In the extraordinary short story, A perfect day for bananafish, J D Salinger (he of Catcher in the Rye) depicts a tender encounter between a sweet little girl called Sybil and a much older man, Seymour, who gently, and innocently takes her out on a float in the shallows of the sea off Florida. Sadly Seymour is not as carefree and happy as the story at first appears. But I won’t spoil it for you! There are many Seymours around us.
I think of a bereaved widow I know who’s world was shattered by the sudden death of her husband. She would greet me with a timid version of a smile that hid a mountain of sadness. But smile she would.
That splendid GP educational organisation Red Whale helpfully sends out updates from time to time, and a recent one was on the subject of grief and abnormal grief. It’s a helpful reminder of how all pervading and bewildering the experience is. Summarising 2 recent BMJ articles it reminds us that grief has many faces, and can be subtle in its effects.
Impaired functioning: within the family, socially, ability to work/go to school.
Intense yearning and sadness, emotional and physical pain. There may be physical symptoms of anxiety. Mental fogginess, difficulty concentrating, forgetfulness.
Loss of sense of self or sense of purpose in life.
Feeling disconnected from other people and ongoing life. Difficulty engaging in activities or making plans for the future.That disconnected person who just can’t get themself going maybe hiding a grief unknown to those around. And since grief has many causes, although it has death at its heart, this may not just refer to physical death. There can be death of status through loss of job, by illness, redundancy, retirement or divorce. Loss of a dreamed for future is a kind of death which may only be known to the afflicted.
I'm thankful that there is increasing emphasis on the need for resources and attention to be drawn to mental health issues. I recently re-read Reasons to stay alive by Matt Haig and felt again the sympathy that is due to the sufferer and the sheer sense of physical pain that low mood can produce. It is indeed agony.
I recall an old patient of mine whose dog had died. The old chap was single, disabled and his dog was his life. The dog died in the middle of the night and my patient called for an ambulance to move the dog onto his knee. Fortunately the paramedics took pity and obliged. I suspect our NHS accountants are less than impressed. But grief is grief whatever the source and is equally shattering. Lets try to be aware of each other's grief, whatever the cause.