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The Totally Obvious but Still Totally Shocking

The other day a friend and I were talking about how so many people we know have been dealing with hardcore struggles lately. Some of this has to do with patterns inevitable to our age group, fifty-somethings having heart attacks, strokes, giving care to eighty-some-year-old parents, etc., though the suffering seems more to arise from a dark or negative synchronicity than just "old people problems" in this case, as if the pandemic may be on the wane (sort of) but only in the COVID-19 sense, while a shapeshifting Dark Night of the Soul has replaced it, randomly tapping on our friends' and family's shoulders and saying, "Got some bad news for you. Now look in the mirror... who are you anymore?"

Among the many musings that came up in conversation was the shock that strikes us when we face a catastrophic life crisis. This upheaval can take many forms, of course, but always involves some devastating loss, whether it's a child, pet, marriage, job, parent, ability, or some other relationship or function that defines us. Now, when cancer plays a major role in the turmoil, it seems logical to suppose that someone would be less shocked by the outcome than if they had lost a loved one to a sudden event like an aneurysm or automobile accident. But having experienced both types of loss, I can say this is probably not the rule for everyone, even though it makes perfect sense. I bring this up because I think the relationship between cancer and shock as a grief reaction says a lot about the depth and variation of humans experiencing bereavement.

Now that nine months have passed, I have been thinking often of the mindset that Kara and I cultivated throughout her cancer journey.... and the effects it had on both of us.

Without going too deep into the subject, we decided to shoot for the impossible at every step. This was how Kara wanted to live her life, regardless of how drastic the treatments might get or how disappointed she might feel with a turn in her cancer forecast. She would often tell people in and out of the medical establishment to let her manage her expectations and emotions. She adopted this attitude not because she was terrified of not being alive, but because she hated the feeling of not trying for some sort of improvement. No matter the circumstances, this striving was key for her: Experiencing the world as an opportunity to aim for something better, even when all signs indicate that nothing better in terms of healing is forthcoming.

Not everyone faces a "terminal" illness with this mindset (I hate that term unless applied to someone who has already died). The argument can be made that it creates a lot of unnecessary exertion and suffering for the patient. Another point could be made that it requires a kind of self-induced doublethink for the caregiving partner. As Kara's condition worsened, I became both Charles the hospice nurse helping his wife to pass peacefully and Charles the cutman keeping his fighter in the game, two roles that seem contradictory when observed from the outside. In reality, each personality helped the other do their job. But this is only because the plan always reflected the mindset, which in turn reflected how Kara felt about what makes life meaningful and worth the cost of suffering.

Yet in hindsight, I can see enormous value in approaching the final days with a shared mindset of acceptance and communication about death. I can see the advantages of bringing in a real-deal hospice nurse to administer hands-on care (when available) and provide information about the signs of death and a general rundown of the dying process. I can see the benefit of alleviating grief by talking with Kara about the amazing life we have had together and how it will go on after she dies. "Death ends a life, not a relationship," the notion that a departed loved one lives on in the love and memories of those who cherish them. I can even see us taking it one step further and drawing comfort from a mutual belief in an afterlife where further adventures together can eventually ensue.

To sum up, I can see how surrendering to the facts and becoming more informed about death could help ease one's passing and soften the blow for the surviving loved one. Many bereavement experts and hospice workers agree that acceptance and talking about death in an educated manner are vital ingredients to a smoother transition for the dying and recovery for the grieving, and I can see how adopting a mindset of acceptance and communication about death could create a beautiful, yet also practical experience from an unavoidable but heartbreaking situation.

To return to cancer and shock as a grief reaction, when I realized Kara was actively dying, Charles the hospice nurse evaporated, Charles the cutman exploded, and Charles the husband slammed back into my body with such force that as I grasped my wife's shaking hand I began to scream. That is the last thing I wanted for her was to leave this world with me wailing at her bedside in terror and emotional agony, but it happened, and I can't help that I am still a little haunted by the fact, even though with a mindset such as ours I can't see how the shock would be any less in its way than when I got a phone call from my mom telling me my dad had been killed by a log truck while driving home from the coast.

The months afterward were no less shocking as I suffered from visions of Kara's death and the level of care I had given her. Had I adopted a mindset of acceptance and communication about death, I might have felt less shocked by her passing in the way that accords with common sense. If you're bathing someone in an in-home hospital bed who has become paralyzed and who has run out of treatment options for stage 4 cancer, you should expect to have their ashes in an urn at some point. But I wandered through the days as if a boulder had fallen from the sky and pulverized my wife into a pile of dust. How could this have happened? Why am I still alive? What could I have done to save her? Charles the cutman came back in again, and he demanded answers that would never satisfy him. But with a little distance now, I can at least say this: Do what's right for both you and your loved one is the only answer when it comes to an illness from which one of you is not coming back. Whatever the price of suffering and shock, Kara and I did what was right for us.

None of this is to take away from experiences of actual sudden and unexpected loss. I am only saying that shock can come with its own acuteness for caregiving partners as well, depending on their mindset in the trenches.

Just a thought as the Dark Night of the Soul seems to be throwing a party out there.

Until next time.

--Charles Austin Muir


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