The invisible injury of grief

Just because you can’t see it doesn’t mean it isn't real.

Today calls for another PSA¹.

Because I can.

Because it is my father’s yahrzeit.²

Because the world is grieving in ways we can see and in many more ways we cannot.

The invisible injury of grief can arise from loss of any and every kind. And like all injuries, it can range from mild to disabling.

Yet, unlike a physical injury which has a visibly identifiable site, the invisible injury of grief is an injury to the soul. It permeates every part of us. Yet, not even Dr. McCoy’s³ tricorders can gauge its severity.

Fortunately, we don’t need a new medical device start-up company to solve for that. Our souls know when we are injured. What we do need is a paradigm shift that recognizes grief as an injury. Doing so will enable us to create support that promotes resilient healing.

Sadly, (no pun intended) when it comes to the injury of grief, the care available is equally invisible.

So walk with me through a metaphor. Wait, my metaphor includes a broken leg. Instead, sit with me. Read and imagine… you’ve just sustained a serious injury including a severely broken leg, ⁴ and suddenly find yourself in the intensive care unit. Can you imagine a doctor telling you this?

“You’ve been in the ICU for 3 days. No matter what you may be thinking or feeling, it’s just in your head. Time for you to get back to work.”

Well, at least in this scenario you had 3 days of intensive care support. Speaking from experience, in certain circumstances, a significant amount of stabilization can occur within three days of being cared for in the ICU.⁵ Unfortunately, no one gets this type of coordinated, intensive care for the injury of grief. The expectation is that we all sort this out for ourselves by ourselves. Even the scientific literature considers grief to be a “natural process.”

You know what else is a natural process? Mending a broken leg. Bones “know” how to heal. It’s just that we’ve figured out that bones do a much better job lining up and re-connecting when they are supported and not forced to bear weight until the bone is…you guessed it, healed!

The injury of grief is no different. Yet, we continue to “walk” and “work” and force our souls to “bear weight” when injured, then wonder why we can’t sleep, think or stop crying in pain.

And don’t get me started on the relationship between mechanism of injury and severity of an injury. Too late, I’ve started….

As a doctor, I’ve observed how one person can step off a curb and destroy their ankle requiring emergency surgery to stabilize three bones, while another can fall off a roof and walk away with only a bruise. In this case, time to heal was inversely related to height of the fall. Imagine if medical care were determined by the mechanism of injury rather than the injury, itself?

"You said you just tripped off the curb? You'd have to at least fall off a ladder to warrant x-rays or crutches. Whatever you think you are feeling, it’s all in your head. You can walk just fine."

Healing is not the same as getting through, grinning and bearing, ignoring or creating distractions. In order to become strong and flexible and resilient, injuries need support and collaborative tending to, with sufficient time and space to heal. This is not a solo activity. And it isn’t going to be easy.

Anticipation of pain and scar formation is part of the process. These are the low-tech and highly sensitive and specific guideposts that track where we are along the undulating road of healing. When we learn how to recognize these markers, they help us learn how much we can do before we unintentionally compound the injury.

For the past 16 years, I never worked on July 11 because I knew my injury of grief was vulnerable, sensitive and unstable. I knew that ignoring the pain would not improve my work productivity let alone joy, gratitude and sense of accomplishment. It would only make me angry, frustrated, disappointed and tired. My colleagues would be left wondering what was wrong with me. Which would lead to my covering up what was wrong with me. (To be clear, in this PSA, nothing was or is wrong with me. It is the words we are using that are wrong).

Today, I took a different stance. Literally. I now realize I have an injury and it is called grief. The injury of grief does better when light is shined on it. It does better when allowed to breathe. And it will never be gone which is not to say it isn’t healed.

My metaphorically broken leg is stable. It has a well-defined scar. It is strong even when it is sensitive. Today I knew it would hold. I openly acknowledged my father’s yarhzeit first thing this morning so my colleagues, friends and family didn’t have to wonder, “What’s wrong with Dawn? She seems kinda out of it.” Rather, they became my metaphorical cast and crutches so what I carried was not heavier than what I could bear. They held the metaphorical doors open so I could walk through without injuring myself. And even more importantly, I got to share what hurts, which is ultimately what matters most to me, because the only reason it hurts after 16 years is because my love runs that deep.

Though the cause of the injury can occur in the blink of a moment, healing does not happen overnight⁶.

Just like a broken leg, the injury of grief heals in phases. What you need at the moment of injury is different than what you will need weeks, months and years later.

Today, I needed to be with my friends at work, doing the work I love until I needed to go be with my mother and visit my father in the cemetery, to say Kaddish⁷, share memories and create new ones.

In the past 16 years, I have become intimate with grief. I have come to realize the inseparability of Grief and Love.⁸ You do not grieve what you do not love. Grief is the deepest form of love you can know.

My father’s name is Roy as in Royalty, Royal and Roy-tee⁹. I miss him every day. And my love for him grows to this day. I wish he had known you. Because just like me, he would be so grateful to know YOU ARE HERE.

.

1. Public Service Announcement. Some may find my inaugural PSA relevant, so I encourage you to review here.

2. Pronounced yart-site, is a Yiddish word meaning “year time” recognizing the anniversary of a loved-ones death.

3. If a Star Trek reference has caught you off guard you can find your refresher here.

4. Or, perhaps a serious illness like the one I am writing about in slow motion…

5. This may be another bit of foreshadowing. Only way to know for sure is to keep reading.

6. Or even in 3 days of bereavement leave. Here is a link to a poem by Donna Ashworth that captures this sentiment with precision.

7. A prayer in Hebrew recited for people who have died expressing gratitude for all of Life and an intention for Peace.

8. I created the term “Grieflove” to distinguish this unique form of love from other forms of love, such as romantic love.

9. Stories for another day:)