A pink heart on sagging cracked concrete;  broken heart concept

“The horse came out of the barn.”

These six words from my husband’s oncologist changed our lives forever, even though the sense of impending loss had begun weeks earlier with a blood test. There would be more tests, exams and visits to specialists. While George and I waited for the final diagnosis, we bargained with ourselves and with the universe. When we finally met with the cancer team to go over all the tests, George, 6ft 2in, could hardly fit at the small table where we watched the conversation intently. Hearing the word “metastatic”—meaning that the cancer had spread throughout his body—was like running your nails across a blackboard.

But there is no real way to prepare for grief, an inevitable feature of the human condition. His stress after the death of a loved one can lead to physical illnesses: cardiovascular disease, broken heart syndrome (takotsubo cardiomyopathy), cancer, and ulcers. Emotional distress often causes physical ailment, known as somatic symptoms. How each person experiences grief is different. Comfort takes different forms for different people. While my journey is individual, my story touches on universal themes, especially for those who are grieving during COVID-19.

Preemptive grief strikes first

George’s diagnosis was advanced metastatic prostate cancer that had spread to the lymph nodes and bones. There would be no operation. No radiation. No chemotherapy. Only palliative care.

For several days, George only wanted to talk to me. On other days, he wanted to talk to those who were “in the same boat.” He saw himself cast ashore on a new, unknown continent. I felt washed away with him. The National Cancer Institute describes these feelings as preemptive griefa reaction that anticipates an impending loss.

Over time, we returned to daily activities. Sometimes we laughed and did not think about his illness. George even conceived and organized an annual party for his best friends – the men who were supposed to carry his coffin – and their partners. The “coffin party,” as it came to be known, was a surprisingly noisy event. The grown men laughed to tears. Every year, by the end of the night, I knew I was crying from the anticipated loss.

George lived another 11 years, more than twice as long as expected. But the anticipation of his loss did not soften my broken heart.

Acute grief after death

George died in May 2020, at the beginning of quarantine due to COVID-19. Despite dress rehearsals with a coffin, there was no funeral, no meeting of relatives. Nothing to ease my overwhelming pain.

In those first few weeks, time seemed stretched out, moments repeating like musical notes on a scratched record. I felt detached, anchored, adrift. My sides hurt from crying; my knees were unstable. I don’t remember eating.

At the funeral home, when I saw George in the coffin, the large room seemed bright from the light falling on the shiny wooden floor. Later I realized that the room was much smaller and darker than I remembered, its floor not shiny but covered with oriental rugs. Burgundy curtains protected from the sun. When I saw a scene so different from my memory, my chest heaved and contracted.

These physical reactions and perceptions are characteristic of acute grief. The death of a loved one is accompanied by waves of physical suffering, which can include muscle pain, shortness of breath, nausea, and trouble sleeping. Food may not taste good, and some experience visual hallucinations. The heartbroken may not believe that their loved one is dead.

Grief during COVID-19

Restrictions to prevent the spread of COVID-19 have disrupted the social rituals that bind us during times of grief. AT Atlantic OceanEd Yong describes this lack of much-needed support as “last pandemic betrayal.”

Although my husband died of cancer, not COVID, I experienced a loss of comforting rituals and a feeling that my grief was never truly acknowledged. Experts call it disenfranchised grief. Some predict that prolonged grief disorder caused by this pandemic can reach rates only seen in survivors of natural disasters and wars.

Grief is proof of love

The loss of loved ones does not fit easily into the history of our lives, although it becomes part of it. Finality and acceptance of a monumental loss takes time. AT Year of magical thinking, Joan Didion captured the sudden, tragic death of her husband: “John spoke and then fell silent.” Life changes in an instant. However, it takes time to unravel and accept all that it means.

Now my life has to be rebuilt and rethought without George. Grief letting go is intermittent. Gradually I noticed that more and more of my memories of George were happy, gradually crowding out the all-consuming early intensity of grief. Over time, I began to re-interact with the world.

Like George, I found myself wanting to talk to others in the same boat. A bereavement group helped. I started doing more sports. This helped too. When our dogs died, I bought a new puppy. First of all, I learned to be kind to myself.

If you, too, are struggling with loss, experts offer some basic advice: Try to eat, sleep, and exercise regularly; think of a bereavement group or look for others who are grieving; stay open to new opportunities—new hobbies, people, and opportunities. Speak with a specialist if, after months, you are consumed by thoughts about your loved one or do not find the meaning of life without them. These may be signs that your grief has stalled or dragged on. Effective treatment can help.

Every “first” without George – the first birthday, the first wedding anniversary, the first anniversary of his death – awakened the first days of deep grief. However, the experience of living in each of them made me realize that I can survive. I think George would be pleased.

Additional Resources

Grief and lossCDC

NIH Health News: Coping With GriefNational Institutes of Health

Center of prolonged griefColumbia University

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