A sunset is a reflection of grief

How to Grieve

The bereavement fair is coming to a location near you

Grieving is a process. The psycho-babblers describe five stages of grief, which they label Denial, Anger, Famine, War, and Conquest. Or something like that. It really doesn’t matter, because after this generalization, they go on to say that the stages are totally different for everyone, which is a pretty effective disclaimer. When my wife died I was vaguely aware of all this, and I knew that I would go through a series of changing emotions lasting indeterminate amounts of time. What I failed to appreciate was the extent to which this process has been dissected, defined, addressed, and monetized by the medical establishment and its metastatic associates.

My foot got hurt a couple of weeks ago, so I made an appointment to go see Dr Oops1. It was the first time I had seen her since my wife’s passing, and she hugged me while collecting her co-pay. In the examining room she poked at the sole of my foot for a while and said “That’s weird”. Then she told me it should get better by itself and to see a podiatrist if it didn’t. On my way out, the nurse gave me a smile and two sheets of paper. One was a referral to a podiatrist in Pacifica. The other, in standard operating procedure format, was entitled “Grief (Actual/Anticipated): Home Care Instructions”.

The document began by undermining its own existence with a paragraph explaining that grief is natural and does not require medical treatment. I surmised that there must exist aberrant grief conditions that do, in fact, require some medical intervention because the document went on for a full page after that. Indeed, some of these situations were listed:

Contact your doctor if you have any of the following problems that last for 2 or more weeks:

  • You feel sad a lot or cry all the time.    I have to say I found the prescribed interval for chagrin to be a bit meager. I have been sad for far more than two weeks. I haven’t told the doctor, though, because it seems ridiculous to dwell on it. And I really don’t want any Prozac.
  • You have trouble sleeping.     Sleeping has not been a problem. Waking up is where it gets hard.
  • You find it hard to concentrate, make decisions, or remember things.     This, too, has been going on for more than 2 weeks. More like 20 or 30 years, actually. But Dr Oops knows about this already: she insisted on putting me through some kind of cognitive ability test one morning last summer, before I’d had coffee. She gets a remittance from Medicare.
  • You change how you normally eat.     My refrigerator’s content is now comprised of a half dozen eggs, a sixpack, four peaches and a supermarket roasted chicken. Also 12 bottles of mango protein shake.
  • You feel guilty about the death or loss you have suffered.    I’ve discussed this previously.
  • You are using alcohol or drugs to help you cope with your loss.     I use alcohol or drugs to cope with everything. That’s what they’re for. If I told my doctor, I’d just get hassled and given a prescription for some other drug, something made by Lilly and stepped on by CVS. Who needs it.
  • Be sure to contact your doctor if you think about killing yourself    It’s good to know she’ll be there for me. Suicidal urges must be managed on an appropriate schedule, however. If I call Dr Oops’s office between the hours of 12 and 2 on weekdays, I will be informed that the staff are at lunch. If I call on a weekend, I will hear recorded laughter.

Curious about where my small town doctor was sourcing her prose, I looked more closely at the paper I’d been handed. In the margin there was the web address of a company called athenahealth (“At athenahealth, we put people first”). Apparently, they are Oops’s chosen provider of electronic health records and home care instructions, including grieving protocols for those having recently lost a spouse, job, or pet.

It is in the nature of businesses to differentiate themselves by offering their customers more services, especially ones that can be culled from government databases and cost nothing. It is in the nature of entrepreneurs to fill niches, offering to those who grieve — and to those who know them — every conceivable solace. And so we have grief counselors, support groups, grief camps, sleeping pills, and home care instructions to go along with the cards and tissues.  And these are offered by companies and charitable institutions, and it is in their nature to hire management and staff and to protect their economic turf and thereby their salaries. And so, out of death, an industry is born.

At this point I received a phone call from Dr Mimi, wife’s failed oncologist. My nosey eldest son had contacted her and voiced concern about my mental state, my ability to cope with engrievement. What an asshole. Dr Mimi wanted to reach out to me, all according to best practices, and to offer me the resources of her formidable university. Normally I would have blown her off, but the word “resources”, unexpected in this context, somehow made me think of Australia, which is being exploited by the Chinese according to an article I had been reading while practicing grief unassisted. In private. This left me slightly confused, and I agreed to have her send these resources, whatever they might be.

They turned out to be links to some websites, online grief clearing houses. I felt compelled to explore.

The first was an outfit called Kara (“Our guiding value is empathy”), with the succinctly delineative web address kara-grief.org. Kara sends out volunteers to support dying patients and survivors in the Palo Alto area. I’m not sure what the volunteers do, actually, but it seems all to be based on something called the Shanti Project, so I think mantras must be involved.

I moved on to Pathways, a provider of home health and hospice care. Pathways publishes a quarterly newsletter, “Seasons Through Your Grief”, for those who want to be kept up to date (on grievous matters?). I learned that Pathways partners with eCondolence.com, “the premier resource for condolence, sympathy, and loss-related content and gifts”.

These outfits offer counseling, workshops, support groups, memorial events, and more. There was also a link for Hospice by the Bay, a UCSF affiliate which is currently advertising for graduate students to apply for bereavement internships. Send an email to Human Resources.

For myself, I have no use for most of these professional outlets. I’ll keep my distance from the ghouls, thank you. I’m not a social person, nor do I choose to grieve in the presence of others, to elicit rote responses, however sincere or adept. The thought of support groups is revolting. Why would I want to rub elbows with a bunch of other people who have just suffered a loss? Why would I listen to their stories? Fuck them.

The dynamics of the market affect everything in society, of course, and it’s interesting, if depressing, to see them play out here. Functions once considered religious have been deconsecrated and market segments are being contested by lay, medical interests. But why go to a doctor for something that is natural and does not require medical treatment? Why not apply the AirBNB model? Locally sourced solace. Through a central booking service, empathetic individuals could set up shop, offering a kind ear, platitudes from a list provided by the franchisor, and perhaps access to a room with yoga mats. All for $75 an hour billed to your insurer. Everyone makes out. Some would specialize in clients grieving for pets — a lucrative market segment, as the shorter lifespans offer potential for repeat business. Others might choose to concentrate on those in the less violent stages of grief, avoiding clients who might kick walls in anger and risk hurting their own feet.

1 The naming of Dr Oops is described here.


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