Being a cancer doctor, I thought I knew a thing or two about grief. Beyond my professional experiences, I lost close friends in an accident when I was a newly qualified doctor - grief was something I shared with my friends at the unexpected age of 24.
I am now in the middle of messy, aching grief. Just over two months ago, my father was diagnosed with cancer, and he died a month later. In the month that followed, we went on to lose two other close family members. It feels a little like we are bathing in grief.
Losing my dad feels somewhat unreal, probably because I've only just scratched the surface of what it means to have lost him. We have all read notices like this - died at home after a short illness. You realise who can read between those lines, and imagine the struggle that went on behind the scenes to achieve that brief, peaceful sentence. As a doctor, and a cancer doctor at that, it was to live a double life. It was to have the world's worst insight into the future, to know what was coming, to know what it would look like, to know what needs to be done (and how to ask for it), to feel both powerless and responsible. Of course all of that can't prepare you for the reality of it all. The truth of the struggle is hard to put into words. What to say, and to whom, and when. People imagine that as a doctor, you have this ability to override things, but that suggests that our families are passive, unintelligent people who don't want to have agency and autonomy, and that we function in isolation rather than the necessarily multi-layered system of healthcare. The bottom line is you are traversing this divide of supporting those most precious autonomous principles whilst trying to steer things with your professional skills and knowledge. Anyone who thinks that is easy - well, let me tell you, it is not. The result is constantly second guessing yourself, worrying that you are doing too much or not enough, and ultimately whatever you do will never feel adequate. It is a sort of trauma.
Grief right now does not feel beautiful or wonderful, nor did it during my dad's final days. I am grateful for friends who sit at ease in that space with me, without sugar coating it in magical or romantic words. The thing about grief that I resent the most at the moment is my inability to embrace unfettered joy in other people - I resent this for how selfish and mean-spirited it seems. Sometimes I can play pretend, as I suspect it's a bit of a self-fulfilling prophecy - you can't feel joy if you don't at least try to share in it. Sometimes it is easier to share these selfish musings with friends who have overcome, or are overcoming, some sort of adversity themselves - I find when I confess these feelings, they confess the same. That doesn't mean I don't want to hear about the happy things happening in friends' lives. It's just that I can manage it in a trickle rather than a flood. I know that sounds terrible, but perhaps these are helpful things to understand if you, dear reader, are wondering how to approach a grieving friend. It's also important to hear about the struggles. I think people might feel they shouldn't share their difficult times in fear of overwhelming me, or feeling they are trivial, but quite the opposite - it gives me an opportunity to be a friend back, and that is also important. Friends are getting me through these times - what helps is the regular timbre of daily life, feeling included in things, being invited in a very specific way, even if the answer is sometimes no. When I visited my best friend a few days after dad died, there was something wonderfully regular about the fact she had to spend the first twenty minutes frustrated on the phone to her internet provider, leaving me to mooch around her new house and make us a brew. It makes you feel that friends are not afraid of you, that life will go on, and that you are a part of it.
One of the errors I made, along with many of my peers, when we lost our friends in 2013, was to think I was somehow indispensible in my work. My whole professional world, both research and clinical, is cancer and my life was full of it. That all seems so far away right now. I had one day recently where the sum achievements of my day were emptying the dishwasher and doing some laundry. I am exhausted all the time. I can find joy in meeting with a friend, and indeed I endeavour to get out of the house every day to do *something*, but it's hard to stress enough how far that is from my usual daily routine. People have told me not to feel guilty about this - I don't, because I can't. Losing my dad is one thing, but when other bereavements follow so closely, you start thinking every time you pick up the phone that it will be bad news. By extension, it feels like good news is something that only happens to other people. A handy thing about working in the field is that you have to explain very little to your colleagues, and people can imagine what you're facing without your having to verbalise a great deal more. I made errors in not seeking help in 2013, and I think as a result felt resentment and anger towards the system for not seeing my pain. I remember being told at the time by someone senior that 'these things happen', and being made to feel spectacularly invisible when grief caught me one day in front of clinical team members. This time I have accepted my professional dispensibility, and have been warmly supported by my GP, seniors and supervisors. Kids, this is a lesson for life. Work somewhere that supports you the way I have been supported. I suspect it's a longterm win for all concerned. It's really made me appreciate the fantastic teams in which I work.
It's taken a while but I've begun to find it helpful to read what others have written about grief. My best friend directed me to the Reverend Richard Coles - however, it was accidentally hearing him on a BBC Radio 2 programme one evening that I actually listened to him speaking about grief for the first time. To my surprise, there was a form of relief in hearing someone else describe feelings to which I could relate. He describes grief not being the 'work of a moment' - people want to ask if he is getting over losing his husband, and that this isn't something you 'get over' - it's more like getting used to living with the feeling. The importance of friends - and being surrounded by love, friendship and patience. The grief of the future actually being the greatest unpleasant surprise than that of grieving the past. I can relate very much to all of these - and by extension I feel these emotions on behalf of others grieving my dad, which feels like an additional sadness. Facing grief for me must involve talking about it - and for this, Maggie's has been absolutely amazing. It is a tremendous thing to have somewhere to go where it's just about 'you' - you don't need to ask beyond the usual social niceties about the other person - and frankly have a good cry, as I have done every time I've been there.
I'll conclude these musings by saying that I don't think this experience will make me a better doctor and oncologist - I hope I was compassionate and empathetic before all of this happened. Rather, taking time to digest everything is in hopes that I remain inquisitive, enthusiastic and passionate about working in cancer. I am grateful to each and every person who has walked these last few weeks with me. I am lucky to have a family who have supported each other so completely. I await what this journey in grief next has in store for me.
