Broken Heart Syndrome

Broken heart syndrome -- not just an invention of romance novelists. Takotusbo cardiomyopathy, or sudden heart failure linked to extreme stress, is also known as broken heart syndrome and is most prevalent in post-menopausal women. The heart receives a flood of stress hormones that causes ballooning of the left ventricle, chest pains, shortness of breath, and an irregular heartbeat. An especially stressful physical or emotional situation, such as a traumatic injury or the sudden death of a family member, can set off an attack.

Richard and I have joked that we want to die at the same moment at the age of 90 while scuba diving of Grand Cayman Island. Neither one of us wants to survive the other for very long. What follows is a sad-sweet story of a long-term partners who died minutes apart from each other.

"James and Marjorie Landis of Westmont, Pa., were married and inseparable for 65 years. They died this week just 88 minutes apart.

Marjorie, 87, passed away Monday after a long illness.

James, 88, died an hour and 28 minutes later of a heart attack. He was at his wife's side when she died.

"The last thing he said to her was, 'It's OK. I love you. We had many good years goether. I will see you real soon,'" said the couple's granddaughter, Erin Miller.

'I just think he died of a broken heart. I don’t think they could have lived apart from each other.'

The cause of the death of bereaved longtime spouses, the study found, can be a condition known as takotusbo cardiomyopathy or sudden heart failure linked to an emotional experience. Some experts have dubbed the condition 'broken heart syndrome.'"

How Do Men Grieve?

I spent a week staying with a friend whose wife died from acute myeloid leukemia two months ago. He is, of course, bereft, but shows it in ways that are not like the womenfolk I know who have lost partners. I am used to women really crying, with all their sisters, and being somewhat immobilized if work and children permit that. Women also look sad and exhausted. Women also seem to know that grieving takes time and that being lost and lonely don't mean that you're stuck and not healing. Of course this isn't true for all women, but it is for many I have known.

My friend wants to be doing "better." And by better, I think he means getting back into life with vigor. After a few days of the sanctioned mourning period, he started going back to work for hours, then days, and now weeks. He socializes with friends many evenings during the week - friends who loved them both, and now sustain him. He started doing a vigorous training program to get back in shape and is running and eating well. There are pictures of his wife all over the house and he likes to engage in conversations about her. He asks, "Don't you think I am doing better?"

I know his heart is shattered and that he misses her with his entire soul. But his ways of grieving and engaging in life I find are somewhat foreign to me. So I ask myself, and you, the question: How do men grieve? I am very interested in your thoughts.

How Do You Grieve for Your Partner?

Sorry for the absence. I was with a friend who was dying from leukemia and then with her husband and adult sons after her passing.

She and her husband were one of those lucky couples who totally adored each other, from the day they met. And he continues to adore her after her passing. They were so loving to each other that even when they fought, each person tried to comfort the other for the pain he or she was inflicting. To be angry and compassionate is a high state of relationship.

Sixty people stood by her open grave for over two hours on a bitingly cold New England afternoon. Many shared stories that commemorated her selflessness, her vivaciousness, and her love for her husband, family, and friends. Everyone helped shovel dirt onto her plain wooden coffin, an act of final respect her community and family paid to her.

The husband is bereft, robbed of half of his spirit, his memory, his daily reality. How can he preserve the forty years they spent together; and how is he to grieve for the remaining 20 or 30 years he will have without her? Right now he is being a good host to all those who have come to gather in her memory. He is worried about how his children are doing. He went back to the hospital where she was treated and died to thank the nurses and aides and doctors who cared for her. He has had a few episodes of crying on the shoulder of some dear friends. He cries more freely at night, alone, in bed.

I took him on a walk around their neighborhood. He started to tell me how sorry he was that she had so much loss and pain in her life. Sorry that he could not diminish it or protect her from it. Sorry that he could not help her. I told him to tell her. Talk to her. Say to her, "I am sorry you had pain and that I could not make it better for you." He asked me to tell her for him. I did. Then he cried. A few minutes later he sighed deeply and said, "I did make it better for her. I did." Then he turned to me and said, "You know, this is like a prayer. Better than a prayer."

We are so amputated from expressions of grief in our western, U.S. culture. We hurry grief along as if it were not a river. We don't have a catalog of possibilities for holding and expressing our grief, so we wonder what is OK and what is not. Some may have religious ritual to guide them; many don't; and even religious ritual may not offer all the forms of expression a mourner might need.

Mourning, I believe, does not only occur after the moment of death. I think we (both the ill and the well partner) experience forms of grief with each diminishment of function and possibility that illness inflicts throughout its course.

Grief, I believe, is not completely apart from celebration. Grief forces memory, and memory connects us to experiences we cherished and invites us to reclaim a life that was a force of joy. A life that merits celebration.

Her husband wrote this in an email he sent to me:
"People have told me that I should be nourished by my memory of our relationship. I cry because the despair, the yearning ache I suffer, is just not sated by remembering the way in which she and I loved any more than my hunger is satisfied by remembering a delicious meal I once ate."

I emailed him back:
I think remembering is not a substitute, it's not even an approximation. It's one way to remain connected to not only her, but to a vital part of ourselves. The good part -- the part she inspired us to get better at.

Remembering, talking to her, seeing her in her favorite chair or playing with the dogs. These acts bring a rush of sweetness that is too soon eclipsed by the overpowering sadness. But I want the sadness as much as I want the sweet memories. It all helps me to feel close to her, to feel her in my present and not just the past.

In the Jewish tradition, we don't ask that the mourner be nourished by the memory of the person who died. We say - May her memory be a blessing to you.

I think that means that at some point in time, maybe now, may the ways in which she lives inside you help you to continue to be the best person you can be.
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How have you mourned for your partner, or for yourself? What advice or counsel or comfort did you receive that was helpful? What did you receive that was definitely not helpful?

Memorial for My Father

This weekend the extended family is making a pilgrimage to the Catskill Mountains where we spent summers as kids. We city kids were so lucky to have two months every year to get lost in the woods, dig up earthworms as bait for fishing expeditions, swim in an isolated mountain lake, have campfires with roasted marshmallows and silly songs, play endless games of canasta and hide and seek....and be a family together.

We are returning to the place of many of our best times to remember my father. It's a testament to how well he was loved that relatives from all over are gathering. His rabbi said he was an "adam shem tov," a man of good name. He was the most good man I know. He is why I married a very good man.

He taught me about happiness and he taught me how not to throw a baseball like a girl.

I love you Dad and will always miss you. Have a good passage.

The Shape of Grief

I've been thinking a lot about grief lately. Back in the days of my psychology training, we learned that grief follows a predictable pattern and happens in progressive stages:
Denial, Anger, Bargaining, Depression, Acceptance (based on the work of Kubler-Ross.

That's not the tune my grief over my father's recent death dances to. For the first week after he died, I was just plain exhausted. This was a completely physical experience. Being with him in the hospital for ten hours a day for two weeks with all chakras wide open left me empty. Once I got home, I lived on the couch.

I guess I expected that I would cry most of the time. Dramatic meltdowns of wracking sobs eventually tapering down to trickles and sniffles. Or at least an hour's worth of steady tears running down my face. Didn't happen.

What did happen was that I would stumble over some flicker of a memory from his hospitalization at random, incongruous moments. While riding the exercise bike or cooking scrambled eggs. I would suddenly be abducted by this memory - staring into his blue eyes; wiping slow tears from his face; hearing doctors use words like failure and damage; watching his chest rise with his final three breaths.

These snatches of memory would prick open some swollen balloon of sadness, and deep sobs would would burst out. Sobs from the chest, that lasted a minute, maybe two. Then back to pedaling or cooking.

It's been a little over two week since he died, and even though I was by his side, I still don't know how to know that he's dead. I don't know how to let his death change my world. Is this strange?

Thinking about grief has also led me to ask what are the social allowances for grief.

We are expected to grieve over a death or a divorce. But we are not given a mourning period for serious illness or chronic pain. After diagnosis, we are expected to jump on the treatment treadmill and keep running after the magic pill. My father was praised for being such a fighter and for not complaining about his infirmities. Is it ok to cry about losing the pieces of life illness and pain take away? Is it ok to mourn for the trip to Paris you won't get to make or the mountains you'll no longer climb? Is it ok to cry because illness had made you too tired or pained to love your family and friends in the way you want to?

Must we be uncomplaining soldiers fighting the good fight? Or can we make room and rituals for grieving over the losses of illness and pain.

My Father in the Hospital

We, the family, wander the yellow corridors of the ICU, searching for answers. The doctors and nurses turn away as we pass them, looking hard at the clipboards and folders they carry. They know that eye contact will mean a prolonged hallway conversation that will take them away from their real job, their medical job. They know that we will batter them with questions for which no answers exist in this world. Questions that begin with, "What's the probability that....?" or, "How much longer...," or, "how do we know when to stop..."

We hear the sounds of the machines as they beep steadily while dripping brown and white fluids into his veins. We hear the sharp and sudden blast that means one of the many numbers on the monitors we watch with vigilence has gone out of range. Some noises make the nurse come into the room, while others bring a whole platoon armed with new machines. After eight days we understand the rhythm of the machines. They become background music to this dance of dying.

I stand by his side holding his hand. I lean over him stroking his brow. With a soft voice, I take him on journeys to happier days. I tell him about the sweet, cool blue river that flows through him and around him, connecting him to all the healing forces in universe. I tell him he is surrounded by love - love from the people who stand around him now, and love from everyone who has ever loved him. I tell him that all that love enters his body with each breath and makes the waters of that blue river even sweeter.

On October 15 at 10:40 am, my father died. I, my brother, my husband, and Maisie, the woman who had been his caretaker for the past year, were by his side. There were three breathes and then no more.

His rabbi said that he was an "adam shem tov" - a man of good name. He said his death was a holy one.

He taught me about happiness, and he taught me how not to throw a baseball like a girl.

I love you Dad and will always miss you. Have a good passage.

My Father is Moving On

He is very ill and yet still shows his loving essence. It's been a terribly sad and a terribly sweet time. Does that make sense? Our thinking and emotions have such a clarity to them. Luckily we all have a quick and twisted sense of humor we can rely on to bring a smile to his face and a breath of clean air into the hospital room.

Looks like we're saying good-bye to him.

Thank you for your good thoughts - we need them.

Patrick and Lisa Swayze Face His Cancer Together

From an article in Examiner.com about Patrick and Lisa Swayze's plans for writing a memoir together as they face his pancreatic cancer. This is their way of reconsecrating their relationship and love as they are dealing with the pain and turmoil of cancer.


"Swayze and wife Lisa, gave a touching and powerful interview about their 36 year relationship with Barbara Walters, which aired on January 8th. The couple told Walters about their belief that they were soul mates and had known each other before. Swayze credited his wife's support with his ability to endure and face his illness "with gracefulness."

Lisa revealed that when she first heard the news about his cancer and prognosis she said, " How dare you, you have to stay here." They both agreed that had this situation been reversed, he would have had an angrier reaction than Lisa.Understanding how they each react, can help them better support each other.

The Swayzes are doing many things that are helpful for couples facing a life threatening illness. They are discussing not only the impact of the illness on the everyday functioning of their lives, but also reflecting on how grateful they are for the life they have shared together.

They also recently renewed their wedding vows which can help couples ritualize their commitment to one another. The memoir may also serve as an important way of memorializing and understanding the life they share. The words on the printed page can make their experiences more concrete and provides an enduring legacy in a way that verbalization of their memories can not."

The courage to review their lives together,at this sensitive time, can provide inspiration to other couples who may be fearful that this would mean they were saying goodbye or giving up hope. Although it may be emotionally painful, this shared intimacy can actually be helpful to better cope with the challenges ahead."

Saying Goodbye to a Good Dog

Ambrose Bierce in his Devil's Dictionary defines "DOG" this way:
"DOG, n. A kind of additional or subsidiary Deity designed to catch the overflow and surplus of the world's worship."


My sweet dog Mina died a year ago today, and I am ready to say goodbye. She came into my life when I was very sick with an uncontrollable pain condition. She was as important a part of my recovery as was my husband and my doctors. She gave me shelter in her heart -- that is what I felt every day of our time together. And, in the ways of a universe with a sense of irony, she died at age twelve from an enlarged heart. Her breeder had told us about her many gifts and promised that she would only disappoint us once. Mina kept that promise.

Here is the eulogy I shared with her many friends after she died:

As many of you know, Mina has been slowly declining over the past year. She has had a heart condition since she was young and has compensated masterfully for it over the years. Two days ago she went into serious respiratory distress, and last night we brought her into the emergency ward of Angell Memorial Animal Hospital. Despite their tireless efforts, she continued to deteriorate. She lay on her side, breathing rapidly, and was largely unresponsive. I called her name once, and she lifted her head. Our eyes met, and we said good-bye to each other. At 5:30 am on May 1st, just as the sun was rising, we brought her out of the hospital into the cool morning air and laid her down on her blanket under a tree. I held her as Richard knelt by her side. She was one month past her twelfth birthday when she died.

We have been blessed to have had her in our life for seven years. Every moment with her was an invitation to live with joy and equanimity. Her high-held, swishing tail was a signal to relish the day. Her determined sniffing as she hunted down the exact right spot to dig in to excavate some long buried chicken bone was a reminder to pay close attention to the concealed miracles that surround us. Her delight at reuniting with her beloved friends, all of you, called on us to deepen our own commitment to community. Her forbearance of our impatience when we needed to get going and she was still sniffing, was a gentle lesson in magnanimity. And her capacity for empathy while respecting boundaries is a power I will continue to strive to emulate.

One of her vets once said that some dogs are dogs; and others are people. Mina was people. I know that she left her paw mark on each of you. I also know that you share in our deep sadness in her passing. Mina always remembered her friends, no matter how much time passed since the last visit. Know that she loved you, and that your love made her life richer, as it does ours. May her imprint remain in all our hearts, and may all of us take what she gave us and express it in our lives.

Please join me in taking a moment to honor Mina and the animals in your life who give you love and shelter.