The Triage Nurse In Your Head
I had not planned to write this article. It is a follow-up to "Where Do Men Grieve?". I received some feedback on this article from a friend asking me what advice I would give someone who was grieving. In that article I had made the following statement.
I am not a person who likes to prescribe to others how they should live their lives, never mind how they should grieve the loss of a child.
My attitude does feel it is counter to what the Beyond the Expected Substack is attempting to achieve, i.e., sharing hard-won wisdom. There are reasons why I do not want to prescribe a checklist to get through grief. This can become another thing a newly grieved person has to do when they are tormented and barely coping. I would hate to have what I have written to be used against them as proof they are not “grieving” properly. Another concern is that in certain areas of loss that I do not have the experience to write with any authority. For example, I have no idea what it is like to deal with suicide. I have been told by the parents of children who took their own life that they feel incredibly guilty and persecute themselves for years. As discussed in the article "Could Have, Should Have, Would Have", these thoughts can haunt parents, and this appears to be something felt far more acutely in cases of suicide. An innocent comment from me about what a relationship with a deceased child should or should not have been, has the potential to cause a huge amount of distress to these families.
What are my responsibilities?
My friend said people who are reading my Substack may be desperate and want to find some sort of solution. They could even be relatives or friends trying to support someone they love. It did remind me of the initial period after my son’s death when we were looking around for a book, website, or social media groups that could help us. He had made me consider my responsibilities. Maybe I was avoiding some of them by being so risk-averse…..or am I in denial about some of the insights I have on the topic because I feel guilty about something good coming out of a terrible situation? I touch on these themes in The Audacity of Post-Traumatic Growth.
I do not think we can tell people what to do. Trying to life-coach someone’s grief is unpalatable and would leave a bad taste in any reasonable person’s mouth. I may write an article about what has worked for me at times… please note the caveat “at times”. A lot of experimentation has been and will continue to be required. I do have some certainty that some things should just be avoided. I think it is probably more useful to suggest to people what to try to avoid, as it will only bring unnecessary suffering. Most of the things I say will appear self-evident. What might not be obvious is how little capacity a grieving person has to respond and recover. For example: an argument with a spouse can make you so angry and sad at the same time. Both of you are in so much pain that “big arguments” that occur in all marriages, are no longer something you can indulged in. Before you know it, truly hurtful words are exchanged, fuelled by grief, that can damage a relationship beyond repair.
When people are suffering under extreme duress, they need to drill into themselves the ability to spot when they are becoming overwrought with emotions that will make matters much worse. There are thought and behaviour patterns that only person experiencing them can initially recognise. These are the symptoms that, if you ignore, can only lead to undesirable outcomes.
Triage Nurse in Your Head
Recently, I was in an A&E Department at a local hospital. Anyone who walks into the hospital with a medical condition will have to speak to the triage nurse, who will assess them. If you get rushed straight in, then you know things are serious. Most of us must sit around for several hours trying to work out what system they are using that is apparently in no way appearing to prioritise you. The gatekeeper is the triage nurse; they will speed up your access to help or bat away your queries about what is taking so long. They will keep you on ice by giving you pain medication to settle you down while you are waiting to be seen.
This nurse will have certain criteria to assess patients. Certain symptoms will trigger immediate action. For example, symptoms of a stroke will always get you through the doors into the A&E ward.
You must become the triage nurse in your own head when your grief is overwhelming you. There are certain symptoms that require you to stop what you are doing immediately and seek help.
Survival is Victory
Using the example of the loss of a child, you will not be thriving for years; in the initial stages, survival is victory. By survival, I mean literally…survive. Everyone I have spoken to who has experienced this has seriously thought about taking their own life. They may have never entertained these thoughts in their life before, but now it appears on the menu every day. If you are feeling this way and it is leading to plans of action, you must seek out support. This is not only for your sake, but also for the sake of those around you. Your family has just lost a beloved member and cannot cope with any more loss. If you have a child that is alive, they will want you to go on in any form. You may never be the same person as before, but you still are their parent. It was a mantra I have had to repeat far too often for comfort.
I am not only just talking about literal survival. Your family needs to survive intact; your valuable friendships also need to survive. At some point in the future, you will appreciate these people more than you ever have done in your life.
Some Things Do Not Work
The second thing the triage nurse in your head must look out for is excessive consumption of alcohol or drugs (legal and illegal). I think everyone would allow or expect some excess in this area after a tragic death. Ironically, you may find that others around you may see this as a more legitimate coping strategy for your grieving than you may do.
This was certainly my experience. I sometimes felt people on the fringes of my social circle would have been much happier and comfortable if my grieving had lead me to be permanently intoxicated. I have yet to develop any insight into why this may be considered a honourable way to grieve. If your excesses are affecting your relationship with your family and adding to their pain, then you must seek help. If they are affecting your ability to earn a living, then you must also seek help.
A person in the grip of the acute stages of grief cannot function properly in major areas of their life. The layers and depth of this dysfunction are something no one can prepare you for. Your job is to stabilise the situation as soon as humanly possible and not succumb to the desperate nature of your feelings.
Give Yourself Permission to Remove Yourself
This may be a less obvious symptom for the triage nurse in your head to look at: removing yourself from scenarios and people. If you have been to a location, workplace, or in the company of “friends” and you come away feeling terrible, it may well be because of your grief. However, if this has happened more than three times or is becoming a progressively worse experience, you need to avoid these scenarios. Often your mind is telling you something. These places, careers, and people may about to become part of your past. You must give yourself permission to remove yourself from a situation. It could mean you spend time away until these things become more manageable. This then begs the question: does it have to be managed? It is good to try to come back to it when you have the capacity to cope, but if this is not an important part of your life, then you may well be better investing your time in other pursuits.
Your Responsibility
There are certain extreme scenarios in life that would be seen to be unbearable and only a tiny percentage of the population could cope with. I am not going to list them here. If many people can survive a situation and go on to live something approximating a “normal” life, then this means we all can do this. Your life may not ever be the same and may become far more challenging. In the initial stages of grieving the loss of a child, your job is to not make it worse for those you love. This is particularly true for any of the deceased child’s siblings. The triage nurse in your head needs to protect you from making decisions that will directly impact you, and in turn, your living children. Hopefully, in time, you will start to accept your new life with some genuine hope that you did the best for your family under extreme circumstances. On your deathbed, you will have enough sadness to reflect on the child you lost. Hopefully, this will be done surrounded by a family that still loves you.