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Overview
Offering hope and healing for the brokenhearted, The Tender Scar addresses the heart-wrenching pain of losing a spouse. Working from journal entries written after the death of his wife, Mabry uses his own journey as a stepping-stone to a practical discussion of the grief process. In this second edition, Mabry includes a new chapter that highlights the process of building a second marriage and blended family after loss.
Product Details
| ISBN-13: | 9780825444760 |
|---|---|
| Publisher: | Kregel Publications |
| Publication date: | 02/27/2017 |
| Edition description: | 2nd ed. |
| Pages: | 128 |
| Product dimensions: | 5.40(w) x 8.30(h) x 0.50(d) |
About the Author
Read an Excerpt
The Tender Scar
Life After the Death of a Spouse
By Richard L. Mabry
Kregel Publications
Copyright © 2017 Richard L. MabryAll rights reserved.
ISBN: 978-0-8254-4476-0
CHAPTER 1
Playing the Blame Game
"Did I do everything I could?" One of the overwhelming emotions that affect the grieving individual is guilt. The games of "What if I had ...?" and "If only I could have ..." or even "I should have ..." are endless. When considered through the perspective of time, most of us see these speculations as useless.
I still continue to replay the three-plus hours between the time of Cynthia's stroke and the surgery meant to relieve the pressure in her brain. I repeatedly torture myself with thoughts of "Could we have gotten her to the medical center more quickly?" or "Should I have done this or that to speed up the process?" I'm a doctor, and I'm supposed to help people, to intervene, to take action. But things dragged on so slowly, and I felt so powerless. My colleagues tell me that Cynthia's stroke was not a survivable injury, and everything that could be done was done. But, despite its lack of logic, I've continued to grieve over my inability to make things happen faster and better. I wonder if I'll ever get over this guilt. (Author's email to a friend who suffered a similar loss)
Husbands and wives spend years taking care of each other, thinking of their spouses' needs, often subjugating their own desires and plans for those of their mates. When a spouse dies, whether quickly or after an extended period of illness, the opportunity for what-if scenarios and the attendant guilt is enormous. These feelings can linger for months and years, crippling the surviving spouse with guilt. In most cases, an unbiased observer will tell us we did everything we could. But even if we didn't, we can't change the final outcome. As Omar Khayyam wrote, "The Moving Finger writes; and having writ, moves on."
There is also a feeling of guilt at being the one left alive. "Why couldn't it have been me?" we think. This may lead, in turn, to an attitude of "I shouldn't do anything for myself. I don't deserve to be happy." Often we can't enjoy the simple pleasures of life because we think our spouses will never again enjoy the things we continue to experience, and for that we blame ourselves. The little voice inside us says, "Why should I enjoy the sunrise when my spouse will never see another one?" The response may not be rational, but it certainly is real — and crippling.
Despite all the good advice in the world, guilt and what-ifs are part of grieving. The best advice I can offer is to talk things over with someone (repeatedly, if necessary), starting with an unbiased family member or friend. Expand the support base from there until you're able to not only say, "I did what I could at the time," but also, "I can't change it now."
Now may be the time to look for a support group. Sometimes you may find that friends, and even church staff, are too close to you. It's hard to open up around these people because you don't want to reveal your frailties and what you may perceive as shortcomings. If you're computer literate, you may find help through an online resource such as WidowNet (www.WidowNet.org), where it's possible to unburden yourself and receive advice and support in relative anonymity. In addition, though, it's best to seek human contact for face-to-face support. I was fortunate to find a widowed persons support group in my area through AARP.
Whatever the means chosen, now is the time to begin talking out the what-ifs and to start dealing with the survivor guilt that can plague the widowed for months and sometimes years. The feeling of guilt is normal, natural, and — to a degree — understandable. But it need not be permanent.
Who can discern their own errors? Forgive my hidden faults.
(Ps. 19:12 NIV)
* * *
Loving Father, forgive us when we sometimes take responsibility for things we can't control. We are imperfect, faulted, and frail. Pardon us when we stumble, admonish us when we stray, but always keep us aware that You are a God of mercy, grace, and love. We accept that we cannot undo our actions, revise our omissions, or change what we've already done. But we acknowledge that in Your love we start each day forgiven and cleansed. Help us to move forward, not necessarily always understanding but always trusting. In Your name, amen.
CHAPTER 2Confronting End-of-Life Issues
A difficult decision in end-of-life situations is to remove life support. Physicians offer their best counsel, and family and friends provide support, but the decision leaves lingering doubt and guilt in the mind of the person charged with that ultimate responsibility.
After Cynthia's massive stroke, the neurosurgeons said, "Let's give it some time." I think they believed she would soon die peacefully, because later they confided that they knew her episode was not a survivable one. For two weeks, she was on life support, and every day I looked for change but didn't see any. As a doctor, I knew she was already essentially dead, but as a husband I couldn't give up hope. Finally, the neurosurgeon said, "Do you want to wait for her to eventually die, or are you ready to withdraw life support?" Cynthia and I had talked this over long ago, we both had living wills, and in my heart I knew what she would want. We took her off the ventilator and she gently slipped away. I cried uncontrollably when I made that decision. I cried even more when Cynthia breathed her last, and I'm crying now as I write about it months later. Even with all that justification, since that time I have suffered terribly, wondering if she might have eventually recovered (I'm told she never would), wondering whether I acted in order to end her state of nonrecoverable vegetative existence or to put a stop to my personal hell on earth as I waited in the ICU for an awakening that was not going to come in this life. (Author's email to an online contact who had taken her husband off life support)
In the past few decades, medical science has made gigantic strides, providing avenues to cure and control diseases and conditions that at one time were tantamount to a death sentence. As a result, the average life expectancy in our country continues to climb. But all this comes at a price. Each of us recognizes that in some situations life may be prolonged, but sometimes at costs that may include constant pain and debilitating side effects — not to mention the emotional and economic toll exacted by such measures. This is especially true for situations in which cancer and other malignancies have reached a stage at which there is no longer any hope for cure or even remission. All that can be hoped for is slowing the inevitable progression of the disease, allowing the afflicted person a bit more time to be with his or her family and friends. Eventually a point may be reached at which the patient is so dulled by ever-increasing amounts of pain medication, so debilitated by the disease, that the prospect of death offers the only hope of release.
When are heroic measures and intensive treatment no longer in anyone's best interest? The presence of a living will makes this decision easier, but not everyone has expended the time and effort to execute one. Whether or not a living will is in place, the spouse or responsible family member must first of all seek wise counsel from a physician. None of us can predict the future, and physicians are certainly no exception, but an experienced doctor can help immeasurably by guiding decisions at such a time.
In addition, sharing all the circumstances openly with other close members of the family will ease the burden of the one making the decision. There may be a single person (generally a spouse or the eldest child) on whom the responsibility falls for making the ultimate choice to discontinue treatment except for palliative measures aimed at comfort. But be sure to tell all family members about what is influencing your decision before — not after — it is made.
Finally, spiritual guidance is imperative. The Bible is essentially silent (or at best ambiguous) about end-of-life decisions, but the support of clergy and church family can help and should be allowed and actively sought. And, of course, prayer is important — not just one-way prayer that asks for guidance, but also two-way prayer in which you pour out your anguish to God, and then, in worshipful silence, allow God to speak to you. Don't expect a rushing wind or a burning bush, but do anticipate a peace from letting God help you with your burden.
When a loved one suffers a stroke and lies comatose for a prolonged period of time, the natural reaction is to think, "She'll recover — all that's needed is time." Medical science, though inexact, can give some guidance. When all signs indicate that the person who lies silent (being maintained on a respirator and fed via a tube, or receiving intravenous fluids) has no prospect of ever again being a sentient human, it should — at least theoretically — be easy to make the decision to remove life support. At this point we sometimes encounter a story (often passed on second- or third-hand) of a person who has been in a coma for months or years and suddenly recovers. Much as we'd like to think our loved one would do likewise, let me warn you: those cases — most often reported not in medical journals but in newspapers and magazines — represent highly unusual situations in which there was always a chance (however slim) of recovery. In most cases of massive stroke or extreme head injury, recovery is not even a possibility. Skilled clinicians can generally assess the amount of permanent injury to the brain and realistically predict whether any degree of recovery is possible. Ask questions, get advice, and lean on it.
It is helpful when a husband and wife are able to frankly discuss all these matters before the fact. I was fortunate because Cynthia and I — long before I was called upon to make a decision — openly shared our feelings about prolonging nonproductive life. We had some warning, since we knew that she had a malformation of blood vessels in the brain. She considered all the possible scenarios, and then made her wishes clear. Whether or not I agreed with them, I had unambiguous marching orders when the time came to make the decision.
You may be asking, "Why all this discussion about how to handle the removal of life support? That's all past me now." There are two reasons. First, this chapter may spark you to make your own wishes evident to your family members, preferably in the form of a living will, but certainly at least in clear conversation. Many hospitals have living will forms and patient representatives who will help you execute one. And, in the shadow of your recent loss, right now may be the best time for you to consider this step.
The second reason is to provide counsel and comfort to you if you have already made this tough decision. There are many circumstances that can leave a life hanging on by the thread of artificial life support. When this occurs, decisions must be made, and they are never easy, but here are some guiding principles: take the best available medical counsel, talk it over with the closest family members, seek spiritual guidance, and then make the best decision you can make. When that's been done, try not to look back and second guess yourself after it's all over. You've done your best. That's all anyone can do.
I can see now, God, that your decisions are right; your testing has taught me what's true and right. Oh, love me — and right now! — hold me tight! just the way you promised.
(Ps. 119:75–76 MSG)
* * *
Caring Father, sometimes we're called upon to make decisions that weigh upon us for months and years afterward. Teach us to do our very best and then to peacefully accept it's over and done, the results unchangeable. Help us to know that Your love for us never changes and Your decisions are never wrong. We put You in control, and thank You for the peace that doing so gives. In Your loving name, amen.
CHAPTER 3Experiencing Tears and Shock
From early childhood, we're admonished not to cry. We're told to hold our emotions in check. But grief is accompanied by tears, anger, frustration, and a flood of other emotions. All of this is normal, but nonetheless frustrating.
Well, I thought I could do it. It's been five days since Cynthia's death. I awoke this morning at 5 a.m. I spent the morning cleaning out her cosmetics (the unused ones will go to a battered women's shelter). I cried until I thought I couldn't cry any more. Finally, I had to get out of the house and away from all the things that remind me of Cynthia. It's Sunday, and I decided to slip unobtrusively into the church just after it started. I was able to sneak into the balcony without attracting attention, but I lasted about five minutes before I broke down, began crying, and had to leave. I can't describe all the emotions I'm feeling. I continue to alternately pray for strength and feel angry/hurt/confused with God for what has happened.
I try to think back and feel good about the past forty-plus years, and I do — but then I realize that my life will absolutely never be the same. I'm crying now as I write this, and for me that's absolutely out of character. I've always been the strong one, comforting and helping others. I'm not the same ... and maybe I never will be again. Nothing has ever hit me as hard as this. (Author's email to his pastor)
Although I'm told I acted rationally at the time, the two weeks when Cynthia lay in the ICU and the days following her death are a blur. Part of this relative amnesia is caused by the brain's blocking out extremely unpleasant memories. I do know I cried uncontrollably at times, at the slightest provocation. I was able to make decisions about final arrangements and other needful things. I even offered the prayer at the family meal before her memorial service, but I honestly don't remember much about all that. I was truly on autopilot.
The shock of the death of a close loved one can have both physical and emotional consequences. At these times, a bereaved spouse who has a heart condition or high blood pressure would do well to consult a physician. The stress of the event might place him or her in jeopardy of a heart attack or stroke. Both stimulants and depressants (such as alcohol) should be used with great care, if at all. And it may be wise to discuss with your physician, either now or at some time in the future, the possibility of a mild sleeping pill to allow for adequate rest.
In the weeks and months that follow, watch for the signs of depression: difficulty concentrating, trouble sleeping, lack of appetite, loss of energy, apathy, and thoughts of suicide. (For more details, see sites such as www.about-depression.com.) There is no disgrace in considering taking prescription antidepressants during this time. I resisted doing so for almost three months, finally giving in to the suggestions of my family and my physician. Their intervention led me to being dramatically helped. Although antidepressants have their own potential side effects (which your doctor and pharmacist will discuss with you) and do not provide instant relief, they can smooth out the roller-coaster of emotions experienced by a recently bereaved person.
Finally, be aware that what you're likely experiencing is a typical situational depression. That is, something very bad has happened in your life, something that would cause emotional distress for any normal person, and as a result you've begun to exhibit the signs and symptoms of clinical depression. It's a very normal reaction, and it is (or should be) a self-limited condition that will eventually clear. Some people have it to a greater degree than others, and sometimes help is needed in dealing with it. Just be thankful for the "better living through chemistry" that your physician can add, along with the counsel and support you will receive from those around you. Take comfort that, whether you are in the depths of depression or on the mountaintops of joy, God is with you. Lean on Him.
Why are you in despair, O my soul? And why are you restless and disturbed within me? Hope in God and wait expectantly for Him, for I shall again praise Him, the help of my [sad] countenance and my God. (Ps. 43:5 AMP)
* * *
Ever-present Father, You have promised You will not leave us alone or comfortless. When we feel most bereft, help us to reach out to You. When we are angry with You, when we are hurt, and when we continue to wonder why, reach down and touch us so we can know that, even when we find it hard to love You, You love us. Give us the faith that looks beyond today and the courage to travel on. In Jesus's sustaining name, amen.
(Continues...)
Excerpted from The Tender Scar by Richard L. Mabry. Copyright © 2017 Richard L. Mabry. Excerpted by permission of Kregel Publications.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
Contents
Preface to the Second Edition, 5,Preface to the First Edition, 7,
Acknowledgments, 9,
1. Playing the Blame Game, 11,
2. Confronting End-of-Life Issues, 14,
3. Experiencing Tears and Shock, 18,
4. Avoiding a Shrine to Grief, 21,
5. Accepting the Community Factor, 25,
6. Finding a Support Group, 29,
7. Avoiding a Self-Centered Outlook, 33,
8. Resigning Your Commissions, 37,
9. Tackling the Puzzle of Prayer, 41,
10. Overcoming Frustration, 44,
11. Changing Your Way of Thinking, 47,
12. Expanding Your Horizons, 51,
13. Putting Flowers on the Grave, 55,
14. Playing Back the "Scripts", 58,
15. Finding Someone to Talk To, 61,
16. Throwing Away the Cards, 65,
17. Handling the Unfinished Projects, 69,
18. Reviewing the Souvenirs of a Lifetime, 72,
19. Considering a Move, 76,
20. Facing Hospital Memories, 80,
21. Combating Funeral Flashbacks, 84,
22. Getting Better — Fast or Slow?, 89,
23. Facing the Holidays, 94,
24. Remembering an Anniversary, 98,
25. Being Open to a Second Chance, 102,
26. Telling You My Backstory, 107,
27. Married ... Again, 110,