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When counselors grieve: Witnessing a loved one approach death gracefully

By Suzanne A. Whitehead March 21, 2022

My wonderful, dear, precious mother is dying. She has terminal metastatic cancer, adenocarcinoma, that began in her colon and quickly metastasized to her liver. She first started experiencing periodic stomach pains in early 2019, but numerous tests and exams divulged no significant results. We were concerned for her but felt relieved when all tests came back negative. It is with her gracious permission and indominable spirit that I relay our story.

When the global COVID-19 pandemic shut the world down in March 2020, we sheltered in place as most Americans did and prepared to ride out what we hoped would be a short storm. I was teaching remotely from home, and as the coordinator of a counselor education program, I was blessed to be able to make the final decisions on that front. As May 2020 rolled around, my mother complained off and on of more stomach discomfort, but it would quickly fade and was nonspecific. On May 18, however, she woke with great discomfort in her belly. A trip to the doctor led to more tests, and we were finally able to schedule a barium swallow exam for early morning on May 20.

My mother endured the pretest liquids with great difficulty but was eventually able to have the test completed. She came home with us, feeling exhausted and very nauseated. The vomiting soon ensued, and she became increasingly uncomfortable. Our alarm grew after making frantic calls to the doctor throughout the day and taking a resultant trip to the emergency room in a neighboring city.

After my mother had a thorough examination, a surgeon was consulted, and a blockage was located in my mother’s large intestine. Papers were hurriedly signed, and we kissed my mother goodbye. Due to COVID-19 restrictions, no one could stay with her. My mother was 94 at the time and scared to death to face the operating room alone.

The surgeon called us close to midnight. My mother had made it through the surgery OK and (miracles as well) did not need to have a stoma or colostomy bag put in. The surgeon believed he had been able to dissect the entire tumor but would have to test the margins of course. This was a slow-growing tumor, he told us, and my mother had probably had it for some time. Due to her advanced age, even if it ever spread in her colon, she might actually pass away from something else entirely. So, not to worry, he said.

Recovery in the hospital was a nightmare. The first night went well, but my mother had sadly aspirated the next morning and wound up with pneumonia. The medical staff was trying its best to help her, but that becomes trickier with advanced age. My mother is a bit hard of hearing, has short-term dementia-related memory loss and can be a very feisty Italian lady. She stands all of 4 feet, 4 inches and has severe osteoporosis that has resulted in very pronounced scoliosis of her spine. Therefore, she cannot, lie flat and must have the head of her bed propped “just so” to even sleep. I learned later that the medical staff had called the crash cart twice for her, almost losing her in the process.

I tried frantically to get answers as my mother seemed to linger but not improve. Several days went by, and numerous “hospital specialists” were assigned to her case, but none realized all the nuances of her interwoven symptoms. My first career in life, before I became a substance use disorder counselor, school counselor and university professor, was as a respiratory therapist. The names of some of the equipment have changed over the years, but not a person’s anatomy and metabolic processes. I was therefore able to keep up with the physicians regarding the dire circumstances of my mother’s respiratory acidosis, lowered PO2 oxygen levels in her blood, and the infiltrates and atelectasis in her lungs.

The head medical staff finally acquiesced on my mother’s eighth day there, and they let me visit her. My counselor training helped profoundly in working with everyone in her care. My mother was quite in distress when I first arrived, but as is often the case with family visits, began to thrive. The nursing staff said I had to stay put in her room, and they brought me meals and provisions. By the second day, I had her up walking. I swapped places with my grown daughter, and by the fourth day, they said we could take my mother home. It was indeed a miracle that we were able to wheel her out of the hospital.

Twists and turns

We took the rest of the summer of 2020 to help my mother recover. It was slow going, but she gained strength each day. It was decided that the fall of 2020 would be taught remotely at my university, so I looked for a wonderful place for her to convalesce. I was incredibly fortunate to find a condo for rent right on the ocean, and we spent the month of September sitting by the ocean, taking long walks on the beach, watching the boats sail by, and loving every minute of life.

My mother was feeling stronger by October and was even cooking again, which is her favorite pastime. A monthly checkup raised some concerns, and more tests were ordered. To our heartbreak and dismay, the cancer had massively invaded my mother’s liver and was voracious. Her oncologist suggested chemotherapy medication that she could take at home but, sadly, it would perhaps prolong her life by only a few weeks or months. There was no cure or other treatment.

My irascible and feisty mother said she wasn’t ready to give up, so we began the ritual of chemotherapy pills at home just after Thanksgiving. She seemed to tolerate that well until just a few days after Christmas. The pills had reduced the size of her tumors, but she became quite toxic to the point of having constant diarrhea, vomiting and not eating.

January 2021 rolled around, and my mother was still quite ill from the chemotherapy. With incredible strength of will and sheer grit, she fought on and finally began to feel a little better by the end of the month. Her oncologist introduced the chemotherapy again, but at a lower dosage, and she tolerated that well.

By June, her tumor marker blood tests showed that they had been reduced by over half. That was indeed remarkable in and of itself. Her oncologist had thought in October 2020 that my mother might possibly live up to another year; by June 2021, she seemed to be thriving. Incredibly, we were able to bring her to Hawaii that month, where I was presenting at an international conference that had been postponed from the year before. We were so very blessed to have that conference occur during the brief “sweet spot” when COVID-19 seemed to diminish a bit and the delta variant had yet to arrive. The trip was glorious. Several family members joined us, and we were able to visit many places we had gone to when we lived on Oahu a few years previously.

Early July brought another jolt of reality when another severe colon obstruction landed my mother in the hospital. After six days of intense, painful therapy and tests, my mother was slated for additional surgery. Her physician was extremely cautious and tentative about her prognosis. Literally, at the eleventh hour, just before her scheduled surgery, the treatments they had given her began to work. Another miracle had occurred! Three days later, we were again able to wheel my mother out of that hospital, without more surgery. It was a day to celebrate.

Sadly though, by September, her blood tests revealed that her tumors were growing again with a vengeance. The painful decision to stop the chemotherapy was agreed upon, because by then it was doing her more harm than good. Fall 2021 also had its extreme joys, however, as we were able to celebrate our daughter’s very tiny, but beautiful, wedding on Nov. 6. My mother was able to stand up for her as the matron of honor; it was a poignant and blessed day for all.

The long goodbye

The holidays have now come and gone, and again I marvel at my dear mother’s strength and perseverance. Despite our fastidious precautions, with all of us getting the vaccines and booster shots, COVID-19 entered our home in early January, and we all became infected with the omicron variant. It is a true testament to my mother’s will that even COVID-19 cannot stop her. Her symptoms resembled that of a bad cold — something else she could have done without. Thankfully, however, she made it through that horrible hurdle too.

Painful realities remain though, and we all agreed in late January that the time had truly come to begin the hospice process. I have never had hospice services for a loved one before, and there was a lot to learn. Some of the realities were quite painful, such as that my mother cannot see her established physicians any longer. We’ve also been asked several times to consider a “Do Not Resuscitate” order; we’re not quite there yet. I am reminded once again that death and dying is a process, not an event.

A plethora of nurses, social workers, delivery workers (bringing oxygen tanks, shower supplies and comfort meds) and a minister for spiritual support have come to visit. The very slow reality of the long goodbye is now at hand. As a counselor and university professor, I “know” about self-care, the many aspects of grief and loss, the need for continued support, and the existential angst one feels when realizing that nothing else can be done. It is an empty, hollow feeling that begets profound sadness.

I am extraordinarily blessed with wonderful family support. My husband and I have three grown children (two of whom are nearby and one six hours south), a wonderful son-in-law and daughter-in-law, and two amazing grandchildren. My university colleagues have been immensely supportive, as has my faculty and staff. I have the dearest friends one could ask for but, sadly, most are a great distance away. The miracle of iPhones and the internet have helped with that.

The pandemic has brought innumerable obstacles and immense sadness, pain, distress and heartache to us all, in one form or another. For us, it has meant that the last remaining months and days of my mother’s life must be limited to home. Yet serendipitously, I have been given even more precious moments at home with her. The days of shopping together, visiting nearby museums, going on short camping trips or talking for long hours at a lovely luncheon spot have all ceased. Instead, the tiny joys of taking an afternoon walk, watching a great movie together or enjoying the sunshine and warmth on our faces have taken on greater significance.

I marvel at my mother’s internal strength, her spirit and her deep love of life. I sit in despair sometimes as I watch her try to catch her breath, see her moving much more slowly, and recognize the distant look in her eyes; I wonder where she has drifted off to at times.

We talk often. She shares her innermost fears, regrets (blessedly, very few), and final wishes with me. These are sometimes painful talks, but they are necessary, cathartic, and I let her choose her timing.

I find myself walking with great trepidation down the long hallway to my mother’s bedroom in the morning when I haven’t heard her stir yet. Will I at some point just find her gone, peacefully? Will she have to suffer greatly (I fervently pray that she doesn’t), as my dear father — her husband — did from cancer so many years ago? Will I be able to let her know how very, very much she has meant to me, how much she is so dearly loved by us all? Can I properly express that without her, I never would have become the counselor, teacher, mentor and social justice advocate that I am? My family and I have been blessed by her comfort, wisdom and beautiful spirit for close to 96 years now. Letting go by inches is so incredibly difficult …

A shared reality

So many of my dear counselor colleagues, friends and students have lost loved ones due to COVID-19 over the past two years. We have shared this reality as human beings, and together we mourn each loss. I have been honest about my mother’s condition with all of them so that they realize that even counselor educators deal with grief and loss. I teach all my students about the vital importance of knowing your limitations, knowing when to reach out for support, knowing when to step back and take a break, knowing when you are not at the “top of your game,” and knowing that it is OK for us to be fully human.

Perhaps putting my thoughts into words here is just my way of doing so. I hope that for those who have endured or are enduring similar circumstances, my words can offer some support, connection and solace. It is our humanity and spirit as counselors that binds us.

So too, as counselors, each of us has helped dozens, if not hundreds, of people cope and work through their grief and loss. It is part of our very nature. It is what we do, and we are honored to do so. We have learned our craft well and know what to say, how to say it and how to sit with another human being during their profound sense of pain and despair. We must make that kindness and compassion that we so freely give to others available for ourselves as well.

My mother is dying with grace; I am learning from her strength to honor her journey thusly. I will grieve horrifically when she passes. She has asked me not to grieve so, but that would be impossible. What a gift she has been to my entire family, that she even worries about how we will feel once she is gone! The price we pay for loving someone so fully, so unconditionally and so openly is to grieve their passing with our whole heart, soul and being. To have been eternally blessed with her love, I would not have it any other way.

Leon Seibert/Unsplash.com

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Suzanne Whitehead is an associate professor and the program coordinator of the counselor education program at California State University, Stanislaus. She is a licensed mental health counselor, a retired school counselor and a licensed addiction counselor. Contact her at swhitehead1@csustan.edu.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

8 Comments

  1. Courtney

    I stumbled on this while looking for insight into cancer-specific grief on an overwhelming day. Reading your words offered a more forgiving perspective on my own pain after losing my mother at 62, just weeks before the pandemic on my 31st birthday. Living alone now in an unfamiliar city, I did indeed find comfort and solace in your words.

    My most prominent takeaways —

    “I teach all my students about the vital importance of knowing your limitations, knowing when to reach out for support, knowing when to step back and take a break, knowing when you are not at the “top of your game,” and knowing that it is OK for us to be fully human.”

    “The price we pay for loving someone so fully, so unconditionally and so openly is to grieve their passing with our whole heart, soul, and being.”

    Thank you, again. From a grieving daughter.

    Reply
    1. Dr. Suzanne Whitehead

      Dear Courtney,
      I so appreciate your kind and thoughtful words; they have touched me deeply. I also lost my dear father to cancer when he was just 51, and my dear husband and I were 8 months pregnant with our first child, Grief seems to find you, regardless of timing or life’s plans. I am so very sorry to hear of the loss of your dear mother; she sounds like an amazing soul! I am glad to know that my mother’s and my story somehow brought you some solace and comfort. As counselors, we are all connected, I believe, and it’s the very least we can do for each other. I will keep you in my prayers, Courtney.

  2. Shelisse Sims

    As I stumbled upon your article, I was able to empathize and sympathize with you, Dr. Whitehead. You are truly blessed to have had the opportunity to be raised by such a wonderful mother! Whenever she decides to transition from this life, I believe that you will find an inner strength to continue with grace in her honor. I can tell that she was a great example for your and your family; a pillar that cannot be replaced, but will forever remain because of her dedication & love for you all. Though you have the skills and tools to deal with the inevitable grief that will ensue, I pray that God’s peace will sustain you and your family. What a blessing to have been able to share so much and create such beautiful memories with someone you love so dearly!

    Reply
    1. Dr. Suzanne Whitehead

      Dear Shelisse
      Thank you so very much for your dear and warm post! You are so very kind to write your heartwarming words about my mother; they have meant so much. It is so very painful to watch our precious loved one leave us by inches each day. But, we are surrounded by our love and fond memories of a life well-lived together. I so appreciate the time you took to write your comments to my article. I am humbled to know you were able to empathize with my writing, and I am overwhelmed with your incredible blessings. i too will keep you in my prayers, Shelisse, and I wish you much peace and comfort. Be well.

  3. Amber Madden

    I loved reading your article. My mom was diagnosed with cancer at 70 in October 2021. It was a very quick, downward spiral full of much of what you summarized here. However, we did not get to say goodbye as I had hoped. She became ill, went into the hospital and because she was still fighting, we had hoped she would come back home to begin treatment. Unfortunately, she caught covid while in the hospital. We were restricted from seeing her. I never really got to say goodbye because the last time I told her goodbye, I didn’t know it was the last time. I’m glad you were able to bring your mother home. I wanted that more than anything. I can only hope that she knew how much I wanted to be there with her. And no… as a counselor, I don’t know if it gets any easier. I suppose it just gives me a different perspective now of grief and grieving.

    Reply
    1. Dr. Suzanne Whitehead

      Dear Amber,
      Thank you for sharing what has to be a very difficult part of your life. i can empathize greatly with your pain as we very nearly lost my dear mother during her first operation in May 2020. They would not let us go to the hospital either to see her, but by the 10th day, she was suffering from so many complications, that somehow when i begged, they let me come. It is a miracle she even survived the extensive surgery. When I got to the hospital, the nurses saw my mother rally in just a few hours, so they secretly let me stay in her room and brought me food. To this day, I am so very grateful for their compassion! I cannot imagine the sorrow you must have felt not to be able to be with your mother. I believe it is a fervent wish of all of us that our loved ones somehow truly know how very dearly we love them and would do anything to be with them. I don’t know you, but just by your heartfelt words I can tell that you are a very caring and loving person. I have no doubt whatsoever that your mother felt and knew that with every fiber of her being. You are definitely in my prayers, Amber.

  4. Ann Marie Petricca

    Thank you for sharing your lovely words. I agree it is a blessing to feel sorrow and loss because it is also to feel love. In 2019 I completed the long goodbye to my mom. I had said goodbye to my Dad in 2018. I was a 48-year-old single orphan. My twin boys lived only a second when they were born in 2013 at 16 weeks. Now my family was all at the same beautiful cemetery. Grief is love equally as much as joy. Love is an action, not just a feeling or a state of being. To love means to care, to have gratitude, to have respect, to cry when saying goodbye.. for a long time..to wonder where she is now. My mother promised she would find me if I were to need her no matter where she would be. “Nothing can ever separate you from my love.” Even now writing to you, I enjoy my sorrow. It connects me to my mom. Some people told me “it will never get easier.” I kept wishing I could go with my mom. That was a terrifying state of mind. Thanking God today they were wrong. About a month after my mom died, I found the love of my life. Through him, I became a mom to a now 5-year-old beautiful girl. My mother is always near as I try to be 1/2 as great a parent as she. I think of the words of Thich Naht Hahn..”We do not mourn the clouds as they turn to rain. Neither need we mourn our loved ones.” I see my mom in the spring flowers, the snow on the tree branches, the leaves changing color, and the gifts of the sunrise. My prayers for your peace. My gratitude for your story.

    Reply
    1. Dr. Suzanne Whitehead

      Dear Ann Marie,
      What a beautiful, dear story! I had tears in my eyes as I read about your journey. The highs and lows of your life have been tremendous, from losing your twin baby boys, to your father, and then your mother. It must indeed have been a very dark and lonely time for you, as you mentioned. Somehow, life had different plans for you and you were able to find the love of your life and even have a beautiful daughter! I too lost my dear father when I was 8 months pregnant with his first grandchild; at the time, I thought I would never be able to smile again. But somehow, we do go on, and wonderful joys can be had. I appreciate your caring sentiments so very much; it does help to know others can identify with having such loss. My dear mother was able to celebrate her 96th birthday with us last week; what a blessing! We learn to cherish each moment even more, to not take things for granted so much, and to be grateful for the small wonders of life. I wish you great peace, Ann Marie. I too see and hear my amazing father in my grown children’s faces, in the quiet moments of my life, and in his precious legacy. My warmest blessings to you!

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