Grief is selfish

I sat and wrote this maybe 9 days ago . Maybe 12 days ago.
Thought I would blog it . May still do it . Been away from my base Bombay for almost 8 weeks now . Being away means missing out on many things . But the love and good times i find here on the other side of the world make up for it . Then I hear of the passing of friends . Four already . And I grieve . And I feel desolate . I mourn . It is difficult . Today I learn of one more …
This is what I wrote then , a few days ago .

Grief is selfish .
And grieving for a loved one is a self serving process .
It is all about what the loss means to you and how your life changes and all that you will miss now that the person who meant so much to you is no longer there .
The process of grieving is left to you to work out in all its complexities .
I don’t think one can ever get over the shock of losing a loved one . It’s like a gash on your arm that may heal (?) over a period of time with new tissues manufactured with one’s own set of coping mechanisms but the damage is done . Your once flawless , smooth skin bears the unmistakable and indelible mark of the trauma .  It’s ugly, painful and a constant reminder of the loss and of what once was .

In my line of work I lose people that I have grown to love and care for .  More than is good for me or for them ; or so the text books say. But what do those these text books know . I have revelled and blossomed in the love my patients have given me so unconditionally and I know for a fact so have they. We live in a very special world that allows this unconditional love . For I am no one to them . Not a lover , not a parent nor child ;  not a sibling not aunt or uncle or anything that can be defined . I am to each one of them only what they want me to be to them . But to me they are my life , my work and my whole world .  They may know it or they may not. It makes no difference for the love I have for them serves me in a way that helps me help them . When they want it .  And how they want it.
It is a love that has allowed  me to give and in giving there is so much joy and such rewards .
I call it Qualified Love . And that charmed circle is peopled with little toddlers I held in my arms who are happy teenagers today ; teenagers whom  I have seen growing up into awesome young adults ; young adults becoming householders and making a life with their loved ones , proud parents become happy grandparents and then I have held the hands of many as they move on to find meaning in their “senior years ” so to say.

And because I am no one to them in their established hierarchy of family and friends I become , like many of my ilk ( counselors, therapists, treating physician too) an anonymous safekeeper of many secrets , longings , confessions, fears and more.   And I ? I am like a sponge , that very anonymity allowing me to absorb and retain without losing my own dimensions .

And then comes Death to take them away for ever . Life interrupted . For ever.
And I am left the sole custodian of shared dreams and hopes and conversations .

I am asked , by many , how do I cope with the loss of my patients ? When they die ? How do I indeed ? I honestly don’t know . Each death , each loss hits me anew.

Last week I woke up in DC just as India had already slipped into its late evening and found a message in WhatsApp from one of my young patients. It began as most messages do : Amma , ( to my dying day I will never be able to comprehend the kind of love and affection my patients have for me which makes them call me Amma )   And then as I read the message I felt this cold hand close itself around my heart.
The message said , Amma , Bhaiyya nahi rahey ab.
Mother , brother is no more.

Just over a couple of weeks ago this young man and I had chatted over that very WhatsApp when he had come to office and missed me and we had promised to meet up once I was back. I simply could not accept that I was not going to be able to do that. Not ever again . It dawned on me then how far away i was from him and everything that connected me to him. Waking up in another country and in another time zone whereas back home the day was almost done and the reality of the loss final and unchangeable . Even though i was yet to live that day that had already in another place in time , taken him away.

This is not the first time that i have not been around when someone in my care has died. I realise that this huge chasm between myself and a dearly loved patient is not just caused by my physical absence separated as we are by the oceans. That  chasm exists even if I am right there in the midst of the grieving family . For, who was I to him or to the members of the family ? Not family and  not a friend in the real sense of the word . Take away the reason for my existence in that dear life and I ceased to exist .

This harsh truth always prevents me from processing the loss , and therefore the process of grieving is a complicated one.  And closure ? Well nigh impossible !

Just as the bereaved parent or child or partner would balk at the painful process of taking down and putting away all visible signs of the loved one I too cannot bring myself to erase them from my mind .

The phone numbers remain in my phone contacts . The photographs on my wall lull me into a false sense of continuity of the relationship and I  keep going to their pages on Face Book …as long as these signs exist I exist .

For all that I gave them , what I got in return was immeasurable . A validation of my worth to them ; of my love for them .  Without them I cease.

What do I do with all that I know and to whom do I share those shared confidences that might help in the grieving process .

Respecting Patient Confidentiality  is of paramount importance and is sacrosanct in our line of work . In many cases , not all family members or friends are even aware of the situation .  Time and time again I have caught myself reaching out and then drawing back and keeping my overtures in check.

So in answer to that question raised above , my grief is mine alone and I grieve alone . I grieve for the loss of what gave meaning to my act of giving .

DC Sunday morning 5th July : I have just edited the above and given it a spell check and shared a few thoughts with this friend I am spending the holiday weekend with . Mostly about the young man who has died and my anguish at being so far away and how it anyway makes no difference for the reasons given above .

We are having tea and reading the morning papers . And I come across the following in the Sunday New York Times …
It is as though I am listening to myself

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