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Anticipatory Grieving – an essay about death

What hurts more? The death of someone very close that gets seriously ill or a sudden death of someone without warning?


Family gathered to celebrate my father’s 60th birthday
Family gathered to celebrate my father’s 60th birthday

Will it be better to have time to say goodbye to the person? Or is it more terrible to  wait for the inevitable? We know that there isn’t a hierarchy for pain or for the grieving process but  Dr Ana Claudia Quintana Arantes, specialist in palliative care who has been doing follow up with terminal patients and families for more than 10 years has no doubts: “When we have the chance to go through a anticipatory grieving process we favor a healthy process of grieving”.

The term “Anticipatory Grieving” was first used by psychiatrist Erich Lindemann (The Symptomatology and Management of Acute Grieving) in 1944 from the observation of the phenomenon that happened with wives of soldiers who went to war. Knowing that they might not return, he activated the trigger loss of feeling and all the emotional consequences that the situation evoked. Since then, doctors and psychologists who accompany families in the process say that the interventions made during the anticipatory grieving can prevent the development of problems in the post-death grieving, while subsequent therapies can only try to remediate the difficulties that have already occurred.

My first significant experience with death was to live the anticipatory grieving with my father. I say WITH  because, as we discover that he had a metastatic cancer with virtually no chance of cure, we decided to covertly go this way together, learning not only the depths of pain, but the beauty that death could unravel us. Many of them only happened because we accept the imminent possibility of his death, avoiding all attempts to denial of medical prognoses. Together the parting process, untying the knots and the sorrows and opening the armor for love, comfort and care. If I had not allowed myself to live this experience with him, I might still be (6 years later) suffering for life taking my father away from me!

“This is a stage where we are on the edge, says the expert Jose Paulo da Fonseca, author of Anticipatory Grieving (Book Publisher Full) about such a delicate moment. On one hand, we have to prepare for death ahead and on the other, we must devote all our love, attention and care to the terminally ill patient. And it was precisely these two living overwhelming counterpoints soul I discovered that, as Dr. Ana Claudia says, “Death teaches how to live.” It is from this perspective of life that I would like to report here my pain: I have learned that when we live the experience of death, making room for the positive outlook that pain and fear mask, we go through a transformation and, I would say, less devastating.

Today, after establishing my grieving, I can relive those days with gratitude. My father was in physical presence, but lives in me every time I come across some positive change that his disease process and death gave me. It was the healthiest way I could find not to make useless all the suffering that he went through. If that reality was inevitable that planted seeds for a better life. I was so instinctively following what my heart told me, learn as much as you can with the situation that life presented because we’ll never be ready for the departure of a loved one, but we can PREPARE BETTER TO STAY! I started to pay attention to small details and learning and discoveries throughout his treatment. It was 5 months of testing our ability to face fear and pain, but were also the months when we revealed what was most genuine in us.

Dr. Ana Claudia says that if death were a character main feature it would be the loveliness! That death is who knows best about life and what is really important. A person who is in terminal stage comes into contact with what is best inside. No longer having to play a character, there is more time and importance to this, it makes room to exercise their higher state of being human. My mother often refers to this stage with a mix of pain and longing. She says it was the time when she felt my father closer to her. And so it was with all the children and people who visited him. I found inside myself the strength, the power of the presence! Until then, as for most people, thinking about the possibility of death had always been a trouble. I knocked on wood three times and tried to get rid of that image out of my mind. I was desperate just to imagine my helplessness before it and how I would live after it! Facing it as I did was surprising and reassuring. Not less painful, but easier to bear.

Today I no longer feel that pain in the chest. I know I can take a lot more from my life, not  being less afraid of losing someone close, but with the courage to face it, knowing that I will fall, but knowing that I can choose new possibilities for living. The pain and longing are inevitable, but when we make room for the new, that feeling begins to fit back into the heart. If I elect the greatest legacy that this stage let me, I would say it was discovering the importance of the family! Our family was always close. Me, my three brothers and my parents always had a good relationship, but with a certain individuality that time brings.

When the diagnosis of his illness was given, our connection took a huge proportion where we turned almost one. Complicity in pain, although each of us assimilated it in a different way, it gathered us tremendously. No one understood us better than ourselves, and I just wanted to be with them. It was as if we went back to being children protected by parents, feeling that brought me confidence. When he was gone, our relations were already transformed. Nowadays we have an intimacy and a bond of trust and complicity that I feel is an example for my children. I won three major safe places and it turned the four children in the greatest and best support my mother needed and needs!

During the illness of my father, time went by and I did not know that I was working on what experts say is the anticipatory grieving. I didn’t imagine that it would be the basis and support to keep me standing when the day of death came. And when that day came, I faced it in the most unexpected and surprising way!

We took turns with my father in the ICU room. At the Syrian-Lebanese Hospital in Sao Paulo, where he was admitted there are some ICU rooms in which family is allowed full-time. Another important finding: the hospital system could offer this privilege for families, death would not be something so lonely and isolated! In my turn I asked God to prepare me and give me strength if my father chose me to witness his death. I couldn’t take my eyes from his vital signs. In one of the early mornings when I saw his heart rate began to fall. I looked at my brother doctor next to me and I felt his gaze back to me – I think the time has come. Within seconds I thought, if it is to be now, then let it be the best way, doing what he loved: listen to us sing! I chose a song by Roberto Carlos, that he loved and sang until his signs began to return. He lived for another day.
While singing, I had my last revelation: if death is part of life, why not include the life in the experience of death?