Living with Ghosts

It happened twice in one week. On her routine walk with our dogs, my wife ran into one of our neighbors, Beth. We usually encounter neighbors walking their dogs and we usually wave, say hi, and do the neighborly thing. When running into Beth, my wife noticed that she didn’t have her dog. “Where’s Bubba?” my wife asked. Beth immediately teared up, on the verge of crying hysterically. Bubba was her bulldog, and he had an unfortunate incident of gastric volvulus syndrome, drinking water while panting. My wife immediately apologized and couldn’t believe the unfortunate luck that Beth had. Later that week, my wife ran into Gloria, who had a little yorkie she walked around in the neighborhood, off leash. She was walking with her husband and kid, but no yorkie. “Where’s the little doggie?” my wife asked. Gloria turned pale and started walking away. Her husband explained that their dog passed away after getting anesthesia for a teeth cleaning. My wife was horrified to find out about these dogs passing away. She said that if anything were to happen to our Jimbo or Leah, she just wouldn’t know what to do.

Loss can take many forms. My patient Robert, was an eighty nine year old gentleman that I met three years ago. I was treating him and his wife when they first joined our practice. His wife, unfortunately, passed away a year later from complications of dementia. Robert was devastated when it first happened, but he shrugged it off, telling me that it was expected and that he saw it coming. Robert ultimately went on, feeling depressed and having difficulty with sleep. He drank more. He would tell me how he missed her and that he wasn’t feeling well.

We all live with ghosts. Whether it’s the loss of a friend, a spouse, or a pet. Whether it’s a celebrity that we never met or a daughter that went too soon, loss is always painful. There is no timeline for how soon someone can “get over” a loss because in some cases, we never “get over” it. Accepting the reality of loss is not a negotiation. It’s a judgement. There is no plea deal. There are no take-backs. The finality of death only leaves echoes from the past, memories that haunt us, some good and some bad.

Kubler-Ross defined five stages of grieving in 1969. They are denial, anger, bargaining, depression, and acceptance. Working through the pain of grief is a difficult task that can have setbacks. Some people may revisit the stages of grief years after the loss. Some losses are harder than others. There are services available to help patients through their grief. With hospice, grief counseling is a service they offer readily. There are support groups that help, again offered through hospice, but also through churches and synagogues.

People handle loss in different ways. For some, they focus on filling their time with tasks to distract themselves. For others, they face the loss head on and explore their feelings of guilt, loss and mortality. Robert did both. I would see him privately, in our office visits, where he would express how much he missed his wife. He would go into detail about feeling her absence, as if absence can be felt. I would also see him publicly, where he would attend our grief support meetings and our community bingo events to try and occupy his time. Both are effective.

I offered him medications and he finally, reluctantly, agreed. It helped him somewhat, but he was never the same. Even after seeing the grief counselor, he felt lost. The thing about grief is that it changes a person. Living one way for years, and then suddenly, changing direction the next. It changes a person, psychologically and physically.

There is a condition known as broken heart syndrome, where the events of a loss can lead to the physical manifestations of a heart attack. The theory is that such a stressful event leads to a surge in cortisol, or the stress hormone, that ultimately leads to the heart mimicking symptoms of a heart attack. In some cases, if untreated or with pre-existing heart conditions, the heart can actually fail.

Whether it’s a friend, an uncle, a spouse, or a pet, grief is grief. A loss is a loss. After two years of dealing with the loss of his wife, Robert finally succumbed to his grief. He had his own medical issues that included heart failure. I talked to him one last time and he said that it was time for him to rejoin her. He was subsequently admitted to hospice and passed away peacefully. I, too, live with ghosts and Robert is one of them. I think about him from time to time and wonder if he is finally at peace with his wife beside him.

By: Dr. Juan Borja
Original post: https://yourdoctordad.com/living-with-ghosts/

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