Grief Coronafied, Redux
This column went to print in its original form in July of 2020. Since that time I have been privileged to hear many heart wrenching stories of loss from COVID-19 and from other calamities, stories that my patients and friends have entrusted to me and that I will carry with me always. I love to hear about the triumphs my patients celebrate, but I also feel so very fortunate when they trust me to share their grief. As we ready ourselves to celebrate a joyous holiday season, I wanted to remind us one more time that for some, this time is hard, challenging and covered with a glittering veneer of deep sadness.
You are all familiar with the five stages of grief, made famous by Elisabeth Kubler-Ross. They are denial, anger, bargaining, depression and acceptance. We have heard about these and thought about them in many contexts over the years, most commonly in the face of the death of a loved one or some similar loss that broadsided us, left us reeling, and engaged our brains in trying to find any way possible to reverse the course of the terrible events we were experiencing. We’ve all been there. Think back to a time that you suffered a major loss. Think about how you felt, deep down inside, how your thoughts organized themselves, and how you really did ponder the possibility of magical thinking.
A few things about these five stages before I get to my observations today. Read more detail about this subject at https://grief.com/the-five-stages-of-grief/. First, they are meant to be guidelines, or guideposts to the process of grief, not a rigid system of hurdles that one must jump over in a very specific way in a specific timeframe. People grieve very differently from their fellows. I have worked with patients who lost spouses and were truly happy and content after one month, and with parents who lost a child and never really finished the traditional grieving process at all before their own deaths. Next, not everyone goes through them the same way, in the same order, for the same amount of time. We process things differently. That being said, many things have popped up over these past twenty two months that have made me rethink these five stages in the context of the coronavirus pandemic.
First, denial. Must I get political here? No, of course I won’t, as that is not the reason for this column. Suffice it to say that none of us saw this coming, at least in real time. Yes, people like Bill Gates and others have made speeches and written books in the last decade that foreshadowed this event, but when the actual virus that causes COVID-19 burst on the scene in December of 2019, we were simply not prepared. We heard about it, thought about it briefly, thought about how far China is from where we live, and gave it little more attention. Government leaders, policy makers, medical professionals and ultimately all of us thought to ourselves, No, this could never happen here. We will be fine. Nothing can harm the greatest country in the world with the best healthcare system in the world. The greatest difference between the denial that defined us early on in this pandemic and the denial that happens when a loved one is suddenly lost is that we did not know enough about what we were about to lose. We could not see the horses of the apocalypse galloping our way. We did not know enough to be able to deny in the way that helps a grieving person, or nation, survive. We denied in a way that made us blind and lost us precious time, time that could have mitigated the fallout from the disaster. Coronavirus was so stealthy that early on, we did not even know what to fear.
Anger. It’s here. How on earth did it get through our borders and start to move across the United States? Who was responsible for this growing fiasco? Who can be blamed for this? Anger is usually an anchoring emotion, one that gives pain and hurt and loss some structure that makes it helpful. Not so for this scenario, when the thing that invaded us and started to make us sick is so tiny that we cannot even see it. How do you get angry at something you cannot see, touch, confront, look in the eye? So what do we do? We find a surrogate. We get angry at the politicians, the healthcare policy makers, the manufacturers of goods that are in short supply, the people who do not look like us. Our anger is righteous and mighty and backed by allegiance to religion and party and ethnic group and geographical section of the country. The problem with that is that the coronavirus does not respect any of those things. It is happy to infect and spread in those who are angry just as easily as those who are still in denial, maybe more so.
Bargaining. If only I could get my loved one back, I promise that I would wear a mask twenty-four hours a day and respect physical distancing and wash my hands twice an hour and … When we know we are stuck, that things have happened that we have no control over, we will often go back before the event and try to reconstruct it in our minds. What could we have done better, sooner, faster? What did we miss? If just given the chance, we would “get it” this time and make the right decisions, perform the correct actions that would prevent the grief and heartache that we now deal with. We want to make it right, make it disappear, make it hurt less, and at least in that moment we are willing to consider almost anything that would accomplish that for us. Why is it so hard to bargain in the time of COVID-19? Because we hope we are in the latter stages of a pandemic that has no well-defined parameters. We still do not know the end game or what this is going to look like when it’s over. Even if we figured out what we could have done differently or better, it’s much too late. Sometimes, when we realize this, it can lead us right back to anger, or…
Depression. When we realize that the loss is real, that the new normal is not anything we would have voluntarily chosen for ourselves, we go numb. We feel empty. We are sad, at everything and nothing at all. We are truly grieving now, realizing that this situation is here to stay, perhaps for a very long time. It has been twenty two months and counting. In this pandemic, we have suddenly been thrust into a situation where we are distrustful of others, where the things that normally give us solace might now be dangerous and where we get conflicting information that makes it almost impossible to know what to do to keep ourselves safe. Some of us become quite depressed and even suicidal , but it is very important to know that what the vast majority of us are feeling, the confusion and fear and sadness and lethargy, are normal responses to a very abnormal set of circumstances. Circumstances that have not really existed in similar fashion for over one hundred years. This will end, as all pandemics end, but our lives may be affected in profound ways that persist for a very long time. Once the sadness starts to lift, the realization that we must find new ways to cope, to love, to learn and to socialize will drive us to make positive changes in our lives that will see us back to some sense of normalcy.
Lastly, we will enter some sort of acceptance. This does not mean that we like what has happened to us. It does not mean that we embrace it wholeheartedly with a whimper. Not at all. We can go kicking and screaming into the rest of 2021 and on to 2022, but into that time we must go. We may lose some of the things or people we loved. We may not be able to do things the way we did in 2019. We may have to change the way we experience our relationships. Once we allow time for the grief over the losses that we all surely feel right now, then we can begin to heal and grow again and experience joy.
My daughter stated it very well in a post to social media that she gave me permission to share with you.
“How do I use this time, or at least sit in it without feeling sorry for myself, waiting on a normalcy that may never return? I exercise some control over the controllable, I will try to change what I can, I use creativity to stay connected and move forward when it may feel easier to be isolated and stagnant. I will love my friends and family fiercely and extend grace freely, to others and to myself. And while I may not mean it every time I say it, I’ll keep saying it. Everything really will be fine.”