The anatomy of grief

M. A. Sarfraz explores bereavement through his personal experience - how to live with that which you can never 'get over'

The anatomy of grief
Surprisingly the Californian sun had still come up that day and shone down on Redondo Beach.  There were no loud noises, no screams and no breaking glass - just silence and the first rays of sunshine. You could be forgiven for thinking that this had happened on a different planet. I cannot say, and I will not, that he died; but the text from Nabeel Awan had said so. Saeed Iqbal Wahlah had just gone away on 08/11/2012 from his office in Lahore, and was not expected to be back. It is one of the mysteries of our nature that someone unprepared such as I, in the early hours of the morning in a far-off land, situated in a different time zone, can receive a thunderbolt like this and still live.

Whenever his smoking was criticised, being fit and health-conscious otherwise, Wahlah used to laugh out loud, “I am not afraid of death, I just don’t want to be there when it happens.” As the fourth anniversary of his passing away approaches, his friends and family experience a heartache no one can heal and his love that no one can steal. People like him rarely walk into our lives, but when they enter, usually un-announced; they leave behind footprints on our hearts. They are always in front of us, shining a beacon of light, marking out the horizon of our lives. But when the horizon suddenly becomes empty, what happens to the view? How do we get the energy and the courage to get out of bed in the morning and face the day?

As a culture, we are very good at bearing witness to grief - before & after the funeral and during the 3rd-, 10th- and 40th- day rituals when we remember and pray for the deceased.  However, the burden of loss is placed entirely upon the bereaved next of kin; the rest of us are often present there, waiting for those in mourning to stop being sad: to let go, and to move on. The reality is that they will grieve forever. They will never get over the loss of their loved one; they will only learn to live with it.  They will heal in due course and they will rebuild their lives around the loss that they have suffered. At some point, they will perhaps be whole again but they will never be the same. In any case, neither should they be the same, nor would they want to be.
Years will pass and you would still at times find yourself disagreeing with people who are dead

Saeed Wahlah was a thoroughly interesting man. We came across each other for the first time when the Chief Minister (CM) of Punjab was interviewing him for a District Coordination Officer (DCO) posting in 2008. When asked about his style of management, Wahlah came up with an anecdote about the most successful Australian-rules football team. It ended with the coach pronouncing, “The secret of my success is to put good men to work, and then go to sleep.”  The CM became perturbed and asked, “What if one cannot sleep and there are no good men to rely on?”  Wahlah replied, “Sir, men get separated from the boys when I lead them into battle 24/7. Where sleep is concerned, if one does not have a psychiatrist-in-residence, sedatives can be handy!” The CM was not amused, but the Chief Secretary of Punjab came to his rescue and Wahlah was appointed.  In the years to come, this hard-to-please CM was to declare him his best divisional Commissioner.

I had not known him for long enough to deserve the way he felt about me and vice versa. Sometimes, friendship isn’t about whom you have known the longest - it’s about who came and never left your side. There were many dimensions to him - obsessional, angry, charming, generous, funny, romantic, loyal and ambitious. People believed only what they saw. He knew many people but had few friends. Tariq Mehmood Khan adored him for living many lives in one. Nabeel Awan admired him for finishing whatever he started - except perhaps the story of his own life. But, a book is judged by the quality of its contents and not by the number of pages, and some of our best symphonies are also “unfinished”.  It is a blessing to have known Wahlah and his passing served as a reminder that our time on Earth is limited and we should seize the opportunity that we have to love, forgive, create and share.

It is a common practice in Pakistan to expound one's own philosophical or religious worldview to a grieving person
It is a common practice in Pakistan to expound one's own philosophical or religious worldview to a grieving person

It is really difficult to know how to be with someone who has experienced sudden bereavement because the victim goes through various stages of grief at his or her own pace. The bereaved often experiences a shock, followed by numbness, anger, despair, denial (‘it is not happening’), self-blame, periods of crying, anxiety, nightmares, lack of appetite, loss of interest in life, etc.  Some are terrified of being left alone; others want to hide away.  Some shun any offers of lending a hand. Being a friend or a relative, how could you help?

For a start, always try and be there whenever you can. When you get there, even if you don’t know what to say, make a point of saying something as simple as, “I’m really sorry to hear what has happened.”  Then leave it to them if they want to talk about it.  If you cannot be there, make sure you call, text or send a card.  Nothing can make the situation better. But it’s about being there to listen when needed, and being willing to cope with someone who is either traumatised, numb or in a state of shock. You may feel helpless around the person because you are unable to ‘do’ anything to fix things. If you can hold on to this discomfort, you will be the support they need. Be sensitive to the fact that this person’s life will never be the same, nor will they ever ‘get over’ it. However they may find ways to cope with what has happened. This can take years, if not the rest of their life.

If you are allowed, just be there. However, do not try to tell the bereaved what to think or what to do, or offer your own spiritual or religious wisdom. This can, on occasions, make the situation worse, especially when someone’s life has been thrown into unexpected turmoil.  Instead, try and do something practical to help them, such as tidying up the house, looking after children, putting food in the freezer, helping with the visitors, etc. Don’t take offence if your offer of help is refused but just be on hand to help out when asked. Please don’t be embarrassed to talk about your own experience of grief. However, try not to dwell upon it - that could take the wind away from their sails.

Some people are going to leave, but that’s not the end of your story. That’s the end of their part in your story. It is not necessary to hold on to the grief in order to hold on to the one you lost. Coming to terms with the loss doesn’t mean letting go of the love you had for them, or forgetting them. When tragedy occurs, it also presents a choice to us. You can give in to the void, and the emptiness that fills your heart, your lungs, and constricts your ability to think or even breathe. Or you can try and find meaning. In the ensuing days, one may spend many moments lost in that void, and also feel there are future moments queuing up to be consumed by the vast emptiness. But when you can, you should choose life and meaning. I could never understand the meaning of the prayer “Please do not let me die before I live” until I, myself, was stricken with grief.

As soon you recover some of your strength, try getting back to your day-job.  This is likely to be your saviour: it would make you feel useful and connected. At work, you would need to let your colleagues in by being open - it is okay to feel vulnerable. Let them ask questions. Tell them that it is all right for them to talk about how they felt.

Years will pass and yet you would still at times find yourself disagreeing with people who are dead. The present disagreement would be a remnant of an issue from the past. For example, perhaps you could never get your father to see the merits of your career choice, so you try to convince him via getting worked-up with the person sitting next to you at a dinner table. It is just that when someone goes away, you do not get over his or her absence by forgetting, you fill that void by remembering in other ways. I strongly believe in the maxim that people you love become ghosts inside of you and in this manner you keep them alive. When I once relayed this to Wahlah, he chuckled, “When I die, I want to go peacefully like my grandfather did - in his sleep. Not yelling and screaming like the passengers in his car!”

Dr. M. Aamer Sarfraz is a Consultant Psychiatrist & Director of Medical Education in London. He is the author of ‘People, Places & Pickles’ and ‘Talking Points’

The writer is a consultant psychiatrist and visiting professor