The evolution of grief
Relatives prepare for the cremation of a Covid victim in Guwahati, September 28 (Photo: AP)
My first experiences with grief were from the stories of my grandmother. For an old and benign woman of sunny disposition, she had a penchant for narrating the grimmest of stories with us children huddled around her in rapt attention, taut in fear of her delivering a shocking finale in those early evening sessions. They were either related to relatives or picked up cleverly from the Puranas. Her favourite was about the plight of Sita, who, hoping to escape from an unjust world, returns to the womb of her mother, the earth, which splits open to save her from her difficult life as a woman spurned and exiled to the forest by her husband, Lord Rama, over an apparently frivolous reason.
Another was about the beheading of Drona, the royal guru of the Pandavas and the Kauravas, when he laid down arms in the battlefield due to unfathomable sorrow after he was tricked into believing that his son Ashwatthama was killed in the battle of Kurukshetra. These experiences were from my pre-school days and, as it happens, still have the power to create a tinge of anguish and loss.
The later experience was more personal, a sudden death that many people are experiencing with greater frequency thanks to Covid-19—or is it that there is more shock about the pandemic that has taken lives in a way nobody expected any disease to do in these modern times? Covid-19 has, without doubt, unleashed a wave of torment, a mental fatigue, across the world that is unlikely to be healed easily.
When I hear of parents or siblings of friends and even friends who never had any health conditions passing away after contracting the coronavirus, I am anxious for my own loved ones and, very often, reminded of my father’s premature death at the age of 41 when I was just five years old. His death didn’t generate immediate angst or suffering because it was a death well mourned with people coming and going in an unending stream of familiar and strange and new faces. True, grief was all around with people giving vent to their sadness in a variety of ways: wails, cries, tight hugs. But as a little child, this hubbub is precisely what insulated me: to children, people milling and leaving as if in some mysterious cadence tends to appear like a mild celebration. It was only later when the crowds left, and maybe years later, that the grief began to set in.
The late Swiss-American psychiatrist Dr Elisabeth Kübler-Ross has talked famously about the stages of grief. For a child of four or five, these stages don’t follow their usual order. Grief doesn’t start with denial or end with acceptance—at least in my case it didn’t. But I feel for my friends and even strangers who had to mourn and grieve their near and dear in this unforgettable year and hope that those stages come sequentially because that is what helps you cope and overcome: denial, anger, bargaining, depression and acceptance.
Everyone seeks a closure for their grief, but sometimes they try to underestimate the scale of scars inside. It has happened with the Jews who migrated to the US looking for a new beginning after escaping persecution and death in Hitler’s concentrations camps in Nazi Germany and neighbouring countries. Tales of their parents and grandparents attempting to start over and failing have been documented by hundreds of writers over the past 75-odd years. Research into post-traumatic psychiatric morbidity has revealed that their suffering is no different from soldiers in long and intermittent wars, a condition generally described as ‘soldier’s heart’ or Da Costa’s syndrome whose symptoms include fatigue from exercise, chest pain, palpitations, sweating and shortness of breath. It is named after Jacob Mendes Da Costa who investigated into such disorders among participants of the American Civil War.
Psychiatrists Yoram Barak and Henry Szor have examined Holocaust survivors and World War II veterans. They found that rather than starting afresh, the majority of them had post-traumatic stress disorder ‘[persisting] into old age’ although age at the time of trauma is a crucial factor (‘Lifelong Posttraumatic Stress Disorder: Evidence from Aging Holocaust Survivors’, Dialogues in Clinical Neuroscience, March 2000). They concluded that for those survivors who turned psychotic, memory remained a burden for long. Many of them paid for being in denial for too long.
People who have been through unexpected losses and therefore prolonged grief naturally find ways to cope, although like Holocaust survivors and soldiers back from extended wars, there are chances of them being at a disadvantage of ignoring their inner demons. Viktor Frankl has written about this in his deeply moving Man’s Search for Meaning (1946). Laura Hillenbrand’s powerful biography of World War II survivor Louis Zamperini, Unbroken: A World War II Story of Survival, Resilience, and Redemption (2014), too, acknowledges this part of his life.
Psychologists and psychiatrists note that for those who end up in such conditions due to bereavement, recovery is easier when they believe they have done what they could to make the departed happy in life. Regret is an unsparing burden. Also, those who have a lasting sense of purpose to do something worthwhile to commemorate the dead—and this includes taking up a social cause after the untimely death of a loved one—are able to come to terms with their loss quicker. In this context, experts believe that rituals, religious or otherwise, performed to honour the dead also play a role in healing as one feels, thanks to faith and conviction, that one is reverential of those who have gone from their lives.
In India, it is medical indifference that is proving to be the silent, unnoticed killer. Like wars or natural catastrophes, Covid-19 has fallen upon us this year like an unexpected visitor out to shock the human race. Unlike wars or natural catastrophes, though, Covid-19 is also likely to leave in its wake more insidious consequences of enormous grief
What, from a practical point of view, assuages the minds of mourning families is the idea of being together. Here comes the role of customs in paying respect to the dead—in societies I am familiar with in India, irrespective of religion, there are elaborate post-cremation and post-burial ceremonies and functions that more or less announce the closure of someone passing. In Kerala, according to Thiruvananthapuram-based trained priest and expert in Vedic and Tantric rites Jayakrishnan Nair, the Garudapurana is the ultimate text for death rituals among Hindus. While these customs were passed on to other communities from the Brahmins of the state over a long period, 41 days of observance is key even though, thanks to life in the fast lane, people have reduced the number of days of mourning at least by half. Another Vedic scholar from Kannur, K Sanil Kumar, who has contrarian views on the subject, points out that Santhigiri Ashram founded by Karunakara Guru, which follows Ayurvedic and Siddha practices, advocates burial to cremation even though the latter is not frowned upon. “The rituals are meant for a much broader purpose, but observing them offers solace to individuals and families and helps them cope with tragedies,” he avers.
Elaborate rites for the dead are not unheard of in many parts of India as well as the world. Communities the world over take pride in their rituals. However, in India, some of the rites performed are not only for close relatives or friends or even humans but also for anything and everything that exists on earth, animate or inanimate.
Grief pushes some to pursue painful missions. People, such as Delhi-based Neelam Katara, who fought a court battle against her son Nitish’s well-connected and powerful killers. More than 14 years after his brutal honour-killing by the kin of his former girlfriend, the Supreme Court awarded the two relatives and a hired assassin 25 years’ imprisonment without remission. The accused had earlier used their political connections to get frequent bails. Helen Todd’s iconic lawsuit against an Indonesian general responsible for the killing of her 20-year-old son Kamal Bamadhaj in 1991 along with close to 300 others in the notorious Dili massacre in East Timor attracted global attention to the cause of the people of that region, which became an independent nation and separated from Indonesia in 1999. For Stan Marsden, a father who lost his son to drug overdose in Alaska, liberation from trauma came from carving and building what became the ‘Healing Heart totem pole’. It even helped some Vietnam War veterans to recover from alcoholism. The lesson from these stories is that a sense of purpose and a feeling of community uplift people on the brink.
William Genovese, a Vietnam War veteran who lost both his legs, felt less aggrieved due to his own trauma and more owing to his sister’s murder when he was barely 16, an event that altered his life. The name of Kitty Genovese became synonymous with ‘bystander apathy’ due to a New York Times report in 1964 that none of the 38 witnesses outside her flat in Queens, New York did anything as she was stabbed to death by her attacker. However, in a documentary about Kitty’s murder titled The Witness by James D Solomon, William Genovese goes on to uncover the truth and nail the media lie 50 years after his sister’s death. Williams found, and was relieved, that there were people who did help her and that she died in the arms of her friend—and that more than the apathy of the bystander, it was the police that was indifferent.
In India in the time of Covid, it is medical indifference that is proving to be the silent, unnoticed killer. Take Vasundhara Khanna (named changed on request), a 70-year-old Gurugram resident whose friends admired her for her “jolly” nature, childlike laughter and “positive” outlook in the face of adversities, which were too many in her life. She got a cold in September and soon tested positive for Covid-19. While her husband recovered, Vasundhara had to be admitted to a prestigious hospital nearby in the ICU after her breathing became laboured. Visitors were disallowed. Her 36-year-old daughter, who had shifted to India from the US to live with her parents some years ago as her brother too lived abroad, was worried what the isolation would do to her gregarious mother. Doctors then reported that Vasundhara had suffered brain damage. Her confinement in the ICU stretched to a month. Her daughter took to prayer and begged alternative therapists and spiritually inclined friends to send her mother “healing energy”. When Vasundhara finally passed away, alone in a cold hospital ward, what her daughter found most devastating was that a woman so full of life and love had not been able to see any of her family before she passed; she had last met her son years ago.
Her experience is being played out on a larger scale across India even as the coronavirus is mutating around the world. Human-rights activist Harsh Mander shared his Covid-19 experience in a public hospital ward and how the isolation, indifference and alleged medical negligence by the authorities left him with brain injury and nearly cost him his life. The unpreparedness of the medical fraternity in India in the face of such a devastating pandemic is only exacerbating the emotional trauma that victims and their families have to face. It is therefore most likely that we are underestimating the collective trauma caused by the viral disease, which has till date claimed more than 1.4 lakh Indians and over 17 lakh worldwide and has long surpassed the fatalities of the Vietnam War or, for that matter, the eight-year-long Iran-Iraq war, or the Siege of Leningrad or the death toll in Auschwitz. The disease continues to wreak havoc.
By the time the pandemic is under control, most of us would have a friend, a relative or an acquaintance who died from Covid-19 or is gravely impacted by it or living with its aftereffects. Like wars or natural catastrophes, Covid has fallen upon us this year like an unexpected visitor out to shock the human race, irrespective of social or other statuses—or even the economic prowess of a country. Unlike wars or natural catastrophes, though, Covid-19 is also likely to leave in its wake more insidious consequences of enormous grief. For many of us who took pride (false, in hindsight) in the advances of 21st-century medical science and technology and had begun contemplating living long, healthy lives and had even daydreamed about immortality (thanks to major leaps in regenerative medicine), Covid-19 has left a rude message: like its bounty, never underestimate the implacable ways of nature. All this has resulted in people taking a new look at life, a closer one, in which we are unlearning and re-learning our approaches to life and death. Perhaps as much as we hope for a medical or scientific revolution, a human revolution is also in order.
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