By the time you read this, most of you probably will be firmly settled in the anger stage of grief over what happened on September 11. I feel fairly confident presuming this because, much to my distress, I’ve become something of a lay expert on grief during this past year. Aside from the fact that my wife and I were visiting New York the day that terrorists laid waste to the World Trade Center, earlier in the summer I lost my father to a disease that, in its way, killed just as suddenly and wantonly as the Arab assassins did.
Indeed, I had just begun to get a grip on my sadness over my father’s death when I was presented with an entirely new emotion: grief over a loss of innocence. As I watched the horrifying images from lower Manhattan on TV in my hotel room, I felt that at least I knew what to expect from my psyche. I would first curl my emotions into a tight fetal position of denial until the oddly consoling heat of anger arrived. In this case, given the 24-hour news coverage—not to mention the fact that the smoke and carnage were just sixty blocks away—it arrived even before we left the city, five days later. Since this was more or less where my emotions still ran about my father’s passing, I briefly wondered if this was healthy, then realized that that question, like most others about this most common of human emotional conditions, is probably unanswerable.
In fact, as long as I’ve been at this grief business (really, you could date it even further back, to last fall, when my father-in-law passed away from Alzheimer’s disease), the only thing I’ve learned for certain is that no one knows all that much. I mean, we’ve all heard Elizabeth Kubler-Ross’s stages of the condition: denial, anger, bargaining, depression, and acceptance. And there seems to be general agreement among health care professionals that though different people express grief differently, all such expressions are healthy. But beyond that, all the Web sites and very earnest books I’ve perused on the subject have had little but platitudes to offer. The only insightful observation I’ve heard came from the University of Texas M. D. Anderson Cancer Center’s venerated hospital chaplain, Sister Alice Potts, who said of grief, “You can’t fight it. You have to give in to it. It’s not something you’re just going to ‘get over’ in the way you get over other things.”
My experience with grief hasn’t given me any pat answers to the condition, but I do have three observations about it that may prove helpful as we process this unprecedented collective bereavement.
Some of it actually is your fault. When my father called to tell me of his diagnosis with colorectal cancer this past June, I was actually cocky in my response. I had been researching a story on M. D. Anderson Cancer Center over the preceding month or so, I told him. “They’ve got all kinds of treatments to run through before it can really be called terminal.” But within days, the diagnosis had worsened. It wasn’t just cancer of the rectum, but stage 4 metastatic cancer that had spread to his liver. This was not so clearly within the reach of even the newest magic bullets; in fact, Dad was terminal. I remember thinking this was an oddly archaic term here in the age of stem cell research. Maybe that was the fate of the Ali MacGraw character in Love Story, but that sort of cruel finality just didn’t happen anymore, did it?
Dad insisted on at least one round of chemo, but on my return from a short vacation to Mexico, I had a message from my sister: The chemo had only weakened him more; he was back in Wilford Hall Medical Center in San Antonio. My wife and I visited him later that week and were shocked at how quickly cachexia (wasting) had set in; he was a specter of his former self and unable to speak clearly or swallow. Three days after our visit, my father quietly died. Three days after that, we quietly buried him. For all the good modern bioscience had done him, I thought, he may as well have developed the disease back in the fifties or sixties—or the nineteenth century, for that matter.
But it wasn’t really modern bioscience’s problem, was it? It was mine for having so zealously imagined curative powers far beyond doctors’ actual capability. When I asked M. D. Anderson’s vice president for research administration, Leonard A. Zwelling, if we were winning the war on cancer, he said, “We’re doing a lot better, but cancer is still smarter than we are. It’s very close to us. It arises from our own being. It’s not like an infection. In Darwinian terms, it should have been eliminated. Why is it still here?”
It was worth remembering, I realized, that the disease that killed Dad had started with an almost innocent handful of genetic errors in the DNA that told the cells there how to reproduce themselves—the kind of incipient mutiny that really doesn’t show up on the radar. And even as this biochemical insurrection gained momentum and bulk, Dad felt no pain or experienced any other warning that something was afoot. Who could be arrogant enough to think that we could ever conquer such an insidious foe?
In the same way, I think, we all had come to overestimate our imperviousness to terrorist attack, or to underestimate the terrorists’ sociopathic guile. America is, among many other things, the land of magic bullets, whether they are for molecular or human pathogens. Learning the hard way that you really didn’t have a cure after all makes the grieving all the more painful.
There really is nothing you can say. When tragedy strikes, it is in the American character to try to talk our way around, through, or over it. I know when I stood at my father’s bedside, watching the cancer quite literally suck the life from him, I felt that there should be something more I could say. When I have tried to console my friends on the death of one of their parents, I’ve felt the same sense of inadequacy. Words always seem to be enough in almost any other human circumstance, but when it comes to grief, we become verbally challenged.
In fact, I found it perversely comforting that Brokaw, Rather, Jennings, et. al., didn’t have much more of use to say to us after the terrorist attack than I did to my dying father. We all wanted to make everything all right by saying it was, but when it comes to death, it’s never really all right. I was still chewing on all of this when I visited M. D. Anderson a few weeks after my father’s death for another round of interviews for my story and asked Sister Alice about it.
“Actually, there is not much to say when someone is dying or has died,” she said. “Sometimes just being with that person is enough. All you really needed to say to your dad was, ‘Dad, I don’t know what to say. But I wanted to be with you.'”
So the dying are okay with that?
“Yes. See, they’re not still trying to fix it like you are. They know there’s nothing to say. They just want to leave in peace.”
I wondered whether my father had. It’s hard to die that way these days: You’re too worried that you’re missing some new magic bullet. But I recalled that when I visited him that final time, Dad seemed strangely tranquil, even as all of us fussed over him. I also recalled that author Sherwin Nuland had explained in his seminal book How We Die that the terminally ill often come to a new, scaled-down version of hope long before their loved ones do. We may have been hoping for a miracle, but my father knew he was dying and all he hoped for was to see all of us one last time and to get the will squared away with the lawyer. In that sense, he died hopeful and at peace.
Of course, the sudden, savage deaths of September 11 wouldn’t seem to have allowed time for even a modulated form of hope to emerge, either for the victims or the bereaved. But I did find it interesting that many of the victims called their loved ones from the planes or the towers on cell phones, knowing even more clearly than my father did that they were going to die, just to express their love one last time—their final hope, perhaps.
It happens to everyone. No one is, or ever has been, fully prepared for the death of a loved one. But I have to believe that our forebears had a better grip on this complicated emotion, making grief the single type of human suffering that seems to have gone backward over the decades. In the old days—not so long ago, as it turns out—there weren’t many miracles of the medical or search-and-rescue variety, and so death was more readily accepted. Those who died natural deaths passed quietly and comfortably at home, allowing loved ones to get used to the idea. The hospice movement has tried to restore this way of dying and grieving. But these days, most people still die in medical facilities—places not conducive to proper grieving.
Most of the published advice I found on the subject of grief was too predictable: you know, take it easy on yourself, get some exercise, don’t try to get back to work too fast, pay attention to your anger, and the like. This is all well intentioned and true—as far as it goes. The problem is, none of it really helps.
It seems to me that grief may be best understood as something like puberty: A passage that everybody goes through yet no one has much useful advice about, an experience that involves a lot of formless suffering but which invariably makes the sufferer better. Some people just naturally handle it more gracefully than others do. And, as with puberty, some never grow out of it.
As I write this—two months after the death of my father, two weeks after the death of my innocence—the fog of low-grade anger and emotional aimlessness that I’ve been lost in has finally begun to lift. I can’t be sure why, but I think it may be because, in both cases, I’ve begun to come to terms with the inevitability of those deaths. It really does happen to everyone. And in that sense, when a father is ambushed by cancer or a nation by terrorism, what we are really grieving is our own mortality.