ANTICIPATORY GRIEF

        This is the second article in my series of posts on my experience of grieving the recent loss of my wife Margie. My next article will be entitled "Savoring Love."

ANTICIPATORY GRIEF

Like most pastors I have read many books and articles about grief. In her first classic text, On Death and Dying (Simon and Schuster/Touchstone, 1969) Swiss psychiatrist Elisabeth Kubler-Ross identified five stages of grief (1. denial and isolation, 2. anger, 3. bargaining, 4. depression, 5. acceptance).

The girl I married . . .

Some still want to impose those five stages on the grieving process and have applied them even to what has been called “anticipatory grief.” More recent writings have moved away from such a linear approach, with which I was never comfortable. I have never felt any anger about my wife Margie’s death. Perhaps I would if it had been the result of someone’s incompetence, or negligence, or violence, or failure in some manner.
Nor have I felt any sense of denial or isolation, and I certainly wasn’t trying to bargain with God. I was always hoping that some new miracle drug or medical process might be found in time to cure her or at least prolong her life, but from the first moment we received the diagnosis of her fatal disease, we both accepted it. We were in “stage 5" from the start, if you want to call it that.
As for stage 4, I am sad but not dysfunctionally depressed. Sadness can cause one to feel depressed at times. It’s the periodic realization of the never-again aspect of a precious relationship, the ever-present absence and the ever-absent presence of one’s beloved spouse, that causes a sinking feeling in one’s heart. I’ve had moments of feeling depressed, but I certainly haven’t gone through any stage of depression. Counting my blessings dispels my momentary depression, but not my abiding sadness.

I mention these things because some people might want to think of anticipatory grief as a “stage.” It is a stage only in that it obviously occurs before one’s loss. I want to talk about it not as a stage but as recurring emotional experience, and not theoretically but experientially.

. . . and will love forever.

From the moment I first committed myself toMargie, heart and mind, I could hardly bear the thought of life without her. She felt the same way about me. We never took one another for granted. As our love deepened and matured with the years, our mutual appreciation of and dependence upon each other was continually growing. We shared the same interests, the same values, the same outlook on life, the same political views, the same faith. We agreed on how to raise our children, who quickly learned that their Mom and Dad were a united front. We comforted each other in times of sorrow, supported each other in times of stress, were there for each other in times of need.
So when Margie was diagnosed with uterine cancer in 2001, I was immediately devastated at the thought of losing her. But we both were hopeful that it had not metastasized. She underwent a complete hysterectomy and after three years of regular follow-up examinations was pronounced cured. She was a cancer survivor!
The possibility of Margie’s death gave me my first experience of anticipatory grief. It was quite different, however, from the grief I experienced after she was diagnosed with acute myeloid leukemia. That was a death sentence. She was given twelve to eighteen months to live. The diagnosis of uterine cancer was not a death sentence; there was a good possibility she would survive, and she did. We praised God for that.
But there was no chance of her surviving the rare combination of AML and leukemia cutis. The thought of life without Margie was for me no longer an imaginative supposition. It was a reality I would be facing all too soon. Now I was grieving in anticipation of not having her in my life any more.
Margie was so courageous, and more stoic than I. She hid her illness well. People in our community had no idea what she was having to endure. She never complained, despite the  discomfort of the radiation treatments, her almost constant nausea, and the horrible sarcomas that covered her body. I would change her bandages every night, and during the day when they needed it.  She was so grateful to have me as her primary care giver; for anyone else to do for her what I did would have offended her modesty. She wanted no one else to see her sores, especially our children and grandchildren.
Margie had her own anticipatory grief. Because of her strong faith, she was not afraid of death. Whenever we talked about being separated by death, however, she would sometimes say, “I wish we could go together.” That was simply her way of expressing her sorrow for me, knowing how much I would miss her. But we both knew that while dying together would spare one of us the grief of separation, it would be so much harder for our children to lose both of us at once. Neither one of us wanted that.
  There is a positive side of anticipating death. Knowing our time together was limited, we made the most of it. We talked long and often about every aspect of our situation. We savored every second we had together, and we prepared for the time to come. We put everything into the context of our faith, and our prayer times were immensely meaningful and comforting. We did not grieve as those who have no hope.
On the practical side I had the opportunity to ask Margie all kinds of questions. She made lists indicating where things were and what I would need to know about the routine household chores and matters she had been regularly attending to. She made known her wishes about her memorial service and burial, and what to do with her important possessions, and which items should go to whom. We both had wills and living wills and had indicated our desire to be cremated.
Our children and grandchildren were a great comfort to us and most helpful throughout Margie’s illness. She treasured every moment with them. Caring for her family had been her vocation, and no one could have been a more devoted wife, mother, grandmother, or great-grandmother. Every member of the family had his or her special relationship with her, and each was experiencing his or her own anticipatory grief.
         Despite all the blood tests, infusions, and radiation treatments, Margie and I went about our lives fairly normally at first. As the months rolled by and she was slowing down, I would wonder if we were doing this or that for the last time. She had almost completely lost her appetite. She had cancelled her appointments with her hairdresser and her manicurist. She endured but was completely exhausted by visitors, but shortly before she died she wanted to see her dear friend Eileen Moffett one last time. She mustered up the strength to drive with me to Cooperstown in September, where our daughter Elsie serves as pastor of the First Presbyterian Church. We both knew it would be Margie’s last visit.
I wondered how all my grieving in anticipation of her dying would impact my reaction to her death, when it finally occurred. Would it make it easier? The answer is emphatically no! If anything it made it worse. That’s because anticipatory grief is penultimate grief. Your loved one is still there. She or he hasn’t gone yet. There is still time to say “I love you,” still time for another hug, another kiss. Anticipatory grief makes the finality of death all the harder to bear, because now your loved is no longer there. He or she is gone forever. Grief after death is different from anticipatory grief . Both are difficult, but anticipatory grief has a “not yet” quality about it.
Throughout her terminal illness I played the piano for Margie often, all the while grieving inwardly that the time was coming when I wouldn’t have her to play for. I know about anticipatory grief! In the anticipatory stage she was still there. I could talk with her, be with her, give her a hug, tell her I love her.  We had our little routines. For example, when I would ask her, “Do you know how much I love you?,” Margie would always reply, “Not as much as I love you!” I would become so sad at the thought of not being able to have those loving exchanges.

A former familiar scene with the addition of
great-grandson Gabe. Margie is in her chair.

Now I can only pretend. I still say my lines, but there’s no response. Even so I talk often to Margie, when I’m alone. I play the piano, pretending that she is sitting in her customary chair, loving every note. One of my presents to her on every birthday or anniversary or holiday was an hour-and-a-half or two-hour “concert,” when I would play her favorite songs, always ending with “Margie, I’m Always Dreaming of You, Margie.”
For weeks after Margie died I didn’t want to play the piano. I felt it would be too emotionally difficult for me, because it would evoke so many precious memories and tender moments. But late one night, in the midst of my tears, I sat down at the piano and started playing and singing “Margie.” I was weeping the whole time, but I felt so close to her.
That broke the ice, and from then on I’ve been playing often, though not always without tears. The words of so many of “our” songs have taken on a new meaning for me since Margie died, like this final line from one of my own songs: “Since she went away, I’ve been so awfully blue.”
Little did I know how blue, when I wrote that song many years ago.