IF SYMPTOMS PERSIST Dr. Jose Pujalte, Jr. “Come lovely and soothing death” Walt Whitman (1819-1892), American poet “Leaves of Grass” (1900) I missed my mother’s death that Friday by an hour or so. I was at the Philippine Orthopedic Center seeing OPD patients when my sister from the US called me. “She’s gone,” Ate Fides sighed. At the ICU, I saw my mother draped in white, mummy-like, but I asked the nurse to unwrap her for a final kiss on the forehead, and some pictures too. My father, who was with her as she gave up the ghost, was not around because he was already arranging her early cremation – the next day, to be exact. Our family saintess is wasting no time to get to heaven. Instead, I found my aunt Tita Vin (and Tito Jimmy) by the hallway. Tita Vin, my mother’s sister, was ever dependable during this stressful six months of my mother’s illness. Grief Stages. In 1969, psychiatrist Dr. Elizabeth Kubler-Ross forever changed how we thought we should view death by postulating the five stages of dying: denial, anger, bargaining, depression, and acceptance. By the 1970s, the stages of dying were modified into stages of grief. But the fact remained that these were not products of scientific research. She herself wrote: “How do you research on dying, when the data is so impossible to get? . . .We believed that by doing many interviews ...we would get a feeling for the terminally ill.” Stages are Myths? Russell Friedman and John W. James, co-authors of the The Grief Recovery Handbook dispute the stages of grief and believe that “since every griever is unique, there are no pat answers about grief.” For them, wide acceptance is not the same as scientific fact. They argue of the potential harm of believing in stages. For example, the elements of sadness of losing a long-term spouse or partner overlap with clinical depression. Some of these are:inability to concentrate, disturbance of sleeping patterns, upheaval of eating patterns, roller coaster of emotions, lack of energy. But by most accounts, not all grievers are clinically depressed. To accept depression may be counterproductive because the ones left behind will just wait for it to lift. What’s worse is that professional help may bolster the diagnosis of depression leading to the use of anti-depressants. Sadness is different from depression. Grieving is Unique. Dr. Ross’last book, co-authored with David Kessler was On Grief and Grieving (published after her death in 2004). She wrote nothing short of an apologia:The stages have evolved since their introduction, and they have been very misunderstood over the past three decades. They were never meant to help tuck messy emotions into neat packages. They are responses to loss that many people have, but there is not a typical response to loss, (italics mine) as there is no typical loss. Our grief is as individual as our lives. Not everyone goes through all of them or goes in a prescribed order.” Grieving is not forever.This much I know I guess, as a son and doctor: grieving doesn’t last forever. Maybe it doesn’t methodically follow “stages” or steps but each one of us has enough wisdom to go through difficult times and emerge stronger. Who mourns but those who are alive? Since grief is part of living, we have the choice to embrace it thoughtfully, gently, instead of wishing it was over, or denying it was ever there. After all, we only grieve for those we have loved. (Dr. Pujalte is an orthopedic surgeon. email [email protected])