Saturday, February 18, 2012

Denial & grieving

I have always known what denial was, but have never really experienced it to the full extent of what it can be, until last friday.
 When my mom got diagnosed with stage 3 breast cancer a few years ago, i guess i sort of was in denial, but only a little bit. I accepted the diagnoses and would cry and pray about it often..but thats all. Whenever she would talk to me about plans for the unsure future, if she died sometime soon, how me and my sisters would have to move on and keep living our lives etc...i would just push it to the back of my mind, tell her i didnt want to talk about it and run to the bathroom to start crying. I thought that i was denying the fact that my mom could very possibly pass away in the near future. (thank heavens she is alive and well today!) But that was my way of living in denial. i just didnt want to discuss it with her, even though i knew it was there. i knew it was a possibilty, i knew i may have to deal with something traumatic soon...but i chose to not deal with it 100%, and thats how i got through. I accepted it, privately grieved over the possibility of losing my mother, but chose to not discuss it with her. I thought that was denial.

But last week at the hospital i ran into full fledged DENIAL, and i have never felt so strange talking to someone who was clearly not in the state of mind for greiving, when thats where her heart should have been. Everyone grieves differently...but i had never seen this before.

(Being a social worker in the hospital has opened up my heart to so many sad, and heartwrenching situations....sometimes i wonder if i can do this for the rest of my life, because it sort of makes me crazy.)

Last week we got a call while in our pediatrics meeting, that we had a '38 week demise' we needed to attend to in Labor and Delivery. The mother (lets call her..Jane Doe.)...had worked in an OBGYN office just down the hall from us at the hospital. She had difficulties with infertility, previously had a miscarraige, so this time around tried in-vitro. Jane finally carried and held on to her pregnancy, and im sure working in an obgyn got all the special treatments from the doctors there. She was close with everyone in the office, and everyone was very attached to her and this pregnancy she was trying so hard for. She recieved an ultra sound that day at work from her doctor and friend, and the doctor found that the baby's heart had stopped beating. And that was it. Jane immediately wanted things taken care of, so she checked into L&D about a half hour later. After Jane had left, the doctor was in tears for her friend, and handed off the case to a colleague. The nurses we talked to all were heartbroken, the social workers felt a pang of sadness...everyone involved in the case just had a heavy heart this day.

After giving Jane and her husband about an hour to get a grasp on the situation and get situated in their room, and try to fathom what had just happened, my boss and I entered their room. Initially, it just felt weird. Aside from her reddened eyes, it seemed like any other post-partum consult, but maybe the mother and father had been fighting before we entered?...which would have been weird for a situation like this. Jane's husband was sitting almost on the other side of the room, far away from her hospital bed. Jane was sitting up in bed and could tell was still trying to grasp that her 38 week old baby, whom she had felt kick in her tummy only hours before, had stopped living. I couldn't stop staring at her huge, beautiful pregnant belly.

We began to discuss the circumstances they were under and gently explained the greiving process that would be ahead of them in the days/months to come. We always talk about how men and women greive differently, and you could obviously tell with this couple we needed to talk to them in depth about this. Jane's husband seemed absolutely flat...had no emotion, and it was as if he was sitting in a work meeting just being BORED...bored and maybe a little bit angry. He showed nothing and did not look up to make eye contact when answering any of the questions. It was almost as if he was angry with later on that day, we made sure to discuss that sometimes couples need to find a reason why this awful thing could have happened..and sometimes people blame theirselves or their spouses. We appropriately made it clear it was neither of their faults..talked more about the stages of grief they may be feeling..and moved on. He didnt seem to care or be listening to us. He still was flat and far away, obviously not present at the moment.

 Jane on the other hand, aside from her slightly swollen eyes, was very talkative...and giggling after almost every sentence. We began with the necessary mortuary paperwork (a word that you hate to even think about or mention in a situation like this) and all the other legal documents that needed to be signed that day. Paper after paper, not a single tear. Just professionalism and the occasional giggle. When she laughed, i watched her 9 month baby bump jiggle..and it pulled at my heart to know that her babe was in there, but she would never get to fully meet her child. Why was she laughing? Why was she alright and signing all these death certificates without any tears running down her face? Yes she was in shock..but I'd never seen shock like this before. And why wasn't her husband holding her hand or at least sitting by her?

I felt a complete punch in the stomach when we asked for the baby's name for the death certificate..Jane had to get her husbands attention because he was on the phone..and after a few seconds of questions to her husband, she said they hadn't really decided on a name yet. *painfully hurtful silence*  I wanted to get up and run outta that room. Not because it was a miserable subject, but because they weren't really even sad when they had said it. He was on the phone, she was being businesslike. If someone had asked me what i was planning on naming my unborn child who had literally just passed away, I would break down... absolutely break down. I'd kick the stupid social workers out and demand privacy and some tissues. I would make my husband get in the hospital bed with me, and hold me while i sobbed and snotted all over, while i held my pregnant belly.

Now please know, i am not criticizing their grieving process. Everybody grieves differently. And pure denial, not choosing to recognize what has happened, is just a serious defense mechanism. And I felt so sad for them. I felt even more sad on this case than the cases where I feel my eyes sting with tears when I see the mother cradle her empty stomach and talk about her baby she had just lost. I just wanted this couple to recognize what had happened...because the healing process would be so much longer if they chose not to accept what was happening.

Towards the end of the day, Jane had told us that she wanted to immediately make plans to get pregnant again and that her doctor said it was fine if she did. She still had her baby inside of her and she was already making plans for a new one. I couldn't understand it still. Medically and emotionally that is not the healthiest thing to do after a loss like this.

I knew the true grief this mom would experience would not hit for at least a week, maybe even a month-6 months. She was not dealing with the truth. This baby she had planned for, for a VERY long time, would not be coming home with her, and she claimed she realized it, but she didnt. I wanted to hug her and tell her to cry. I wanted to tell her husband to go hold her and hand let his wife know that it was going to be okay!

Doing grief counseling with couples during a fetal demise always pains me because i have a dear friend who has gone through this situation, and listening to the pain and emotions she went through over the months just made me ache for her and with her. It makes me hurt for every patient who loses a child. Whenever we get called onto a fetal death, especially a late-term  fetal death, it is very hard to grasp that the situation is real, and that people will live with this memory the rest of their lives. They will always remember that day on the calendar, and they will always remember the details about when they heard the awful news.

Perhaps the news had not hit Jane and her husband. Perhaps it hit them and they refused to believe it was real. Perhaps they had had so many let downs in the past, that they were used to grieving and this was just another hard situation they would have to get over and this is how they 'deal'.

I just hope that when i'm a legit social worker..and have a real, grown up job all by myself..I will be able to help grieving women in times like these. If i wasnt 'just an inten' i would start a greiving group at the hospital for moms who had lost their babies... because moms who accept the loss need help grieving and going through the motions to get back into their daily routines, but moms who don't choose to accept the reality of their loss, need it even more. And i pray i will be able to learn what to say and the appropriate actions to take in future cases like this one.

At the end of the day, after you've done all you can do, you have to let go of your cases and that sucks. But i still take them home with me and still think about them for a while until my head starts to hurt..and...until my heart settles and believes i've done everything i could have done to help those patients.

Grieving is hard, but living in denial is even harder.


Blane181 said...

I came across your blog via 20SB. My heart breaks reading this post and I hope that this couple comes to grips with everything that has happened and are even stronger because of it. You are incredibly strong for doing this, I don't think I ever could!

Kelly Bryson said...

My brother and sister in law went through this a few months ago- except their baby died a couple of days before the due date. My SIL recognized that for her, the best way to get through delivery was to not think any farther ahead than the next step, then the next step. She was cheerful as well. It's sad that the couple here weren't able to be supportive/seem connected, but they may need some time to process the loss.

Something that was helpful to our whole family was to come down and meet the baby just as we would have if she had been born alive. The nurses dressed her in her blessing gown and we counted her tiny toes & touched her soft, fuzzy hair. My husband and I left it up to our older kids (ages 9 and 11) if they wanted to see her. One chose to, the other did not. It helped us to understand the depth of their loss and to show my B&SIL that they're not alone in grieving.