NPR TED Radio Hour Podcast: What can grief provide us?

My NPR TED Radio Hour podcast episode has dropped! 🎙

In this podcast, Manoush explores a few TEDTalks connected to the topic of Heartache. Starting at 27:00, my interview with her explores some of my bittersweet experiences as a nurse and the hard-wrought lessons grief has brought about over the years in this profession.

I can think of no other time in our lives when we as an entire world have experienced sorrow, heartache and grief as a collective whole for over 1.5 years. I hope a bit of what I share here is an encouragement, a balm for our weary souls.

You can listen to just my segment alone here, find the entire episode here, or you can click below and listen through Spotify.

Grief and the Good and Hopeful Life


In my last blog post, I took a birds-eye view with some thoughts on why we don’t know what to do with grief. I’m not trying to talk us out of grief by rationalizing. It only makes sense that we don’t readily know what to do with grief. It can hurt like hell. Its existence means something has gone dreadfully wrong. There are moments where it feels completely dark; I’ve known those moments myself. But perhaps it’s for those very reasons that I think it’s important to look at it from more angles than the typical ones we come at it with.

In this blog post, I want to spend some more time on my final thought in the previous post: We struggle to see what a good and hopeful life can look like with grief always present.

This isn’t to deny the permanent wound a significant loss can leave on us; life will never be as we knew it. But with social media feeding into the rather narrow (read: curated) ways we define a good life which often include some version of lying carefree, young and beautiful on a luxury vacation, it is no wonder that we can feel almost doomed once significant suffering or loss find their way into our lives.

What are we doing to ourselves – and to each other – when we primarily define a good life as one that involves minimal heartache and tears?

What we do when we define a good life in a narrow, idealistic way

We live superficially and don’t allow ourselves to be challenged to consider what can make for a meaningful existence even when circumstances are deeply painful and far from ideal.

We miss out on a certain depth to our perspectives and our care for others that can really only come through wrestling with harder questions and circumstances.

We create a divide between perceived haves and have-nots, further isolating those who are suffering and compounding their sadness with despair.

We set our hope solely upon ideal circumstances that aren’t guaranteed to hold up, and this lays shaky ground for our long-term sense of well-being.

What we can do when we learn to broaden the definition of a good and hopeful life to one that includes grief

We can discover a different and more solid foundation for life – a process that is, quite frankly, work. It’s built through a process of dismantling old foundations that might’ve been easier to establish, ones that are sufficient for effortless days but can never hold up in the storm. It’s built with hammering, fire, sweat, tears, questioning if it’s worth all the cost and effort. But in the end, the new foundation holds solid, firm, unshakable when everything else is shaken. It can be terrifying to build and test, but it ends up providing the greatest sense of security we could find.

We develop an intimate understanding of hope beyond ideal circumstances where there was once ignorance.

We are less intimidated by people who are suffering and develop more capacity to share space with them without feeling desperate to sugar coat the conversation.

We discover deeper and more authentic community. Is it not true that when we are hurting, we gravitate more towards those who have been through similar heartache and less towards those who seem to have never tasted hardship? Our ability to truly know and be known by one another grows in new dimensions through shared suffering. My richest and most significant relationships are with those who have shared their grief with me and who have borne mine as well.

I wish grief upon no one, but we do ourselves such disservice when we pretend that we can or should avoid it throughout our lifetime. Its reality is sobering, but its reality also does not automatically mean a good and hopeful life becomes unattainable for all who experience it. Without discounting the very real pain that suffering brings, my years of being an ICU nurse and my own encounters with personal grief have taught me that in some ways, those who wrestle hard with grief are the ones who find a deeper understanding of what a good and hopeful life really mean.

Why We Don’t Know What to do With Grief

(Taken from my nursing blog, http://heartofnursing.blog)

In my recent interview for an upcoming NPR TED Radio Hour podcast (9/17) on “Heartbreak,” the host, Manoush Zomorodi, asked a series of insightful questions from many angles about my experiences with grief over the years as a pediatric ICU nurse. Those questions have sparked many thoughts that I believe are worth exploring and sharing in a series here on grief, with hopes that we can take a closer, courageous look at grief and reframe our perspective on it during a time when we are all feeling it perhaps more than ever.

Unfortunately, recent world events give us countless issues to grieve on many levels. Please note this blog series will primarily focus on grief and loss more on the individual/personal level, though I think some of these ideas will be pertinent to broader societal issues.

And with that, the first thought I want to tackle is: Why we don’t know what to do with grief.

Before we tackle some reframing of grief, I think it’s important to consider why we run for the hills from it before we even give it a chance to just be a normal part of our lives.

Denial of its possibility is ingrained into our culture from day one.

I’ve lost track of the number of times I’ve heard or said myself, “I just thought that happens to other people in other places, not to me, not to us here.” Our blind spots to the assumptions we make about life as people in a wealthy, powerful nation profoundly shape our shaky personal response to real suffering, loss and grief.

We are a culture obsessed with convenience and easy fixes. Any ICU nurse (that’s me) can tell you how much we love our easy fixes to life’s pains and problems (hello, all the medical interventions), but also how powerless and detrimental some presumed fixes can actually be (again hello, all the medical interventions). We just keep assuming we can always find a way out of our grief, if not avoid it altogether.

Grief is too closely associated with negativity.

This is a tricky statement because there is obviously some connection between the two. But sometimes “toxic positivity” is completely out of touch with reality, and grief is more in touch with reality than we care to admit. You can have days of intense grief and intense negativity, but they don’t necessarily go hand-in-hand. You can also have days of intense grief and also have solid hope. Because we have such a hard time recognizing this, and we are a fix-it culture addicted to “positive vibes only,” we are strongly tempted to reply to someone’s healthy, normal grief with “At least you…(can still have another child),” or “You should just be thankful that x, y, and z.” This actually ends up invalidating and somewhat shaming what is actually a normal, healthy response of grief to a real loss. We think it’s necessary (and even possible) to somehow cancel out the grief by diverting attention to some more “positive” thing over there, instead of giving healthy space and permission to cultivate and process normal grief.

In other words, we only know how to battle negativity by trying to shut it down, which in most cases is probably wise to not indulge it too much. Unfortunately, because we almost automatically associate grief with negativity, this means we typically respond to grief by trying to squash it as well, even when its manifestation is actually a very healthy thing.

We struggle to be quiet and patient with hard questions.

With Google Search at our fingertips, we are more accustomed than we realize to having all the seemingly hard answers so readily accessible. Will my children growing up in this Internet age really even learn to think for themselves? It is in many ways a gift to crowdsource knowledge and have others do so much of this hard work for us. But when it comes to grief and loss, which are so intensely personal and complicated, we have to do the work ourselves of wrestling with the hard questions grief often raises, and this feels daunting because we simply don’t practice it much day to day. We deeply resist the discomfort of having our worldview and our assumptions of how life “should” operate be so profoundly challenged, and often prefer relief and escape from that discomfort over working towards the building of a different, deeper life foundation.

We don’t know what to do with things that cannot be explained.

Even as we work through hard questions, there remain some things that cannot be fully explained. There may be a medical explanation, coroner’s cause of death, but there are other types of answers we often search for that we simply won’t find in their entirety. Our need for control and power chafes against this. But when I’m suffering, it’s usually not clear and specific answers that actually soothe my soul. As the wise singer/songwriter Rich Mullins once sang, “And I know that it would not hurt any less…even if it could be explained.” When I’m suffering acutely, I find the most comfort in having space to lament, being accepted and embraced as I am by safe loved ones, and being helped to just take the next step forward when everything else about the future seems too murky or overwhelming.

We struggle to see what a good and hopeful life can look like with grief always present.

This, I think, is key, and will be the topic of a future blog post. (Note: it won’t be a blog post with answers, per se, but an exploration of what we do to ourselves and each other when we only define a good life in a narrow way – and what we can do for ourselves and each other when we learn to broaden that definition of a good and hopeful life.)

Thanks for reading this far. I would love to hear thoughts, comments, disagreements, as long as they stay civil and productive.

Columbia University Narrative Medicine Volvox Presentation

Please join me, the editors of “The Healer’s Burden: Stories and Poems of Professional Grief,” and two other contributors to the book, Lara Ronan and Rondalyn Varney Whitney, for a virtual panel discussion in the upcoming Columbia University Narrative Medicine Volvox Presentation on Wednesday, October 28th, 2020, from 7-9 pm EST / 5-7 pm PST.

I and the other contributors will be reading our pieces, and then we will have a discussion about the incredibly important and pertinent topic of professional grief in healthcare workers.


I can think of no other year when this conversation matters more.

You can find the link for registration and other info about the book here.

https://healersburden.com/upcoming-events/

Pre-Order Available: The Healer’s Burden

I am beyond thrilled to share that this book I had the privilege to contribute an essay to, The Healer’s Burden: Stories and Poems of Professional Grief, is now available for pre-order. My essay is titled “Silent Intercession,” and I am so looking forward to slowly making my way through the rest of the pieces.

Here is a description of the book from the editors:

What is Professional Grief?

Ignore. Suppress. Hide. Work in high-loss healthcare environments commonly demands turning away from one’s interior experiences in order to rapidly turn toward the next patient. In a culture that discourages vulnerability, how can a care provider effectively deal with the challenging emotions that naturally arise when faced with death, especially now in this critical time of pandemic? Thankfully, The Healer’s Burden: Stories and Poems of Professional Grief makes a space to tend this occult grief, and not a moment too soon. In a broad array of artistic and accessible perspectives, healthcare workers from multiple disciplines bravely pull back the curtain on their experiences of loss. Despite delving into death, The Healer’s Burden eschews the twin traps of despair on the one hand and platitude on the other. Using principles of narrative medicine, the editors catalyze a much-needed conversation about professional grief by including thoughtful questions and writing prompts. This book is a must for educators and clinicians alike who wish to constructively engage with rather than avoid their experiences of patient death.

With a foreword by Rana Awdish, MD, author of LA Times best-selling memoir In Shock:
“Reckoning with grief is no small task. But ignoring it is no longer necessary. ”

I can’t encourage you enough to buy this book, and share it with the healthcare professionals around you. It’s such an important time for us to bring this conversation to light in this extraordinary year that is 2020.

what I wish I could heal as your nurse

Would you give me permission to tell you

without overstepping my bounds, personal, professional

that this is not your fault.

You were only trying to take good care of your baby;

you didn’t know,

you didn’t know.

 

I see the protest in your eyes,

Someone has to be to blame, and that someone is me.

If I had known, if I hadn’t done this, if we hadn’t done that

our baby would still be alive.

 

How can I help loosen the grip that this mistake

threatens to hold over your life?

Would you give me permission to tell you

Can I tell you, you are still a good mama

Can I tell you, you are still a good papa

 

Can I tell you, your baby would forgive you too if he had the words;

of this I am sure.

 

Can I tell you, he knew you loved him to the very end.

Your tears baptize him

and your blessings flow

 

and flow

 

and flow.

 

No Ordinary Sunday

The readjusting back and forth between intensely challenging nursing shifts and everyday normal life is a real thing to navigate. It still catches me by surprise every time, how hard it really is.
I am in the thick of a full 12+ hours of trying to manage chaos and logistics in a unit full of very sick patients as charge nurse. In the blur, I am stopped in my tracks by moments of seeing family members who had literally just a minute ago received devastating news. A mother weeps, clutching her child’s teddy bear to her chest. The teddy bear is caught in this strange in-between of what was, and what now is. And then just 30 minutes later, I see the next set of family members with the same, but profoundly unique, broken expression.
I don’t want to grow overly accustomed to that expression on the family members’ faces and what it means. Yesterday held neither the appropriate time or space to let the stories sink in, to let me pay respect to the stories by allowing a human emotional response to all that they hold.
They always hit the next day. I work every Saturday, so often it’s Sunday at church. I’m catching up with friends I haven’t seen in a week. I want to hear about their life and their own joys and burdens. In the pit of my stomach I am nauseous with sadness over the stories that are hitting me. I am singing songs about hope, redemption, and joy, and it is in the practice of trying to form truthful words with my lips that I find the rubber hits the road with what faith in a good and loving God really means. This happens every Sunday for me, this small crisis of faith, as I am reconciling everything I have seen just the day before at work with everything my soul aches to sing with conviction on an ordinary Sunday at church.
I am chasing my healthy children in the church courtyard, taking in the gift that these ordinary moments are – to be able to just chase my healthy children at church. In my mind, I find myself reverently asking the parent next to me, “Isn’t it incredible…that we are here, watching our children play?” But I realize how odd that would sound. I am trying to catch up with friends after a week apart. And I am trying to decide whether to speak of my nausea and sadness, my mini crisis of faith, my weekly reconciling at church of what hope and joy look like for me, what they look like for the families with that indescribable expression that I left at the hospital yesterday. Do they look the same, or are they altogether different? Should they?
This is the navigating that I do as a nurse, between ‘work’ and ‘real life.’ They seem so entirely opposed and contradictory to each other, and yet so deeply and profoundly connected.
There is, for me, no ordinary Sunday.

TED-Ed Lesson for TEDxTalk “How Grief Can Enable Nurses to Endure” is now available!

For all nurse educators, managers, leaders, bookclub facilitators, or bedside nurses looking for a guided way to talk about work-related grief with other nurses:

I have created a new TED-Ed lesson based on my original TEDxTalk, “How Grief Can Enable Nurses to Endure.” It includes some introductory prompts allowing for people to share about their work-related grief experiences as well as their perspectives towards grief. The lesson then provides additional insights and references to other authors who have addressed grief and self-care in less traditional ways. Finally, the lesson concludes with closing discussion prompts to help participants consider how they can begin reframing their perspective towards work-related grief in nursing.

Participants do not currently need a TED-Ed account to participate in the discussion, as my desire is to reduce all barriers for voices to be heard in this conversation.

Please share this lesson with nurses, nurse leaders, managers, administrators and educators. It is my deep conviction that these conversations need to happen for the betterment and well-being of nurses who regularly encounter suffering, death and dying, and all the accompanying emotions.

Click here to access the lesson, and thank you in advance for contributing to this vital conversation!

A Strange Gift

Warning: This post is a bit on the heavier side, especially compared to the silliness of my recent conversations with Siri.

Yesterday was the first time I’ve ever done post-mortem care on a little patient, minus the partial experience I had as a nursing student a few years ago. Surreal hardly begins to describe the experience, from cleaning up a messy room that bears witness to the intense activity involved in coding a patient, to making eye contact with parents who are absolutely raw with grief, to bathing the patient in order to restore some small sense of dignity, to wrapping the patient with a shroud and bringing the patient to the hospital morgue.

Surreal. But it is part of my world. Our world, whether we choose to acknowledge it or not.

I was drawn to ICU nursing because I have a strong appreciation for the depth of issues that we face there, and I see it as an incredibly precious time to be a support for not only the patient but their grieving family members as well, particularly when we are dealing with end-of-life care.

But the weight of it all is substantial. The quiet entrance into a room full of grieving family members is the entrance into a space that has just suffered the most violent of all emotional earthquakes, looking for a foundation, is there one left? A space full of disappointment beyond measure but sometimes also hope, anger but sometimes also peace, and exhaustion… always exhaustion. After all, it takes everything you have and everything you are to say good-bye to the heart of your own heart. It takes all your being to search for light in a very dark place. This is the space that I entered as a nurse yesterday. What could I bring? What could I bring, and would it change anything in this space?

I could bring juice and crackers to parents who have thought very little of their own needs for hours, days, weeks, months, years.

I could clean up the room, quietly, gently, respectfully. There are some parts of saying good-bye that you just don’t need to remember, especially in an ICU. I could reduce the sense of chaos in some small way. I wanted such a clean room for them.

I could bring silence. Of course if they had questions, I would do my best to answer. But in terms of consolation for newly grieving parents, I am convinced that less is more. Maybe I say this out of my own lack of tolerance for pat answers. The movement towards resolution with our suffering is simply not as neatly packaged and bow-tied as some might have us think, and I am convinced we need to learn how to get more comfortable with being really uncomfortable in the gray areas – even as people of faith. I am convinced that the gift of silence to a grieving family is the recognition that they have now been thrust into an extremely uncomfortable, gray area, where they will likely stay for a very long time. Trying to move them out of it with premature clichés is counterproductive and potentially very hurtful.

I was so thankful for the accompaniment of an incredibly tender-hearted, skilled social worker who truly bore the brunt of the family’s grief yesterday. I told her how thankful I was that she was there, and that she did what she did so well. Her response was inspiring, sober, and honest. “Some of us are just gifted for this. And it’s a strange gift to have.” I am not an expert. I am awkward and new and scared as a young nurse facing these kinds of big issues. But by the grace of God, I believe I am gifted and called to this work. And I could not agree more. It is a strange gift to have, but it is mine, and it is what I have to offer.

Reblogged: Can Grief and Joy Coexist?

I deeply appreciate the honesty of this blog. I have lost my stomach for pat answers laden in overspiritualized vocabulary that invalidate the reality of what people experience when life is just honestly, hard. I have a deeper hunger for something both honest and real when we talk about joy in Christ, because of Christ. The same Christ who knew the Father was good, loving, and in complete control when He was broken on the cross and asked why He had been forsaken. He knew He wasn’t back Home yet, and He knows we are not either, not yet. This is the Savior I love, in whom I hope and in whom I can rejoice.

Clearing Customs

There is a phrase in Mandarin Chinese, bei xi jiao ji (悲喜交集), meaning “mixed feelings of grief and joy.” Grief and joy aren’t commonly thought of as partners, but when faced with loss, cross-cultural workers need to understand that one doesn’t necessarily cancel the other one out.

Expressing Grief

Dr. Steve Sweatman, president and CEO of Mission Training International (MTI), says that the call to take the gospel of Christ to another culture “inevitably is a call to sacrifice, to losses, to things that you will have to leave behind or give up.” This sacrifice takes many forms, and MTI has identified five categories of loss experienced by Christian cross-cultural workers. They are

  • a stable home
  • identity
  • competence
  • support systems
  • a sense of safety

In an audio presentation at Member Care Radio (entitled “Good Grief“), Sweatman also discusses the differences between concrete and abstract losses felt by cross-cultural…

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