Wendy Harpham on Healthy Survivorship

Tears and Healthy Survivorship

Susan Gubar's latest entry in her Living with Cancer Series (NYTimes Well Blog), titled Shedding Tears, is filled with insights about tears and Healthy Survivorship.

Painful Platitudes

I regret the times a stupid platitude popped out of my mouth in my efforts to comfort or support. Sadly, I'll continue to screw up because platitudes are ingrained in our culture of comforting. My hope is that the more I talk about the problem, the fewer times I'll say something that mght harm another.

Dropping a Seriously Ill Friend

Nurse Carol A. Miele writes about her life with Stage IV breast cancer to help people understand and talk about the challenges many such patients face in their efforts to embrace life.

Lessons Learned from the Death of Dave Goldberg

After a tragedy, looking for life-enhancing lessons and making positive life changes give meaning to a seemingly senseless event. So what can we learn from the accidental death of Dave Goldberg, who suffered fatal head trauma and hemorrhaging while exercising on a treadmill?

Letting Go Part V

10 days ago, I promised to write about "letting go" and grief. Ironically, since then I've had to let go of blogging. 

Newtown Massacre and Healthy Survivorship

What does a Healthy Survivor do about the constant news coverage of the Connecticut massacre? 

How We Die: Natural Law

Dr. Nuland opens Chapter 2 of How We Die saying, "No one dies of old age, or so it would be legislated if actuaries ruled the world."  Later in the chapter he introduces a perspective on aging that can serve Healthy Survivors well.

What a Difference a Letter Can Make

When young parents are dying, they face the loss of everything they know and hold dear. Arguably their greatest pain is losing the chance to raise their child(ren). To help such parents find hope in desperate times, I offer a suggestion:

Relieving Major Depression in Cancer Patients

An Oncology Times article caught my eye: "Relieving Major Depression in Cancer Patients: Specific 'Biopsychosocial' Method Found Useful."  It reviewed a study that addressed the impact of an intervention developed to treat depression, reduce stress and help patients develop coping strategies.

To Survive with Cancer

James C. Salwitz, MD doesn't use the term Healthy Survivor. Still, the story he tells offers a name and face to the idea that patients in difficult circumstances can find Happiness in a Storm.

Grief and Acceptance - Conclusion

Sometimes I fear saying the wrong things when trying to comfort a bereaved friend. The temptation to say nothing can be strong. So to conclude this series on grief and acceptance, I've decided to share a recent letter to a friend. 

But first, I want to mention that I expect to continue learning, gaining insights that will help me find gentler, stronger, more comforting words for future letters.

When I wrote the letter, it was the best I could do with what I knew then and where I was at the moment. Both my writing the letter and my sharing it here reinforce the notion that the best we can do is the best we can do. And the best is good enough.

Dear Friend,

If only we had access to an easier, less painful path through grief that heals. We can escape the pain of an incision if anesthetized while the two sides of the wound knit nicely together. In contrast, loss of a love causes pain, without which healing doesn’t progress.

The "medicines" that ease the pain of grief are facts and hope. May you find help in the knowledge it will not always be like this and that your pain reflects having enjoyed true love. May you find comfort in the hope that you always feel his love and that someday soon you begin to feel more joy than pain when remembering him.

I wrote the essay (below) after the death of a treasured colleague in the prime of life. For me, the message is applicable to the loss of a love of any age. I hope you find it comforting in some small way as you remember your loved one. May his memory be a blessing.

Patent Pending: The Measure of a Life

"So young!" I cry. "Too soon. Cut short, it feels. How could this be?"

The teacher nods sympathetically and then drops a hint, "Your measurement is wrong."

"You're wrong!" I think to myself, trying to hide my anger. "My numbers add up perfectly, every way I count them. I can calculate to the minute. To the second, if you like." I think longingly of all the days that he might have had, the dreams now gone forever. "I'm sure my numbers are accurate," I say, my veneer of calm slipping. "Which is why it's not fair. Not right. Surely, a mistake."

The teacher once again nods, “Your readings are correct, but look at your yardstick.”

"My ruler?" Suddenly I remember an afternoon in my youth when the world was a wonder and I was thirsty. I demanded the tall slender glass, absolutely sure it held more juice. When handed the stubby tumbler, I was furious. I got less, I protested. It's not fair! So my mother poured the contents of each glass into side-by-side identical measuring cups. At first, I thought it was a trick. Or magic. Then I saw I was wrong. Just as the difference in height of the orange menisci had disappeared, so, too, did my anger. I was once again happy, my thirst quenched. And thereafter I knew: My mind can deceive me if I use the wrong measuring tool.

"So how does one measure a life? “ I ask.

"Not by how many, how quickly, how far. Not by how much.”

"Then, how?"

“Yes. How.”

"How?“

"What matters is not what one does, but how. With purpose? With loving kindness?”

"Can I know the heart of someone who is gone? How? “

"By focusing on the imprint in the sand or the ripple in the pond.”

I don't understand.

“When an artist is done, do you measure how much paint is on the canvas or how long it took to put it there? Do you add up the notes on the score or the words in the book? Stop counting the number of nails the carpenter used and stop looking for the price tag on the curtains if you want to see the home in the house.”

I'm beginning to see that mournful measuring can lead me away from truth into anger or despair. "So, please, tell me, I yearn to know, the reproducible irreducible measure of a life. Is there such a thing?"

“You want a unit, like an inch or a pound?”

"I want to know the measure of a life."

“I told you that one way to measure is by looking at what's left behind. There are other ways, but they all require faith.”

"Faith? “

"You must believe—have trust in measures that are unlike inches or pounds. And then you can know.”

"What other measures?“

"A measure that convinces you Michelangelo's meticulously painted Sistine Chapel and Picasso's Dove, created with but one deft brush stroke, are both masterpieces. A measure that assures you an eight-year-old child's Haiku is as complete as Moby Dick. A baby's giggle? As glorious as Beethoven's Ode to Joy.”

"Does this measure count heroism? Quiet acts of fortitude? Generosity? Honor? Duty? Beauty? Does this measure weigh-in love?“

"A single kiss can be eternal. But beware: All that glitters is not gold. Measure wisely and you won't be fooled.”

My desire for a measure reminds me of a time when I was a doctor and needed an exact weight of one of my patients. I can still see my old office scale: the stand-up kind whose big round face had numbers around the edge except at 12 o'clock, where two words marked the spot. I can still picture my patient lumbering onto its platform, his weight far exceeding capacity and forcing me to look elsewhere for my answer.

Yesteryear's exasperation is today's comfort: Were my friend to step on a scale-of-life, he would surely, as did my patient, send the needle spinning wildly—once, twice—before it slowed down to a stop, the tip of the arrow pointing to Patent Pending.

Grief and Acceptance - Part XI (Mattering)

Thinking about loss and grief, I have three postulates:

Grief and Acceptance - Part IX (Time)

A reader commented on my last post, eloquently sharing his hard-won insights about grief. In doing so, he highlighted an important element of grief: time.

Grief and Acceptance - Part VIII (Struggle)

Since my February 11th post, I've been thinking about the idea that grief reflects the struggle to hold onto what has been -- or soon will be -- lost. For me, it's not that simple.

Grief and Acceptance - Part VII (Striving)

Most of this series has focused on grief at the end of life. But grief also plays a role in Healthy Survivorship at the time of diagnosis and  evaluation, treatment, recovery and long-term survivorship.

Grief and Acceptance - Part VI (Distress)

To understand how to address the emotional distress of terminal illness, let's look at the relationship between "peace" and "struggle" at the end of life (EOL).

Grief and Acceptance - Part V (Promoting Acceptance)

The preceding four posts on grief and acceptance set the stage for a closer look at how patients can be Healthy Survivors at the end-of-life. In other words, how can you both get good care and live as fully as possible after a diagnosis of terminal disease?

Grief and Acceptance - Part IV (PEACE tool)

The preceding post discussed grief experienced in the setting of bereavement. Let's return our focus to grief and acceptance at the end of life.

Grief and Acceptance - Part III (Prolonged Grief Disorder)

A blogger commented on part I of this series, "One friend, after five years of grief and going to therapy is still grieving, and it is hard for me to deal with what to say to her." Is this normal?

Grief and Acceptance - Part II (Realistic Goals)

Yesterday's post linked to an editorial by two well-credentialed psychiatrists with special interest in end-of-life care. Their studies led them to consider grief as "the state of emotional unrest and frustration associated with wanting what one cannot have."

Grief and Acceptance

Illness is often associated with loss, even when the medical outcome is excellent.

Since prolonged grief is associated with distress and dysfunction, an understanding of healthy ways to deal with loss may propel patients' pursuit of Healthy Survivorship -- and happiness. Reading a 2008 editorial in the British Journal of Psychiatry might further this understanding.