Living with the Full Catastrophe

Dear friends -

In a recent phone conversation, a well-intentioned friend, after inquiring how Christopher, Ileah and I were doing, responded very cheerfully that time heals all wounds. I felt stunned by her comment, unsure how to respond. Does she really believe this? Because I work in an organization that serves many people whose wounds don't get all better, and from some wounds people actually die. One's definition of "healing" has to be pretty broad to include all that.

Cliff's death ripped a hole in the world where he used to be. After the shock of that, I found a part of me had died, too. While some things heal, that part hasn't grown back. It may not be evident to others that anything is missing, but it's very evident to me. It's as if I'm living in a different body, experiencing the world through a different set of senses, having had to re-familiarize myself with everything from a changed perspective.

As well as they are functioning and re-engaging with the world, Christopher and Ileah are also experiencing an irreparable loss. As someone whose own father died at 46 of cancer, I know what a hole that left in my life, particularly during my 20s and 30s. Christopher and Ileah had unique relationships with their very unique Papa. This, their ages and maturity, and the sudden and traumatic circumstances of his death have shaped and will continue to shape their own experiences.

I don't want people to feel sorry for any of us. We are each taking care of ourselves, taking the next steps in our lives. We are each in our own ways very capable people. We have amazing circles of family and friends, and we have the love and support of each other, all of which has been tested and deepened.

Yes, there is healing that happens. Yes, there can be creative, generative, adaptive responses to this kind of loss. Christopher and Ileah, two of the most creative and intelligent people I know, have already demonstrated this. And there are also some wounds that can never completely heal, some parts of us that can't grow back. We live with all of this -- as Jon Kabat Zinn says, the full catastrophe.

Collaboration with Andrew

Dear friends -

At the end of November as I was contacting different agencies to learn about their services, one of my contacts introduced me to Andrew Curran. Andrew's wife, Jane Storey, died by suicide January 25, 2012 at the age of 33. Since Janey's death, Andrew underwent a formal complaint process through Vancouver General Hospital and has done an impressive amount of research.

Janey's situation was disturbingly similar to Cliff's. She grappled with anxiety and depression for months. Unlike Cliff, she expressed concerns about the suicidal thoughts she was having, which finally led to her admission to Vancouver General Hospital.

The psychiatrist assigned to treat Janey was not a personable man. Their relationship was uncomfortable at best. Because no office was available, sessions with her doctor were conducted at one end of a hall in the ward. There was no privacy from the other patients. Although Andrew and Janey were married, the professionals treating her gave Andrew no more opportunity to be involved in Janey's care than there had been for me to be involved in Cliff's.

At the end of her hospital stay, Janey's discharge was handled very casually. The suicidal ideation was assessed as being "resolved". Consequently, unlike Cliff, she was never connected with community outreach services despite Andrew's daily phone calls. Far from being resolved, the suicidal impulses Janey was experiencing had, in fact, heightened. She died under very similar circumstances as Cliff only two weeks after her discharge.

Even before Andrew and I met in person or shared our stories, I had the sense we knew each other. We talked for two and a half hours when we first had tea. At our second meeting in early January, we were ready to dive into collaborating. Here's the action plan we crafted.

Strategy #1: Family Involvement in Patient Care

• Meet February 22 with the manager of Vancouver Community Mental Health Services to learn about their Family Advisory Group
• Access opportunities to tell medical professionals about our experiences via the Patient Voices Network
• Identify potential sponsors in health care administration

Strategy #2: Suicide Assessment and Intervention Training for Mental Health Professionals

• Organize a research project to assess the current state of training requirements in British Columbia
• Consult with Jennifer Stuber, instrumental in getting suicide assessment and intervention training requirements legislated for mental health professionals and other front-line care providers in Washington state.
• Identify potential sponsors and allies in professional associations, public policy, and government

Strategy #3: Psychological Workplace Safety

• Continue to learn about and share work being done in this area
• Promote psychological safety principles, and mental health and suicide intervention training within my own workplace as appropriate

Strategy #4: Support for Companions

• Connect with organizations that run support groups for family and friends of people with mood and anxiety disorders (e.g. Mood Disorders Association, AnxietyBC, SAFER)
• Assess resources currently available to companions and opportunities to augment these

If you have connections, suggestions, or an interest in participating in any of the above, please let me know.

I've learned a great deal from Andrew already, both from the research he's done and from his calm and principled approach. Working together, we've been able to develop a clearer sense of direction and bolster more energy than either of us had been able to maintain on our own.

Cliff and Jane were both remarkable, loving, kind, creative people. Part of their legacy will be positive, enduring, systemic changes that improve survival rates and quality of life for others like them.  Meeting Andrew has renewed my optimism that those changes are possible.