choking with shortness of breath, need for sighing, and an empty feeling in the abdomen, lack of muscular power, and an intensive subjective distress described as tension or mental pain.” Intensive subjective distress. Yes, exactly: that was the objective description I was looking for. The experience is, as Lindemann notes, brutally physiological. It literally takes your breath away. Its physicality is also what makes grief so hard to communicate to anyone who hasn't experienced it.

One of the questions I had was whether there was any empirical evidence supporting the famous “five stages of grief.” Mention that you had a death in the family to anyone, stranger or friend, and he is likely to say something about the five stages. According to “stage theory,” an idea popularized by Elisabeth Kübler-Ross in her famous 1969 study
On Death and Dying
, grieving typically takes the form of five emotional stages, in sequence: denial, anger, bargaining, depression, and acceptance. This idea took hold in American culture almost as soon as Kübler-Ross articulated it (even though originally she used it to describe the grief the
dying
feel), perhaps because it makes loss sound controllable—and because the idea of acceptance appeals to our national character. In the months after my mother died, I saw stage theory invoked repeatedly, especially on TV medical shows. But my experience seemed to bear little resemblance to the “stages,” and as it turns out, stage theory isn't a very accurate description of what it's like to grieve. There is little evidence suggesting that most people experience capital-letter Denial, Anger, Bargaining, Depression, and Acceptance in simple sequence. Instead, according to a study that Prigerson, the Dana-Farber researcher, worked on, Kübler-Ross's stages seem to be more like states. Though Kübler-Ross captured the range of emotions that the dying and their families experience, grief doesn't generally follow a checklist. It's less like an orderly progression of stages and more like an ongoing, messy process—sometimes one that never fully ends.

One of the things Prigerson told me when I talked to her on the phone was that researchers now believe there are two kinds of grief: “normal grief” and “complicated grief” (also called “prolonged grief”). “Normal grief” is a term for what most bereaved people experience. It peaks within the first six months and then begins to dissipate. “Complicated grief” does not, and often requires medication or therapy. But even “normal grief,” Prigerson said, is hardly gentle. Its symptoms include insomnia or other sleep disorders, difficulty breathing, auditory or visual hallucinations, appetite problems, and dryness of mouth. I had had all of these symptoms, including one banal hallucination at dinner with a friend, when I imagined I saw a waitress bring him ice cream. In addition to the symptoms Prigerson named, I had one more: difficulty spelling. Like my mother, I had always been a good speller. Now I had to rely on the dictionary to ascertain whether
siege
is spelled
ie
or
ei
. My problem was not unusual; certain forms of grief can take a toll on your cognitive functions.

An enduring psychiatric idea about grief is that the mourner needs to “let go” in order to “move on,” and in the weeks after my mother died, people kept suggesting as much. But I didn't want to let go. And in fact studies have shown that some mourners hold on to a relationship with the deceased with no notable ill effects. In China, for instance, mourners regularly speak to dead ancestors, and one study demonstrated that the bereaved there “recovered more quickly from loss” than bereaved Americans do.

I wasn't living in China, though, and in those weeks after my mother's death, I felt that the world expected me to absorb the loss and move forward, like some kind of emotional warrior. One night I heard a character on
24—
the president of the United States—announce that grief was a “luxury” she couldn't “afford right now.” This model represents an old American ethic of muscling through pain by throwing yourself into work; embedded in it is a desire to avoid looking at death. We've adopted a sort of “Ask, don't tell” policy. The question “How are you?” is an expression of concern, but as my dad had said, the mourner quickly figures out that it shouldn't always be taken for an actual inquiry. Around this time I read a book by a Johns Hopkins researcher in which she described an exchange, three months after her husband's death, with a colleague who asked her to peer-review an article. The researcher said, “My husband just died.” To which her colleague responded, “It's been three months.” A mourner's experience of time isn't like everyone else's. Grief that lasts longer than a few weeks may look like self-indulgence to those around you. But if you're in mourning, three months seems like nothing—going by Prigerson's research, three months might well find you approaching the height of sorrow.

 

 

My pervasive loneliness was a result, I believe, of what I now think of as the privatization of grief. For centuries, private grief and public mourning were allied in most cultures. In many places, it used to be that if your husband died the village came to your door, bearing fresh-baked rolls or soup. As Darian Leader, a British psychoanalyst, argues in
The New Black: Mourning, Melancholia, and Depression
, mourning—to truly be
mourning
—“requires other people.” To lose someone was to be swept into a flurry of rituals. In many nations some kind of viewing followed the cleaning of the body—what was known as a wake in Ireland, an “encoffining” in China. Many cultures had—and some still have—special mourning clothes. In the Jewish shiva, a mourner sits on a low chair and is visited by friends and family. In
The Hour of Our Death
, a magisterial history of Western attitudes toward mortality, which Isabel had given me, Philippe Ariès notes that until the turn of the twentieth century, “the death of a man still solemnly altered the space and time of a social group that could be extended to include the entire community.”

Why, I wondered, did I live in a world where there were so few rituals to guide me through this loss? The British anthropologist Geoffrey Gorer, the author of
Death, Grief, and Mourning
, argues that, at least in Britain, the First World War played a huge role in changing the way people mourned. Communities were so overwhelmed by the sheer number of dead that the practice of ritualized mourning for the individual eroded. Other changes were less obvious but no less important. More people, including women, began working outside the home; in the absence of caretakers, death increasingly took place in the quarantining swaddle of the hospital. The rise of psychoanalysis shifted attention from the communal to the individual experience. In 1917, only two years after Émile Durkheim wrote about mourning as an essential social process, Freud's “Mourning and Melancholia” defined it as something essentially private and individual, internalizing the work of mourning. Within a few generations, I read, the experience of grief had fundamentally changed. Death and mourning had been largely removed from the public realm. By the 1960s, Gorer could write that many people believed that “sensible, rational men and women can keep their mourning under complete control by strength of will and character, so that it need be given no public expression, and indulged, if at all, in private, as furtively as . . . masturbation.” Today, our only public mourning takes the form of watching the funerals of celebrities and statesmen. It's common to mock such grief as false or voyeuristic (“crocodile tears,” one commentator called mourners' distress at Princess Diana's funeral), and yet it serves an important social function. It's a more mediated version, Leader suggests, of a practice that goes all the way back to soldiers in
The Iliad
mourning with Achilles for the fallen Patroclus.

I found myself nodding in recognition at Gorer's conclusions. “If mourning is denied outlet, the result will be suffering,” Gorer wrote. “At the moment our society is signally failing to give this support and assistance. . . . The cost of this failure in misery, loneliness, despair and maladaptive behavior is very high.” Maybe it's not a coincidence that in Western countries with fewer mourning rituals, the bereaved report more physical ailments in the year following a death.

 

 

After my mother died, I kept thinking, “I just want somewhere to put my grief.” I was imagining a vessel for it: a long, shallow wooden bowl, irregularly shaped. I had the sense that if I could chant, or rend my clothes, or tear my hair, I could, in effect, create that vessel in the world. Five days after my mother died a man elbowed me aside on the subway and I felt bruised and angry; if I had been wearing mourning clothes, I furiously thought, he would have taken greater care. I longed for rituals not only to indicate I was still in mourning but also to have a nonpsychological way of commemorating and expressing my loss. Without ritual, the only way to share a loss was to talk about it—foregrounding the particularities of my own emotions, my own bereavement. At times, though, this sharing felt invasive. I did not want to be pitied. In those moments, I wanted a way to show my grief rather than tell it.

One reason people over the ages have ritualized grief is to perform it and thereby descant it. For most of human history, as Robert Pogue Harrison shows in
The Dominion of the Dead
, elaborate rituals surrounding death served both to express and limit its power over our minds. “By expressing grief in the various forms of celebration or cult of the dead,” the Italian philosopher Benedetto Croce writes, “one overcomes heartbreak, rendering it objective.” Ritual helps us let go of our identification with the dead. In this way, ritual can contain what Robert Pogue Harrison calls the “crisis” of grief, so that the mourner doesn't plunge into “sheer delirium.” All this clarified to me what I had been craving: a
formalization
of grief, one that might externalize it.

For I had some understanding of delirium. At my nadir, on a wintry night after my mother died, I opened up the cut on my arm—the cut I'd given myself at Thanksgiving. My entire mind and body hurt. Watching TV and eating dinner, I'd started to weep violently, almost as if someone had knocked the wind out of me. With my nails pressing deeply into the skin, I scraped open my inner arm. The flesh turned pink. I took an ivory-handled dinner knife on the plate beside me and dragged it along the healing scar. Red drops of blood welled up. It's hard to describe this now, because putting it in words seems to sensationalize it, or to devalue it. I did not want to hurt myself, or to die. I just wanted to create some embodiment of the heartbreak eating me up. And, oddly enough, it was clarifying. As soon as I did it, I thought: I need to get away for a bit. I went back to the desert, near Marfa, Texas, and while there I bought a black-and-white friendship bracelet to signify my loss, and I wore it for three months, never taking it off.